Christian and Political Conservatism Predict Opposition to Sexual and Gender Minority Rights through Support for Christian Hegemony.

Although significant strides have been made for sexual and gender minority (SGM) rights in the United States, there continues to be opposition to SGM rights from many conservative Christians and political conservatives. In this study, we investigate this opposition by examining support for Christian hegemony (i.e., the idea that Christianity should be the norm and Christians should be in power in the United States) and unawareness of Christian privilege (i.e., unearned advantages for Christians) as religiopolitical variables that help to explain the association between Christian and political conservatism and opposition to a host of SGM rights (same-sex marriage, same-sex adoption, nondiscrimination policies in jobs and housing for SGMs, and bills regarding transgender public bathroom use). Based on structural equation modeling analysis with heterosexual cisgender Christian (n = 688) and Areligious (n = 327) students, we demonstrate that support for Christian hegemony and unawareness of Christian privilege help to explain the association between Christian and political conservatism and opposition to SGM rights. These findings advance our understanding of a new type of religious-based variable focused on religious power and privilege to help understand conservative religious and political opposition to SGM rights. Limitations, implications, and directions for future research also are discussed.

Minority Stressors Associated with Sexual Risk Behaviors and HIV Testing in a U.S. Sample of Transgender Individuals.

The majority of published research on transgender health focuses on associations between external minority stressors (e.g., discrimination) and health. Little is known about how internal minority stressors (e.g., identity concealment and expecting rejection) might predict HIV disparities. The current study addresses this gap by examining the association between external and internal minority stressors and sexual risk behaviors and HIV testing history in a sample of 300 transgender adults across the U.S. Transgender-related discrimination and expecting rejection were associated with sexual risk behaviors. When controlling for covariates, none of the minority stressors were associated with HIV testing. Results illustrate how minority stress, both external and internal, may operate uniquely for transgender individuals.

Risking It Anyway: An Adolescent Case Study of Trauma, Sexual and Gender Identities, and Relationality.

This article presents the case of a Chinese-American adolescent with a significant trauma history who was questioning her sexual and gender identities. The implications of the client's intersecting identities for case conceptualization and treatment are considered within the framework of affirmative practices for sexual and gender minority (SGM) clients. The impacts of stress and trauma on this client's experiences-and SGM clients more broadly-are also considered, particularly with respect to how this client understood and negotiated her experiences of relational trauma. This case is intended to illustrate some best practices with SGM clients within an intersectional framework which underscores the importance of multiple salient cultural identities.

The Ecology of Teachers' Experiences with Violence and Lack of Administrative Support.

Teacher-directed violence is a common, yet understudied, phenomenon. Perpetrators of violence against teachers include not just students, but also administrators, parents, and colleagues. Administrators are key stakeholders when it comes to shaping school climate and safety that can reduce or increase the negative impact of violence against teachers. In this study, 237 teachers' qualitative responses from a larger sample of 2,431 anonymous, online survey responses were examined to better understand their experiences with incidents of violence and how administrators played a role in these experiences. Results reveal that lack of administrator support negatively impacts teachers at multiple levels, including teachers' feelings (individual); challenges associated with addressing issues related to students, parents, and other perpetrators (interpersonal); and school systems and policies (organizational). This study highlights the importance of administrative support and illustrates how administrators' actions and inactions can have ripple effects at each level of the school microcosm. Implications for research, practice, and policy are discussed.

Complicating Counterspaces: Intersectionality and the Michigan Womyn's Music Festival.

The counterspaces framework articulated by Case and Hunter (2012), follows from community psychology's long-standing interest in the potential for settings to promote well-being and liberatory responses to oppression. This framework proposes that certain settings (i.e., "counterspaces") facilitate a specific set of processes that promote the well-being of marginalized groups. We argue that an intersectional analysis is crucial to understand whether and how counterspaces achieve these goals. We draw from literature on safe spaces and present a case study of the Michigan Womyn's Music Festival (Michfest) to illustrate the value of an intersectional analysis and explore how these processes operate. Based on 20 in-person interviews, 23 responses to an online survey, and ethnographic field notes, we show how Michfest was characterized by a particular intersection of identities at the setting level, and intersectional diversity complicated experiences at the individual level. Moreover, intersectional identities provided opportunities for dialogue and change at the setting level, including the creation of counterspaces within counterspaces. Overall, we demonstrate the need to attend to intersectionality in counterspaces, and more broadly in how we conceptualize settings in community psychology.

Trans women and Michfest: An ethnophenomenology of attendees' experiences.

The rise of queer and transgender studies has greatly contributed to feminist and lesbian understandings of sex, gender, and sexuality and also has resulted in rifts, tensions, and border wars. One such tension is around the inclusion of trans women in women-only space, such as the Michigan Womyn's Music Festival (Michfest). In this ethnophenomenological study, we interviewed and surveyed 43 cisgender women who attended Michfest in 2013. Participants had a variety of perspectives on trans inclusion and on the dialogue surrounding it, and these paralleled intersections, frictions, and tensions between feminism, queer theory, and transgender studies.

The role of attitudes toward White privilege and religious beliefs in predicting social justice interest and commitment.

The current study examines links among attitudes toward White privilege, religious beliefs, and social justice interest and commitment for White Christian students. Two distinct patterns of results emerged from a path analysis of 500 White Christian students. First, a willingness to confront White privilege was positively associated with the sanctification of social justice (i.e., attributing spiritual significance to working for social justice) and both were positively associated with social justice interest and commitment. Second, awareness of White privilege was negatively associated with religious conservatism, and religious conservatism was negatively associated with social justice interest. These patterns show that White privilege attitudes directly (i.e., willingness to confront White privilege) and indirectly (i.e., awareness of White privilege through religious conservatism) predicted social justice interest and commitment. Moreover, religious beliefs demonstrated opposite patterns of association with social justice interest and commitment such that the sanctification of social justice positively predicted social justice interest and commitment whereas religious conservatism negatively predicted social justice interest. Overall, findings demonstrate direct and indirect links between White privilege attitudes, religious beliefs, and social justice interest and commitment. Limitations and implications for future community psychology research and collaboration also are discussed.

Embodied, Situated, and Co-Constructed: Young Sexual Minority Men's Experiences of Intersectional Identity and Minority Stress.

Intersectionality, minority stress, and social ecological theories have all been important frameworks for understanding mechanisms that create and maintain sexual and gender minority health disparities. In this study, we integrated these frameworks to guide a grounded theory examination of identity-related experiences in specific settings among 33 Black, White, and Latino young sexual minority cisgender men who lived in Chicago. Analyses identified four key categories: Racism Manifests in Context- and Sexual Minority-Specific Ways, Sexual Orientation Can Mean Feeling Safe and Seen or Threatened and Alone, Gender is a Matter of Self-Expression, and Bodies Are Not Always Made to Fit In. Participants reported both identity-based privilege and marginalization as well as unique forms of minority stress at the intersection of specific identities. Across these categories, participants' experiences of their intersecting identities and associated forms of minority stress were embodied in their physical appearance, situated in specific neighborhoods and contexts, and co-constructed through their interpersonal interactions with others. Further, participants' narratives provide powerful insights about the nuanced ways in which young sexual minority men understand and negotiate their lived experiences. Findings highlight how experiences of identity and minority stress are both intersectional and located within specific social ecological contexts, which has important implications for research, clinical practice, and advocacy.

Multiple Minority Stress and LGBT Community Resilience among Sexual Minority Men.

Minority stress theory has widespread research support in explaining health disparities experienced by sexual and gender minorities. However, less is known about how minority stress impacts multiply marginalized groups, such as lesbian, gay, bisexual, and transgender people of color (LGBT POC). Also, although research has documented resilience in the face of minority stress at the individual level, research is needed that examines macro-level processes such as community resilience (Meyer, 2015). In the current study, we integrate minority stress theory and intersectionality theory to examine multiple minority stress (i.e., racial/ethnic stigma in LGBT spaces and LGBT stigma in one's neighborhood) and community resilience (i.e., connection to LGBT community) among sexual minority men of different racial/ethnic groups who use a geosocial networking application for meeting sexual partners. Results showed that Black sexual minority men reported the highest levels of racial/ethnic stigma in LGBT spaces and White sexual minority men reported the lowest levels, with Asian and Hispanic/Latino men falling in between. Consistent with minority stress theory, racial/ethnic stigma in LGBT spaces and LGBT stigma in one's neighborhood were associated with greater stress for sexual minority men of all racial/ethnic groups. However, connection to LGBT community played more central role in mediating the relationship between stigma and stress for White than POC sexual minority men. Results suggest that minority stress and community resilience processes may differ for White and POC sexual minority men. Potential processes driving these differences and implications for minority stress theory are discussed.

Identity, Victimization, and Support: Facebook Experiences and Mental Health Among LGBTQ Youth.

The rise of social networking sites (SNSs) has created new contexts within which lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and young adults manage their social identities and relationships. On one hand, SNSs provide important social support; on the other, they comprise another realm for victimization and discrimination. Context collapse refers to the ways diverse subgroups (e.g., family, co-workers) are often united in Facebook networks, which presents unique challenges related to outness. In this study, we examine the Facebook contexts of a cohort of LGBTQ youth and young adults with regard to outness, victimization, social support, and psychological distress by first examining descriptive statistics and correlations, and then testing a series of multiple regressions in an analytic sample of 175 (Mage = 24.02 years) LGBTQ youth. Participants reported levels of daily Facebook use comparable to other samples of non-LGBTQ youth; however, they reported greater use of security controls, which may function as a tool for managing outness. Participants reported slightly lower outness across relational subgroups on Facebook, and associations between outness to relational subgroups were slightly stronger on Facebook, illustrating the potential impact of context collapse. Regression results showed that great victimization, cyberbullying, and the offering of support online were positively associated with psychological distress. Study findings illuminate how LGBTQ youth use and manage their identities on Facebook and highlight the importance of online contexts in shaping wellbeing for LGBtQ outh and young adults.

The Marijuana Phenomenon: Contradictions and Silence.

The United States is trending toward more permissiveness regarding recreational and medicinal marijuana (MJ). Many conditions for which MJ is recommended, prescribed, or self-prescribed are symptoms that advanced practice nurses address daily. Yet, the silence of nursing scientists on ethics, practices, and policies regarding such clinical decisions is deafening. This is but one of many contradictions about MJ use that we discuss in this article. We do not propose to resolve these contradictions; that is left to the community of nurse scientists in interprofessional discourse. Collectively, we must explore these contradictions and, through evidence-based policy recommendations, overcome the silence about how providers view MJ, how it might be helpful, its risks, and cultural shifts that have accompanied a changed political/legal environment. Long term, we must close the gaps in the nursing knowledge base regarding MJ as it affects users and how it is used interventionally.

Families Matter: Social Support and Mental Health Trajectories Among Lesbian, Gay, Bisexual, and Transgender Youth.

PURPOSE: Lesbian, gay, bisexual, and transgender (LGBT) adolescents are at greater risk for mental health problems than their heterosexual peers, in part due to victimization. Social support, particularly from families, has been identified as an important promotive factor. However, little is known about how LGBT youth experience multiple forms of support or how early support predicts mental health across adolescence and into young adulthood. METHODS: In an analytic sample of 232 LGBT youth aged 16-20 years at baseline across 5.5 years, we compared developmental trajectories of psychological distress between three empirically derived social support cluster types at baseline: those who reported uniformly low support, those who reported uniformly high support, and those who reported nonfamily support (i.e., high peer and significant other but low family support). RESULTS: Longitudinal multilevel modeling, controlling for age, victimization, and social support at each wave, indicated key differences between cluster types. Youth in the low and nonfamily support clusters reported greater distress across all time points relative to youth in the high support cluster; however, they also showed a sharper decline in distress. Youth in the nonfamily cluster gained family support across adolescence, such that they resembled youth in the high support cluster by early adulthood. CONCLUSIONS: Findings underscore the importance of family support for LGBT youth. Youth who lack family support, but who have other forms of support, report a decrease in psychological distress and an increase in family support across adolescence. Youth who are low in all forms of support continue to exhibit high distress.

Typologies of Social Support and Associations with Mental Health Outcomes Among LGBT Youth.

PURPOSE: Lesbian, gay, bisexual, and transgender (LGBT) youth show increased risk for a number of negative mental health outcomes, which research has linked to minority stressors such as victimization. Further, social support promotes positive mental health outcomes for LGBT youth, and different sources of social support show differential relationships with mental health outcomes. However, little is known about how combinations of different sources of support impact mental health. METHODS: In the present study, we identify clusters of family, peer, and significant other social support and then examine demographic and mental health differences by cluster in an analytic sample of 232 LGBT youth between the ages of 16 and 20 years. RESULTS: Using k-means cluster analysis, three social support cluster types were identified: high support (44.0% of participants), low support (21.6%), and non-family support (34.5%). A series of chi-square tests were used to examine demographic differences between these clusters, which were found for socio-economic status (SES). Regression analyses indicated that, while controlling for victimization, individuals within the three clusters showed different relationships with multiple mental health outcomes: loneliness, hopelessness, depression, anxiety, somatization, general symptom severity, and symptoms of major depressive disorder (MDD). CONCLUSION: Findings suggest the combinations of sources of support LGBT youth receive are related to their mental health. Higher SES youth are more likely to receive support from family, peers, and significant others. For most mental health outcomes, family support appears to be an especially relevant and important source of support to target for LGBT youth.

Distinct Coping Combinations are Associated with Depression and Support Service Utilization in Men who have Sex with Men Living with HIV.

Stigma and stress may place HIV-positive men who have sex with men (HIV+ MSM) at risk for depression. Additionally, HIV+ MSM might utilize multiple HIV-related services as a way to gain support for, and more effectively manage, HIV-related stressors. Although prior research has demonstrated that depression severity and utilizing support services are associated with functional or dysfunctional coping strategies, researchers have not investigated the impact of different coping combinations-specifically, the concurrent use of functional and dysfunctional strategies-in this population. Thus, we explored (1) how items on one measure of coping, the Brief COPE, capture HIV-related coping of HIV+ MSM using Principal Components Analysis, (2) how HIV+ MSM's coping groups into unique combinations, and (3) how these coping combinations relate to depression and the scope of HIV-related support service utilization. Our sample consisted of 170 HIV+ MSM engaged with medical care. Results indicated the use of both functional and dysfunctional coping strategies. Unique combinations of functional and dysfunctional strategies showed differential associations with depression and the extent of HIV-related support service utilization. Specifically, individuals who engaged in low levels of both functional and dysfunctional coping, compared to individuals who more frequently engaged in functional coping strategies, were significantly less likely to utilize a range of critical HIV-related services. Individuals who reported frequent use of dysfunctional coping strategies, regardless of functional coping strategy use, reported higher levels of depression. Therefore, providers should continue to focus more closely on identifying functional coping strategies and reducing dysfunctional coping when working with HIV+ MSM.

Design of a comparative effectiveness evaluation of a culturally tailored versus standard community-based smoking cessation treatment program for LGBT smokers.

BACKGROUND: Smoking prevalence rates among the lesbian, gay, bisexual, and transgender (LGBT) population are significantly higher than the general population. However, there is limited research on smoking cessation treatments in this group, particularly on culturally targeted interventions. Moreover, there are few interventions that address culturally specific psychosocial variables (e.g., minority stress) that may influence outcomes. This paper describes the protocol for a comparative effectiveness trial testing an evidence-based smoking cessation program, Courage to Quit, against a culturally tailored version for LGBT smokers, and examines the role of culturally specific psychosocial variables on cessation outcomes. METHODS/DESIGN: To examine the effectiveness of a culturally targeted versus standard smoking cessation intervention, the study utilizes a 2-arm block, randomized, control trial (RCT) design. Adult LGBT participants (n = 400) are randomized to one of the two programs each consisting of a six-session group program delivered in a community center and an eight week supply of the transdermal nicotine patch. Four individualized telephone counseling sessions occur at weeks 2, 5, 7, and 9, at times of greatest risk for relapse. Study outcome measures are collected at baseline, and 1, 3, 6, and 12 months post quit date. Primary outcomes are expired air carbon monoxide verified 7-day point-prevalence quit rates at each measurement period. Secondary outcomes assess changes in cravings, withdrawal symptoms, smoking cessation self-efficacy, and treatment adherence. Additionally, study staff examines the role of culturally specific psychosocial variables on cessation outcomes using path analysis. DISCUSSION: Determining the efficacy of culturally specific versus standard evidence based approaches to smoking cessation is a critical issue facing the field today. This study provides a model for the development and implementation of a culturally tailored smoking cessation intervention for LGBT participants and addresses a gap in the field by examining the role of culturally psychosocial variables associated with cessation outcomes. TRIAL REGISTRATION: U.S. National Institutes of Health Clinical Trials NCT01633567 Registered 30 May 2012.