LGBT assisted reproduction: Current practice and future possibilities - Eyler, A. Evan; Pang, Samuel C.; Clark, Anderson (LGBT Health, 2014)
Presents an interview with Samuel C. Pang, a reproductive endocrinologist who treat couples who have infertility and Anderson Clark, a research biologist with experience in reproductive biology. The focus of the interview is to highlight LGBT assisted reproduction, current practice and future possibilities. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: adulthood; bisexual; fertility; gay; gender transition; gender variance; lesbian; LGBT youth; LGBT families; reproduction; role of mental health professionals in gender transition; suicide; transgender; Family; Homosexuality; Reproductive Technology; Health Personnel; Bisexuality; Male Homosexuality; Transgender

Sexual risk behaviors and steroid use among sexual minority adolescent boys - Blashill, Aaron J.; Safren, Steven A.; Jampel, Jonathan D. (Drug and Alcohol Dependence, 2015)
Background: Previous research has extensively examined the relationship between the use of alcohol and illicit substances with sexual risk behaviors among sexual minority (i.e., gay and bisexual) male youth; however, no known studies have assessed the association of steroid use to risk behaviors among this population. Methods: Participants were 556 sexually active sexual minority adolescent boys (M age = 16.2, SD = 1.3), taken from a pooled dataset of the 14 jurisdictions from the 2005 and 2007 Youth Risk Behavior Surveys that assessed sexual orientation. The association between lifetime use of steroids and sexual risk behaviors were examined. Results: Controlling for number of sexual partners, depression, victimization, and race, boys who reported increased steroid use were at increased odds of engaging in condomless sex, OR = 1.55, p = .003, and use of alcohol/drugs during sex, OR = 1.48, p = .002. Conclusions: Steroid use among sexual minority adolescent boys is prevalent and associated with HIV/STI sexual transmission risk behaviors. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Sexual risk; Adolescent boys; Steroids; Sexual orientation; Substance use; Drug Usage; Sexual Risk Taking; Steroids; Sexual Minority Groups; Bisexuality; Male Homosexuality; Minority Groups

Parental rejection following sexual orientation disclosure: Impact on internalized homophobia, social support, and mental health - Puckett, Julia A.; Woodward, Eva N.; Mereish, Ethan H.; Pantalone, David W. (LGBT Health, 2015)
Sexual minority individuals face unique stressors because of their sexual identity. We explored associations between parental reactions to children’s coming out, internalized homophobia (IH), social support, and mental health in a sample of 257 sexual minority adults. Path analyses revealed that higher IH and lower social support mediated the association between past parental rejection and current psychological distress. Mental health providers may benefit clients by utilizing interventions that challenge internalized stereotypes about homosexuality, increase social support, and process parental rejection, as well as focusing on how certain crucial experiences of rejection may impact clients’ IH and mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: internalized homophobia; LGBT; mental health; minority stress; parental rejection; social support; Adolescent; Adult; Aged; Anxiety; Depression; Fathers; Female; Homophobia; Humans; Male; Mental Health; Mothers; Parents; Sexuality; Social Support; Suicidal Ideation; Transgender Persons; Young Adult; Parent Child Relations; Parental Attitudes; Self-Disclosure; Sexual Orientation; Social Support; Homosexuality (Attitudes Toward); Internalization; Mental Health; Parent Child Communication; Social Acceptance; Minority Stress

Reshaping time: Recommendations for suicide prevention in LBGT populations - Mullaney, Clare (Journal of Homosexuality, 2016)
This article serves as one of the supplementary pieces of this special issue on 'Mapping Queer Bioethics,' in which we take a solipsistic turn to 'map' the Journal of Homosexuality itself. Here, the author examines the journal’s 2011 consensus recommendations for the prevention of LGBT suicide. Invoking the axiom approach of Eve Kosovsky Sedgwick’s seminal Epistemology of the Closet, the author argues that merely offering practical guidelines at the level of the demonstrative and the instructive may not be sufficient models to address the urgency of suicide rates in LGBTQ youth populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Bioethics; childhood sexuality; gender identity; LGBT education; LGBT youth; psychiatry; suicide; suicide prevention; suicide risk; the closet; Education; Gender Identity; Sexuality; Bioethics; Psychiatry; Suicide Prevention

Utopian hopes or dystopian fears? Exploring the motivational underpinnings of moralized political engagement - Skitka, Linda J.; Hanson, Brittany E.; Wisneski, Daniel C. (Personality and Social Psychology Bulletin, 2017)
People are more likely to become politically engaged (e.g., vote, engage in activism) when issues are associated with strong moral convictions. The goal of this research was to understand the underlying motivations that lead to this well-replicated effect. Specifically, to what extent is moralized political engagement motivated by proscriptive concerns (e.g., perceived harms, anticipated regret), prescriptive concerns (e.g., perceived benefits, anticipated pride), or some combination of these processes? And are the motivational pathways between moral conviction and political engagement the same or different for liberals and conservatives? Two studies (combined N = 2,069) found that regardless of political orientation, the association between moral conviction and political engagement was mediated by the perceived benefits of preferred but not the perceived harms of non-preferred policy outcomes, and by both anticipated pride and regret, findings that replicated in two contexts: legalizing same-sex marriage and allowing concealed weapons on college campuses. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: moral conviction; morality; political engagement; activism; moral motives; prescription; proscription; same-sex marriage; gun control; Attitude; Emotions; Female; Humans; Male; Morals; Motivation; Politics; Activism; Morality; Motivation; Politics; Gun Control Laws; Same Sex Marriage

Sexual orientation, adult connectedness, substance use, and mental health outcomes among adolescents: Findings from the 2009 New York City Youth Risk Behavior survey - Seil, Kacie S.; Desai, Mayur M.; Smith, Megan V. (American Journal of Public Health, 2014)
Objectives: We examined associations between identifying as lesbian, gay, or bisexual (LGB) and lacking a connection with an adult at school on adolescent substance use and mental health outcomes including suicidality. Methods: We analyzed data from the 2009 New York City Youth Risk Behavior Survey (n = 8910). Outcomes of interest included alcohol use, marijuana use, illicit drug use, depressive symptomatology, suicide ideation, and suicide attempt. Results: The prevalence of each outcome was significantly higher among LGB adolescents than heterosexual adolescents and among those who lacked an adult connection at school than among those who did have such a connection. Even when LGB adolescents had an adult connection at school, their odds of most outcomes were significantly higher than for heterosexual adolescents. Those LGB adolescents who lacked a school adult connection had the poorest outcomes (about 45% reported suicide ideation; 31% suicide attempt). Conclusions: Adolescents who are LGB, particularly those who lack a connection with school adults, are at high risk for substance use and poorer mental health outcomes. Interventions should focus on boosting social support and improving outcomes for this vulnerable group. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: mental health outcomes; adult connection; heterosexual adolescents; suicide ideation; Adolescent; Depression; Female; Humans; Male; Mental Health; New York City; Risk-Taking; Sexuality; Social Support; Socioeconomic Factors; Substance-Related Disorders; Suicidal Ideation; Suicide; Suicide, Attempted; At Risk Populations; Mental Health; School Based Intervention; Urban Environments; Health Outcomes; Lesbianism

Review of Suicidal behavior: Underlying dynamics - Harsheeta (Journal of the Indian Academy of Applied Psychology, 2016)
Reviews the book, Suicidal Behavior: Underlying Dynamics by Updesh Kumar (2014). This book has been divided into two sections, section one includes chapters that delve into theoretical underpinnings for conceptual understanding while the chapters in section two shed light on research evidence, future directions for research and assessment techniques. The volume comprises of 16 chapters which have been authored by eminent scholars across the world thus enhancing the scope of this volume and bringing forth various cultural perspectives. The latter section of the book emphasizes upon research evidence based assessment and evaluation perspectives with regard to societal and cultural differences and the need for resources to tackle incidence of suicidal behavior. This segment begins with a chapter on marginalized group of LGBT youth that is vulnerable to suicide risk as a result of psychosocial stressors like peer victimization, nature of familial relationships etc and the various measures that health care professionals can take to combat these issues with collaborative efforts of one’s social support. This volume is a comprehensive text of conceptual and theoretical frameworks, causal factors, assessment, and prevention strategies in the area of suicide. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal behavior; evidence based assessment; LGBT youth; suicide risk; Male Homosexuality; Suicidal Ideation; Suicide; Risk Factors

An overview of gay, lesbian and bisexual issues in Botswana - Selemogwe, Morekwe; White, Dale (Journal of Gay & Lesbian Mental Health, 2013)
In Botswana, homosexuality is criminalized, stigmatized, and considered by some to be 'un-African.' Unsurprisingly in this context there has been scant research on lesbian, gay, and bisexual (LGB) issues. This paper reviews what research has been done in the areas of HIV risk, substance abuse, and mental health; explores the issues facing LGBs in Botswana; and offers recommendations for policy and future research. Notable findings reviewed include high rates of men who have sex with men also engaging in heterosexual relationships, and high rates of suicidal thoughts and substance use in the LGB community. Human rights practitioners and health professionals have called for repealing sodomy laws and creating programs specific for LGBs in order to effectively promote health in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gay; lesbians; bisexuality; Botswana; HIV risk; substance abuse; mental health; African Cultural Groups; Bisexuality; Lesbianism; Male Homosexuality; Drug Abuse; HIV; Mental Health

Effects of minority stress processes on the mental health of Latino men who have sex with men and women: A qualitative study - Holloway, Ian W.; Padilla, Mark B.; Willner, Lauren; Guilamo-Ramos, Vincent (Archives of Sexual Behavior, 2015)
Emerging literature on minority stress among sexual minority populations has described the negative consequences that multiple minority statuses may exert on mental health and well-being. This literature has tended to focus on individuals whose self-identifications reflect sexual minority sexual categories, such as gay or bisexual, and has explored the intersection of these definitions with ethnic, racial, and class statuses. Few such studies have explored mental health among men who actively deny a sexual minority sexual identity label while engaging in same-sex sexual behaviors. The present study used ethnographic interview data from 20 non-gay-identified bisexually behaving Dominican and Puerto Rican men in New York City. Participants described discovery of same sex sexual behavior as a threat to their intimate relationships, community affiliation, and counter to expectations of Latino masculinity. Recounting a wide range of information management strategies used to avoid open disclosure about their sexual lives, participants experienced the potential consequences of disclosure as extreme and even life threatening. Men anticipated social isolation, depression, self-injury, and suicidality as possible outcomes from disclosing sexual behavior with other men to their female romantic partners. This analysis provides direction for future research on minority stress processes and mental health service delivery among Latino men who have sex with men and women. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Men Who Have Sex with Men; Bisexual; Sexual orientation; Latino; Stress; Mental health; Minority Groups; Stress; Sexual Partners; Same Sex Intercourse; Minority Stress; Well Being; Latinos/Latinas

Implicit measure of life/death orientation predicts response of suicidal ideation to treatment in psychiatric inpatients - Ellis, Thomas E.; Rufino, Katrina A.; Green, Kelly L. (Archives of Suicide Research, 2016)
In this study, we set out to extend empirical research on the Life-Death Implicit Association Test (IAT) by administering the measure to an adult psychiatric inpatient population with suicidal ideation. We sought to examine its association with other suicide-relevant measures and to determine whether it adds predictive utility beyond that offered by other measures of suicide risk. The IAT was administered (N = 124) at biweekly intervals as part of an assessment battery at an inpatient facility for complex, treatment resistant psychiatric disorders (average length of stay: approximately 6 weeks). Multiple regression procedures were utilized to examine relationships among the measures and their predictive utility with respect to suicidal ideation at discharge. Consistent with prior research with other populations, significant associations were found between IAT performance and explicit (self-report and interview) measures of suicide risk. Moreover, the IAT was found to predict suicidal ideation at discharge above and beyond number of prior suicide attempts and admission scores on measures of depression, suicidal ideation, and hopelessness. Change in IAT performance over the course of treatment was observed. The IAT shows promise as an addition to explicit measures conventionally used to estimate suicide risk in psychiatric patients. These findings are consistent with a cognitive vulnerability model of suicide risk. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: cognition; Implicit Association Test; psychiatric inpatients; suicide risk assessment; Adolescent; Adult; Aged; Anxiety Disorders; Association; Attitude to Death; Bipolar Disorder; Cognition; Depressive Disorder, Major; Female; Humans; Inpatients; Life; Male; Mental Disorders; Middle Aged; Personality Disorders; Regression Analysis; Risk Assessment; Self Report; Suicidal Ideation; Suicide, Attempted; Transgender Persons; Treatment Outcome; Young Adult; Psychiatric Patients; Suicidal Ideation; Risk Assessment; Implicit Measures; Cognition

Self-reported sexual and psychosocial health among non-heterosexual Danes - Graugaard, Christian; Giraldi, Annamaria; Frisch, Morten; Eplov, Lene Falgaard; Davidsen, Michael (Scandinavian Journal of Public Health, 2015)
Introduction: Little is known about the sexual and psychosocial health of non-heterosexual Danes. Based on a large population study, the aim of this article was to compare quality-of-life-related key variables of heterosexual and non-heterosexual men and women, aged 16–66. Materials and methods: Cross-sectional data from the nationwide, representative Health and Morbidity Survey (n = 8496) were used to compare variables concerning both general and sexual well-being of self-identified heterosexual and non-heterosexual respondents. Results: Nearly twice as many non-heterosexual than heterosexual men rated their sexual life as bad or very bad (22.5% versus 12.8%), while no statistical difference was seen among women (13.6% versus 10.6%). For both genders, significantly more non-heterosexuals than heterosexuals stated that their sexual needs were not met (17.9% versus 7.7% for men and 14.8% versus 6.9% for women), and significantly more non-heterosexuals reported acts of sexual violence (8.3% versus 2.1% for men and 35.8% versus 13.0% for women). Finally, non-heterosexual respondents had contemplated suicide more than twice as often as heterosexuals (15.9% versus 7.4% for men and 19.7% versus 8.3% for women). Actual suicide attempts were roughly three times more frequent in the non-heterosexual groups (8.3% versus 2.6 % for men and 11.8% versus 4.2% for women). Conclusions: Overall, non-heterosexual Danes reported higher degrees of sexual and/or psychosocial distress than heterosexuals. Further research is needed; but scientists, clinicians and public health workers should be aware that non-heterosexuals may pose specific health-related challenges and requirements. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Denmark; distress; homosexuality; mental health; psychosocial health; quality of life; sexual health; sexuality; suicide; Adolescent; Adult; Aged; Cross-Sectional Studies; Denmark; Diagnostic Self Evaluation; Female; Health Surveys; Heterosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Male; Middle Aged; Personal Satisfaction; Self Report; Sex Offenses; Stress, Psychological; Suicide; Young Adult; Homosexuality; Mental Health; Physical Health; Quality of Life; Morbidity; Sexuality; Suicide; Sexual Health; Social Health

The needs of students with intersex variations - Jones, Tiffany (Sex Education, 2016)
To date, people with intersex variations have been mainly studied via small-scale clinical research, with only a small amount of reflective commentary contributed by sociocultural scholars. This paper reports on findings from a 2015 online Australian survey of 272 people with intersex variations, which aimed to redress the gap in research on this groups’ experiences and perspectives concerning education. Participants ranged in age from 16 to 87 years, and represented all Australian states and territories. Most had experienced two medical treatment interventions related to their intersex variation: commonly reported interventions included hormonal treatment and genital surgery delivered to participants when they were aged under 18 years of age. Participants reported various physical and psychological impacts from these treatments. Well-being risks were high; most of the group had engaged in suicidal ideation, particularly when individuals first found out about their variation. This impacted on their schooling—almost one-fifth of survey respondents had received no high school certification due to their early dropout and the overwhelming majority did not attend schools with inclusive puberty/sex education provision or counselling. Most survey participants had not disclosed their intersex variation to staff, although more than half had done so to their classmates. Many had experienced bullying. Only one-quarter of participants rated their overall education experiences positively. Participants suggested improvements to schools’ information provision and support features. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Intersex; sex education provision; support; puberty; Australia; Hermaphroditism; Puberty; Sex Education; Social Support; Intersex Conditions

'Live Chat' clients at kids help phone: Individual characteristics and problem topics - Haner, Dilys; Pepler, Debra (Journal of the Canadian Academy of Child and Adolescent Psychiatry / Journal de l'Académie canadienne de psychiatrie de l'enfant et de l'adolescent, 2016)
Objective: Young people in Canada prefer to use the Internet over face-to-face contact when seeking help for problems of daily living and mental health problems. Kids Help Phone (KHP) provides on-demand, anonymous help to young people via telephone and Live Chat technologies. Methods: Two hundred thirty-two phone clients and 230 Live Chat clients responded to a questionnaire at this otherwise anonymous service, providing previously inaccessible data about their individual characteristics and characterizations of the problems for which they sought help. Results: There was a larger proportion of weighty problems (mental health and suicide) among chatters than callers. There were also more non-heterosexual youth, and those who identified as Asian and Black African or Caribbean, using Live Chat than phone. Conclusions: Implications for training Live Chat counsellors to respond effectively to chatters are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: telephone counselling; e-counselling; computer-mediated communication; help-seeking; adolescence; Health Care Services; Help Seeking Behavior; Internet; Mental Health; Telephone Systems

Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths - Mustanski, Brian S.; Garofalo, Robert; Emerson, Erin M. (American Journal of Public Health, 2010)
Objectives: We examined associations of race/ethnicity, gender, and sexual orientation with mental disorders among lesbian, gay, bisexual, and transgender (LGBT) youths. Methods: We assessed mental disorders by administering a structured diagnostic interview to a community sample of 246 LGBT youths aged 16 to 20 years. Participants also completed the Brief Symptom Inventory 18 (BSI 18). Results: One third of participants met criteria for any mental disorder, 17% for conduct disorder, 15% for major depression, and 9% for posttraumatic stress disorder. Anorexia and bulimia were rare. Lifetime suicide attempts were frequent (31%) but less so in the prior 12 months (7%). Few racial/ethnic and gender differences were statistically significant. Bisexually identified youths had lower prevalences of every diagnosis. The BSI 18 had high negative predictive power (90%) and low positive predictive power (25%) for major depression. Conclusions: LGBT youths had higher prevalences of mental disorder diagnoses than youths in national samples, but were similar to representative samples of urban, racial/ethnic minority youths. Suicide behaviors were similar to those among representative youth samples in the same geographic area. Questionnaires measuring psychological distress may overestimate depression prevalence among this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: mental health disorders; psychological distress; suicidality; lesbians; gays; bisexuals; transgender youths; Adolescent; Bisexuality; Chicago; Continental Population Groups; Ethnic Groups; Female; Homosexuality, Female; Homosexuality, Male; Humans; Interview, Psychological; Male; Mental Disorders; Stress, Psychological; Suicidal Ideation; Suicide, Attempted; Transsexualism; Young Adult; Distress; Lesbianism; Male Homosexuality; Mental Disorders; Suicidal Ideation; Bisexuality; Mental Health; Psychology; Transgender; Suicidality

Suicide protective factors among trans adults - Moody, Chérie; Smith, Nathan Grant (Archives of Sexual Behavior, 2013)
A recent study indicated a suicide attempt rate of 41 % among trans (e.g., trans, transgender, transexual/transsexual, genderqueer, two-spirit) individuals. Although this rate is alarming, there is a dearth of literature regarding suicide prevention for trans individuals. A vital step in developing suicide prevention models is the identification of protective factors. It was hypothesized that social support from friends, social support from family, optimism, reasons for living, and suicide resilience, which are known to protect cis (non-trans) individuals, also protect trans individuals. A sample of self-identified trans Canadian adults (N = 133) was recruited from LGBT and trans LISTSERVs. Data were collected online using a secure survey platform. A three block hierarchical multiple regression model was used to predict suicidal behavior from protective factors. Social support from friends, social support from family, and optimism significantly and negatively predicted 33 % of variance in participants’ suicidal behavior after controlling for age. Reasons for living and suicide resilience accounted for an additional 19 % of the variance in participants’ suicidal behavior after controlling for age, social support from friends, social support from family, and optimism. Of the factors mentioned above, perceived social support from family, one of three suicide resilience factors (emotional stability), and one of six reasons for living (child-related concerns) significantly and negatively predicted participants’ suicidal behavior. Overall, these findings can be used to inform the practices of mental health workers, medical doctors, and suicide prevention workers working with trans clients. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicide attempts; protective factors; trans adults; social support; optimism; resilience; transgender; Adolescent; Adult; Aged; Female; Friends; Humans; Male; Middle Aged; Risk Factors; Social Support; Suicidal Ideation; Suicide; Suicide, Attempted; Transgender Persons; Transsexualism; Attempted Suicide; Protective Factors; Social Networks; Transgender; Optimism; Resilience (Psychological)

Mental health disorders in young urban sexual minority men - Burns, Michelle Nicole; Ryan, Daniel T.; Garofalo, Robert; Newcomb, Michael E.; Mustanski, Brian (Journal of Adolescent Health, 2015)
Purpose: Very few studies have examined mental disorders among male sexual minority youth. We describe demographic correlates, comorbidity, and history of mental disorders and suicidality in a large sample of male sexual minority youth. Methods: Structured diagnostic interviews were conducted with 449 racially diverse urban sexual minority males, aged 16–20 years, who were recruited using a social network–driven sampling methodology. Results: Lifetime major depressive episode (MDE) affected 33.2% of the youth. Lifetime conduct disorder (23.6%), alcohol abuse/dependence (19.6%), posttraumatic stress disorder (PTSD; 16.0%), and nicotine dependence (10.7%) were also common. Black participants were less likely than white participants to be diagnosed with lifetime MDE, alcohol abuse/dependence, nicotine dependence, suicidal ideation, and anorexia, as well as past 12-month alcohol abuse/dependence (odds ratios [ORs] range from .08 to .46). Relative to participants identifying as gay, bisexual identified youth were at higher risk for lifetime PTSD (OR = 2.04), and participants who did not identify as gay or bisexual were at higher risk for both lifetime and past 12-month nicotine dependence (OR = 4.36 and 3.46, respectively). Most participants with mental disorders never received treatment, and comorbidity was common. Conclusions: MDE, conduct disorder, alcohol abuse/dependence, PTSD, and nicotine dependence are common and infrequently treated in young sexual minority men. Some within-group disparities emerged, suggesting that factors related to racial background and self-identification may help to understand resilience to the unique stressors experienced by these young men. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Minority health; Homosexuality; male; Mental disorders; Comorbidity; Frequency; Adolescents; Young adult; Age of onset; Adolescent; Adult; Bisexuality; Chicago; Cohort Studies; Homosexuality, Male; Humans; Interview, Psychological; Longitudinal Studies; Male; Mental Disorders; Minority Groups; Urban Population; Young Adult; Mental Disorders; Minority Groups; Sexual Orientation; Sexual Minority Groups; Comorbidity; Human Males; Onset (Disorders); Suicidal Ideation

Sexual self‐concept ambiguity and the interpersonal theory of suicide risk - Talley, Amelia E.; Brown, Sarah L.; Cukrowicz, Kelly; Bagge, Courtney L. (Suicide and Life-Threatening Behavior, 2016)
Mechanisms (i.e., thwarted belongingness, perceived burdensomeness, hopelessness) derived from the interpersonal theory of suicide which are hypothesized to account for the relation between sexual orientation self‐concept ambiguity and active suicide ideation were examined. Participants included 349 women, among whom 42% currently self‐ascribed a non‐exclusively heterosexual sexual identity. Among women reporting higher levels of sexual self‐concept ambiguity, greater risk for active suicide ideation is found when perceptions of burden and feelings of thwarted belonging co‐occur with feelings of hopelessness. Results support relevant theory useful for understanding suicide risk among sexual minority women who acknowledge ambiguity with regard to their sexual orientation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: suicide risk; sexual self‐concept; ambiguity; interpersonal theory; Adolescent; Adult; Alcoholism; Female; Humans; Self Concept; Sexual Behavior; Social Identification; Social Support; Statistics as Topic; Suicidal Ideation; Young Adult; Hopelessness; Self-Concept; Sexual Orientation; Suicidal Ideation; Belonging

Our youth at risk - McIntosh, Christopher A.; Bialer, Philip A. (Journal of Gay & Lesbian Mental Health, 2015)
This article provides an overview of the Journal of Gay & Lesbian Mental Health. This issue starts off with an important resource for all concerned about the phenomenon of depression, isolation, and significant suicide risk among lesbian, gay, bisexual, transgender, and queer (LGBT) youth. As this issue was in preparation, yet another young member of our LGBTQ community was in the news because of her suicide. This occurred during the holiday season, a time when many of us are spending time with supportive family and friends, yet we know that there are those in our community who are isolated, depressed and at significant risk for suicide. This article presents the proceedings of a symposium on Bullying and Suicide in the LGBTQ community. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGBTQ; suicide; isolation; depression; youth; lesbianism; gay; bisexual; transgender; queer; bullying; Homosexuality; Major Depression; Suicide; Bullying; Transgender; Bisexuality; Lesbianism; Mental Health; LGBTQ

Violent video games exposed: A blow by blow account of senseless violence in games - Krantz, Andrew; Shukla, Vipul; Knox, Michele; Schrouder, Karyssa (The Journal of Psychology: Interdisciplinary and Applied, 2017)
Violent video game (VVG) use has repeatedly been found to be associated with hostile expectations about others, desensitization to violence, decreased empathy and prosocial behavior, and aggressive thoughts and behaviors. Although these research findings have been widely publicized, VVGs remain the most extensively played games and represent a multi-billion dollar industry. Although VVGs are typically rated 'mature,' indicating they are not suitable for youths, they are often purchased for youths. This may be in part because there is currently no system available to consumers that thoroughly describes the content of video games, and much of the public is unaware of the types of violence that characterize game play. The purpose of this paper is to describe the violent content of some of the top VVGs, based on sales. For the purposes of this issue, acts of senseless, unprovoked violence will be described in detail. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Adolescent media consumption; interpersonal relations; media content; parenting; perspective taking; Adolescent; Antisocial Personality Disorder; Child; Empathy; Evaluation Studies as Topic; Firearms; Homicide; Hostility; Humans; Parenting; Personality Development; Psychology, Adolescent; United States; Video Games; Violence; Wounds and Injuries; Computer Games; Mass Media; Violence; Interpersonal Relationships; Parenting

Decisions we make - Kays, Kristina (PsycCRITIQUES, 2017)
Reviews the film, A Man Called Ove directed by Hannes Holm (2015). The subtitled Swedish film is both tragedy and comedy. This dark comedy, along the lines of Beauty and the Beast, tells a story of love, loss, grief, and rebirth. The curmudgeon, Ove (award-winning actor, Rolf Lassgård), readily gets under the skin of the other characters with his obsessive and demanding behaviors. And yet, these same tendencies connect to Ove’s great strengths of being hardworking, exacting, loyal to the end, and a rule keeper for the good of all. Six months after the death of his wife, Ove is no longer employed and must determine the purpose of his life. Flashbacks are used as bittersweet memories as Ove reviews upon each suicide attempt. There are many important messages to explore through this film, including diversity (e.g., able-bodied, homosexuality, ageism, and culture), attachment, social justice, miscarriage, and grief. Yet, the most enduring may pertain to values and looking past the easy to spot character flaws in others, in order to know and be known. Psychologists in practice or education will find this film (and the book) to be a profound conversation starter. While this film may seem long, the characters and essential lessons inspire the viewer to consider how to live well today. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: A Man Called Ove; tragedy; dark comedy; love; loss; grief; rebirth; life purpose; character flaws; diversity; attachment; social justice; Bereavement; Grief; Love; Personality Traits; Attachment Behavior; Diversity; Social Justice

Domains of distress among people with sexual orientation obsessions - Williams, Monnica T.; Wetterneck, Chad; Tellawi, Ghazel; Duque, Gerardo (Archives of Sexual Behavior, 2015)
Although sexual obsessions in obsessive–compulsive disorder (OCD) are not uncommon, obsessions about sexual orientation have not been well studied. These obsessions focus on issues such as the fear of being or becoming gay, fear of being perceived by others as gay, and unwanted mental images involving homosexual acts. Sexual orientation obsessions in OCD are particularly distressing due to the ego-dystonic nature of the obsessions and, often, stigma surrounding a same-sex orientation. The purpose of this study was to better understand distress in people suffering from sexual orientation obsessions in OCD. Data were collected online (n = 1,176) and subjects were 74.6 % male, 72.0 % heterosexual, and 26.4 % with an OCD diagnosis from a professional. The survey consisted of 70 novel questions that were assessed using a principal components analysis and the items separated into six components. These components were then correlated to distress among those with a prior OCD diagnosis and sexual orientation obsessions. Results indicated that sexual orientation obsessions in OCD were related to severe distress, including suicidal ideation. Implications of these findings and future directions for research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Sexual obsessions; Obsessive–compulsive disorder; Homophobia; Suicide; Sexual orientation; Anxiety; Fear; Female; Heterosexuality; Homosexuality; Humans; Male; Obsessive Behavior; Principal Component Analysis; Psychiatric Status Rating Scales; Sexual Behavior; Social Stigma; Stress, Psychological; Suicidal Ideation; Surveys and Questionnaires; Homosexuality (Attitudes Toward); Obsessions; Obsessive Compulsive Disorder; Sexual Orientation; Anxiety; Distress; Suicide

Educating for diversity: An evaluation of a sexuality diversity workshop to address secondary school bullying - Lucassen, Mathijs F. G.; Burford, James (Australasian Psychiatry, 2015)
Objective: To evaluate the potential of a 60-minute sexuality diversity workshop to address bullying in secondary schools. Methods: Students completed pre- and post-workshop questionnaires. Descriptive statistics were used to summarise results with pre- to immediate post-workshop changes compared using t-tests. Thematic analysis was used to analyse open-ended questionnaire responses. Results: We had 229 students (mean age 13.7 years) attending 10 workshops participate in the study. Three-quarters of students thought the workshop would reduce bullying in schools, and over 95% of the participants thought that other secondary schools should offer the workshop. There was a significant increase in valuing (p < 0.001) and understanding (p < 0.001) sexuality-diverse individuals (e.g. lesbian, gay and bisexual people), between the pre-and post-workshop results. School climates were largely perceived to be ‘hard’ and included ‘bullying/mocking’ of sexuality-diverse students; however, many individual students reported a desire to be supportive of their sexuality-diverse peers. Conclusions: Sexuality-based bullying is commonplace in secondary schools. This form of bullying is associated with depression and suicide attempts. Reducing sexuality-based bullying is very likely to have a positive impact on the mental health of young people. Brief workshops, as a part of a wider suite of interventions, have some potential to create safer school environments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: adolescents; behaviour modification programmes; bisexual; bullying; gay; high school behaviour; lesbian; sexuality; workshop; Diversity; School Based Intervention; Secondary Education; Sexuality; Bullying

An intake template for transgender, transsexual, genderqueer, gender nonconforming, and gender variant college students seeking mental health services - Donatone, Brooke; Rachlin, Katherine (Journal of College Student Psychotherapy, 2013)
As more students identify as transgender and genderqueer, it is essential that staff at college counseling centers are knowledgeable about gender diversity. This article provides a template for intake and initial assessment with transgender, transsexual, genderqueer, and gender nonconforming students. It familiarizes clinicians with gender-affirming language and offers a list of questions to ask. Topics covered include: gender history, coming out, self-injury, suicide, sexual orientation, binding, transition trajectories, options for gender expression, issues with diagnosis and recordkeeping, and interdisciplinary approaches to treatment. The intake is an opportunity to provide comfort and support for students of all genders. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: transgender; transsexual; genderqueer; gender variant; college students; mental health services; sexual orientation; gender nonconforming; intake; College Students; Gender Identity; School Counseling; Transsexualism; Transgender; Intake Interview; Mental Health Services; Gender Nonconforming

Violence victimisation—A watershed for young women’s mental and physical health - Palm, Anna; Danielsson, Ingela; Skalkidou, Alkistis; Olofsson, Niclas; Högberg, Ulf (European Journal of Public Health, 2016)
Purpose: The association between victimisation and adverse health in children is well established but few studies have addressed the effect of victimisation, especially multiple victimisations, in older adolescents and young adults. The aim of this study was to assess self-reported health in young women (15–22 years) victimised to one or more types of violence, compared with non-victimised. Methods: Young women visiting youth health centres in Sweden answered a questionnaire constructed from standardised instruments addressing violence victimisation (emotional, physical, sexual and family violence), socio-demographics, substance use and physical and mental health. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and attributable risk (AR) were assessed. Results: Of 1051 women (73% of eligible women), 25% were lifetime victims of one type of violence and 31% of two or more types of violence. Sexual-minority young women were more victimised than heterosexual women. Violence victimisation increased the risk for adverse health outcomes, especially evident for those multiply victimised. Victims of two or more types of violence had AOR 11.8 (CI 6.9–20.1) for post-traumatic stress symptoms, 6.3 (CI 3.9–10.2) for anxiety symptoms and 10.8 (CI 5.2–22.5) for suicide ideation. The AR of victimisation accounted for 41% of post-traumatic stress symptoms, 30% of anxiety symptoms and 27% of suicide ideation. Stratified analyses showed that lower economic resources did not influence health negatively for non-victimised, whereas it multiplicatively reinforced ill-health when combined with violence victimisation. Conclusion: Violence victimisation, and particularly multiple victimisations, was strongly associated with mental ill-health in young women, especially evident in those with low economic resources. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: violence victimization; mental health; physical health; young women; Mental Health; Physical Health; Victimization; Violence; Human Females

Revenge porn and mental health: A qualitative analysis of the mental health effects of revenge porn on female survivors - Bates, Samantha (Feminist Criminology, 2017)
This study examines the emotional and mental health effects revenge porn has on female survivors. To date, no other academic studies have exclusively focused on mental health effects in revenge porn cases. In-depth qualitative interviews were conducted between February 2014 and January 2015 with 18 female revenge porn survivors, and inductive analysis revealed participants’ experiences of trust issues, posttraumatic stress disorder (PTSD), anxiety, depression, suicidal thoughts, and several other mental health effects. These findings reveal the seriousness of revenge porn, the devastating impacts it has on survivors’ mental health, and similarities between revenge porn and sexual assault. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental health; revenge porn; pornography; qualitative research; sexual assault; sexual harassment; victimization; Harassment; Mental Health; Pornography; Sex Offenses; Victimization; Retaliation

Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort - Cesta, Carolyn E.; Månsson, Mattias; Palm, Camilla; Lichtenstein, Paul; Iliadou, Anastasia N.; Landén, Mikael (Psychoneuroendocrinology, 2016)
Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 5–15% of reproductive-aged women and characterized by high levels of circulating androgens. Given that androgens have been implicated in the aetiology of several psychiatric disorders, it was hypothesized that women with PCOS have high risk for psychiatric comorbidity. We aimed to investigate this risk amongst women with PCOS, as well as in their siblings, to elucidate if familial factors underlie any potential associations. Using the Swedish national registers, we identified all women diagnosed with PCOS between 1990 and 2013 (n=24,385), their full-siblings (n = 25,921), plus matched individuals (1:10/100) from the general population and their full-siblings. Psychiatric disorder diagnoses were identified including schizophrenia, bipolar disorder, depressive and anxiety disorders, eating disorders, personality and gender identity disorder, autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), tics, attempted and completed suicide. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression and adjusted ORs (AOR) were determined by adjustment for comorbid psychiatric disorders. Overall, women with PCOS had an increased odds of having at least one psychiatric disorder (OR = 1.56 [95CI%, 1.51–1.61]). Crude ORs showed associations with nearly all psychiatric disorders included in this study. Following adjustment for comorbid psychiatric disorders, women with PCOS were still at a significantly increased risk for bulimia, schizophrenia, bipolar disorder, depressive and anxiety disorders, personality disorders, with the highest AORs for ASD (AOR = 1.55 [95%CI, 1.32–1.81]) and tics (AOR = 1.65 [95%CI, 1.10–2.47]). Significantly higher AORs were found for ASD in both brothers and sisters of women with PCOS, and for depressive, anxiety, and schizophrenia spectrum disorders in the sisters only. Notably, the crude ORs for attempted suicide were 40% higher in women with PCOS and 16% higher in their unaffected sisters. However, the AORs were greatly attenuated indicating that underlying psychiatric comorbidity is important for this association. Women with PCOS had higher risks for a range of psychiatric disorders not shown before. Elevated risk in their siblings suggests shared familial factors between PCOS and psychiatric disorders. This study is an important first step towards identifying the underlying mechanisms for risk of psychiatric disorders in women with PCOS. Health professionals treating women with PCOS should be aware that these patients—as well as their family members—are important targets for mental health care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Polycystic ovary syndrome; Androgens; Psychiatric disorders; Epidemiology; Sibling analysis; Comorbidity; Endocrine Sexual Disorders; Heritability; Mental Disorders

Hard-to-reach youth online: Methodological advances in self-harm research - McDermott, Elizabeth; Roen, Katrina; Piela, Anna (Sexuality Research & Social Policy: A Journal of the NSRC, 2013)
International research has demonstrated that lesbian, gay, bisexual and transgender (LGBT) youth have elevated rates of suicide and self-harm. What is missing from the evidence base, however, is qualitative research investigating LGBT youth perspectives. This is a sensitive subject area presenting ethical, methodological and epistemological challenges, especially in relation to over-sampling the ‘visible’ sections of a hidden population, retrospective reporting, and capturing complex emotions. We report on our use of qualitative online methodology to examine Internet forums where LGBT youth discuss self-harming. We found that this methodology can address some research dilemmas by generating: (a) diverse samples in terms of sexuality and gender identities; (b) a different type of data, immediate and unmediated by researchers; and (c) complex psychosocial emotional data. We argue that this online data can enhance our understanding of the links among hard-to-reach youth, suicide, self-harm, sexuality and gender, which is crucial to developing effective and appropriate suicide prevention strategies and mental health policies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: self harm; lesbian; gay; bisexual; transgender; suicide rates; Bisexuality; Lesbianism; Self-Injurious Behavior; Suicide; Transgender

Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations - Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; et al. (Journal of Homosexuality, 2011)
Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide risk; suicide; lesbian; gay; bisexual; and transgender populations; suicidal behavior; Bisexuality; Female; Homosexuality; Humans; Male; Mental Disorders; Prejudice; Research; Risk Factors; Suicidal Ideation; Suicide; Suicide, Attempted; Transsexualism; Bisexuality; Epidemiology; Homosexuality; Suicide; Transgender; At Risk Populations; Lesbianism; Male Homosexuality; Suicidal Ideation

Associations of school connectedness with adolescent suicidality: Gender differences and the role of risk of depression - Langille, Donald B.; Asbridge, Mark; Cragg, Amber; Rasic, Daniel (The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 2015)
Objective: Previous studies have not examined associations of school connectedness with adolescent suicidal behaviours stratified by gender, while including a measure of depression. We analyzed survey data to determine whether there are independent protective associations of higher school connectedness with suicidal behaviours in Canadian adolescents, while controlling for potential confounders, including risk of depression; and whether such associations differ by gender. Method: Using data from a stratified cluster sample of randomly selected classes of students in schools in 3 of Canada’s Atlantic provinces, we used multiple logistic regression to examine whether associations of risk of depression, measured using the 12-item Center for Epidemiologic Studies-Depression scale, lessened protective associations of higher school connectedness with suicidal behaviours in grades 10 and 12 students, while stratifying by gender. Results: After adjusting for risk of depression, higher school connectedness was independently associated with decreased suicidal ideation in both genders and with suicidal attempt in females. In males, higher connectedness was no longer protective for suicide attempt when risk of depression was included in the model. Conclusions: School connectedness, which is felt to have positive influences on many types of adolescent behaviour, appears to also be both directly and indirectly protective for suicidality. These effects may occur through different pathways in females and males. Given the protection it offers both genders, including those at risk and not at risk of depression, increasing school connectedness should be considered as a universal adolescent mental health strategy. Studies that examine school connectedness should include analyses that examine potential differences between males and females. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: school connectedness; adolescent suicidality; gender differences; risk factors; depression; Adolescent; Adolescent Behavior; Canada; Depression; Female; Humans; Male; Risk; Schools; Sex Factors; Social Support; Suicidal Ideation; Suicide, Attempted; High School Students; Human Sex Differences; Major Depression; Risk Factors; Suicide; Suicidality

The relationship between stand-your-ground laws and crime: A state-level analysis - Gius, Mark (The Social Science Journal, 2016)
There have been numerous incidents over the past several years involving justifiable homicides and stand-your-ground (SYG) laws. Many of these incidents involved unarmed alleged criminals being shot by armed citizens who claimed a right of self-defense due to perceived threatening behaviors on the part of the alleged criminal. In order to better understand the role that self-defense laws, and in particular stand-your-ground laws, has on these types of shootings, the present study will attempt to determine the relationship between SYG laws and crime. A fixed effects model that controls for both state-level and year fixed effects and a two stage fixed effects model are estimated. Results of the present study indicate that the relationships between SYG laws and crime rates are mixed. For some crimes and for certain time periods, SYG laws are positively related to crime. For other crimes, there is no significant relationship between the two. It is important to note, however, that none of the results of the present study suggest that SYG laws reduce crime. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Stand-your-ground laws; Crime rates; Justifiable homicides; Criminal Behavior; Justice; Laws; Social Issues

The role of social connectedness and sexual orientation in the prevention of youth suicide ideation and attempts among sexually active adolescents - Stone, Deborah M.; Luo, Feijun; Lippy, Caroline; McIntosh, Wendy LiKamWa (Suicide and Life-Threatening Behavior, 2015)
The impact of types of social connectedness—family, other adult, and school—on suicide ideation and attempts among all youth, the relative impact of each type, and effect modification by sexual orientation was assessed. Data were from the 2007–2009 Milwaukee Youth Risk Behavior Surveys. Multivariable logistic regression analyses calculated the risk of suicide ideation and attempts by sexual orientation, types of social connectedness, and their interaction. Among all youth, each type of connectedness modeled singly conferred protective effects for suicide ideation. Family and other adult connectedness protected against suicide attempts. When modeled simultaneously, family connectedness protected against ideation and attempts. Sexual orientation modified the association between other adult connectedness and suicide ideation. Findings suggest that family connectedness confers the most consistent protection among all youth and sexual orientation does not generally modify the association between connectedness and suicidal behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: social connectedness; sexual orientation; prevention; suicide ideation; suicide attempts; sexually active adolescents; Sexual Orientation; Social Networks; Suicidal Ideation; Suicide Prevention; Attempted Suicide

Social and parental support as moderators of the effects of homophobic bullying on psychological distress in youth - António, Raquel; Moleiro, Carla (Psychology in the Schools, 2015)
The aim of this study was to explore homophobic bullying in Portugal, including its forms, prevalence, and consequences, and to verify whether parental and social support moderated the effects of homophobic bullying for victims. An online questionnaire was completed by 211 female and male students, aged 12 to 20 years. Results showed that psychological violence prevailed, male students were more often victims than female students were, and lesbian, gay, and bisexual adolescents were victims more often than their heterosexual peers were. The emotional impact on victims was higher when social support was low, including suicidal ideation and school difficulties. Furthermore, a main effect of parental support was found for emotional and behavioral distress indices experienced by adolescents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: parental support; social support; homophobic bullying; distress; Distress; Parent Child Relations; Social Support; Bullying; Student Attitudes

Sexual orientation and suicide ideation, plans, attempts, and medically serious attempts: Evidence from local Youth Risk Behavior Surveys, 2001-2009 - Stone, Deborah M.; Luo, Feijun; Ouyang, Lijing; Lippy, Caroline; Hertz, Marci F.; Crosby, Alex E. (American Journal of Public Health, 2014)
Objectives: We examined the associations between 2 measures of sexual orientation and 4 suicide risk outcomes (SROs) from pooled local Youth Risk Behavior Surveys. Methods: We aggregated data from 5 local Youth Risk Behavior Surveys from 2001 to 2009. We defined sexual minority youths (SMYs) by sexual identity (lesbian, gay, bisexual) and sex of sexual contacts (same- or both-sex contacts). Survey logistic regression analyses controlled for a wide range of suicide risk factors and sample design effects. Results: Compared with non-SMYs, all SMYs had increased odds of suicide ideation; bisexual youths, gay males, and both-sex contact females had greater odds of suicide planning; all SMYs, except same-sex contact males, had increased odds of suicide attempts; and lesbians, bisexuals, and both-sex contact youths had increased odds of medically serious attempts. Unsure males had increased odds of suicide ideation compared with heterosexual males. Not having sexual contact was protective of most SROs among females and of medically serious attempts among males. Conclusions: Regardless of sexual orientation measure used, most SMY subgroups had increased odds of all SROs. However, many factors are associated with SROs. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: sexual orientation; suicide ideation; suicide risk outcomes; sexual minority youths; sexual identity; Adolescent; Age Factors; Female; Health Behavior; Humans; Male; Risk Factors; Sex Factors; Sexual Behavior; Sexuality; Suicidal Ideation; Suicide, Attempted; United States; Violence; Gender Identity; Minority Groups; Risk Factors; Sexual Orientation; Suicidal Ideation; Sexual Minority Groups

Transformation of health‐care and legal systems for the transgender population: The need for change in Australia - Telfer, Michelle; Tollit, Michelle; Feldman, Debi (Journal of Paediatrics and Child Health, 2015)
This opinion article highlights on transformation of health-care and legal systems for the transgender population in Australia. Awareness of gender diversity is also growing in Australian society. This is the notion that for some people, their gender identity is other than what was assigned to them at birth as male or female. The combination of rapid changes in social attitudes and the awareness of safe and effective gender affirming treatment has led to a significant increase in demand for trans-medicine worldwide. Recent study showed that the greatest risk of attempted suicide occurred between the time that a transgender individual decided to embark on medical care, and the time that he or she was able to access that care. Nationwide, publically funded medical services for the transgender population is required. Equitable access to GnRH analogues, testosterone, oestrogen therapy and the creation of Medicare item numbers for therapeutic gender affirmation surgery in adults is needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: transformation; health‐care; legal systems; transgender population; awareness; Awareness; Health Care Services; Legal Processes; Transgender

Inclusive anti-bullying policies and reduced risk of suicide attempts in lesbian and gay youth - Hatzenbuehler, Mark L.; Keyes, Katherine M. (Journal of Adolescent Health, 2013)
Purpose: To evaluate whether anti-bullying policies that are inclusive of sexual orientation are associated with a reduced prevalence of suicide attempts among lesbian, gay, and bisexual youths. Methods: A total of 31,852 11th-grade public school students (1,413 lesbian, gay, and bisexual individuals; 4.4%) in Oregon completed the Oregon Healthy Teens survey in 2006-2008. The independent variable was the proportion of school districts in the 34 counties participating in the Oregon Healthy Teens survey that adopted anti-bullying policies inclusive of sexual orientation. The outcome measure was any self-reported suicide attempt in the past 12 months. We stratified results by sexual orientation. Results: Lesbian and gay youths living in counties with fewer school districts with inclusive anti-bullying policies were 2.25 times (95% confidence interval [CI], 1.13-4.49) more likely to have attempted suicide in the past year compared with those living in counties where more districts had these policies. Inclusive anti-bullying policies were significantly associated with a reduced risk for suicide attempts among lesbian and gay youths, even after controlling for sociodemographic characteristics (sex, race/ethnicity) and exposure to peer victimization (odds ratio, .18; 95% CI, .03-.92). In contrast, anti-bullying policies that did not include sexual orientation were not associated with lower suicide attempts among lesbian and gay youths (odds ratio, .38; 95% CI, .02-7.33). Conclusions: Inclusive anti-bullying policies may exert protective effects for the mental health of lesbian and gay youths, including reducing their risk for suicide attempts. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: anti-bullying policies; risk factors; suicide attempts; lesbians; gay youth; sexual orientation; Attempted Suicide; Policy Making; Risk Factors; Sexual Orientation; Bullying; Lesbianism; Male Homosexuality

General strain theory for LGBQ and SSB youth: The importance of intersectionality in the future of feminist criminology - Button, Deeanna M.; Worthen, Meredith G. F. (Feminist Criminology, 2014)
This study applies an intersectional general strain theory (GST) framework to understand the experiences of lesbian, gay, bisexual, questioning (LGBQ) youth, and youth involved in same-sex sexual behavior (SSB). Using a statewide probability sample of LGBQ and SSB youth (N = 539) in grades 9 to 12, results show that understanding LGBQ and SSB youths’ experiences with victimization (feeling unsafe, threatened/injured, property stolen) and negative outcomes (poor academic performance, substance use, suicidality) must be underscored with the significance of and intersections between gender, sexual identity, and sexual behavior. Implications for the importance of intersectionality in GST and the future of feminist criminology are offered. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: general strain theory; gender; intersectionality; LGBQ youth; lesbian; gay; Criminology; Feminism; Lesbianism; Sexual Orientation; Bisexuality; Theories

The mental health of multiethnic lesbian and bisexual adolescent females: The role of self-efficacy, stress and behavioral risks - Craig, Shelley L.; Keane, Gina (Journal of Gay & Lesbian Mental Health, 2014)
Multiethnic lesbian and bisexual adolescent females (MLBAF) are vulnerable to health and mental health risks, such as depression, suicide, self-harm, family and school concerns, and stress resulting from a 'triple jeopardy' of marginalization, yet these risks remain virtually unstudied. Based on minority stress theory, this pilot study found that for a sample of MLBAF (n = 116), the odds of self-reported poor mental health were more than five times higher for each unit increase in stress and almost seven times higher for sexual abuse. The presence of youth substance abuse academic problems and younger age made a significant contribution to poor self-reported mental health while high self-efficacy scores resulted in significantly fewer mental health concerns. Implications for practice are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental health; multiethnic lesbian and bisexual adolescent females; self-efficacy; stress; behavioral risks; depression; suicide; Adolescent Development; Bisexuality; Lesbianism; Mental Health; Risk Factors; Behavioral Assessment; Human Females; Self-Efficacy; Stress

High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America - Mimiaga, Matthew J.; Biello, Katie B.; Robertson, Angela M.; Oldenburg, Catherine E.; Rosenberger, Joshua G.; O'Cleirigh, Conall; Novak, David S.; Mayer, Kenneth H.; Safren, Steven A. (Archives of Sexual Behavior, 2015)
The HIV epidemic in Latin America is highly concentrated in men who have sex with men (MSM). In the United States, multiple co-occurring psychosocial conditions have been shown to act as intertwined epidemics to potentiate HIV transmission among MSM. To date, no study has examined the role of syndemics and condomless sex among MSM in Latin America. In 2012, an online survey was conducted among members of the largest social/sexual networking website for MSM in Latin America. Participants were asked about demographics, sexual behaviors, HIV/STI diagnoses, and psychosocial well-being, including depression, suicidal ideation, hazardous alcohol use, hard drug use during sex, history of childhood/adolescent sexual abuse, intimate partner violence, and sexual compulsivity. Multivariable logistic generalized estimation equations were used to assess the relationship of syndemic factors and (1) engagement in higher risk condomless anal sex and (2) self-report of prior HIV diagnosis. Among 24,274 survey respondents, 74.6 % of the sample had at least one syndemic factor. In an additive model, syndemics were associated with increased odds of higher risk condomless anal sex, ranging from adjusted odds ratio of 1.31 (95 % CI 1.20, 1.43) for one syndemic factor to 4.06 (95 % CI 3.25, 5.09) for 6/7 syndemic factors. Similarly, syndemics were associated with increased odds of HIV infection (p < .0001). This study provides initial evidence that intertwined syndemics increase HIV risk behavior and HIV infection among MSM in Latin America. In the Latin American context, comprehensive HIV prevention interventions for MSM should be developed and tested that simultaneously address co-occurring psychosocial conditions and HIV risk. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: HIV; Men who have sex with men; Sexual behavior; Syndemics; Latin America; Internet; Sexual orientation; Adult; Cross-Sectional Studies; HIV Infections; Homosexuality, Male; Humans; Latin America; Male; Prevalence; Unsafe Sex; Young Adult; HIV; Sexual Risk Taking; Same Sex Intercourse; Latinos/Latinas; Epidemics; Psychosexual Behavior; Well Being

Protective school climates and reduced risk for suicide ideation in sexual minority youths - Hatzenbuehler, Mark L.; Birkett, Michelle; Van Wagenen, Aimee; Meyer, Ilan H. (American Journal of Public Health, 2014)
Objectives: We examined whether sexual minority students living in states and cities with more protective school climates were at lower risk of suicidal thoughts, plans, and attempts. Methods: Data on sexual orientation and past-year suicidal thoughts, plans, and attempts were from the pooled 2005 and 2007 Youth Risk Behavior Surveillance Surveys from 8 states and cities. We derived data on school climates that protected sexual minority students (e.g., percentage of schools with safe spaces and Gay–Straight Alliances) from the 2010 School Health Profile Survey, compiled by the Centers for Disease Control and Prevention. Results: Lesbian, gay, and bisexual students living in states and cities with more protective school climates reported fewer past-year suicidal thoughts than those living in states and cities with less protective climates (lesbians and gays: odds ratio [OR] = 0.68; 95% confidence interval [CI] = 0.47, 0.99; bisexuals: OR = 0.81; 95% CI = 0.66, 0.99). Results were robust to adjustment for potential state-level confounders. Sexual orientation disparities in suicidal thoughts were nearly eliminated in states and cities with the most protective school climates. Conclusions: School climates that protect sexual minority students may reduce their risk of suicidal thoughts. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: protective school climates; risk reduction; suicide ideation; sexual minority youths; sexual orientation; Adolescent; Age Factors; Female; Humans; Male; Risk Factors; Schools; Sex Factors; Sexuality; Suicidal Ideation; Suicide, Attempted; United States; Minority Groups; School Environment; Sexual Orientation; Suicidal Ideation; Sexual Minority Groups; Risk Assessment

Non-suicidal self-injury in a large online sample of transgender adults - dickey, lore m.; Reisner, Sari L.; Juntunen, Cindy Lee (Professional Psychology: Research and Practice, 2015)
Non-suicidal self-injury (NSSI) has been increasing in clinical as well as nonclinical populations in recent years. There are few published reports examining lifetime occurrence of this behavior in transgender and gender nonconforming (TGNC) people. An online survey was conducted with self-identified TGNC adults (n = 773) in the United States over the course of 6 months in 2009. The mean age for the sample was 40.4 years (SD = 13.9). Most participants identified on the trans masculine spectrum (female-to-male or FTM; 52.0%), 33.9% identified on the trans feminine spectrum (male-to-female or MTF), and 8.0% identified as genderqueer. Participants completed the Body Investment Scale, the Depression, Anxiety, and Stress Scales, and the Inventory of Statements about Self-Injury. Results indicated that 41.9% of participants had a lifetime history of NSSI. Scores on the subscales of Protection and Feeling from the Body Investment Scale were found to be statistically predictive of NSSI. These findings shed new light on the lifetime prevalence of NSSI in this online TGNC respondent sample. Practice implications are discussed for mental health professionals who work with TGNC clients in addition to research recommendations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: transgender; TGNC; FTM; MTF; NSSI; non-suicidal self-injury; Self-Injurious Behavior; Transgender

Mental health and medical health disparities in 5135 transgender veterans receiving healthcare in the veterans health administration: A case–control study - Brown, George R.; Jones, Kenneth T. (LGBT Health, 2016)
Purpose: There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status. Methods: Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case–control design to determine if medical and/or mental health disparities exist in the TG veteran population. Results: In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups. Conclusion: This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: disparity; gender dysphoria; military; transgender; veteran; Health Care Services; Military Veterans; Health Disparities; Transgender; Mental Health; Mental Health Services

Mental health and suicidality among racially/ethnically diverse sexual minority youths - Bostwick, Wendy B.; Meyer, Ilan; Aranda, Frances; Russell, Stephen; Hughes, Tonda; Birkett, Michelle; Mustanski, Brian (American Journal of Public Health, 2014)
Objectives: We examined the relationships among sexual minority status, sex, and mental health and suicidality, in a racially/ethnically diverse sample of adolescents. Methods: Using pooled data from 2005 and 2007 Youth Risk Behavior Surveys within 14 jurisdictions, we used hierarchical linear modeling to examine 6 mental health outcomes across 6 racial/ethnic groups, intersecting with sexual minority status and sex. Based on an omnibus measure of sexual minority status, there were 6245 sexual minority adolescents in the current study. The total sample was n = 72 691. Results: Compared with heterosexual peers, sexual minorities reported higher odds of feeling sad; suicidal ideation, planning and attempts; suicide attempt treated by a doctor or nurse, and self-harm. Among sexual minorities, compared with White youths, Asian and Black youths had lower odds of many outcomes, whereas American Native/Pacific Islander, Latino, and Multiracial youths had higher odds. Conclusions: Although in general, sexual minority youths were at heightened risk for suicidal outcomes, risk varied based on sex and on race/ethnicity. More research is needed to better understand the manner in which sex and race/ ethnicity intersect among sexual minorities to influence risk and protective factors, and ultimately, mental health outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: sexual minority; sexual minorities; protective factors; suicidal ideation; racially and ethnically diverse; Adolescent; Continental Population Groups; Ethnic Groups; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Health; Minority Groups; Risk Factors; Suicidal Ideation; Suicide, Attempted; United States; Minority Groups; Protective Factors; Racial and Ethnic Differences; Suicidal Ideation; Risk Assessment; Suicidality; Sexual Minority Groups

Measures of sexual minority status and suicide risk among young adults in the United States - Almazan, Elbert P.; Roettger, Michael E.; Acosta, Pauline S. (Archives of Suicide Research, 2014)
Multiple measures of sexual minority status are necessary to accurately describe the diversity of attractions, identities, and behaviors in sexual minority populations. We investigated whether four measures of sexual minority status (sexual minority attraction, sexual minority identity, sexual minority lifetime behavior, and sexual minority recent 12-month behavior) were associated with suicidal thoughts and suicide attempts among young adults ages 24 to 34 in the United States. We analyzed data from Wave IV (2007–2008) of the National Longitudinal Study of Adolescent Health. We employed logistic regression models in the analysis. Multiple sexual minority status measures had significant associations with increased suicidal thoughts among women and men. Multiple sexual minority status measures had significant associations with increased suicide attempts among women, but not among men. Diverse sexual minority populations are at increased risk for suicidal thoughts and suicide attempts. Multiple measures of sexual minority status should be utilized in future studies of sexual minority status and suicide risk. Suicide prevention programs should ensure intervention is available across diverse sexual minority populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicide risk; sexual minority; diversity; suicide prevention measurement; Adult; Bisexuality; Female; Health Status Disparities; Homosexuality; Humans; Logistic Models; Male; Minority Groups; Risk; Suicidal Ideation; Suicide; Suicide, Attempted; United States; Young Adult; Measurement; Minority Groups; Risk Factors; Sexual Orientation; Suicide; Homosexuality; Suicide Prevention; Sexual Minority Groups

The power of 41%: A glimpse into the life of a statistic - Tanis, Justin (American Journal of Orthopsychiatry, 2016)
'Forty-one percent?' the man said with anguish on his face as he addressed the author, clutching my handout. 'We’re talking about my granddaughter here.' He was referring to the finding from the National Transgender Discrimination Survey (NTDS) that 41% of 6,450 respondents said they had attempted suicide at some point in their lives. The author had passed out the executive summary of the survey’s findings during a panel discussion at a family conference to illustrate the critical importance of acceptance of transgender people. During the question and answer period, this gentleman rose to talk about his beloved 8-year-old granddaughter who was in the process of transitioning socially from male to female in her elementary school. The statistics that the author was citing were not just numbers to him; and he wanted strategies—effective ones—to keep his granddaughter alive and thriving. The author has observed that the statistic about suicide attempts has, in essence, developed a life of its own. It has had several key audiences—academics and researchers, public policymakers, and members of the community, particularly transgender people and our families. This article explores some of the key takeaways from the survey and the ways in which the 41% statistic has affected conversations about the injustices transgender people face and the importance of family and societal acceptance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: transgender; suicide; wellbeing; mental health; Attempted Suicide; Mental Health; Well Being; Transgender; Family; Health Promotion; Narratives; Suicide; Treatment

Non-suicidal self-injury in trans people: Associations with psychological symptoms, victimization, interpersonal functioning, and perceived social support - Claes, Laurence; Bouman, Walter Pierre; Witcomb, Gemma; Thurston, Megan; Fernandez-Aranda, Fernando; Arcelus, Jon (Journal of Sexual Medicine, 2015)
Introduction: There is a paucity of systematic research in the area of non-suicidal self-injury (NSSI) in trans people. Aim: The aim of this study was to investigate the prevalence of NSSI in trans people and the associations with intra‐ and interpersonal problems. Methods Participants were 155 untreated individuals with a diagnosis of transsexualism (according to International Classification of Disease-10 criteria) attending a national gender identity clinic. Main Outcome Measures: All participants completed the Self-Injury Questionnaire, the Symptom Checklist-90-Revised, the Rosenberg Self-Esteem Scale, the Hamburg Body Drawing Scale, the Experiences of Transphobia Scale, the Inventory of Interpersonal Problems-32, and the Multidimensional Scale of Perceived Social Support. Results: The sample consisted of 66.5% trans women and 33.5% trans men and 36.8% of them had a history of engaging in NSSI. The prevalence of NSSI was significantly higher in trans men (57.7%) compared with trans women (26.2%). Trans individuals with NSSI reported more psychological and interpersonal problems and perceived less social support compared with trans individuals without NSSI. Moreover, the probability of having experienced physical harassment related to being trans was highest in trans women with NSSI (compared with those without NSSI). The study found that with respect to psychological symptoms, trans women reported significantly more intrapersonal and interpersonal symptoms compared with trans men. Finally, the results of the regression analysis showed that the probability of engaging in NSSI by trans individuals was significantly positively related to a younger age, being trans male, and reporting more psychological symptoms. Conclusions: The high levels of NSSI behavior and its association with interpersonal and interpersonal difficulties and lack of social support need to be taken into consideration when assessing trans individuals. The effect of cross-sex hormones and sex reassignment surgery on psychological functioning, including NSSI behavior, as part of the transitional journey of trans individuals should be explored in future studies. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: trans; transsexualism; dender dysphoria; NSSI; victimization; interpersonal functioning; social support; Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Checklist; Depression; Female; Humans; Interpersonal Relations; Male; Middle Aged; Perception; Prevalence; Risk Factors; Self Concept; Self-Injurious Behavior; Social Support; Surveys and Questionnaires; Transgender Persons; Self-Injurious Behavior; Social Networks; Social Support; Transsexualism; Victimization

PTSD as aftermath for bullied LGBT adolescents: The case for comprehensive assessment - Beckerman, Nancy L.; Auerbach, Charles (Social Work in Mental Health, 2014)
There is overwhelming research that demonstrates a positive correlation between various forms of adolescent bullying and subsequent and serious psychological repercussions such as anxiety, depression, suicidal ideation and attempt as well as posttraumatic stress disorder (PTSD; D’Augelli et al., 2005; Herek & Garnets, 2007; Mustanski, Garofalo, & Emerson, 2010). This study examines a particularly vulnerable adolescent and young adult population: lesbian, gay, and transgendered adolescents who have been bullied (Herek & Garnets, 2006). This study (n = 23) identifies which forms of bullying are more likely to manifest in subsequent symptoms of PTSD. Although there are numerous confounding variables, there are statistically significant findings that demonstrate which forms of bullying are more psychologically treacherous, and employing the PTSD checklist–civilian version (PCL) screening instrument, we learned who and what conditions might predict PTSD in our clients. Clinical implications for comprehensive PTSD screening and assessment are provided for mental health practitioners. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: posttraumatic stress disorder; lesbians; gays; bullying; peer relations; suicidal ideation; Peer Relations; Posttraumatic Stress Disorder; Suicidal Ideation; Anxiety; Lesbianism; Bullying

Bullying explains only part of LGBTQ–heterosexual risk disparities: Implications for policy and practice - Robinson, Joseph P.; Espelage, Dorothy L. (Educational Researcher, 2012)
Students who identify as lesbian, gay, bisexual, transgender, and questioning (LGBTQ) experience higher rates of victimization by bullying than do their heterosexual-identified peers. In this article, we investigate the extent to which this difference in rates of victimization can explain LGBTQ youths’ greater rates of suicidal ideation, suicide attempts, and unexcused absences from school. Our sample consisted of 11,337 students in Grades 7 through 12 from 30 schools in Dane County, Wisconsin. Using both multilevel covariate-adjusted models and propensity-score-matching models, we found that although victimization does explain a portion of the LGBTQ–heterosexual risk disparities, substantial differences persist even when the differences in victimization are taken into account. For example, LGBTQ-identified students were 3.3 times as likely to think about suicide (p < .0001), 3.0 times as likely to attempt suicide (p = .007), and 1.4 times as likely to skip school (p = .047) as propensity-score-matched heterosexual-identified students within the same school who reported equivalent levels of peer victimization. Moreover, in our propensity-score-matched samples, we found substantial differences in suicidal ideation and suicide attempts at both higher and lower levels of victimization. This consistent pattern of findings suggests that policies aimed simply at reducing bullying may not be effective in bringing LGBTQ youth to the level of their heterosexual peers in terms of psychological and educational outcomes. Additional policies may be needed to promote safe, supportive school environments. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: bullying; lesbianism; heterosexuality; risk disparities; policy making; practice; transgender; gay; bisexuality; questioning; High School Students; Middle School Students; Sexual Orientation; Victimization; Bullying; Bisexuality; Lesbianism; Male Homosexuality; Policy Making; Questioning; Risk Factors; Transgender; LGBTQ

Offsetting risks: High school gay-straight alliances and lesbian, gay, bisexual, and transgender (LGBT) youth - Heck, Nicholas C.; Flentje, Annesa; Cochran, Bryan N. (School Psychology Quarterly, 2011)
Lesbian, gay, bisexual, and transgender (LGBT) youth are at risk for engaging in negative health behaviors and for experiencing at-school victimization. Specific benefits of attending a high school with a gay-straight alliance (GSA), including lower levels of suicidality, have been published; however, it is unclear whether GSAs are related to lower levels of problematic substance use, depressive symptoms, and psychological distress. Using a sample of 145 LGBT youth recruited from college and university organizations for LGBT students, we examined whether attending a high school with a GSA was related to more positive school experiences and mental health outcomes for LGBT youth. The results indicate that youth who attended a high school with a GSA report significantly more favorable outcomes related to school experiences, alcohol use, and psychological distress. The implications of the findings are discussed as they relate to school psychologists. Important limitations of this study are reviewed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGBT; alcohol; gay-straight alliance; high school; sexual minority youth; lesbians; bisexuals; transgenderd; Bisexuality; Health Behavior; Homosexuality; Lesbianism; Transgender; Alcohol Drinking Patterns; Distress; Health; High School Students; High Schools; Major Depression; Mental Health; School Club Membership; School Environment; Sexual Minority Groups

Correlates of bullying in Quebec high school students: The vulnerability of sexual-minority youth - Cénat, Jude Mary; Blais, Martin; Hébert, Martine; Lavoie, Francine; Guerrier, Mireille (Journal of Affective Disorders, 2015)
Purpose: Bullying has become a significant public health issue, particularly among youth. This study documents cyberbullying, homophobic bullying and bullying at school or elsewhere and their correlates among both heterosexual and sexual-minority high school students in Quebec (Canada). Method: A representative sample of 8194 students aged 14–20 years was recruited in Quebec (Canada) high schools. We assessed cyberbullying, homophobic bullying and bullying at school or elsewhere in the past 12 months and their association with current self-esteem and psychological distress as well as suicidal ideations. Results: Bullying at school or elsewhere was the most common form of bullying (26.1%), followed by cyberbullying (22.9%) and homophobic bullying (3.6%). Overall, girls and sexual-minority youth were more likely to experience cyberbullying and other forms of bullying as well as psychological distress, low self-esteem and suicidal ideations. The three forms of bullying were significantly and independently associated with all mental health outcomes. Conclusions: The results underscore the relevance of taking into account gender and sexual orientation variations in efforts to prevent bullying experience and its consequences. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Cyberbullying; Homophobic bullying; Psychological distress; Self-esteem; Suicidal ideations; Sexual-minority youth; Adolescent; Bullying; Crime Victims; Female; Homophobia; Humans; Internet; Male; Minority Groups; Quebec; Self Concept; Sexual Behavior; Students; Vulnerable Populations; Distress; Homosexuality; Homosexuality (Attitudes Toward); Self-Esteem; Bullying; High School Students; Minority Groups; Suicidal Ideation; Sexual Minority Groups

Does 'it get better' for depressed sexual minority youth in young adulthood? - Cardom, Robert; Rostosky, Sharon; Danner, Fred (Journal of Adolescent Health, 2013)
Purpose: To examine depressive symptoms and suicidality in adolescence and adulthood in a sample of depressed adolescents in five sexual identity groups (heterosexual, mostly heterosexual, bisexual, mostly gay, and gay). Methods: Depressed adolescents (N ¼ 1,591) from the National Longitudinal Study of Adolescent Health were examined again in young adulthood. Results: Paired t-tests revealed that depressive symptoms declined significantly in all five sexual identity groups. McNemar chi-square tests revealed that the percentage of participants reporting suicidal ideation decreased significantly in all groups except for the mostly gay group. The percentage of participants reporting suicide attempts declined in all groups except the bisexual group. Conclusions: Within-group differences are important to consider in delivering effective mental health services. Although depressive symptoms diminished in young adulthood in all groups, suicidality did not. Mostly gay and bisexual young adults did not report the same significant declines as their peers. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: sexual minority; depressive symptoms; suicidality; sexual identity; age differences; adolescence; adulthood; Adolescent; Bisexuality; Child; Depressive Disorder; Female; Heterosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Male; National Longitudinal Study of Adolescent Health; Quality of Life; Sexual Behavior; Suicidal Ideation; Suicide, Attempted; United States; Young Adult; Age Differences; Depression (Emotion); Suicide; Symptoms; Gender Identity; Minority Groups; Suicidality; Sexual Minority Groups

Conflating sexual orientation and gender identity—Authors' reply - Meader, Nick; Chan, Melissa K. Y. (The British Journal of Psychiatry, 2017)
Reply by the current authors to the comments made by Margaret l. white (see record [rid]2018-36883-019[/rid]) on the original article, Sexual Orientation and Suicidal Behaviour in Young People by Nick Meader and Melissa K. Y. Chan (2017). The authors thank Margaret White for responding to their editorial and would like to take this opportunity to respond to some of the points she makes. First, she argues that authors conflated gender identity and sexual orientation and treated LGBT youth as a ‘monolithic entity. Authors agree that LGBT young people are not a ‘monolithic entity. Authors stated clearly that they think it is important to understand the experiences of LGBT young people and to identify where risks for engaging in suicidal behavior differ between groups. Authors also gave brief illustrative examples of why risk factors may vary between groups. Second, White provides two examples that she considers reflects a conflation of gender identity and sexual orientation. Authors are sorry for any misunderstanding and acknowledge that wording could have been more precise. Third, as regards risk factors for transgender youth, authors agree that there are a number of potential factors that may have an impact on risk of suicidality in transgender young people. When read in context as a suggestion for further research on risk factors for suicidal behavior in transgender populations, authors thought it was clear that we were citing higher rates of stigma as an illustrative example and not intending to provide a comprehensive list of risk or protective factors, as that would be pre-empting what emerges from future research. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: sexual orientation; LGBT; suicidal ideation; sexuality; gender identity; Gender Identity; Sexual Orientation; Sexuality; Bisexuality; Lesbianism; Male Homosexuality; Suicidal Ideation; Transgender

Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings - Diamond, Gary M.; Diamond, Guy S.; Levy, Suzanne; Closs, Cynthia; Ladipo, Tonya; Siqueland, Lynne (Psychotherapy, 2012)
[Correction Notice: An Erratum for this article was reported in Vol 50(4) of Psychotherapy (see record [rid]2013-41712-019[/rid]). Contained minor errors in the results and discussion sections. The corrections are discussed in the erratum as well as corrected tables.] The objective of this paper is to adapt attachment-based family therapy (ABFT) for use with suicidal lesbian, gay, and bisexual (LGB) adolescents and to obtain preliminary data on the feasibility and efficacy of the treatment with this population. In Phase I, a treatment development team modified ABFT to meet the unique needs of LGB suicidal youth. In Phase II, 10 suicidal LGB youth were offered 12 weeks of LGB sensitive ABFT. Adolescents' report of suicidal ideation, depressive symptoms, and maternal attachment–related anxiety and avoidance were gathered at pretreatment, 6 weeks, and 12 weeks (posttreatment). In Phase I, the treatment was adapted to: (a) include more individual time working with parents in order to process their disappointments, pain, anger, and fears related to their adolescent's minority sexual orientation; (b) address the meaning, implications, and process of acceptance; and (c) heighten parents' awareness of subtle yet potent invalidating responses to their adolescents' sexual orientation. Results of Phase II suggest this population can be recruited and successfully treated with a family based therapy, evidenced by high levels of treatment retention and significant decreases in suicidal ideation, depressive symptoms, and maternal attachment–related anxiety and avoidance. This is the first family-based treatment adapted and tested specifically for suicidal LGB adolescents. Though promising, the results are preliminary and more research on larger samples is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: adolescents; family therapy; gay; lesbian; suicide; bisexual; attachment-based family therapy; Adolescent; Bisexuality; Depressive Disorder, Major; Family Therapy; Feasibility Studies; Female; Homosexuality, Female; Homosexuality, Male; Humans; Individuation; Male; Manuals as Topic; Mother-Child Relations; Object Attachment; Personal Autonomy; Pilot Projects; Professional-Family Relations; Sexual Behavior; Suicidal Ideation; Treatment Outcome; Attachment Behavior; Bisexuality; Family Therapy; Homosexuality; Lesbianism; Adolescent Development; Family; Suicide; Treatment Effectiveness Evaluation

Psychiatric disorders, suicidality, and personality among young men by sexual orientation - Wang, J.; Dey, M.; Soldati, L.; Weiss, M. G.; Gmel, G.; Mohler-Kuo, M. (European Psychiatry, 2014)
Personality and its potential role in mediating risk of psychiatric disorders and suicidality are assessed by sexual orientation, using data collected among young Swiss men (n = 5875) recruited while presenting for mandatory military conscription. Mental health outcomes were analyzed by sexual attraction using logistic regression, controlling for five-factor model personality traits and socio-demographics. Homo/bisexual men demonstrated the highest scores for neuroticism-anxiety but the lowest for sociability and sensation seeking, with no differences for aggression-hostility. Among homo/bisexual men, 10.2% fulfilled diagnostic criteria for major depression in the past 2 weeks, 10.8% for ADHD in the past 12 months, 13.8% for lifetime anti-social personality disorder (ASPD), and 6.0% attempted suicide in the past 12 months. Upon adjusting (AOR) for personality traits, their odds ratios (OR) for major depression (OR = 4.78, 95% CI 2.81–8.14; AOR = 1.46, 95% CI 0.80–2.65) and ADHD (OR = 2.17, 95% CI = 1.31–3.58; AOR = 1.00, 95% CI 0.58–1.75) lost statistical significance, and the odds ratio for suicide attempt was halved (OR = 5.10, 95% CI 2.57–10.1; AOR = 2.42, 95% CI 1.16–5.02). There are noteworthy differences in personality traits by sexual orientation, and much of the increased mental morbidity appears to be accounted for by such underlying differences, with important implications for etiology and treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Depression; ADHD; Anti-social personality disorder; Suicidality; Personality; Homosexuality; Bisexuality; Depressive Disorder, Major; Homosexuality, Male; Humans; Male; Mental Disorders; Personality; Risk Factors; Sexual Behavior; Suicide, Attempted; Switzerland; Young Adult; Attempted Suicide; Mental Disorders; Personality Traits; Sexual Orientation; Suicidality; Antisocial Personality Disorder; Human Males; Military Personnel

Non-suicidal self-injury and identity distress in Flemish adolescents: Exploring gender differences and mediational pathways - Gandhi, Amarendra; Luyckx, Koen; Maitra, Shubhada; Claes, Laurence (Personality and Individual Differences, 2015)
There is an increasing amount of research that examines non-suicidal self-injury (NSSI) in relation to identity formation in adolescents. However, little or no research to date has explored associations between NSSI and identity distress in specific domains. To address this shortcoming, we assessed NSSI, identity distress, anxiety, and depression using self-report questionnaires in 568 high school students. Gender differences in NSSI were found with lifetime prevalence of NSSI being twice as high in females as compared to males. Gender differences in terms of identity domains were also significant; adolescent females showed higher levels of distress in the identity domains of career goals, friendship, and group loyalties as compared to males. Adolescents engaging in NSSI showed higher distress in domains of long-term goals, friendship, sexual orientation and behavior, values and beliefs. Results indicated that it was not distress in specific domains as such but the impairment due to daily impact of identity distress that explained additional variance in lifetime prevalence of NSSI above and beyond gender, age, depression, and anxiety. We also demonstrated that gender differences in lifetime prevalence of NSSI were mediated by differences in such identity impairment. Clinical implications of these findings are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Non-suicidal self-injury; Identity domains; Adolescents; Human Sex Differences; Identity Formation; Self-Injurious Behavior; Adolescent Development; Distress; Suicide

Impact of victimization on risk of suicide among lesbian, gay, and bisexual high school students in San Francisco - Shields, John P.; Whitaker, Kelly; Glassman, Jill; Franks, Heather M.; Howard, Kelli (Journal of Adolescent Health, 2012)
Purpose: This study investigated the association between sexual orientation, victimization, and suicide risk-related outcomes among youth attending public high schools in San Francisco. Methods: Data from the 2009 Youth Risk Behavior Survey were analyzed using bivariate and logistic regression methods for complex samples to examine the relationship between sexual orientation, victimization, and three suicide risk-related outcomes (sadness/depression, suicide planning, and attempting suicide) while controlling for demographics and substance use. Results: Lesbian, gay, or bisexual (LGB) youth reported significantly higher rates of substance use, victimization, and suicide risk-related outcomes than heterosexual youth. However, in the controlled regression models, victimization was a significant predictor of sadness/depression and suicide attempts, regardless of sexual orientation. There was a significant interaction effect between sexual orientation and victimization on suicide planning, with heterosexual youth more affected than LGB youth. Conclusions: Results underscore the deleterious effect of victimization on suicide risk-related outcomes, regardless of sexual orientation. As LGB youth continue to report higher rates of victimization, effective violence prevention approaches must focus on reducing violence among youth, specifically LGB youth. Additional research should focus on identification of other factors that may help further explain elevated suicide risk among LGB youth. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: victimization; suicide; lesbianism; gays; bisexualism; high school students; San Francisco; risk factors; Adolescent; Bisexuality; Crime Victims; Data Collection; Depression; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Risk Factors; San Francisco; Students; Suicidal Ideation; Suicide; Bisexuality; High School Students; Lesbianism; Suicide; Victimization; Male Homosexuality; Risk Factors; Risk Assessment

Caring for our transgender troops: The negligible cost of transition-related care - Belkin, Aaron (The New England Journal of Medicine, 2015)
This opinion article briefs the negligible cost of transition-related care in caring for the transgender troops. On July 13, 2015, U.S. Defense Secretary Ashton Carter announced that the military anticipates lifting its ban on service by transgender persons, those whose gender identity does not match the sex that they were assigned at birth. Having analyzed the cost that the military will incur by providing transition-related care, the author convinced that it is too low to warrant consideration in the current policy debate. Actual costs could be lower than expected, because transition related care has been proven to mitigate serious conditions including suicidality that, left untreated, impose costs on the military, and addressing symptoms might conceivably improve job performance as well. Finally, if transgender civilians join the military in order to obtain care, costs will be higher than estimated. Military recruiters have used the promise of health care benefits to entice civilians to enlist, and if transition-related coverage motivates outstanding transgender candidates to serve, that is not necessarily problematic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: transition-related care; transgender troops; job performance; transgender persons; Female; Health Care Costs; Humans; Male; Military Personnel; Sex Reassignment Procedures; Transgender Persons; United States; Health Care Costs; Health Care Services; Transgender; Mental Disorders

What has changed from 2001 to 2012 for sexual minority youth in New Zealand? - Lucassen, Mathijs F.G.; Clark, Terryann C.; Denny, Simon J.; Fleming, Theresa M.; Rossen, Fiona V.; Sheridan, Janie; Bullen, Pat; Robinson, Elizabeth M. (Journal of Paediatrics and Child Health, 2015)
Aim: To provide an overview of the health and well‐being of sexual minority high school students in New Zealand, investigate differences between sexual minority youth (SMY) and exclusively opposite‐sex‐attracted youth (EOSAY), and examine changes across survey waves. Methods: Nationally representative cross‐sectional surveys were completed in 2001 (n = 9011), 2007 (n = 8002) and 2012 (n = 8167). Logistic regressions were used to examine the associations between selected outcomes and sexual attraction across survey waves. Results: SMY accounted for 6% of participants in all three waves, with a greater proportion being ‘out’ in 2012 (P < 0.0001). SMY were more likely to work as volunteers (OR = 1.37) than EOSAY, and the majority of SMY reported good general health, liking school and having caring friends. With the exceptions of binge drinking and being driven dangerously by someone, SMY reported comparatively diminished health and well‐being relative to EOSAY. Increasing proportions of SMY had depressive symptoms from 2001 (OR = 2.38) to 2012 (OR = 3.73) compared with EOSAY. There were some differences between the sexes; female SMY were less likely to report positive family relationships (OR = 0.59) and liking school (OR = 0.55), and they were more likely to have been hit (2012 OR = 1.95) than female EOSAY. Male SMY reported especially high rates of suicide attempts (2012 OR = 5.64) compared with male EOSAY. Conclusions: Health services, schools, communities and families must be more responsive to the needs of SMY to ensure that disparities are addressed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: adolescent; bisexual; gay; lesbian; well‐being; Adolescent; Bisexuality; Cross-Sectional Studies; Female; Health Status Disparities; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Health; New Zealand; Surveys and Questionnaires; Adolescent Development; Binge Drinking; Homosexuality; Sexual Attraction; Well Being; Sexual Minority Groups

The mediating roles of stress and maladaptive behaviors on self-harm and suicide attempts among runaway and homeless youth - Moskowitz, Amanda; Stein, Judith A.; Lightfoot, Marguerita (Journal of Youth and Adolescence, 2013)
Runaway and homeless youth often have a constellation of background behavioral, emotional, and familial problems that contribute to stress and maladaptive behaviors, which, in turn, can lead to self-harming and suicidal behaviors. The current study examined the roles of stress and maladaptive behaviors as mediators between demographic and psychosocial background characteristics and self-injurious outcomes through the lens of the stress process paradigm. The model was tested in a sample of runaway and homeless youth from Los Angeles County (N = 474, age 12–24, 41 % female, 17 % White, 32.5 % African American, 21.5 % Hispanic/Latino). Background variables (gender, age, sexual minority status, parental drug use history, and emotional distress) predicted hypothesized mediators of maladaptive behaviors and recent stress. In turn, it was hypothesized that the mediators would predict self-harming behaviors and suicide attempts in the last 3 months. Females and LGBT (lesbian, gay, bisexual, transgender) youth were more likely to have self-harmed and attempted suicide; younger participants reported more self-harming. The mediating constructs were associated more highly with self-harming than suicide attempts bivariately, although differences were modest. Maladaptive behaviors and recent stress were significant predictors of self-harm, whereas only recent stress was a significant predictor of suicide attempts. All background factors were significant predictors of recent stress. Older age, a history of parental drug use, and greater emotional distress predicted problem drug use. Males, younger participants, and participants with emotional distress reported more delinquent behaviors. Significant indirect effects on self-harming behaviors were mediated through stress and maladaptive behaviors. The hypothesized paradigm was useful in explaining the associations among background factors and self-injurious outcomes and the influence of mediating factors on these associations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: runaway youth; homeless youth; stress; suicide attempts; maladaptive behaviors; self-harm; Adaptation, Psychological; Adolescent; Child; Cross-Sectional Studies; Factor Analysis, Statistical; Female; Homeless Youth; Humans; Interviews as Topic; Juvenile Delinquency; Male; Models, Psychological; Models, Statistical; Self Report; Self-Injurious Behavior; Stress, Psychological; Substance-Related Disorders; Suicide, Attempted; Young Adult; Attempted Suicide; Homeless; Self-Destructive Behavior; Stress; Suicide; Runaway Behavior

Sexual violence against men who have sex with men in Brazil: A respondent-driven sampling survey - Sabidó, Meritxell; Kerr, Ligia Regina Franco Sansigolo; Mota, Rosa Salani; Benzaken, Adele Schwartz; Pinho, Adriana de A.; Guimaraes, Mark D. C.; Dourado, Ines; Merchan-Hamman, Edgar; Kendall, Carl (AIDS and Behavior, 2015)
We estimated the prevalence of sexual violence (SV) experience among men who have sex with men (MSM) in Brazil and identified its associated risk factors. We recruited 3859 MSM through respondent driven sampling. A multivariable hierarchical analysis was performed using an ecological model. The prevalence of having ever experienced SV was 15.9 % (95 % confidence interval [CI] 14.7–17.1). SV experience was independently associated with discrimination due to sexual orientation (odds ratio [OR] 3.05; 95 % CI 2.10–4.42), prior HIV testing (OR 1.81; 95 % CI 1.25–2.63), ≤14 years at first sex (OR 1.86; 95 % CI 1.28–2.71), first sex with a man (OR 1.89; 95 % CI 1.28–2.79), presenting STI symptoms (last year) (OR 1.66; 95 % CI 1.12–2.47), and having suicidal ideas (last 6 months) (OR 2.08; 95 % CI 1.30–3.35). The high levels of SV against MSM in Brazil place them at a markedly higher risk of SV than the general population. Homophobic prejudice is the strongest determinant of SV and urgently needs to be included at the forefront of the national response to SV. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Sexual violence; Risk factors; MSM; Respondent-driven sampling; Brazil; Epidemiology; Human Males; Risk Factors; Sexual Abuse; Same Sex Intercourse

Nonsuicidal self-injury in sexual minority college students: A test of theoretical integration - Muehlenkamp, Jennifer J.; Hilt, Lori M.; Ehlinger, Peter P.; McMillan, Taylor (Child and Adolescent Psychiatry and Mental Health, 2015)
Background: Individuals identifying as a sexual minority report engaging in nonsuicidal self-injury (NSSI) at substantially higher rates compared to their heterosexual peers. Given that NSSI is a known risk factor for suicide, it is important to understand the processes unique to being a sexual minority that increases risk for NSSI so that adequate prevention efforts can be established. The current study integrated Minority Stress Theory and the Interpersonal Theory of Suicide to test a model of NSSI and suicide risk. Methods: A total of 137 college students who identified as a sexual minority completed an anonymous on-line study assessing NSSI, suicidal thoughts/behaviors, and constructs of the minority stress and interpersonal theories. Two linear regressions using bootstrapping analyses were conducted to test our hypotheses. Results: Minority stress was directly associated with NSSI and via perceived burdensomeness, explaining 27 % of the variance. NSSI was associated with increased risk for suicide thoughts/behaviors directly, and through acquired capability, explaining 45 % of the variance. Conclusions: These findings provide evidence that unique stressors individuals face as a result of their sexual minority status increases risk for self-harm by influencing cognitive and emotional processes such as burdensomeness and acquired capability. Implications for prevention, intervention, and future research are briefly discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Sexual minority; Youth; NSSI; Suicide; Self-injury; Self-harm; College; Minority stress; Burdensomeness; College Students; Risk Factors; Self-Injurious Behavior; Stress; Minority Groups; Suicide; Sexual Minority Groups; Minority Stress

Cyberbullying: Review of an old problem gone viral - Aboujaoude, Elias; Savage, Matthew W.; Starcevic, Vladan; Salame, Wael O. (Journal of Adolescent Health, 2015)
Purpose: Despite being relatively new, cyberbullying is now well recognized as a serious public health problem affecting children and adolescents. Scientific exploration has lagged media attention, but a synthesis of studies across several disciplines permits an understanding of its epidemiology, phenomenology, mental health dimensions, and management tools. Methods: To assess current knowledge of cyberbullying, we searched the MEDLINE, PubMed and PsycINFO databases for articles on 'cyberbullying' and related designations. The Google search engine was used to capture otherwise unpublished legislative, governmental, and community response data and to help identify relevant books and book chapters. Results: A significant proportion of children and adolescents (20%–40%) have been victims of cyberbullying, with females and sexual minorities seemingly at higher risk. Perpetrators are more likely to be male. By nature of the electronic platform, there seems to be an easier path to the bully-victim phenomenon (victims who become bullies or vice versa) than that in traditional bullying. A nonlinear relationship with age is suggested, but demographic data overall are preliminary. Accompanying psychopathology, including an increasingly well-established link to suicidality, is common. Several prevention and management approaches have been proposed to help prevent cyberbullying or mitigate its effects. Discussion: Cyberbullying's seeming ubiquity, its disproportionate toll on vulnerable populations (e.g., children and sexual minorities), the link with suicidality, and the expected continued rise in Internet penetrance and connectivity make confronting it an urgent matter. A multipronged approach is most likely to succeed and would include: educational media campaigns; school-based programs; parental oversight and involvement; legislative action; and screening and evidence-based interventions by health care providers, especially pediatricians and mental health professionals. Conclusions: More research is needed into cyberbullying, but available data suggest a serious problem whose consequences are real and should not be dismissed as a 'virtual' by-product of an increasingly digitalized childhood and adolescence. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Cyberbullying; Bullying; Social media; Cyberstalking; Peer victimization; Adolescent suicide; Bully-victim; Adolescent; Adult; Bullying; Child; Crime Victims; Female; Humans; Internet; Male; Psychopathology; Social Media; Suicidal Ideation; Public Health; Cyberbullying; School Based Intervention

Australian trans men: Development, sexuality, and mental health - del pozo de Bolger, Andrea; Jones, Tiffany; Dunstan, Debra; Lykins, Amy (Australian Psychologist, 2014)
The aim of the study reported in this article was to gain an understanding of the experiences, developmental trajectories, and mental health status of Australian trans men. Participants were 279 trans men. The majority preferred to identify as 'male'; from an early age, they had experienced their gender identity as different from that normatively expected of their natally assigned sex and had undertaken practices so as to facilitate their presentation as male in accordance with their gender identity. A majority reported a diagnosis of depression or anxiety within the last 12 months and attributed suicidal ideation and self‐harm and attempted suicide to personal issues with gender identity. Going through a masculinisation process and coming out reportedly led to improved mental health. The findings highlight the need to educate mental health and health care professionals on trans issues. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Keywords: gender identity; mental health; trans men; transgender; transsexual; Gender Identity; Human Males; Mental Health; Transsexualism; Transgender; Human Sex Differences

Differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified young adults - Coulter, Robert W. S.; Blosnich, John R.; Bukowski, Leigh A.; Herrick, A. L.; Siconolfi, Daniel E.; Stall, Ron D. (Drug and Alcohol Dependence, 2015)
Background: Little is known about differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified populations. Using data from a large-scale health survey, we compare the drinking patterns and prevalence of alcohol-related problems of transgender-identified individuals to nontransgender-identified males and females. For transgender-identified people, we examine how various forms of victimization relate to heavy episodic drinking (HED). Methods: Cross-sectional surveys were completed by 75,192 students aged 18–29 years attending 120 post-secondary educational institutions in the United States from 2011 to 2013. Self-reported measures included alcohol use, alcohol-related problems, victimization, and sociodemographics, including 3 gender-identity groups: transgender-identified individuals; nontransgender-identified males; and nontransgender-identified females. Results: Compared to transgender-identified individuals, nontransgender-identified males were more likely to report HED in the past 2 weeks (relative risk = 1.42; p = 0.006); however, nontransgender-identified males and females reported HED on fewer days than transgender-identified people (incidence-rate ratios [IRRs] ranged from 0.28 to 0.43; p-values < 0.001). Compared to transgender-identified people, nontransgender-identified males and females had lower odds of past-year alcohol-related sexual assault and suicidal ideation (odds ratios ranged from 0.24 to 0.45; p-values < 0.05). Among transgender-identified people, individuals who were sexually assaulted (IRR = 3.21, p = 0.011) or verbally threatened (IRR = 2.42, p = 0.021) in the past year had greater HED days than those who did not experience those forms of victimization. Conclusions: Compared to transgender-identified people, nontransgender-identified males and females: have fewer HED occasions (despite nontransgender-identified males having greater prevalence of HED); and are at lower risk for alcohol-related sexual assaults and suicidal ideation. Experiences of sexual assault and verbal threats are associated with greater HED occasions for transgender-identified people. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: transgender; alcohol use; heavy episodic drinking; alcohol-related problems; violence; Alcohol Abuse; Alcohol Drinking Patterns; Transgender; Alcohols

The associations of race/ethnicity and suicidal ideation among college students: A latent class analysis examining precipitating events and disclosure patterns - De Luca, Susan; Yan, Yueqi; Lytle, Megan; Brownson, Chris (Suicide and Life-Threatening Behavior, 2014)
The aim of this paper was to examine precipitating events for suicidal ideation and how these experiences relate to disclosure in a diverse sample of college students were examined. Among non‐Hispanic White students, relationship/academic problems were most associated with ideation. A romantic break‐up increased the odds of getting help. Among racial/ethnic minority students, family/academic problems were most associated with ideation and students who reported multiple events were less likely to get help compared with those not reporting events. Future research should examine the reasons for interpersonal conflict among this high‐risk group and their attitudes about help‐seeking, and identify cultural norms associated with disclosure. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidal ideation; college students; precipitating events; racial/ethnic minority students; European Continental Ancestry Group; Hispanic Americans; Humans; Risk Factors; Sexuality; Students; Suicidal Ideation; Suicide; Suicide, Attempted; Surveys and Questionnaires; Truth Disclosure; College Students; Minority Groups; Suicidal Ideation; Latent Class Analysis; Colleges; Suicide

Rural‐urban disparities in school nursing: Implications for continuing education and rural school health - Ramos, Mary M.; Fullerton, Lynne; Sapien, Robert; Greenberg, Cynthia; Bauer‐Creegan, Judith (The Journal of Rural Health, 2014)
Purpose: Little is known about the professional and educational challenges experienced by rural school nurses. We conducted this study to describe disparities between the urban and rural professional school nurse workforce in New Mexico and to identify how best to meet the continuing education needs of New Mexico's rural school nurse workforce. Methods: We analyzed state data from a 2009 New Mexico Department of Health school nurse workforce survey (71.7% response rate). We included all survey respondents who indicated working as a school nurse in a public school setting in any grade K‐12 and who identified their county of employment (N = 311). Findings: Rural school nurses were twice as likely as metropolitan nurses to provide clinical services to multiple school campuses (67.3% compared to 30.1%, P < .0001). They were less likely to hold a nursing degree at the baccalaureate level or higher (62.7% compared to 82.3%, P = .0002). Rural school nurses were less likely than metropolitan nurses to have received recent continuing education on anaphylaxis (P < .0001), asthma (P = .027), body mass index (BMI)/healthy weight (P = .0002), diabetes (P < .0001), lesbian, gay, bisexual and transgender (LGBT) health (P = .0004), and suicide risk identification and prevention (P = .015). Online courses and telehealth were identified by rural school nurses as among the preferred means for receiving continuing education. Conclusions: Our findings support the provision of online courses and telehealth content to address urban‐rural disparities in school nursing education and support rural school health. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: health disparities; health services research; nursing; rural health; school health; Education, Distance; Education, Nursing, Continuing; Health Services Research; Healthcare Disparities; Humans; New Mexico; Rural Health; School Nursing; Telemedicine; Urban Health; Rural Environments; School Nurses; Rural Health; Body Mass Index; Continuing Education

Suicide risk in the UK trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt - Bailey, Louis; Ellis, Sonja J.; McNeil, Jay (Mental Health Review Journal, 2014)
Purpose: The purpose of this paper is to present findings from the Trans Mental Health Study (McNeil et al., 2012)—the largest survey of the UK trans population to date and the first to explore trans mental health and well-being within a UK context. Findings around suicidal ideation and suicide attempt are presented and the impact of gender dysphoria, minority stress and medical delay, in particular, are highlighted. Design/methodology/approach: This represents a narrative analysis of qualitative sections of a survey that utilised both open and closed questions. The study drew on a non-random sample (n = 889), obtained via a range of UK-based support organisations and services. Findings: The study revealed high rates of suicidal ideation (84 per cent lifetime prevalence) and attempted suicide (48 per cent lifetime prevalence) within this sample. A supportive environment for social transition and timely access to gender reassignment, for those who required it, emerged as key protective factors. Subsequently, gender dysphoria, confusion/denial about gender, fears around transitioning, gender reassignment treatment delays and refusals, and social stigma increased suicide risk within this sample. Research limitations/implications: Due to the limitations of undertaking research with this population, the research is not demographically representative. Practical implications: The study found that trans people are most at risk prior to social and/or medical transition and that, in many cases, trans people who require access to hormones and surgery can be left unsupported for dangerously long periods of time. The paper highlights the devastating impact that delaying or denying gender reassignment treatment can have and urges commissioners and practitioners to prioritise timely intervention and support. Originality/value: The first exploration of suicidal ideation and suicide attempt within the UK trans population revealing key findings pertaining to social and medical transition, crucial for policy makers, commissioners and practitioners working across gender identity services, mental health services and suicide prevention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Gender dysphoria; Gender transition; Health inequalities; Suicidal ideation; Suicide attempt; Trans suicide risk; Attempted Suicide; Human Sex Differences; Risk Factors; Suicidal Ideation; Transgender; Major Depression; Suicide; Health Disparities

Religious abuse: Implications for counseling lesbian, gay, bisexual, and transgender individuals - Super, John T.; Jacobson, Lamerial (Journal of LGBT Issues in Counseling, 2011)
Religion is often the place a lesbian, gay, bisexual, or transgender (LGBT) individual may turn to understand and navigate their sexual orientation identity development. However, religious abuse may occur when a religious group or leader, whether intentionally or unintentionally, uses coercion, threats, rejection, condemnation, or manipulation to force the individual into submission of the religious views about sexuality. The abuse may result in great harm to the victim by causing low self-esteem, guilt, shame, spirituality loss, substance abuse, or thoughts of suicide. Counselors need to be aware of religious abuse to help clients navigate any spiritual divide between religious beliefs and sexuality. Therefore, the purpose of this article is to (a) describe the differences between religion and spirituality,(b) define religious abuse, (c) describe the effects of religious abuse on LGBT individuals and society, and (d) delineate the counseling implications of religious abuse in working with LGBT individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: religious abuse; religious counseling; lesbians; gay men; bisexuality; transgender individuals; Counseling; Emotional Abuse; Religious Beliefs; Bisexuality; Lesbianism; Male Homosexuality; Transgender

Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study - Reisner, Sari L.; Vetters, Ralph; Leclerc, M.; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J. (Journal of Adolescent Health, 2015)
Purpose: Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exist to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the present study aimed to fill this gap. Methods: A retrospective cohort study of electronic health record data from 180 transgender patients aged 12–29 years seen between 2002 and 2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM with MTF youth on mental health outcomes. Results: The sample (N = 360) had a mean age of 19.6 years (standard deviation, 3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared with cisgender matched controls, transgender youth had a twofold to threefold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p < .05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Conclusions: Transgender youth were found to have a disparity in negative mental health outcomes compared with cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Mental health; Transgender; Gender minority; Adolescent; Health disparity; Adolescent; Chi-Square Distribution; Child; Cohort Studies; Community Health Services; Depression; Female; Gender Identity; Health Behavior; Health Status Disparities; Humans; Male; Mental Disorders; Mental Health; Multivariate Analysis; Patient Acceptance of Health Care; Retrospective Studies; Risk Assessment; Suicidal Ideation; Transgender Persons; Urban Population; Young Adult; Adolescent Psychiatry; Adolescent Psychology; Gender Identity; Mental Health; Transgender; Adolescent Development; Community Mental Health Centers; Health Disparities; Community Health

Baseline assessment of campus-wide general health status and mental health: Opportunity for tailored suicide prevention and mental health awareness programming - Hawley, Lisa D.; MacDonald, Michael G.; Wallace, Erica H.; Smith, Julia; Wummel, Brian; Wren, Patricia A. (Journal of American College Health, 2016)
Objective: A campus-wide assessment examined the physical and mental health status of a midsize midwestern public university. Participants: Two thousand and forty-nine students, faculty, and staff on a single college campus were assessed in March–April 2013. Methods: Participants completed an online survey with sections devoted to demographics, physical and mental health status, and suicide knowledge and experiences. Results: This study captured broad physical and mental health indicators. Students, faculty, and staff in certain demographic groups were more likely to report significant problems associated with mental and physical health. Specifically, women, faculty and staff of color, and nonheterosexual persons reported worse health outcomes. Across 8 mental health indicators, students reported consistently worse mental health than their faculty/staff counterparts. Conclusions: This paper presents findings from a significant campus-wide physical and mental health surveillance initiative. Results indicate the need for targeted physical and mental health support and intervention among these demographic groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: health education; mental health; Awareness; Faculty; Female; Health Education; Health Status; Humans; Male; Mental Health; Midwestern United States; Predictive Value of Tests; Primary Prevention; Program Evaluation; Suicide; Surveys and Questionnaires; Universities; Young Adult; College Students; Health Education; Mental Health; Health Awareness; Awareness; Physical Health

Health correlates of criminal justice involvement in 4,793 transgender veterans - Brown, George R.; Jones, Kenneth T. (LGBT Health, 2015)
Purpose: Transgender (TG) persons are overrepresented in prison settings and in the U.S. veteran population. Health disparities studies of large populations of transgender people involved with the criminal justice system have not been published to date. Methods: We studied a large cohort of TG veterans who received care in Veterans Health Administration (VHA) facilities during 2007–2013 (n = 4,793) and a 3:1 matched control group of veterans without known TG identification (n = 13,625). Three hundred twenty six (n = 138 TG, 188 non-TG) had received VHA services in programs designed to address the needs of justice involved (JI) veterans. We linked patients in each of the three groups to their medical and administrative data. Results: TG veterans were more likely to be justice involved than controls (2.88% vs. 1.38%; P < .0001). Compared to non-TG JI veterans, TG JI veterans were more likely to have a history of homelessness (80% vs. 67%; P < .05) and to have reported sexual trauma while serving in the military (23% vs. 12%; P < .01). Significant health disparities were noted for TG JI veterans for depression, hypertension, obesity, posttraumatic stress disorder, serious mental illness, and suicidal ideation/attempts. Conclusion: These data suggest that TG veterans experience a number of health risks compared to non-TG veterans, including an increased likelihood of justice involvement. TG veterans involved with the criminal justice system are a particularly vulnerable group and services designed to address the health care needs of this population, both while incarcerated and when in the community, should take these findings into account in the development of health screenings and treatment plans. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: disparity; incarceration; justice; transgender; veteran; Adult; Aged; Female; Health Status Disparities; Homeless Persons; Humans; Male; Mental Health; Middle Aged; Prisoners; Sex Offenses; Social Determinants of Health; Socioeconomic Factors; Transgender Persons; United States; Veterans; Criminal Justice; Incarceration; Military Veterans; Health Disparities; Transgender; Health; Prisons; Criminal Offenders

Sexuality education school policy for Australian GLBTIZ students - Jones, Tiffany Mary; Hillier, Lynne (Sex Education, 2012)
Education is state-run in Australia, and within each of the eight states and territories there are both government and independent schooling systems. This paper details the position of gay, lesbian, bisexual, transgender, intersex and queer (GLBTIQ) students within Australian education policy documents nationally, focusing on the three largest states and educational sectors in Australia. Survey data are used to report on the schooling experiences of over 3000 Australian GLBTIQ young people aged 14–21 years. Data from interviews with key policy informants identify both the obstacles to implementing policies, and how such obstacles have been overcome. Much official policy sees sexuality education as promoting inclusive, protective and affirming messages around GLBTIQ students. There exist significant correlations between policy and a variety of well-being and psycho-social outcomes for GLBTIQ students, including lowered incidence of homophobic abuse and suicide, and the creation of supportive school environments. Ideal policy visions are outlined, along with practical recommendations of relevance to a variety of stakeholders. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: sexuality education; school policy; school environments; Australia; GLBTIQ; gay; lesbian; bisexual; transgender; intersex; queer; Policy Making; School Environment; Sex Education; Sexuality; Intersex Conditions; Bisexuality; Hermaphroditism; Homosexuality; Lesbianism; Transgender

Health consequences of racist and antigay discrimination for multiple minority adolescents - Thoma, Brian C.; Huebner, David M. (Cultural Diversity and Ethnic Minority Psychology, 2013)
Individuals who belong to a marginalized group and who perceive discrimination based on that group membership suffer from a variety of poor health outcomes. Many people belong to more than one marginalized group, and much less is known about the influence of multiple forms of discrimination on health outcomes. Drawing on literature describing the influence of multiple stressors, three models of combined forms of discrimination are discussed: additive, prominence, and exacerbation. The current study examined the influence of multiple forms of discrimination in a sample of African American lesbian, gay, or bisexual (LGB) adolescents ages 14–19. Each of the three models of combined stressors were tested to determine which best describes how racist and antigay discrimination combine to predict depressive symptoms, suicidal ideation, and substance use. Participants were included in this analysis if they identified their ethnicity as either African American (n = 156) or African American mixed (n = 120). Mean age was 17.45 years (SD = 1.36). Results revealed both forms of mistreatment were associated with depressive symptoms and suicidal ideation among African American LGB adolescents. Racism was more strongly associated with substance use. Future intervention efforts should be targeted toward reducing discrimination and improving the social context of multiple minority adolescents, and future research with multiple minority individuals should be attuned to the multiple forms of discrimination experienced by these individuals within their environments. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: African American; adolescents; bisexual (LGB); discrimination; gay; lesbian; mental health; racism; antigay; Adolescent; Adolescent Behavior; Adult; African Americans; Bisexuality; Depression; Ethnic Groups; Female; Health Status; Homosexuality; Humans; Male; Minority Groups; Racism; Social Discrimination; Substance-Related Disorders; Suicidal Ideation; United States; Young Adult; Bisexuality; Blacks; Discrimination; Homosexuality; Mental Health; Homosexuality (Attitudes Toward); Lesbianism; Racism; Consequence

Invisible victims: Delayed onset depression among adults with same-sex parents - Sullins, D. Paul (Depression Research and Treatment, 2016)
[Expression of Concern Notice: An Expression of Concern for this article was reported in Vol 2016[4981984] of Depression Research and Treatment (see record [rid]2017-38327-001[/rid]). The article has been cited to support arguments about same-sex marriage that Hindawi believes to be hateful and wrong. In June 2016, several readers raised concerns about this article. At that time, the editors evaluated the article’s peer review process and brought several concerns to the handling editor’s attention. These included: the study’s small sample of same sex parents, the lack of discussion of other influences such as family breakup on the wellbeing of the children included in the study, the implied causation in the title 'Invisible Victims,' and the potential conflict of interest implied by the author’s position as a Catholic priest. The handling editor believed the article’s reviewers addressed these concerns, and the author made sufficient revisions to the article to address these flaws. In the editor’s opinion, the limitations of the study did not warrant further correction or retraction. Nevertheless, Hindawi felt it was important for the criticisms of this study to become part of the scientific record.] The relationship of elevated depression risk recently discovered among adult persons raised by same-sex parents with possible precipitating conditions in childhood has not previously been acknowledged. This study tests whether such inattention is supportable. Logistic regression based risk ratios were estimated from longitudinal measures of mental health outcomes observed in three waves (at ages 15, 22, and 28) of the US National Survey of Adolescent to Adult Health (n = 15,701). At age 28, the adults raised by same-sex parents were at over twice the risk of depression (CES-D: risk ratio 2.6, 95% CI 1.4–4.6) as persons raised by man-woman parents. These findings should be interpreted with caution. Elevated risk was associated with imbalanced parental closeness and parental child abuse in family of origin; depression, suicidality, and anxiety at age 15; and stigma and obesity. More research and policy attention to potentially problematic conditions for children with same-sex parents appears warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: onset; depression; same-sex parents; Homosexual Parents; Major Depression; Onset (Disorders)

Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients - Kitts, Robert Li (Journal of Homosexuality, 2010)
The objective of this article was to identify barriers to optimal care between physicians and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) adolescents. To this end, 464 anonymous, self-administered surveys were distributed in 2003 to residents and attending physicians in pediatrics, internal medicine, obstetrics-gynecology, psychiatry, emergency medicine, and family practice at Upstate Medical University. The survey included questions pertaining to practice, knowledge, and attitude pertaining to lesbian, gay, transgender, or questioning (LGBTQ) adolescents. One hundred eight four surveys were returned. The majority of physicians would not regularly discuss sexual orientation, sexual attraction, or gender identity while taking a sexual history from a sexually active adolescent. As well, the majority of physicians would not ask patients about sexual orientation if an adolescent presented with depression, suicidal thoughts, or had attempted suicide. If an adolescent stated that he or she was not sexually active, 41% of physicians reported that they would not ask additional sexual health-related questions. Only 57% agreed to an association between being a LGBTQ adolescent and suicide. The majority of physicians did not believe that they had all the skills they needed to address issues of sexual orientation with adolescents, and that sexual orientation should be addressed more often with these patients and in the course of training. This study concludes that barriers in providing optimal care for LGBTQ adolescents can be found with regard to practice, knowledge, and attitude regardless of medical field and other demographics collected. Opportunities exist to enhance care for LGBTQ adolescents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: optimal care; physicians; lesbians; gays; bisexuals; transgender; adolescent patients; knowledge; attitudes; teenage patients; Adolescent; Bisexuality; Data Collection; Female; Health Knowledge, Attitudes, Practice; Homosexuality, Female; Homosexuality, Male; Humans; Male; Medical History Taking; Medicine; Physician-Patient Relations; Transsexualism; Health Personnel Attitudes; Knowledge Level; Physicians; Treatment Barriers; Bisexuality; Lesbianism; Male Homosexuality; Patients; Transgender

Operational definitions of sexual orientation and estimates of adolescent health risk behaviors - Matthews, Derrick D.; Blosnich, John R.; Farmer, Grant W.; Adams, Brian J. (LGBT Health, 2014)
Purpose: Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. Methods: Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. Results: Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as 'not sure' also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors. Conclusion: Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: adolescents; data analysis; health behavior; measurement; sexual orientation; Bisexuality; Health Behavior; Lesbianism; Risk Taking; Health Disparities; Adolescent Health; Health Risk Behavior

Gays in the gang - Totten, Mark (Journal of Gang Research, 2012)
This paper reports on the experiences of fifteen gay, bisexual, and transexual (GBT) youth gang members who engaged in serious street violence. These acts often endangered the lives of others. It is based upon an ethnographic study of how youth gang members aged fourteen - twenty years accounted for their physical, sexual and emotional violence against heterosexual peers, strangers, sexual minorities, and racial minorities. In-depth interviews and participant observation methods were used. A main objective was to understand GBT gang members' use of violence in a heterosexual gang context, from their perspective. There is no existing literature on this topic. The pressure to conform to heterosexism and homophobia, along with repressed homosexuality, are key to understanding the motives behind violence used by gay, bisexual and transsexual youth. The experiences of gay and bisexual young men in homophobic environments likely take on significantly different meanings than those of girls who identified as bisexual in correctional settings. Their gangs were not monolithic. Gender role construction was an ongoing process for these youth, negotiated and developed with limited resources at hand. Their life courses were all very different. Some said that they chose a pathway out of traditional gender roles to separate themselves from the violence of their caregivers. Other participants reported that they always knew that they were gay. Finally, some disclosed that they became aware of their identities in early adolescence. Rejected by their families in large part due to their sexual orientation or gender identity, they turned to street families and gangs for a sense of belonging and support. However, most indicated that if other heterosexual gang members discovered their sexual orientation or gender identity, they would have been severely beaten or killed. None were part of gangs where other members identified as GBT. All participated in severe, public beatings of individuals the gangs considered to be gay or sexually abnormal. These GBT youth resorted to constructing hyper masculine or violent feminine identities to protect their safety. Sadly, these youth are among the highest risk of all young people to experience suicide attempts and self-harm, to live on the street, abuse substances, and to have serious conflicts with their families - this was true for many of the young people in this study. Research, policy and clinical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: adolescent gang violence; bisexual young men; gender role construction; ethnographic study; gangs; heterosexual gang members; heterosexual peers; homophobic environments; GBT; gay; bisexual; transsexual; gang behavior; sexual identity; gender identity; psychosocial development; Bisexuality; Homosexuality (Attitudes Toward); Juvenile Gangs; Psychosexual Behavior; Violence; Communities; Gender Identity; Lesbianism; Male Homosexuality; Sexual Development

Mortality risks among persons reporting same-sex sexual partners: Evidence from the 2008 General Social Survey—National Death Index Data Set - Cochran, Susan D.; Mays, Vickie M. (American Journal of Public Health, 2015)
Objectives: We investigated the possibility that men who have sex with men (MSM) and women who have sex with women (WSW) may be at higher risk for early mortality associated with suicide and other sexual orientation–associated health risks. Methods: We used data from the 1988–2002 General Social Surveys, with respondents followed up for mortality status as of December 31, 2008. The surveys included 17 886 persons aged 18 years or older, who reported at least 1 lifetime sexual partner. Of these, 853 reported any same-sex partners; 17 033 reported only different-sex partners. Using gender-stratified analyses, we compared these 2 groups for all-cause mortality and HIV-, suicide-, and breast cancer–related mortality. Results: The WSW evidenced greater risk for suicide mortality than presumptively heterosexual women, but there was no evidence of similar sexual orientation–associated risk among men. All-cause mortality did not appear to differ by sexual orientation among either women or men. HIV-related deaths were not elevated among MSM or breast cancer deaths among WSW. Conclusions: The elevated suicide mortality risk observed among WSW partially confirms public health concerns that sexual minorities experience greater burden from suicide-related mortality. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: suicide mortality; same-sex sexual partners; associated health risks; Adult; Female; Health Status; Homosexuality, Male; Humans; Male; Middle Aged; Mortality; Risk Factors; Socioeconomic Factors; Suicide; Surveys and Questionnaires; United States; Death and Dying; Suicide; Sexual Partners; Health Risk Behavior; Mortality Rate; Risk Factors; Same Sex Intercourse; Data Sets

Conditions of living: Queer youth suicide, homonormative tolerance, and relative misery - Cover, Rob (Journal of LGBT Youth, 2013)
Despite the increasing social tolerance accorded nonheterosexual persons in many Western countries, queer youth suicide rates remain high. This opens the need to question not only how broad social conditions continue to make lives unlivable for many queer youth but whether queer community formations and representations that emerge within a tolerance framework provide supportive environments for fostering youth resilience. This article presents a theoretical approach to understanding the continuity of youth suicide by considering how queer community formations built on tolerance create new exclusions for some queer youth that can make a life unlivable in relation to peers. The article articulates the tolerance framework through a return to Dennis Altman’s 40-year-old Homosexual Oppression and Liberation and the more recent 'homonormativity' critique of queer politics. It examines how tolerance and homonormativity are implicated in exclusions and suicidality through the 'relative misery' suicide thesis and the concept of frustrated aspiration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: living conditions; queer youth suicide; homonormative tolerance; relative misery; social issues; Homosexuality; Lifestyle; Social Issues; Suicide; Tolerance

A comparison of lesbian, bisexual, and heterosexual college undergraduate women on selected mental health issues - Kerr, Dianne L.; Santurri, Laura; Peters, Patricia (Journal of American College Health, 2013)
Objective: To investigate selected mental health characteristics of lesbians and bisexual undergraduate college women as compared with heterosexual college women. Participants: Self-identified lesbians and bisexual and heterosexual female college students who took part in the American College Health Association National College Health Assessment II (ACHA-NCHA-II) in Fall 2008, Spring 2009, and Fall 2009. Methods: A secondary analysis of the ACHA-NCHA-II data set for 3 semesters was conducted. Comparisons of lesbians and bisexual and heterosexual female college students were made. Results: Bisexual women reported the worst mental health status in all areas studied including anxiety, anger, depressive symptoms, self-injury, and suicidal ideation and attempts. Both bisexual women and lesbians had a far greater likelihood of having these mental health issues when compared with heterosexual women. Lesbians and bisexual women utilized significantly more mental health services (with the exception of clergy) than heterosexual women. Conclusions: College health professionals should recognize and address the mental health needs of bisexual and lesbian undergraduate college women. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: lesbians; bisexuality; heterosexuality; college undergraduate women; mental health issues; health promotion; Adolescent; Adult; Anger; Anxiety; Bisexuality; Continental Population Groups; Depression; Female; Heterosexuality; Homosexuality, Female; Humans; Mental Health; Self-Injurious Behavior; Socioeconomic Factors; Students; Suicidal Ideation; Universities; Young Adult; College Students; Health Promotion; Lesbianism; Mental Health; Bisexuality; Heterosexuality; Human Females

'A hope to lift both my spirits': Preventing bisexual erasure in aboriginal schools - Robinson, Margaret (Journal of Bisexuality, 2014)
Education is a treaty right for Aboriginal people in Canada and the United States, and Aboriginal schools aim to provide a comprehensive education rooted in indigenous knowledge and culture. In an Aboriginal context, antibullying programs may address microaggressions against lesbian, gay, bisexual, trans, queer, and two-spirited youth. Two-spirited identity offers a model of sexuality that may reduce youth suicide by providing a sense of cultural belonging and purpose for sexual and gender minority Aboriginal people. Yet even as it offers social support, the two-spirited identity model risks replicating the dichotomous constructions of sexuality that form the basis of bisexual erasure. This article discusses strategies for preventing such erasure within Aboriginal schools. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: bisexual erasure prevention; Aboriginal schools; sexuality models; social support; risk factors; sex education; Bisexuality; Indigenous Populations; Sex Education; Models; Prevention; Risk Factors; Social Support

Constructing the Suicide Risk Index (SRI): Does it work in predicting suicidal behavior in young adults mediated by proximal factors? - O'Connor, Maebh; Dooley, Barbara; Fitzgerald, Amanda (Archives of Suicide Research, 2015)
Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17–25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p < .001), and a mediated effect (ß = .204, 95% CI = [.186, .222], p < .001), between the risk index and suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mediation; psychosocial factors; risk index; self-harm; suicide; Adaptation, Psychological; Adolescent; Adult; Bisexuality; Bullying; Depression; Divorce; Emotions; Female; Homosexuality; Humans; Male; Parents; Prevalence; Risk Assessment; Risk Factors; Self Concept; Self-Injurious Behavior; Sex Factors; Substance-Related Disorders; Suicidal Ideation; Suicide; Suicide, Attempted; Young Adult; Psychosocial Factors; Suicide; Test Construction; Coping Behavior; Emotional States; Mediation; Rating Scales; Risk Factors; Self-Injurious Behavior

Suicidal ideation among sexual minority veterans: Results from the 2005–2010 Massachusetts Behavioral Risk Factor Surveillance Survey - Blosnich, John R.; Bossarte, Robert M.; Silenzio, Vincent M. B. (American Journal of Public Health, 2012)
Suicide is a public health problem disproportionately associated with some demographic characteristics (e.g., sexual orientation, veteran status). Analyses of the Massachusetts Behavioral Risk Factor Surveillance Survey data revealed that more lesbian, gay, and bisexual (i.e., sexual minority) veterans reported suicidal ideation compared with heterosexual veterans. Decreased social and emotional support contributed to explaining the association between sexual minority status and suicidal ideation. More research is needed about suicide risk among sexual minority veterans; they might be a population for outreach and intervention by the Veterans Health Administration. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidal ideation; sexual minorities; military veterans; suicide; sexual orientation; demographic characteristics; lesbians; gay males; bisexual individuals; risk factors; Adolescent; Adult; Bisexuality; Chi-Square Distribution; Female; Homosexuality; Humans; Logistic Models; Male; Massachusetts; Middle Aged; Population Surveillance; Risk Factors; Suicidal Ideation; Surveys and Questionnaires; Veterans; Military Veterans; Risk Factors; Sexual Orientation; Suicidal Ideation; Suicide; Bisexuality; Demographic Characteristics; Lesbianism; Male Homosexuality; Sexual Minority Groups

A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people - King, Michael; Semlyen, Joanna; Tai, Sharon See; Killaspy, Helen; Osborn, David; Popelyuk, Dmitri; Nazareth, Irwin (BMC Psychiatry, 2008)
Background: Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people. Method: We conducted a systematic review and meta-analysis of the prevalence of mental disorder, substance misuse, suicide, suicidal ideation and deliberate self harm in LGB people. We searched Medline, Embase, PsycInfo, Cinahl, the Cochrane Library Database, the Web of Knowledge, the Applied Social Sciences Index and Abstracts, the International Bibliography of the Social Sciences, Sociological Abstracts, the Campbell Collaboration and grey literature databases for articles published January 1966 to April 2005. We also used Google and Google Scholar and contacted authors where necessary. We searched all terms related to homosexual, lesbian and bisexual people and all terms related to mental disorders, suicide, and deliberate self harm. We included papers on population based studies which contained concurrent heterosexual comparison groups and valid definition of sexual orientation and mental health outcomes Results: Of 13,706 papers identified, 476 were initially selected and 28 (25 studies) met inclusion criteria. Only one study met all our four quality criteria and seven met three of these criteria. Data was extracted on 214,344 heterosexual and 11,971 non heterosexual people. Meta-analyses revealed a two fold excess in suicide attempts in lesbian, gay and bisexual people [pooled risk ratio for lifetime risk 2.47 (CI 1.87, 3.28)]. The risk for depression and anxiety disorders (over a period of 12 months or a lifetime) on meta-analyses were at least 1.5 times higher in lesbian, gay and bisexual people (RR range 1.54-2.58) and alcohol and other substance dependence over 12 months was also 1.5 times higher (RR range 1.51-4.00). Results were similar in both sexes but meta analyses revealed that lesbian and bisexual women were particularly at risk of substance dependence (alcohol 12 months: RR 4.00, CI 2.85, 5.61; drug dependence: RR 3.50, CI 1.87, 6.53; any substance use disorder RR 3.42, CI 1.97-5.92), while lifetime prevalence of suicide attempt was especially high in gay and bisexual men (RR 4.28, CI 2.32, 7.88). Conclusions: LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental disorder; suicide; deliberate self harm; lesbians; gays; bisexuals; transsexuals; prevalence; heterosexuals; substance misuse; suicidal ideation; Bisexuality; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Disorders; Self-Injurious Behavior; Suicide; Bisexuality; Lesbianism; Male Homosexuality; Mental Disorders; Drug Abuse; Epidemiology; Self-Destructive Behavior; Suicidal Ideation; Suicide

Ptsd and trauma‐related difficulties in sexual minority women: The impact of perceived social support - Weiss, Brandon J.; Garvert, Donn W.; Cloitre, Marylène (Journal of Traumatic Stress, 2015)
This study examined posttraumatic stress disorder (PTSD) and related symptoms among sexual minority (SM) and heterosexual women and the influence of social support on the relationship between SM status and symptoms. We hypothesized that SM women would endorse higher symptoms of PTSD and related difficulties and that social support would moderate the relationship between SM status and symptoms. The sample, women seeking treatment for PTSD related to interpersonal violence (n = 477; mean age = 36.07 years; 22.9% SM) completed clinician‐administered measures of PTSD and self‐report measures of trauma‐related difficulties and social support. The rate of PTSD diagnosis was higher for SM women. Social support and SM status were significantly associated with suicidality, self‐perceptions, depression, somatic complaints, and functional impairment. The interaction between social support and SM status was significant for both functional impairment (β = −.26) and somatic complaints (β = −.39). High social support had an equal, positive effect among SM and nonminority women, whereas low social support had a greater negative impact among SM women. Results suggested the particular salience of social support on functioning and symptom severity among SM women and the potential importance of including interventions addressing social support into PTSD treatments for SM women. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: social support; sexual minority women; posttraumatic stress disorder; treatment seeking; Adult; Adult Survivors of Child Adverse Events; Crime Victims; Exposure to Violence; Female; Homophobia; Homosexuality, Female; Humans; Minority Groups; New York City; Sex Offenses; Social Support; Stress Disorders, Post-Traumatic; Minority Groups; Posttraumatic Stress Disorder; Sexual Orientation; Social Support; Sexual Minority Groups; Health Care Seeking Behavior; Human Females

Gender dysphoria in adults - Zucker, Kenneth J.; Lawrence, Anne A.; Kreukels, Baudewijntje P. C. (Annual Review of Clinical Psychology, 2016)
Gender dysphoria (GD), a term that denotes persistent discomfort with one’s biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gender dysphoria; gender identity disorder; transsexualism; causal mechanisms; treatment; Human Sex Differences; Major Depression; Gender Dysphoria; Health Care Services; Transsexualism; Treatment

It's not all darkness: Robustness, resilience, and successful transgender aging - Witten, Tarynn M. (LGBT Health, 2014)
We review the recent psychosocial literature on transgender aging. We also report relevant in-press results from the Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (TMLS) on end-of-life and later-life trans-aging. To obtain relevant literature, we employed the search engines Google Scholar, Stanford Highwire, and PubMed/Medline. Databases searched included Web of Science, Cinhal, PsyINFO, Gender Studies Database, Sociological Abstracts, and Social Services Abstracts. Keyword searches included 'transgender' and 'transsexual.' Key phrases included 'transgender aging,' 'transsexual aging,' and 'LGBT aging.' Years searched were from January 1, 2011, through April 26, 2013. We found two types of articles: LGBT aging-related (or lumped aging) articles and articles that focused specifically on transgender aging, or trans-aging. We found that the articles spoke of concerns and fears regarding discrimination, potential abuse at the hands of caregivers, inability to live out their lives in their true identities, risk of becoming homeless, loss of independence, and dementia, among other concerns. We note that the elder trans-identified population is significantly ill-prepared for the major legal issues that arise and events that occur in the later-life to end-of-life time periods. Despite these difficulties, a few articles spoke of resilience and successful aging in the population. Some TMLS respondents indicated that they were considering either 'detransitioning,' that is, changing social presentation to the pretransition gender identity, or suicide (which some referred to as euthanasia) as means of managing the severe problems they expected to encounter later in the aging process. A number of potentially modifiable risk factors exist within this population. Modification strategies include increasing the population awareness of the need for end-of-life legal preparations for members of the trans-identified community as well as those who serve it. There is a continued need to reduce stigma and to include gender identity/gender presentation in nondiscrimination and hate crime statutes. Despite these difficulties, there is a resilience and robustness that can be found in many individuals within the community of transgender older adults. There is a need to investigate this further. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: aging; chronic illness; cross-dresser; disability; eldercare; end of life; gender; gender identity; gender self-perception; hospice; later life; LGBT; palliative care; queer; sex; sexuality; transgender; transsexual; Aging; Resilience (Psychological); Risk Factors; Transgender; Hate Crimes

HIV risk, substance use, and suicidal behaviors among Asian American lesbian and bisexual women - Lee, Jieha; Hahm, Hyeouk Chris (AIDS Education and Prevention, 2012)
The authors examined the association between lesbian/bisexual identity and three risky health behaviors (HIV risk, substance use, and suicidal behaviors) in a sample of Asian American women. This cross-sectional study was designed to investigate the prevalence of HIV risk behaviors and mental health functioning among unmarried Chinese, Korean, and Vietnamese women ages 18 to 35 who are children of immigrants (N = 701), using computer-assisted survey interviews (CASI). Approximately one out of five Asian American women in the sample identified themselves as a lesbian and bisexual woman (18%). Overall, Asian American lesbian and bisexual women reported higher proportions of risky health behaviors than did their exclusively heterosexual counterparts. The odds of engaging in HIV risk behaviors, using substances, and experiencing suicidal ideation were two to three times higher for lesbian and bisexual women than for exclusively heterosexual women. These findings suggest that rigorous screening is necessary for identifying women in this lesbian/bisexual subgroup in order to provide them with better assessment and services. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: HIV risks; substance use; suicidal behaviors; lesbians; bisexual; Asian American; women; Adult; Asian Americans; Bisexuality; China; Cross-Sectional Studies; Female; HIV Infections; Health Behavior; Homosexuality, Female; Humans; Interviews as Topic; Korea; Male; Massachusetts; Mental Health; Middle Aged; Prevalence; Risk Factors; Risk-Taking; Sexual Partners; Socioeconomic Factors; Substance-Related Disorders; Suicide; Vietnam; Young Adult; Asians; Attempted Suicide; Bisexuality; Lesbianism; Risk Factors; Drug Abuse; HIV; Human Females

Improving the lives of students, gay and straight alike: Gay‐Straight Alliances and the role of school psychologists - Murphy, Heather Elise (Psychology in the Schools, 2012)
Lesbian, gay, bisexual, and transgender (LGBT) students face many risk factors every day when they enter their school's door. These students often fear for their safety at school, are victimized, have academic difficulties, suffer from issues with their identity development, and are at risk for suicide. School‐based Gay‐Straight Alliances (GSAs) have been shown to reduce the risk for LGBT students in these areas. School psychologists are in a unique position to be instrumental in alleviating many of the problems LGBT students face every day by being a GSA advisor. This article reviews the literature on LGBT student risk in terms of the benefits of a GSA and guides school psychologists on how to start and advise a GSA in their schools. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: lesbian & gay & bisexual & transgender students; school-based gay‐straight alliances; school psychologists; role; Group Dynamics; Heterosexuality; High School Students; Homosexuality; School Psychologists; Bisexuality; Lesbianism; Roles; Transgender

Centering transgender voices in research as a fundamental strategy toward expansion of access to care and social support - Thompson, Hale M.; Karnik, Niranjan S.; Garofalo, Robert (Journal of Adolescent Health, 2016)
Comments on an article by Gridley et al. (see record [rid]2016-26042-001[/rid]). In their paper, Gridley et al. made a timely contribution to the literature with an analysis of barriers to care for trans and gender nonconforming youth in the Seattle, Washington area. Importantly, the authors centered the voices of patients and caregivers and identify some salient themes from a series of interviews, focus groups, and an online survey. The authors also presented numerous quotes from caregivers and patients that cumulatively reflect a deep anxiety around a troubling combination of a lack of knowledge, care coordination, and support emanating from their providers and insurance carriers. Of note, Gridley et al. repeatedly quoted participants who correlated the high risk for trans youth suicide in general with physicians, such as theirs, who deny youth access to hormones or hormone blockers rather than the associations established in recent analyses with a lack of familial and social supports. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Transgender; Gender dysphoria; Gender incongruence; Adolescents; Qualitative study; Puberty suppression; Cross-sex hormones; Preferred name; Barriers; Multidisciplinary gender clinic; Caregivers; Treatment Barriers; Transgender; Pediatrics

Cyberbullying and LGBTQ youth: A deadly combination - Wiederhold, Brenda K. (Cyberpsychology, Behavior, and Social Networking, 2014)
This editorial discusses the deadly combination of cyberbullying and LGBTQ youth. Several studies agree that cyberbullying is more common in youth who do not identify as heterosexual, and it results in serious mental health consequences. Regardless of sexual orientation, youth who experienced only cyberbullying were at higher risk of depressive symptoms, suicidal ideation, self-injury, and suicide attempt compared with those who had only experienced school-based bullying, with LGBT youth at a significantly higher risk for these outcomes. To counter the disturbing trends, a variety of organizations are dedicated to improving life for LGBTQ teens. The Trevor Project has been providing crisis intervention and suicide prevention services to LGBTQ teens and young adults since 1998. The Cyberbullying Research Center offers a fact sheet that includes what the law says about protection from sex discrimination and gender-based harassment, and suggests establishment of a school-based Gay-Straight Alliance. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: mental health consequences; suicide prevention services; suicidal ideation; sexual orientation; Adolescent; Bisexuality; Bullying; Crime Victims; Crisis Intervention; Cross-Sectional Studies; Female; Gender Identity; Homosexuality, Female; Homosexuality, Male; Humans; Male; Psychology, Adolescent; Suicide; Transgender Persons; United States; Prevention; School Based Intervention; Sexual Orientation; Victimization; Cyberbullying; Bisexuality; Homosexuality; Lesbianism; Mental Health; School Psychology; Transgender; Consequence; LGBTQ

Sexual violence among youth in New Mexico: Risk and resiliency factors that impact behavioral health outcomes - Reed, Danielle; Reno, Jessica; Green, Dan (Family & Community Health: The Journal of Health Promotion & Maintenance, 2016)
Research has consistently demonstrated a relationship between history of forced sex and poor behavioral health outcomes. The objectives of this study were to describe this relationship among high school students and to explore the impact of resiliency factors. Using data from the 2013 New Mexico Youth Risk and Resiliency Survey, we found that history of forced sex was associated with negative behavioral health outcomes for males and females, regardless of sexual orientation and disability status. Furthermore, the presence of a caring adult at home appeared to reduce the risk of substance abuse and suicidality among students with and without a history of forced sex. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: adolescents; mental health; resiliency; sexual violence; substance use; Adolescent; Adolescent Behavior; Adult; Family; Female; Humans; Male; Mental Health; New Mexico; Risk-Taking; Sex Factors; Sex Offenses; Sexual Behavior; Social Support; Students; Substance-Related Disorders; Suicide; Surveys and Questionnaires; Mental Health; Resilience (Psychological); Risk Factors; Sex Offenses; Violence; High School Students; Health Outcomes

The social environment and suicide attempts in lesbian, gay, and bisexual youth - Hatzenbuehler, Mark L. (Pediatrics, 2011)
Objective: To determine whether the social environment surrounding lesbian, gay, and bisexual youth may contribute to their higher rates of suicide attempts, controlling for individual-level risk factors. Methods: A total of 31 852 11th grade students (1413 [4.4%] lesbian, gay, and bisexual individuals) in Oregon completed the Oregon Healthy Teens survey in 2006–2008. We created a composite index of the social environment in 34 counties, including (1) the proportion of same-sex couples, (2) the proportion of registered Democrats, (3) the presence of gay-straight alliances in schools, and (4) school policies (nondiscrimination and antibullying) that specifically protected lesbian, gay, and bisexual students. Results: Lesbian, gay, and bisexual youth were significantly more likely to attempt suicide in the previous 12 months, compared with heterosexuals (21.5% vs 4.2%). Among lesbian, gay, and bisexual youth, the risk of attempting suicide was 20% greater in unsupportive environments compared to supportive environments. A more supportive social environment was significantly associated with fewer suicide attempts, controlling for sociodemographic variables and multiple risk factors for suicide attempts, including depressive symptoms, binge drinking, peer victimization, and physical abuse by an adult (odds ratio: 0.97 [95% confidence interval: 0.96–0.99]). Conclusions: This study documents an association between an objective measure of the social environment and suicide attempts among lesbian, gay, and bisexual youth. The social environment appears to confer risk for suicide attempts over and above individual-level risk factors. These results have important implications for the development of policies and interventions to reduce sexual orientation–related disparities in suicide attempts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: social environments; suicide attempts; lesbians; gays; bisexual youth; risk factors; Adolescent; Bisexuality; Confidence Intervals; Female; Health Status Disparities; Health Surveys; Heterosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Incidence; Male; Reference Values; Retrospective Studies; Risk Assessment; Sexual Behavior; Social Environment; Suicide, Attempted; United States; Attempted Suicide; Bisexuality; Lesbianism; Male Homosexuality; Social Environments; Risk Factors

The impact of a depression awareness campaign on mental health literacy and mental morbidity among gay men - Wang, Jen; Häusermann, Michael; Berrut, Sylvie; Weiss, Mitchell G. (Journal of Affective Disorders, 2013)
Background: High prevalences of depression and suicidality have been found among gay men. This paper assesses the possible impact of Blues-out, a depression awareness campaign based on the European Alliance Against Depression targeting the gay/lesbian community in Geneva, Switzerland. Methods: In 2007 and 2011, pre- and post-intervention surveys were conducted among two distinct samples of gay men in Geneva, recruited by probability-based time–space sampling. Effect sizes and net percent changes are reported for mental health literacy and mental health outcomes in 2007 and 2011 as well as among men aware and unaware of Blues-out in 2011. Results: 43% of the respondents correctly recognized depression in 2011 with no change vis-à-vis 2007. Despite small effect sizes, significant net decreases (from −18% to −28%) were seen in lifetime suicide plans, 12-month suicidal ideation, lifetime depression, and 4-week psychological distress between 2007 and 2011. These decreases were not accompanied by changes in any of the numerous items on attitudes/knowledge, found only when comparing men aware and unaware of Blues-out in 2011. More men aware of Blues-out found specialists and psychological therapies helpful than their counterparts and correctly identified depression and gay men's greater risk for depression. Limitations: Community-level assessment with no control. Conclusions: Although improvement in depression recognition and decrease in suicide attempts could not be replicated unequivocally in this adapted intervention among gay men, there are indications that this evidence-based depression awareness campaign may have lessened suicidality and mental morbidity and improved mental health literacy and help-seeking. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: depression; awareness campaigns; mental health literacy; mental morbidity; gay men; interventions; Adult; Data Collection; Depression; Depressive Disorder; Health Literacy; Health Promotion; Homosexuality, Male; Humans; Male; Mental Health; Middle Aged; Patient Education as Topic; Prevalence; Suicidal Ideation; Suicide; Suicide, Attempted; Switzerland; Young Adult; Health Promotion; Major Depression; Male Homosexuality; Mental Health; Health Literacy; Awareness; Intervention; Morbidity; Mental Health Literacy

Suicidal disclosures among friends: Using social network data to understand suicide contagion - Mueller, Anna S.; Abrutyn, Seth (Journal of Health and Social Behavior, 2015)
A robust literature suggests that suicide is socially contagious; however, we know little about how and why suicide spreads. Using network data from the National Longitudinal Study of Adolescent to Adult Health, we examine the effects of alter’s (1) disclosed and (2) undisclosed suicide attempts, (3) suicide ideation, and (4) emotional distress on ego’s mental health one year later to gain insights into the emotional and cultural mechanisms that underlie suicide contagion. We find that when egos know about alter’s suicide attempt, they report significantly higher levels of emotional distress and are more likely to report suicidality, net of extensive controls; however, alter’s undisclosed suicide attempts and ideation have no significant effect on ego’s mental health. Finally, we find evidence that emotional distress is contagious in adolescence, though it does not seem to promote suicidality. We discuss the implications of our findings for suicide contagion specifically and sociology more generally. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: adolescence; emotional contagion; gender; mental health; social networks; suicide contagion; Attempted Suicide; Distress; Self-Disclosure; Social Networks; Suicidal Ideation; Contagion; Mental Health

Family rejection, social isolation, and loneliness as predictors of negative health outcomes (depression, suicidal ideation, and sexual risk behavior) among Thai male-to-female transgender adolescents - Yadegarfard, Mohammadrasool; Meinhold-Bergmann, Mallika E.; Ho, Robert (Journal of LGBT Youth, 2014)
This study examined the influence of family rejection, social isolation, and loneliness on negative health outcomes among Thai male-to-female transgender adolescents. The sample consisted of 260 male respondents, of whom 129 (49.6%) were self-identified as transgender and 131 (50.4%) were self-identified as cisgender (nontransgender). Initial multivariate analysis of variance indicated that the transgender respondents, when compared to the cisgender respondents, reported significantly higher family rejection, lower social support, higher loneliness, higher depression, lower protective factors (PANSI-positive) and higher negative risk factors (PANSI-negative) related to suicidal behavior, and were less certain in avoiding sexual risk behaviors. Multiple regression analysis indicated that the exogenous variables of family rejection, social isolation, and loneliness were significant predictors of both transgender and cisgender adolescents’ reported levels of depression, suicidal thinking, and sexual risk behaviors. The implications of these findings are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Adolescents; depression; family rejection; loneliness; sexual risk behavior; social isolation; suicidal ideation; transgender; Loneliness; Sexual Risk Taking; Social Isolation; Suicidal Ideation; Transgender; Depression (Emotion); Risk Factors; Health Outcomes

Adolescent gender-related abuse, androphilia, and HIV risk among transfeminine people of color in New York City - Hwahng, Sel J.; Nuttbrock, Larry (Journal of Homosexuality, 2014)
Public health research has indicated extremely high HIV seroprevalence (13%–63%) among low-income transfeminine people of color of African, Latina, and Asian descent living in the U.S. This article combines two data sets. One set is based on an ethnographic study (N = 50, 120 hours of participant observation). The other set is based on a longitudinal quantitative study (baseline N = 600, N = 275 followed for 3 years). Transfeminine people of color are much more likely to be androphilic and at high HIV risk. A greater understanding of adolescent gender-related abuse and trauma-impacted androphilia contributes toward a holistic conceptual model of HIV risk. A theoretical model is proposed that incorporates findings from both studies and integrates sociostructural, interpersonal, and intrapsychic levels of HIV risk. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: adolescent gender-related abuse; androphilia; HIV risk; transfeminine people; people of color; Adolescent; Adult; Age Factors; Child Abuse; Continental Population Groups; Depressive Disorder, Major; Female; Gender Identity; HIV Infections; Humans; Male; Middle Aged; New York City; Prevalence; Risk Factors; Sex Factors; Sexual Behavior; Suicidal Ideation; Transgender Persons; Young Adult; HIV; Minority Groups; Sexual Abuse; Sexual Orientation; Transgender; Adolescent Development; Risk Factors

Juvenile sexual homicide offenders: Thirty-year follow-up investigation - Khachatryan, Norair; Heide, Kathleen M.; Hummel, Erich V.; Chan, Heng Choon (Oliver) (International Journal of Offender Therapy and Comparative Criminology, 2016)
Sexual homicide by a juvenile offender occurs approximately 9 times per year in the United States. Little is known about the post-incarceration adjustment of these offenders. The current study was designed to follow up 30 years later on a sample of eight adolescent sexual homicide offenders who were convicted of murder and sentenced to adult prison. The results indicated that six out of eight offenders were released from prison, and their mean sentence length was 12 years and 2 months. Four offenders out of the six released were rearrested, but none of the arrests were for homicide, sexual or otherwise. The post-incarceration arrests were for violent, drug-related, and property crimes, as well as possession of a firearm. Three out of the four recidivists have been recommitted to prison. Implications concerning the comparability of results to past research, time served in prison, and types of post-release offenses are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: recidivism; sexual murder; sex offenders; juvenile homicide offenders; gay male sexual murder; Homicide; Incarceration; Recidivism; Sex Offenses; Criminal Offenders; Juvenile Delinquency

Inequities in educational and psychological outcomes between LGBTQ and straight students in middle and high school - Robinson, Joseph P.; Espelage, Dorothy L. (Educational Researcher, 2011)
This study finds that, compared with straight-identified youth, youth who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) are at greater risk of suicidal thoughts, suicide attempts, victimization by peers, and elevated levels of unexcused absences from school. Results disaggregated by LGBTQ subgroups reveal heterogeneity within the broad LGBTQ group, with bisexual youth appearing to be particularly at risk. Also, although the risk gaps in school belongingness and unexcused absences are significant in high school, we find that these gaps are significantly greater in middle school, suggesting heightened early risk for LGBTQ-identified students. By raising awareness of educational inequities related to LGBTQ identification, this study lays the descriptive groundwork for interventions aimed at improving psychological and educational outcomes for these students. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: educational inequality; psychological outcomes; straight students; middle schools; high schools; lesbianism; gays; bisexuality; transgender; victimization; suicide; Bisexuality; Equal Education; Homosexuality; Psychodynamics; Suicide; High Schools; Victimization; Transgender; LGBTQ

Using a two-step method to measure transgender identity in Latin America/the Caribbean, Portugal, and Spain - Reisner, Sari L.; Biello, Katie; Rosenberger, Joshua G.; Austin, S. Bryn; Haneuse, Sebastien; Perez-Brumer, Amaya; Novak, David S.; Mimiaga, Matthew J. (Archives of Sexual Behavior, 2014)
Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000) of a sexual networking website targeting men who have sex with men in Spanish- and Portuguese-speaking countries/territories in Latin America/the Caribbean, Portugal, and Spain. Natal sex/gender identity status was assessed using a two-step method (Step 1: assigned birth sex, Step 2: current gender identity). Male-to-female (MTF) and female-to-male (FTM) participants were compared to non-transgender males in age-adjusted regression models on socioeconomic status (SES) (education, income, sex work), masculine gender conformity, psychological health and well-being (lifetime suicidality, past-week depressive distress, positive self-worth, general self-rated health, gender related stressors), and sexual health (HIV-infection, past-year STIs, past-3 month unprotected anal or vaginal sex). The two-step method identified 190 transgender participants (0.54 %; 158 MTF, 32 FTM). Of the 12 health-related variables, six showed significant differences between the three groups: SES, masculine gender conformity, lifetime suicidality, depressive distress, positive self-worth, and past-year genital herpes. A two-step approach is recommended for health surveillance efforts to assess natal sex/gender identity status. Cognitive testing to formally validate assigned birth sex and current gender identity survey items in Spanish and Portuguese is encouraged. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Transgender; Gender identity; HIV; Health; Surveillance; Adolescent; Adult; Caribbean Region; Cross-Cultural Comparison; Cross-Sectional Studies; Female; Gender Identity; HIV Infections; Health Status Indicators; Humans; Latin America; Male; Middle Aged; Population Surveillance; Portugal; Regression Analysis; Reproductive Health; Risk-Taking; Sexual Behavior; Socioeconomic Factors; Spain; Suicide; Transgender Persons; Transsexualism; Young Adult; Gender Identity; Transgender; Health; Human Sex Differences; Self-Concept

Toward developing clinical competence: Improving health care of gender diverse people - Dickey, Lore M. (American Journal of Public Health, 2017)
Research has consistently shown that gender diverse people are at elevated risk for multiple adverse health conditions and other clinical concerns. This includes substance abuse, HIV, non-suicidal self-injury, and suicidal ideation and attempts. These risks are exacerbated by the lack of properly trained providers to address clinical concerns. This paper discusses improving health care of gender diverse people. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: clinical competence; at risk populations; adverse health conditions; gender diversity; transgender; At Risk Populations; Gender Identity; Health Care Services; Professional Competence; Transgender

How gay–straight alliance groups mitigate the relationship between gay-bias victimization and adolescent suicide attempts - Davis, Brennan; Royne Stafford, Marla B.; Pullig, Chris (Journal of the American Academy of Child & Adolescent Psychiatry, 2014)
Objective: We examined the relationships between victimization from being bullied, suicide, hopelessness, and the presence of a Gay–Straight Alliance (GSA) on a school campus. Method: We analyzed data from the California Healthy Kids Survey from 2005 to 2007 using hierarchical modeling. Results: We found that gay-bias (versus non–gay-bias) victimization is meaningfully connected with the inwardly destructive behavior of attempted suicide among adolescents. We also found that hopelessness helps explain associations between gay-bias victimization and suicide attempts and that the presence of a GSA club on a school’s campus attenuates significant connections between gay-bias victimization and suicide attempts by reducing hopelessness. Conclusion: Gay-bias victims are more likely than other victims to attempt suicide while also feeling more hopeless. The presence of a GSA on campus may help to reduce the attempted suicide and hopelessness associated with gay-bias victimization. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: bully; victimization; hopelessness; suicide; gay; Adolescent; Bullying; Crime Victims; Female; Homosexuality; Humans; Interpersonal Relations; Male; Suicide, Attempted; Clubs (Social Organizations); Hopelessness; Suicide; Victimization; Bullying; Attempted Suicide; Cognitive Bias; Homosexuality

Male-to-male sex among men who inject drugs in Delhi, India: Overlapping HIV risk behaviours - Armstrong, Gregory; Jorm, Anthony F.; Samson, Luke; Joubert, Lynette; Singh, Shalini; Kermode, Michelle (International Journal of Drug Policy, 2015)
Background: HIV among people who inject drugs (PWID) is a major public health challenge in India. This paper examines PWID in Delhi who also have male-to-male sex with a focus on overlapping HIV risk behaviours and the psychosocial correlates of a history of male-to-male anal sex. Methods: We analysed data collected in April–May of 2012 from a community-based sample of 420 male PWID in Delhi obtained using time location sampling. Results: One third (37%) of the men reported a history of anal sex with men, among whom just 16% used a condom at last anal sex. Almost all (93%) participants who had a history of anal sex with men also had sex with women. Chi-square tests revealed that a history of anal sex with men was associated with a higher number of female sexual partners and sharing of needles and syringes. Additionally, unprotected sex at last sex with a male partner was significantly associated with unprotected sex at last sex with regular and paid female partners. Multivariate binary logistic regression revealed that the psychosocial correlates of a history of anal sex with other men were: being aged 18–24 (OR = 2.4, p = 0.014), illiteracy (OR = 1.9, p = 0.033), having never been married (OR = 2.6, p = 0.007), a main source of income of crime/begging (OR = 3.1, p = 0.019), a duration of injecting drug use greater than 20 years (OR = 3.4, p = 0.035) and suicidal ideation (OR = 1.7, p = 0.048). Conclusion: Male-to-male sex was associated with psychosocial vulnerability, including a longer history of injecting drug use, suicidal ideation and socio-economic disadvantage. Given the extent of overlapping HIV risk behaviours, HIV programs for PWID would benefit from a strong focus on prevention of sexual HIV transmission, especially among male injectors who also have sex with other men. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: India; Injecting drug use; Men who have sex with men; Overlapping HIV risks; Psychosocial context; Suicide; Adolescent; Adult; Chi-Square Distribution; Cross-Sectional Studies; Drug Users; Female; HIV Infections; Health Behavior; Health Knowledge, Attitudes, Practice; Health Surveys; Homosexuality, Male; Humans; India; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Prostitution; Risk Adjustment; Risk Factors; Risk-Taking; Sex Workers; Sexual Partners; Socioeconomic Factors; Substance Abuse, Intravenous; Suicidal Ideation; Unsafe Sex; Vulnerable Populations; Young Adult; HIV; Intravenous Drug Usage; Risk Taking; South Asian Cultural Groups; Same Sex Intercourse; Psychosocial Factors; Suicide

America’s promise: The harsh reality of school pathways to the juvenile justice system - Butler-Barnes, Sheretta T. (PsycCRITIQUES, 2016)
Reviews the book The School-to-Prison Pipeline: A Comprehensive Assessment by Christopher A. Mallett (see record [rid]2015-38125-000[/rid]). This book highlights thematic issues influencing the school-to-prison pipeline: more specifically, the birth of policies that grew out of American’s worries about crime and delinquency, which is now reflective of adolescents and the criminal justice system. Mallett addresses policies that have led to the increase of policing in public schools throughout America, such as, a) the Gun-Free Schools Act of 1994, b) zero-tolerance policies, c) policing in schools, and d) the No Child Left Behind Act, resulting in the disproportionate representation of marginalized and stigmatized children and adolescents in the juvenile justice system. Mallett discusses how these policies impact children and adolescents of color, while also considering other vulnerable populations, including children and adolescents with learning disabilities, ESL learners, LGBT youth, youth experiencing trauma, and those with a mental illness. The School-to-Prison Pipeline examines how school policies put these youth at an increased risk of being part of the school-to-prison pipeline. Despite the growth of the school-to-prison pipeline, Mallett puts forth several recommendations that will contribute to positive youth development. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: crime; delinquency; policing; public schools; juvenile justice; policies; No Child Left Behind; Crime; Juvenile Delinquency; Juvenile Justice; Prisons; Public School Education; Educational Reform; Laws; Policy Making

Mike Penner ‘or’ Christine Daniels: The US media and the fractured representation of a transgender sportswriter - Pieper, Lindsay Parks (Sport in Society, 2015)
On 26 April 2007, US sportswriter Mike Penner told readers he was transsexual and that he would return to the paper as Christine Daniels. Journalists immediately analysed and assessed this column. Three months later, Daniels' first byline appeared as she assumed her former beats. Yet, after eight months in the spotlight, Daniels faded from view and, without explanation, Penner's name returned. Although the paper did not offer details on Penner's return, his re-emergence proved newsworthy. While the byline appeared consistently, Penner rarely appeared in public. On 27 November 2009, he committed suicide. By interrogating the fragmented coverage of Penner/Daniels in these three periods of his/her life – transition, (re/de)transition and suicide – this paper argues that the media selectively framed Penner/Daniels's gender identity and used gender pronouns purposefully to create specific meanings. Few described Penner/Daniels in entirety; as a result, the life was flattened into a one-dimensional category of gender advocacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: transgender sportswriter; gender identity; transsexual; gender pronouns; Christine Daniels; Mike Penner; Gender Identity; Sports; Transsexualism; Writers; Media Exposure; Pronouns

Early onset alcohol use and self‐harm: A discordant twin analysis - Few, Lauren R.; Werner, Kimberly B.; Sartor, Carolyn E.; Grant, Julia D.; Trull, Timothy J.; Nock, Matthew K.; Bucholz, Kathleen K.; Deitz, Sarah K.; Glowinski, Anne L.; Martin, Nicholas G.; Nelson, Elliot C.; Statham, Dixie J.; et al. (Alcoholism: Clinical and Experimental Research, 2015)
Background: Self‐harm has considerable societal and economic costs and has been extensively studied in relation to alcohol involvement. Although early onset alcohol use (EAU) has been causally linked to maladaptive clinical outcomes, its association with self‐harm is less well characterized. This study aimed to further examine the link between EAU and both nonsuicidal self‐injury (NSSI) and suicide attempt (SA), and elucidate shared familial and causal/individual‐specific pathways that explain this co‐occurrence. Methods: Using data from 6,082 Australian same‐sex twin pairs (1,732 monozygotic [MZ] and 1,309 dizygotic [DZ]), ages 23 to 40, we examined prevalence rates of NSSI and SA among twin pairs concordant and discordant for EAU. Conditional logistic regression, controlling for early clinical covariates and the influence of zygosity on EAU, was used to examine the odds ratio (OR) of self‐harm within twin pairs discordant for EAU. Results: Prevalence rates of both NSSI and SA were highest among twin pairs concordant for EAU and for twins who reported EAU within discordant twin pairs. Results from discordant twin analyses revealed nearly 4‐fold increased odds of SA for the twin who endorsed EAU, and this OR was equal across MZ and DZ twins. EAU also was associated with elevated odds of NSSI (OR = 7.62), although this was only the case for DZ twins in discordant pairs. Conclusions: The equivalent increase in odds of SA for both MZ and DZ twins suggests that causal or individual‐specific influences explain the link between EAU and SA. For NSSI, elevated odds for DZ twins and nonsignificant findings for MZ twins implicate correlated genetic factors in the association between EAU and NSSI. Future studies should test mechanisms through which EAU may causally influence SA, as well as examine whether genetic risk for third variables (e.g., negative urgency, stress reactivity) may explain the genetic overlap between EAU and NSSI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Early Alcohol Use; Self‐Harm; Alcohol Abuse; Attempted Suicide; Onset (Disorders); Self-Injurious Behavior; Twins

Constructing the victim in the bullying narrative: How bullying discourses affirm rather than challenge discriminatory notions of gender and sexuality - Foreman, Victoria (Crime, Media, Culture, 2015)
This project focuses on how bullying victims are constructed as victims through a content analysis of news articles on Phoebe Prince and Tyler Clementi, two teens who committed suicide after being bullied. While the discourse that emerges from these cases appears to do similar symbolic work as hate crime laws that condemn harassment based on sexual orientation, on closer examination the discourses can also be read as upholding discriminatory systems of patriarchy and heteronormativity in their attempts to explain the suicides as an expected or predictable response to homophobia and sexism. Framing Prince and Clementi as victims of bullying, rather than victims of poor mental health or family discord, creates a narrative that reifies rather than challenges repressive and discriminatory notions of sexuality and gender. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Bullying; heteronormativity; media; patriarchy; victim; Content Analysis; Narratives; Sexuality; Bullying; Hate Crimes; Human Sex Differences; News Media; Suicide; Victimization

Transgender affirmative cognitive behavioral therapy: Clinical considerations and applications - Austin, Ashley; Craig, Shelley L. (Professional Psychology: Research and Practice, 2015)
Transgender individuals report pervasive discrimination, microaggressions, and victimization across the life span, contributing to disparate rates of suicide, anxiety, and depression. Clinical interventions must be empirically supported and affirming, competently and sensitively attending to the effect of transphobic discrimination on the lives and experiences of transgender people. Transgender affirmative clinical practice acknowledges and counters the oppressive contexts in which transgender clients often experience health and mental health care. The primary aim of this article is to introduce a transgender-affirming adaptation of a cognitive behavior therapy intervention (TA-CBT) for use with transgender individuals suffering from depression, anxiety, and/or suicidality. Clinical considerations such as the historical context of transgender issues in mental health care, the minority stress framework, current mental health disparities, and resilience will be explored. Transgender-affirming practice applications focused on psychoeducation, modifying problematic thinking styles, enhancing social support, and preventing suicidality will be provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: transgender; cognitive behavior therapy; affirmative practice; gender identity; Cognitive Behavior Therapy; Gender Identity; Transgender

It's more than just 'sext'—A brief discussion on sexting activity among teens - Eugene, Jeffrey (Journal of Adolescent Health, 2015)
Comments on an article by Michele L. Ybarra & Kimberly J. Mitchell (see record [rid]2014-41454-001[/rid]). Significant findings include a higher frequency of sexting among females and lesbian, gay, bisexual (LGB) youth. Additionally, a greater number of past-year sex partners and a greater odds of depression and substance abuse were found among teens who sext. Their work contributes to the growing literature in the area of sexting and provokes further discussion. Findings related to LGB populations are consistent with previous studies on sexting; however, transgender youth were not included. An earlier study found a significant association between sexting and risky sexual behaviors in lesbian, gay, bisexual, and transgender youth. The inclusion of transgender youth in Ybarra and Mitchell's study may have yielded similar findings and revealed associations between sexting and psychosocial issues, such as depression and suicidal ideation because of the mental health disparities seen in transgender youth. Nonetheless, a novel study of sexting among transgender and gender nonconforming youth will further contribute to existing literature. Sexting is a behavior that will likely continue and expand with technological advances. Addressing risky sexual behaviors and psychological symptoms associated with sexting through education and guidance will promotewellness and responsibility within adolescent populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: sexual behavior; adolescents; media; sexting; sexual risk; psychosocial functioning; Adolescent Behavior; Female; Humans; Male; Risk-Taking; Sexual Behavior; Text Messaging; Adolescent Development; Psychosexual Behavior; Psychosocial Development; Computer Mediated Communication; Sexting; Sexual Risk Taking; Internet Usage; Mobile Phones; Social Functioning

Drivers of disparity: Differences in socially based risk factors of self-injurious and suicidal behaviors among sexual minority college students - Blosnich, John; Bossarte, Robert (Journal of American College Health, 2012)
Lesbian, gay, and bisexual (ie, sexual minority) populations have increased prevalence of both self-injurious and suicidal behaviors, but reasons for these disparities are poorly understood. Objective: To test the association between socially based stressors (eg, victimization, discrimination) and self-injurious behavior, suicide ideation, and suicide attempt. Participants: A national sample of college-attending 18- to 24-year-olds. Methods: Random or census samples from postsecondary educational institutions that administered the National College Health Assessment during the Fall 2008 and Spring 2009 semesters. Results: Sexual minorities reported more socially based stressors than heterosexuals. Bisexuals exhibited greatest prevalence of self-injurious and suicidal behaviors. In adjusted models, intimate partner violence was most consistently associated with self-injurious behaviors. Conclusions: Sexual minorities’ elevated risks of self-injurious and suicidal behaviors may stem from higher exposure to socially based stressors. Within-group differences among sexual minorities offer insight to specific risk factors that may contribute to elevated self-injurious and suicidal behaviors in sexual minority populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: risk factors; self injurious behavior; suicidal ideation; sexual minorities; college students; suicide attempts; Bisexuality; Crime Victims; Female; Homosexuality; Humans; Male; Minority Groups; Prejudice; Self-Injurious Behavior; Sexual Behavior; Stress, Psychological; Students; Suicide, Attempted; United States; Universities; Violence; Young Adult; Attempted Suicide; College Students; Risk Factors; Self-Injurious Behavior; Suicidal Ideation; Minority Groups; Sexual Orientation; Sexual Minority Groups

Risk factors associated with self-injurious behavior among a national sample of undergraduate college students - Taliaferro, Lindsay A.; Muehlenkamp, Jennifer J. (Journal of American College Health, 2015)
Objective: Nonsuicidal self-injury (NSSI) and suicidality among undergraduates represent important public health issues. This analysis identified risk factors that distinguished 3 groups, those who reported no history of self-harm; self-injury, but no suicide attempts (NSSI only); and self-injury and a suicide attempt (NSSI + SA) in the past year. Methods: Data came from 16,044 undergraduates who completed the Fall 2010 National College Health Assessment. Results: Over 3% of students reported NSSI, and one third of these individuals also attempted suicide. Factors that distinguished the NSSI only and NSSI + SA groups from the no self-harm group included current depressive symptoms, nonheterosexual orientation, an eating disorder/extreme weight control behavior, and diagnosis of an internalizing disorder. Factors that distinguished the NSSI + SA group from the NSSI only group were current depressive symptoms and diagnosis of an internalizing disorder. Conclusions: Students experiencing mental health problems demonstrate increased risk for NSSI and/or suicidal behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental health; prevention; risk; self-injury; suicide; College Students; Mental Health; Risk Factors; Self-Injurious Behavior; Prevention; Public Health; Suicide

Why alternative teenagers self-harm: Exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity - Young, Robert; Sproeber, Nina; Groschwitz, Rebecca C.; Preiss, Marthe; Plener, Paul L. (BMC Psychiatry, 2014)
Background: The term ‘self-harm’ encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as ‘Alternative’ (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as ‘Jocks’ are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group ‘bonding’) functions. This study explores the links between such aspects of self-harm, primarily NSSI, and youth subculture. Methods: An anonymous survey was carried out of 452 15 year old German school students. Measures included: identification with different youth cultures, i.e. Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic); social background, e.g. socioeconomic status; and experience of victimisation. Self-harm (suicide and NSSI) was assessed using Self-harm Behavior Questionnaire and the Functional Assessment of Self-Mutilation (FASM). Results: An 'Alternative' identity was directly (r ≈ 0.3) and a 'Jock' identity inversely (r ≈ -0.1) correlated with self-harm. 'Alternative' teenagers self-injured more frequently (NSSI 45.5% vs. 18.8%), repeatedly self-injured, and were 4–8 times more likely to attempt suicide (even after adjusting for social background) than their non-Alternative peers. They were also more likely to self-injure for autonomic, communicative and social reasons than other adolescents. Conclusions: About half of ‘Alternative’ adolescents’ self-injure, primarily to regulate emotions and communicate distress. However, a minority self-injure to reinforce their group identity, i.e. ‘To feel more a part of a group’. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: teenagers; self-harm; non-suicidal self-injury; adolescent identity; attempted suicide; Goths; Punk; Emo; Metallers; Heavy metal; alternative adolescent subcultures; Adolescent; Culture; Emotions; Female; Germany; Humans; Male; Schools; Self-Injurious Behavior; Students; Suicidal Ideation; Suicide, Attempted; Surveys and Questionnaires; Adolescent Psychopathology; Attempted Suicide; Self-Injurious Behavior; Subculture (Anthropological)

Psychosocial vulnerability and HIV-related sexual risk among men who have sex with men and women in the United States - Dyer, Typhanye P.; Regan, Rotrease; Pacek, Lauren R.; Acheampong, Abenaa; Khan, Maria R. (Archives of Sexual Behavior, 2015)
In the U.S., HIV is concentrated among men who have sex with men (MSM), some of whom have had female partners (MSMW). MSMW are disproportionately impacted by psychosocial vulnerabilities, like depression and substance use that increase sexually transmitted infection (STI) and HIV risk. Research on psychosocial vulnerability and HIV-related sexual risk among MSMW is warranted to reduce infection transmission among MSM and to prevent bridging to female partners. We analyzed data from Wave IV (2007–2008) of the National Longitudinal Study of Adolescent Health to assess psychosocial vulnerability and HIV risk-taking among MSMW. Using lifetime and past year sexual activity, we classified men as ever having sex with: women only (MSW), men only (MSMO) or MSMW, with further refined categorization of MSMW with male only partners in the past 12 months, only female partners in the past 12 months, and both male and female partners in the past 12 months (N = 6,945). We compared psychosocial vulnerability characteristics and HIV-related risk behaviors among the five categories of men. MSMW were more likely to report depression, suicidality, substance use, and incarceration than MSW and MSMO. Compared to MSW, MSMW with current female partners had greater odds of unprotected sex, exchange sex, and STI. MSMW with male partners in the past year had greater odds of multiple or concurrent partners in the past year. HIV risk and psychosocial vulnerability factors are elevated among MSMW, a priority population for HIV risk reduction. HIV risk reduction interventions should address this and heterogeneity of sexual partnerships among MSMW. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: HIV; Sexually transmitted infections; Substance use; Sexual minorities; Epidemiology; Sexual orientation; Adolescent; Adult; Bisexuality; Child; Depression; Female; HIV Infections; Humans; Interviews as Topic; Longitudinal Studies; Male; Qualitative Research; Risk Factors; Risk-Taking; Sexually Transmitted Diseases; Stress, Psychological; Substance-Related Disorders; United States; Unsafe Sex; Young Adult; HIV; Psychosocial Factors; Sexual Risk Taking; Sexual Partners; Same Sex Intercourse; Drug Abuse; Epidemiology; Minority Groups; Sexual Orientation; Sexually Transmitted Diseases

Opposing abortion, gay adoption, euthanasia, and suicide: Compassionate openness or self-centered moral rigorism? - Deak, Csilla; Saroglou, Vassilis (Archiv für Religionspsychologie / Archive for the Psychology of Religion, 2015)
In secularized modern Western societies, moral opposition to the liberalization of abortion, gay adoption, euthanasia, and suicide often relies on justifications based on other-oriented motives (mainly, protection of the weak, e.g., children). Moreover, some argue that the truly open-minded people may be those who, against the stream, oppose the established dominant liberal values in modem societies. We investigated whether moral and religious opposition to, vs. the acceptance of, the above four issues, as well as the endorsement of respective con vs. pro arguments reflect (a) 'compassionate openness' (prosocial, interpersonal, dispositions and existential flexibility), (b) 'compassionate conservatism' (prosocial dispositions and collectivistic moral concerns), or (c) 'self-centered moral rigorism' (collectivistic moral concerns, low existential quest, and low humility instead of prosocial dispositions). The results, to some extent, confirmed the third pattern. Thus, compassionate openness does not seem to underline modem moral opposition, possibly in contrast to some rhetoric of the latter. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: moral opposition; conservatism; religion; prosociality; homosexuality; euthanasia; Euthanasia; Morality; Religion; Society; Suicide; Motivation

Transgender youth: The building evidence base for early social transition - Turban, Jack L. (Journal of the American Academy of Child & Adolescent Psychiatry, 2017)
This editorial comments on an article by Durwood et al (see record [rid]2017-03804-009[/rid]) regarding early social transition for transgender youth. Turban notes that transgender youth are individuals who experience an incongruence between their gender assigned at birth and their experienced gender identity. Such patients are increasingly coming to the attention of mental health providers, because they are subject to significant rates of depression, anxiety, and suicidality. Durwood et al notes that it would likely be unethical to conduct a randomized controlled trial of transgender children who are and are not permitted to socially transition. Thus, clinicians are faced with imperfect data. Nonetheless, all existing data at this time suggest that transgender youth who are binary in their gender identity, when allowed to socially transition, have developmentally normative mental health scores, at least in the short term. Although the literature is limited as described earlier, the building evidence base suggests that these socially transitioned youth have superior mental health compared with past cohorts of clinic-referred transgender youth who were not permitted to socially transition. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: transgender children; gender nonconformity; social transitions; mental health; self-worth; Adolescent; Humans; Mental Health; Transgender Persons; Intervention; Mental Health; Self-Concept; Self-Esteem; Transgender; Self-Worth

Ending reparative therapy in minors: An appropriate legislative response - Moss, Ian (Family Court Review, 2014)
Reparative Therapy is a controversial Psychological practice designed to 'cure' subjects, many of whom are minors, of their homo/bisexuality. These attempts to alter sexual orientation are not only generally met with failure, but also frequently involve the use of therapy methods that provide no medical benefit and carry a great risk of harm. Most troubling about this practice though is that for years, there have been persistent reports of Lesbian, Gay, and Bisexual (LGB) minors being forcibly subjected to this therapy by their parents. It is known that providers of Reparative Therapy, who maintain that homosexuality is a treatable mental disorder, often mislead parents about the risks of the treatment and the therapy's likelihood of success. This Note proposes a state ban on Reparative Therapy, which would prohibit Reparative Therapy Practitioners from using psychological methodologies to attempt to alter the sexual orientation of minors. Modeled off the statutes of New Jersey and California, this ban would protect LGB minors from ineffective and harmful therapies, and do so in a way that does not violate patients, parents, or practitioners' rights under the 1st and 14th Amendments. Key Points for the Family Court Community: Therapeutic attempts to 'cure' homosexuality, collectively referred to as 'Reparative Therapy,' are widely condemned by most mental health organizations as dangerous and ineffective. There have been many problematic reports of LGB minors being forced into Reparative Therapy, often by parents who have been misled or left unaware of the numerous potential harms that have been associated with the practice like depression, self‐harm, and suicide. State Bans on Reparative Therapy as applied to minors, as seen in New Jersey and California, are an efficient way to protect minors from being subjected to this practice without penalizing parents, who in most cases are acting in good faith. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: reparative therapy; homosexuality; cure attitudes; minor children; legislative response; Homosexuality (Attitudes Toward); Laws; Legislative Processes; Sexual Orientation; Conversion Therapy; Homosexuality

Increased risk of suicide attempts among Black and Latino lesbians, gay men, and bisexuals - O'Donnell, Shannon; Meyer, Ilan H.; Schwartz, Sharon (American Journal of Public Health, 2011)
Members of racial/ethnic minority groups have a lower lifetime prevalence than have Whites of mental disorders, a risk factor for suicide attempts; paradoxically, however, lesbian, gay, and bisexual (LGB) ethnic minority youths may be at increased risk for suicide attempts relative to White LGB youths. We found that the increased risk of suicide attempts among racial/ethnic minority LGB respondents in our sample relative to White respondents was not explained by excess youth onset of depression and substance abuse or by a higher susceptibility to suicide in the racial/ethnic minority LGB group. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: risk factors; suicide attempts; Blacks; Latinos; lesbians; gay men; bisexuals; Adolescent; Adult; African Continental Ancestry Group; Bisexuality; Depressive Disorder, Major; European Continental Ancestry Group; Female; Health Status Disparities; Hispanic Americans; Homosexuality, Female; Homosexuality, Male; Humans; Male; Middle Aged; Minority Groups; New York City; Risk Factors; Substance-Related Disorders; Suicide, Attempted; Young Adult; Attempted Suicide; Bisexuality; Lesbianism; Male Homosexuality; Racial and Ethnic Differences; At Risk Populations; Blacks; Risk Factors; Latinos/Latinas

Rupture, resilience, and risk: Relationships between mental health and migration among gay-identified men in North America - Lewis, Nathaniel M. (Health & Place, 2014)
An established body of research in psychology, psychiatry and epidemiology links social stigma and stress with poor mental and sexual health outcomes among gay-identified men. Less work considers how these linkages are mediated by place and almost none considers the role of movement across places. This qualitative study, based on the migration narratives of 48 gay-identified men living in Ottawa, Ontario, Canada, and Washington, D.C., U.S.A. gives more careful consideration to the ways in which mental and emotional health issues (e.g., anxiety, depression, substance use) in this population both precipitate migration and stem from migration. The narratives show that decisions to migrate often emerge from men's experiences of place-based minority stress and associated health outcomes. At the same time, moving to urban gay communities, when coupled with other life circumstances, can create or reinforce physical and emotional insecurities that lead to low self-esteem, substance use and sexual risk-taking. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Gay; HIV/AIDS; Mental health; Migration; Sexuality; Adult; Anxiety; Canada; Depression; Homophobia; Homosexuality, Male; Humans; Loneliness; Male; Mental Disorders; Middle Aged; Resilience, Psychological; Rural Population; Self Concept; Social Isolation; Suicidal Ideation; United States; Urban Population; Young Adult; Community Development; Human Migration; Male Homosexuality; Mental Health; Sexuality; Resilience (Psychological); Stigma

'A comparative analysis of a community and general sample of lesbian, gay, and bisexual individuals': Erratum - Kuyper, Lisette; Fernee, Henk; Keuzenkamp, Saskia (Archives of Sexual Behavior, 2016)
Reports an error in 'A comparative analysis of a community and general sample of lesbian, gay, and bisexual individuals' by Lisette Kuyper, Henk Fernee and Saskia Keuzenkamp (Archives of Sexual Behavior, Advanced Online Publication, Jan 7, 2015, np). In the original article, There was an error in Table 5. The correct version of Table 5 is present in the erratum. (The following abstract of the original article appeared in record [rid]2015-00404-001[/rid]). Samples recruited at lesbian, gay, and bisexual (LGB) venues have certain benefits, but a major drawback is that these samples are prone to bias as they only contain LGB participants who visit such venues. Empirical data with regard to the potential differences between LGB community samples and LGB general samples may shed some light on the generalizability of research findings from convenience samples recruited through LGB venues. The current study attempted to contribute to existing knowledge by examining differences in social demographics, sexual orientation, minority stress, and mental health between a convenience sample recruited at LGB venues ('community sample,' N = 3,403) and an LGB sample recruited from a general research panel in the Netherlands ('panel sample,' N = 1,000). Various differences were found. In general, community participants were younger, reported a more exclusive same-sex sexual orientation, were more open about their sexual orientation, had lower levels of internalized homonegativity, and encountered more negative social reactions on their LGB status. They also reported higher levels of psychological distress and suicidality. The Nagelkerke R 2 of the analyses (which were adjusted for sociodemographic differences) ranged from .08 (suicide plans among men) to .27 (sexual attraction among women). However, while the estimates of sociodemographics, sexual orientation, minority stress, and mental well-being differed, the relationships between these constructs were comparable in both samples. Implications and suggestions for future studies are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Sexual orientation; Gay men; Lesbians; Bisexuality; Homosexuality; Minority stress; Bisexuality; Lesbianism; Male Homosexuality; Sexual Orientation; Minority Stress; Minority Groups; Stress

Suicide ideation and suicide attempts among White Southern lesbians - Irwin, Jay A.; Austin, Erika L. (Journal of Gay & Lesbian Mental Health, 2013)
Several studies find suicide behaviors to be more prevalent among lesbian, gay, and bisexual (LGB) populations than their heterosexual counterparts. Studies of non-LGB populations reveal 13% prevalence of lifetime ideation and 4% prevalence of lifetime attempts. This study analyzed data from the Lesbian Social Life (LSL) study, a primarily online, survey-based research project focusing on lesbians living in the southern United States, and found that more than 40% of participants had seriously considered suicide and more than 15% had attempted suicide. We estimated the likelihood of suicide ideation and attempts by utilizing known general risk factors and lesbian-specific indicators within hierarchical logistic regression. Predictors of suicide ideation and attempts included depressive symptoms, discrimination, social support, self-esteem, and stigma. Results highlight the magnitude of suicide behaviors in southern lesbians and important predictor variables. Analysis shows support for the minority stress theory, and policy and clinical recommendations are provided. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: suicide ideation; suicide attempts; Whites; lesbians; risk factors; prevalence; Attempted Suicide; Epidemiology; Lesbianism; Suicidal Ideation; Whites; Risk Factors

Corrigendum to 'Structural stigma and all-cause mortality in sexual minority populations' [Soc Sci Med 103 (2014) 33–41] - Hatzenbuehler, Mark L.; Bellatorre, Anna; Lee, Yeonjin; Finch, Brian K.; Muennig, Peter; Fiscella, Kevin (Social Science & Medicine, 2018)
Reports an error in 'Structural stigma and all-cause mortality in sexual minority populations' by Mark L. Hatzenbuehler, Anna Bellatorre, Yeonjin Lee, Brian K. Finch, Peter Muennig and Kevin Fiscella (Social Science & Medicine, 2014[Feb], Vol 103, 33-41). Following the publication of Regnerus's (2017) paper, we hired an independent research group, led by Dr. Katherine Keyes, to replicate the results of our paper entitled 'Structural Stigma and All-Cause Mortality in Sexual Minority Populations'. A coding error was discovered. Specifically, the data analyst mis-specified the time variable for the survival models, which incorrectly addressed the censoring for individuals who died. The time variable did not correctly adjust for the time since the interview to death due to a calculation error, which led to improper censoring of the exposure period. Once the error was corrected, there was no longer a significant association between structural stigma and mortality risk among the sample of 914 sexual minorities. (The following abstract of the original article appeared in record [rid]2014-05711-005[/rid]). Stigma operates at multiple levels, including intrapersonal appraisals (e.g., self-stigma), interpersonal events (e.g., hate crimes), and structural conditions (e.g., community norms, institutional policies). Although prior research has indicated that intrapersonal and interpersonal forms of stigma negatively affect the health of the stigmatized, few studies have addressed the health consequences of exposure to structural forms of stigma. To address this gap, we investigated whether structural stigma-operationalized as living in communities with high levels of anti-gay prejudice-increases risk of premature mortality for sexual minorities. We constructed a measure capturing the average level of anti-gay prejudice at the community level, using data from the General Social Survey, which was then prospectively linked to all-cause mortality data via the National Death Index. Sexual minorities living in communities with high levels of anti-gay prejudice experienced a higher hazard of mortality than those living in low-prejudice communities (Hazard Ratio [HR] = 3.03, 95% Confidence Interval [CI] = 1.50, 6.13), controlling for individual and community-level covariates. This result translates into a shorter life expectancy of approximately 12 years (95% C.I.: 4-20 years) for sexual minorities living in high-prejudice communities. Analysis of specific causes of death revealed that suicide, homicide/violence, and cardiovascular diseases were substantially elevated among sexual minorities in high-prejudice communities. Strikingly, there was an 18-year difference in average age of completed suicide between sexual minorities in the high-prejudice (age 37.5) and low-prejudice (age 55.7) communities. These results highlight the importance of examining structural forms of stigma and prejudice as social determinants of health and longevity among minority populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: mortality; sexual minority; stigma; communities; Communities; Death and Dying; Minority Groups; Mortality Rate; Stigma; Sexual Minority Groups

Mental health in violent crime victims: Does sexual orientation matter? - Cramer, Robert J.; McNiel, Dale E.; Holley, Sarah R.; Shumway, Martha; Boccellari, Alicia (Law and Human Behavior, 2012)
The present study investigates victim sexual orientation in a sample of 641 violent crime victims seeking emergency medical treatment at a public-sector hospital. Victim sexual orientation was examined as it: (a) varies by type of violent crime and demographic characteristics, (b) directly relates to psychological symptoms, and (c) moderates the relationship between victim and crime characteristics (i.e., victim gender, victim trauma history, and type of crime) and psychological symptoms (i.e., symptoms of acute stress, depression, panic, and general anxiety). Results showed that lesbian, gay, bisexual, and transgender (LGBT) victims were more likely to be victims of sexual assault. Heterosexual victims were more likely to be victims of general assault and shootings. LGBT victims demonstrated significantly higher levels of acute stress and general anxiety. Moreover, victim sexual orientation moderated the association of type of crime with experience of panic symptoms. Also, victim sexual orientation moderated the relation of victim trauma history and general anxiety symptoms. Results are discussed in relation to victimization prevalence rates, sexual prejudice theory, and assessment and treatment of violent crime victims. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: LGBT victim; anxiety; sexual assault; sexual orientation; violent crime; lesbian; gay; bisexual; transgender; mental health; emergency medical treatment; Adult; Crime; Female; Humans; Interviews as Topic; Male; Mental Health; Middle Aged; San Francisco; Sexual Behavior; Surveys and Questionnaires; Violence; Crime Victims; Mental Health; Sex Offenses; Sexual Orientation; Violent Crime; Anxiety; Bisexuality; Emergency Services; Homosexuality; Lesbianism; Transgender

Lesbian, gay, bisexual and transgender young people's experiences of distress: Resilience, ambivalence and self-destructive behaviour - Scourfield, Jonathan; Roen, Katrina; McDermott, Liz (Health & Social Care in the Community, 2008)
The research presented in this paper set out to explore the cultural context of youth suicide and more specifically any connections between sexual identity and self-destructive behaviour, in the light of international evidence about the disproportionate risk of suicidal thoughts and suicide attempts in lesbian, gay, bisexual and transgender (LGBT) young people. The empirical basis for the paper is qualitative research that was carried out in the North West of England and South Wales. Focus groups and interviews were conducted with a total of 69 young people, with a purposive sample to reflect diversity of sexual identity, social class and regional and rural-urban location. The paper presents a thematic analysis of the data specifically relating to the experiences of LGBT young people. A range of strategies that LGBT young people employ in the face of distress are described. These are categorised as resilience, ambivalence and self-destructive behaviour (including self-harm and suicide). The potential implications for health and social care of these strategies include the need for ecological approaches and for sexual cultural competence in practitioners, as well as prioritisation of LGBT risk within suicide prevention policies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: lesbian; gay; bisexual; transgender; young peoples experiences; distress; resilience; ambivalence; self destructive behavior; Adaptation, Psychological; Adolescent; England; Female; Focus Groups; Homosexuality; Humans; Interviews as Topic; Male; Self-Injurious Behavior; Sexual Behavior; Suicide; Transsexualism; Wales; Ambivalence; Distress; Self-Destructive Behavior; Sexual Orientation; Suicide; Bisexuality; Lesbianism; Male Homosexuality; Transsexualism

Frequent callers to crisis helplines: Who are they and why do they call? - Spittal, Matthew J.; Fedyszyn, Izabela; Middleton, Aves; Bassilios, Bridget; Gunn, Jane; Woodward, Alan; Pirkis, Jane (Australian and New Zealand Journal of Psychiatry, 2015)
Objective: Frequent callers present a challenge for crisis helplines, which strive to achieve optimal outcomes for all callers within finite resources. This study aimed to describe frequent callers to Lifeline (the largest crisis helpline in Australia) and compare them with non-frequent callers, with a view to furthering knowledge about models of service delivery that might meet the needs of frequent callers. Method: Lifeline provided an anonymous dataset on calls made between December 2011 and May 2013. We assumed calls from the same (encrypted) phone number were made by the same person, and aggregated call level data up to the person level. Individuals who made 0.667 calls per day in any period from 1 week to the full 549 days for which we had data (i.e. 4.7 calls in 7 days, 20 calls in 30 days, 40 calls in 60 days, etc.) were regarded as frequent callers. Results: Our analysis dataset included 411,725 calls made by 98,174 individuals, 2594 (2.6%) of whom met our definition of frequent callers. We identified a number of predictors of being a frequent caller, including being male or transgender, and never having been married. The odds increased with age until 55–64 years, and then declined. Suicidality, self-harm, mental health issues, crime, child protection and domestic violence issues all predicted being a frequent caller. Conclusions: Collectively, frequent callers have a significant impact on crisis lines, and solutions need to be found for responding to them that are in everybody’s best interests (i.e. the frequent callers themselves, other callers, telephone crisis supporters who staff crisis lines, and those who manage crisis lines). In striking this balance, the complex and multiple needs of frequent callers must be taken into account. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Crisis helplines; frequent callers; self-harm; suicide; Adolescent; Adult; Age Distribution; Aged; Australia; Child Abuse; Crime; Crisis Intervention; Data Collection; Domestic Violence; Female; Hotlines; Humans; Male; Marital Status; Mental Disorders; Middle Aged; Risk Factors; Self-Injurious Behavior; Sex Distribution; Suicide; Transgender Persons; Young Adult; Health Care Delivery; Health Care Services; Hot Line Services; Transgender; Crises; Dual Relationships

Sexual orientation, psychological well-being, and mental health: A longitudinal analysis from adolescence to young adulthood - Becker, Michael; Cortina, Kai S.; Tsai, Yi-Miau; Eccles, Jacquelynne S. (Psychology of Sexual Orientation and Gender Diversity, 2014)
In the past, mainly cross-sectional research has shown that nonheterosexuals report lower levels of psychological well-being and functioning than heterosexuals. Drawing on minority stress theory (Meyer, 2003), life span theory, and identity formation theory (Erikson, 1968), the present study analyzed developmental trajectories in psychological functioning from adolescence to young adulthood in nonheterosexual and heterosexual populations. Based on data from the Michigan Study of Adolescent and Adult Life Transitions (MSALT), nonheterosexual adolescents and young adults were compared with their heterosexual peers regarding their psychological development from the ages of 16 to 28. Overall levels of depressive affect, suicidal ideation, alcohol consumption, and social alienation were elevated for nonheterosexual young adolescents. For depressive affect and social alienation as well as suicidal ideation, the 2 groups grew apart during their high-school years but converged after leaving high school. For alcohol consumption, a divergent trend emerged after high school. No differences were found for self-esteem. None of the interactions between sexual orientation and gender reached statistical significance. The results point toward a higher degree of complexity in developmental patterns compared with results of previous studies. The study underscores the nonstatic nature of mental health disparities and highlights the potential and the need to prevent psychological maladjustment for nonheterosexual populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: longitudinal study; mental health; psychological well-being; sexual orientation; Mental Health; Sexual Orientation; Well Being; Psychological Development

Multiple abortions and sexually transmitted infections among young migrant women working in entertainment venues in China - Dong, Yanyan; Zhang, Hongbo; Wang, Yongyang; Tao, Haidong; Xu, Song; Xia, Junrui; Huang, Wen; He, Huan; Zaller, Nickolas; Operario, Don (Women & Health, 2015)
We conducted a survey of 358 young migrant women working in entertainment venues in China to explore the prevalence of and factors associated with two indicators of sexual and reproductive health: (1) multiple abortions and (2) the dual risk of sexually transmitted infections (STI) and abortion history. One quarter (25.4 percent) of the women in this sample had multiple abortions during their lifetime and, of those with any abortion history, 18.3 percent had had an abortion outside of a regulated health clinic. One-third (33.0 percent) of the sample had had an STI during the past year, and approximately one-fourth (23.7 percent) of those women did not receive STI treatment in a public hospital. Approximately one-fourth (23.5 percent) of the sample reported both a history of abortion and an STI during the past year. Women with a history of multiple abortions had significantly lower income levels, were more likely to have sex with clients and with husbands, and tended more to use alcohol before sex. Women who experienced both abortion and STI risks were more likely to report having had unprotected sex, genitourinary tract infections symptoms, anxiety, illicit drug use, and suicidal ideation. Enhanced efforts are needed to improve reproductive and sexual health for female migrants in urban China, particularly those working in entertainment venues. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: China; migrants; reproductive health; sexual health; women; Abortion, Induced; Adolescent; Adult; China; Cross-Sectional Studies; Employment; Female; HIV Infections; Humans; Prevalence; Prostitution; Reproductive Health; Risk Factors; Risk-Taking; Sexual Behavior; Sexually Transmitted Diseases; Socioeconomic Factors; Surveys and Questionnaires; Transients and Migrants; Unsafe Sex; Workplace; Young Adult; Immigration; Induced Abortion; Sexually Transmitted Diseases; Working Women; Hospitality Industry; Infectious Disorders; Sexual Risk Taking; Sexual Health

The moderating role of sexual identity in group teletherapy for adults aging with HIV - Heckman, Bernadette Davantes; Lovejoy, Travis I.; Heckman, Timothy G.; Anderson, Timothy; Grimes, Tiffany; Sutton, Mark; Bianco, Joseph A. (Behavioral Medicine, 2014)
Older adults living with HIV/AIDS experience high rates of depression and suicidal ideation but are less likely than their younger counterparts to seek psychological services. HIV continues to disproportionately impact older men who have sex with men (MSM), many of whom were infected in their 20s and 30s. This study examined whether therapy attendance rates and the efficacies of two group-format teletherapies for the treatment of depression (coping effectiveness group training and supportive-expressive group therapy) were comparable for older MSM and older heterosexuals living with HIV. Intervention-outcome analyses found that older MSM and older heterosexuals living with HIV attended comparable numbers of teletherapy sessions. Older heterosexuals living with HIV who received telephone-administered supportive-expressive group therapy reported significantly greater reductions in depressive symptoms than SOC controls. A similar pattern was not found in older MSM. More research is needed to personalize and tailor group teletherapies for older MSM living with HIV. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: aging; depression; HIV; group teletherapy; sexual identity; therapy attendance; treatment efficiency; men who have sex with men; heterosexuals; coping effectiveness group therapy; supportive-expressive group therapy; older patients; teletherapy; Aged; Aging; Depression; Female; HIV Infections; Heterosexuality; Homosexuality, Male; Humans; Male; Middle Aged; Patient Compliance; Psychotherapy, Group; Telemedicine; Treatment Outcome; Heterosexuality; HIV; Online Therapy; Sexual Orientation; Same Sex Intercourse; Aging; Group Psychotherapy; Major Depression; Treatment Compliance

Safe and successful ECT in a female-to-male transgender individual with major depression - Coffey, M. Justin; Stevens, Jonathan R. (The Journal of ECT, 2016)
Presents the case report of a 26-year-old, right handed, female-to-male transgender man with a family history of major depression who was admitted voluntarily to our facility on transfer from an out-of-state inpatient psychiatry service where he had been admitted for 2 weeks after a suicide attempt via medication overdose. His neuropsychiatric history did not include any periods of mania or any misuse of drugs or alcohol. He had had not tolerated or received sufficient benefit from numerous trials of various types of psychotropic medications. A course of ECT had been recommended to him in the past, but he chose not to pursue it. After discontinuing lithium and providing fully informed consent, he commenced an index course of bifrontal ECT with methohexital anesthesia with succinylcholine muscle relaxation. He tolerated ECT very well and lamented the geographical barriers to continuing ECT back home. He then received 1 continuation ECT treatment before being discharged on a combination of lithium and nortriptyline. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: female-to-male transgender; major depression; family history; neuropsychiatric history; psychotropic drugs; Drugs; Major Depression; Patient History; Transgender

Religious belief, age, and sexual orientation on attributions of younger and older gay and heterosexual men - Kane, Michael; Jacobs, Robin J.; Sherman, Diane (Mental Health, Religion & Culture, 2015)
Using 4 vignettes and 20 response items, this exploratory study investigated attributions about older or younger gay or heterosexual men with a history of multiple sex partners, substance abuse, and legal problems. The character is diagnosed with a terminal illness and two options for care: no treatment or an aggressive treatment protocol with a small chance of recovery. When controlling for respondents’ (N = 324) religious identification, frequency of attendance at religious services, and ethno-cultural identification, a General Linear Model was significant (F = 57.014, df = 20, p < .001). Differences in the vignette responses centred on perceptions of quality of life, the character's lifestyle, and suicide. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: substance misuse; religion; illness; ageism; quality of life; sexual orientation; Aging; Attribution; Heterosexuality; Religious Beliefs; Sexual Orientation; Sexual Partners

Sociable, mentally disturbed women and angry, rejected men: Cultural scripts for the suicidal behavior of women and men in the Austrian print media - Eisenwort, Brigitte; Till, Benedikt; Hinterbuchinger, Barbara; Niederkrotenthaler, Thomas (Sex Roles: A Journal of Research, 2014)
This paper analyzed gender-specific reporting differences in Austrian newspapers on suicidal behavior related to portrayals of and language about suicidal motives in order to shed light on cultural scripts that may both reflect and shape gender stereotypes in a country where conservative gender-role models dominate. A total of 126 Austrian print-media reports on female suicidal behavior were compared to 381 reports on male suicidal behavior. The linguistic text analysis program LIWC was used to compare the use of language indicative of emotions, assess text complexity and detect indicators of social processes in the stories. Mental illness as a motive for suicide was more prevalent in reports on women’s suicidal behavior and was often portrayed in a stigmatizing manner. Consistent with Austria’s prevalent conceptions of gender-role functions, stories about female suicidal behavior contained more words indicating sociability and more references to other persons, and motives for female suicide were often linked to family situations. Words indicating anger were more prevalent in articles on male behavior, and male suicidal behavior was contextualized as stemming from breakups and spousal rejection. Articles on female suicide contained more tentative wording, and the language used to portray women’s suicidal behavior was more complex. These findings are consistent with a script that conforms to sociable, mentally disturbed women and angry, rejected men. This script reflects sexist cultural attitudes relevant to public education efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Print media; Suicide; Suicidal behavior; Gender; Content analysis; Linguistics; Social constructivism; Austria; Human Sex Differences; Newspapers; Schema; Sociocultural Factors; Suicide; Anger; Mental Disorders; Sex Roles; Social Behavior

Mortality among veterans with transgender-related diagnoses in the Veterans Health Administration, FY2000–2009 - Blosnich, John R.; Brown, George R.; Wojcio, Sybil; Jones, Kenneth T.; Bossarte, Robert M. (LGBT Health, 2014)
Purpose: The aims of this project were to document all-cause and suicide mortality among Veteran Healthcare Administration (VHA) utilizers with The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis consistent with transgender status. Methods: The study population consisted of VHA patients identified as having any one of four diagnosis codes indicating transgender status (n = 5,117) gathered from the VA National Patient Care Database. Mortality data were gathered from the National Death Index from 2000–2009 for 1,277 veterans with transgender-related ICD-9-CM diagnoses. The remaining 3,840 were not searched because they had VHA utilization after 2009 (indicating they were alive). Person-time at risk (person-years) for crude rates were calculated based on the time from an individual’s index diagnosis to either death or the end of FY 2009. Causes of death were categorized using ICD-10 code groups. Results: Approximately 9.3% (n = 309) veterans with transgender-related ICD-9-CM diagnoses died across the study period. Although diseases of the circulatory system and neoplasms were the first and second leading causes of death, respectively, the other ranked causes of mortality differed somewhat from patterns for the US during the same time span. The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses across the 10-year period was approximately 82/100,000 person-years, which approximated the crude suicide death rates for other serious mental illness in VHA (e.g., depression, schizophrenia). The average age of suicide decedents was 49.4 years. Conclusion: The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mortality; suicide; transgender persons; veterans; Death and Dying; Epidemiology; Military Veterans; Suicide; Transgender; International Classification of Diseases

Risk of adolescent offspring’s completed suicide increases with prior history of their same-sex parents’ death by suicide - Cheng, C.-C. J.; Yen, W.-J.; Chang, W.-T.; Wu, K. C.-C.; Ko, M.-C.; Li, C.-Y. (Psychological Medicine, 2014)
Background: To investigate the risk of completed suicide in offspring during adolescence in relation to prior history of the same-sex parent’s death by suicide and other causes. Method: A total of 500 adolescents who died by suicide at age 15–19 years between 1997 and 2007 were identified from the Taiwan Mortality Registration (TMR). For each case, 30 age- and time-matched controls were selected randomly from all adolescents registered in the Taiwan Birth Registry (TBR). A multivariate conditional logistic regression model was used to assess the risk of adolescent completed suicide in relation to their same-sex parent. Results: Adolescent suicide risk was positively associated with both paternal [odds ratio (OR) 5.38, 95% confidence interval (CI) 2.17–13.33] and maternal suicide (OR 6.59, 95% CI 1.82–23.91). The corresponding risk estimates associated with paternal and maternal deaths from non-suicidal causes were much lower, at 1.88 and 1.94 respectively. The risk of suicide in male adolescents was significantly associated with prior history of paternal death by suicide (OR 8.23, 95% CI 2.96–22.90) but not of maternal death by suicide (OR 3.50, 95% CI 0.41–30.13). On the other contrary, the risk of suicidal death in female adolescents was significantly associated with prior history of maternal suicide (OR 9.71, 95% CI 1.89–49.94) but not of paternal suicide (OR 2.42, 95% CI 0.30–19.57). However, these differences did not reach statistical significance. Conclusions: Although limited by sample size, our study indicates that adolescent offspring suicidal death is associated with prior history of their same-sex parent’s death by suicide. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Adolescent; case–control studies; parent; suicide; Adolescent; Adult; Child of Impaired Parents; Female; Humans; Male; Maternal Death; Parental Death; Parents; Registries; Risk; Sex Factors; Suicide; Taiwan; Young Adult; Attempted Suicide; Parental Death; Risk Factors; Suicide; Death and Dying

Navigating community institutions: Black transgender women’s experiences in schools, the criminal justice system, and churches - Graham, Louis F. (Sexuality Research & Social Policy: A Journal of the NSRC, 2014)
[Correction Notice: An Erratum for this article was reported in Vol 11(4) of Sexuality Research & Social Policy: A Journal of the NSRC (see record [rid]2014-50808-002[/rid]). In the original article, all co-authors were omitted. The correct author group of this article is present in the erratum.] Young transgender women, especially those of color, are negatively impacted by suicidality, HIV, residential instability, survival sex work, and other challenges. This study used an oral narrative approach to collect life histories of 10 young black transwomen between 18 and 24 years of age residing in Detroit, Michigan. This study used grounded theory analysis to explore institutional violence, discrimination, and harassment (VDH). Participants described their experiences navigating three community institutions (schools, the criminal justice system, and churches) and broader society. Results highlight VDH through gender policing at school, sexual victimization in the criminal justice system, and negative judgment of gender variation in faith-based institutions. Participants reference the essential role of support systems, including other transgender individuals, in both their gender identity development and the navigation of institutions. Significant policy intervention is needed to protect and support transwomen, and prevent VDH perpetuated against them. Across all institutions, policy and practice interventions can focus on use of transgender appropriate and sensitive language, prevention of physical and sexual assaults, and anti-discrimination measures. Specific policy recommendations and future research directions are outlined. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Transgender; Violence; Discrimination; Social support; Narrative; Harassment; Violence; Transgender; Criminal Justice; Religious Buildings; Schools; Sex Discrimination; Social Support

The effects of general and homophobic victimization on adolescents' psychosocial and educational concerns: The importance of intersecting identities and parent support - Poteat, V. Paul; Mereish, Ethan H.; DiGiovanni, Craig D.; Koenig, Brian W. (Journal of Counseling Psychology, 2011)
Many adolescents experience peer victimization, which often can be homophobic. Applying the minority stress model with attention to intersecting social identities, this study tested the effects of general and homophobic victimization on several educational outcomes through suicidality and school belonging among 15,923 adolescents in Grades 7 through 12 on account of their sexual orientation and race/ethnicity. Parent support also was tested as a moderator of these effects. Homophobic victimization had different effects on suicidality across groups, indicating the importance of considering individuals' multiple social identities. However, homophobic victimization had universal negative effects on school belonging for all groups. Nearly all indirect effects of general and homophobic victimization on reported grades, truancy, and importance of graduating were significant through suicidality and school belonging across groups. Parent support was most consistent in moderating the effects of general and homophobic victimization on suicidality for heterosexual White and racial/ethnic minority youth. In nearly all cases, it did not moderate the effects of general or homophobic victimization for lesbian, gay, bisexual, transgender, and questioning youth. Furthermore, in most cases, parent support did not moderate the effects of general or homophobic victimization on school belonging. Findings underscore the need for counseling psychologists to work with parents of all youth on ways to provide support to those who experience homophobic victimization. Furthermore, they highlight the need for counseling psychologists to be involved as social justice advocates in the passage and implementation of school policies that address homophobic bullying and other forms of bias-based bullying and harassment. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: bullying; homophobia; minority stress; parent support; sexual orientation; suicidality; Adolescent; Adolescent Behavior; Bisexuality; Bullying; Child; Crime Victims; Educational Status; Female; Homosexuality; Humans; Interpersonal Relations; Male; Parents; Peer Group; Resilience, Psychological; Sexuality; Social Behavior; Social Identification; Social Support; Suicide; Transsexualism; Wisconsin; Homosexuality; Homosexuality (Attitudes Toward); Sexual Orientation; Victimization; Bullying; High School Students; Minority Groups; Parent Child Relations; Psychological Stress; Social Support; Suicidal Ideation; Suicidality; Minority Stress

Introduction to special issue on suicide, mental health, and youth development - Eliason, Mickey (Journal of Homosexuality, 2011)
In early September 2010, when the Journal of Homosexuality’s editorial staff received a submission of a comprehensive review of research on lesbian, gay, bisexual, and transgender (LGBT) suicide risk that was generated by an expert consensus panel, we decided to feature this document in a special issue by packaging it with articles on mental health. We shifted through the submissions and found a concentration of articles related to LGBT/sexual minority youth mental health and began to prepare the introduction for this special issue. In this volume of the Journal of Homosexuality, we feature the document on the elevated rate for suicide and suicide risk among sexual minority individuals prepared by a consensus panel of LGBT mental health and suicide researchers convened by the American Foundation on Suicide Prevention. The articles in this special issue reveal problems that we as a community have struggled with for more than 30 years. Virtually every study that compares LGBT (or people who are questioning, use other labels, or resist labels) to exclusively heterosexual and cisgender individuals, finds higher rates of depression, substance abuse, and suicidal behaviors. The focus is still on sexual orientation, with very few studies examining the transgender experience. There is also growing evidence that bisexual individuals and those who are questioning or exploring their sexuality or gender without using a label, may be at even higher risk than those who identify as lesbian or gay. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide; mental health; youth development; sexual orientation; Adolescent; Bisexuality; Bullying; Female; Homosexuality; Human Development; Humans; Male; Mental Health; Prejudice; Suicide; Transsexualism; United States; Adolescent Development; Childhood Development; Mental Health; Sexual Orientation; Suicide

Gay affirmative cognitive behavioral therapy for sexual minority youth: A clinical adaptation - Craig, Shelley L.; Austin, Ashley; Alessi, Edward (Clinical Social Work Journal, 2013)
Sexual minority youth (SMY) are at high risk for negative mental health outcomes such as depression, anxiety, substance abuse, and suicidality. However, there has been a disconnect between clinical social work practice and research with SMY, resulting in a lack of rigorous research that demonstrates the use of effective interventions. While cognitive behavioral therapy (CBT) has long been established as a best practice option for the general adolescent population suffering from mental health problems, knowledge about the use of CBT with SMY lags far behind. Thus, the purpose of this article is to present a clearly defined adaptation of CBT for SMY that integrates gay affirmative practices for youth (e.g., coming out, stigma and discrimination, the role of social support and community). Specifically, the authors: (a) discuss the impact of minority stress on SMY; (b) highlight the specific components of CBT that represent a good fit for SMY and also address the criticisms of using such an approach; (c) consider the importance of using gay affirmative practices with SMY; and (d) offer recommendations for incorporating gay affirmative practices into traditional CBT models to better meet the needs of SMY. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: cognitive behavioral therapy; gay affirmative therapy; suicidality; substance abuse; anxiety; Cognitive Behavior Therapy; Male Homosexuality; Mental Health; Suicidality; Sexual Minority Groups; Anxiety; Drug Abuse; Suicidal Ideation; Affirmative Therapy

Childhood gender nonconformity and harassment as predictors of suicidality among gay, lesbian, bisexual, and heterosexual Austrians - Plöderl, Martin; Fartacek, Reinhold (Archives of Sexual Behavior, 2009)
The role of childhood gender role nonconformity (CGNC) and childhood harassment (CH) in explaining suicidality (suicide ideation, aborted suicide attempts, and suicide attempts) was examined in a sample of 142 lesbian, gay, and bisexual (LGB) adults and 148 heterosexual adults in Austria. Current and previous suicidality, CGNC, and CH were significantly greater in LGB participants compared to heterosexual participants. After controlling for CGNC, the effect of sexual orientation on CH diminished. CGNC correlated significantly with current suicidality in the LGB but not in the heterosexual group, and only non-significant correlations were found for CGNC with previous suicidality. Controlling for CH and CGNC diminished the effect of sexual orientation on current suicidality. Bayesian multivariate analysis indicated that current suicidality, but not previous suicidality, depended directly on CGNC. CH and CGNC are likely implicated in the elevated levels of current suicidality among adult LGB participants. As for previous suicidality, the negative impact of CGNC on suicidality might be overshadowed by stress issues affecting sexual minorities around coming out. The association of CGNC with current suicidality suggests an enduring effect of CGNC on the mental health and suicide risk of LGB individuals. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: childhood gender role nonconformity; childhood harassment; suicidality; gays; lesbians; bisexuals; Adolescent; Adult; Aged; Analysis of Variance; Austria; Bisexuality; Child; Child Behavior; Female; Gender Identity; Heterosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Male; Middle Aged; Multivariate Analysis; Social Behavior; Social Perception; Suicide; Young Adult; Child Abuse; Lesbianism; Male Homosexuality; Sex Roles; Suicide; Bisexuality; Early Experience; Suicidality

The health and well-being of transgender high school students: Results from the New Zealand Adolescent Health Survey (Youth’12) - Clark, Terryann C.; Lucassen, Mathijs F. G.; Bullen, Pat; Denny, Simon J.; Fleming, Theresa M.; Robinson, Elizabeth M.; Rossen, Fiona V. (Journal of Adolescent Health, 2014)
Purpose: To report the prevalence of students according to four gender groups (i.e., those who reported being non-transgender, transgender, or not sure about their gender, and those who did not understand the transgender question), and to describe their health and well-being. Methods: Logistic regressions were used to examine the associations between gender groups and selected outcomes in a nationally representative high school health and well-being survey, undertaken in 2012. Results: Of the students (n = 8,166), 94.7% reported being non-transgender, 1.2% reported being transgender, 2.5% reported being not sure about their gender, and 1.7% did not understand the question. Students who reported being transgender or not sure about their gender or did not understand the question had compromised health and well-being relative to their non-transgender peers; in particular, for transgender students perceiving that a parent cared about them (odds ratio [OR], .3; 95% confidence interval [CI], .2–.4), depressive symptoms (OR, 5.7; 95% CI, 3.6–9.2), suicide attempts (OR, 5.0; 95% CI, 2.9–8.8), and school bullying (OR, 4.5; 95% CI, 2.4–8.2). Conclusions: This is the first nationally representative survey to report the health and well-being of students who report being transgender. We found that transgender students and those reporting not being sure are a numerically small but important group. Transgender students are diverse and are represented across demographic variables, including their sexual attractions. Transgender youth face considerable health and well-being disparities. It is important to address the challenging environments these students face and to increase access to responsive services for transgender youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: transgender; high school students; well-being; health; gender groups; Adolescent; Adolescent Behavior; Bullying; Crime Victims; Cross-Sectional Studies; Depressive Disorder; Disclosure; Fear; Female; Health Status Disparities; Health Surveys; Humans; Internet; Logistic Models; Male; New Zealand; Parent-Child Relations; Peer Group; Risk-Taking; Self Report; Sexual Behavior; Students; Suicide, Attempted; Transgender Persons; Health; Well Being; Transgender; Adolescent Health; High School Students; Human Sex Differences

Psychosocial health conditions and HIV prevalence and incidence in a cohort of men who have sex with men in Bangkok, Thailand: Evidence of a syndemic effect - Guadamuz, T. E.; McCarthy, K.; Wimonsate, W.; Thienkrua, W.; Varangrat, A.; Chaikummao, S.; Sangiamkittikul, A.; Stall, R. D.; van Griensven, F. (AIDS and Behavior, 2014)
Men who have sex with men (MSM) in Bangkok may experience multiple psychosocial health conditions, such as substance use, suicidality, and a history of sexual abuse. These factors may contribute to HIV vulnerability in a syndemic way. A syndemic is defined as a number of synergistically interacting health conditions producing excess disease in a population. The objective of this study is to examine whether psychosocial health conditions among MSM have a syndemic association with HIV prevalence and HIV incidence. To do this, we evaluated psychosocial health conditions and their associations with unprotected sex, HIV prevalence and HIV incidence in a cohort of Thai MSM (N = 1,292). There was a positive and significant association between the number of psychosocial health conditions and increased levels of unprotected sex and HIV prevalence at study baseline. The number of psychosocial health conditions at baseline was also associated with increased HIV incidence during follow-up (no conditions, HIV incidence = 15.3 %; one to three conditions, 23.7 %; four to five conditions, 33.2 %). The number of psychosocial health conditions was positively associated with HIV risk behavior and HIV prevalence and incidence. Prevention efforts among MSM need to address the existence of multiple psychosocial health conditions and their synergy to effectively decrease the spread of HIV infection. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Syndemics; HIV/AIDS; Men who have sex with men; Thailand; Adult; Cohort Studies; HIV Infections; Homosexuality, Male; Humans; Incidence; Kaplan-Meier Estimate; Longitudinal Studies; Male; Prevalence; Psychology; Risk Factors; Thailand; Unsafe Sex; Epidemiology; Health; HIV; Psychosexual Behavior; Same Sex Intercourse; Southeast Asian Cultural Groups; Risk Assessment; Social Health

Transgender health disparities: Comparing full cohort and nested matched-pair study designs in a community health center - Reisner, Sari L.; White, Jaclyn M.; Bradford, Judith B.; Mimiaga, Matthew J. (LGBT Health, 2014)
Purpose: U.S. health surveillance systems infrequently include measures to identify transgender respondents or monitor the health of this underserved and marginalized population. Methods: From 2001 to 2002, transgender and nontransgender adults were sampled at a Massachusetts clinic. Health differences were formatively examined by transgender identity using a cross-sectional, clinic-based sample (n = 2,653) and a nested matched-pair subsample (n = 155). Results: Both designs produced virtually identical findings: (1) the prevalence of HIV, substance abuse, and smoking did not differ significantly for transgender and nontransgender patients; (2) transgender patients were more likely to endorse a lifetime suicide attempt and ideation compared with nontransgender patients (p < 0.05); (3) transgender patients disproportionately reported social stressors (violence, discrimination, childhood abuse) relative to nontransgender patients (p < 0.05). Conclusion: Findings suggest that a nested design may provide an effective methodology for using clinical data to study transgender health and underscore the need for routine collection of gender identity in clinical settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gender identity; health disparity; methods; study design; transgender; Gender Identity; Health Disparities; Transgender; Community Services; Experimental Design; Health Care Services; Community Health

Suicidal ideation and sexual orientation in college students: The roles of perceived burdensomeness, thwarted belongingness, and perceived rejection due to sexual orientation - Hill, Ryan M.; Pettit, Jeremy W. (Suicide and Life-Threatening Behavior, 2012)
A theoretical model in which perceived burdensomeness and thwarted belongingness were hypothesized to account for the association between sexual orientation and suicidal ideation among college students was tested. Among 198 college students (mean age 21.28 years), gay, lesbian, and bisexual students (n = 50) reported significantly higher levels of perceived burdensomeness and suicidal ideation than heterosexual students. The relationship between sexual orientation and suicidal ideation was partially accounted for by perceived burdensomeness, but not thwarted belongingness. This indirect effect was stronger at higher levels of perceived or anticipated rejection due to one’s sexual orientation. Implications for intervention and prevention science are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; college students; perceived burdensomeness; thwarted belongingness; sexual orientation; Adolescent; Adult; Bisexuality; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Middle Aged; Models, Psychological; Rejection (Psychology); Sexuality; Students; Suicidal Ideation; Surveys and Questionnaires; College Students; Sexual Orientation; Suicidal Ideation

Physician counseling on firearm safety: A new kind of cultural competence - Betz, Marian E.; Wintemute, Garen J. (JAMA: Journal of the American Medical Association, 2015)
This opinion article discusses physician counseling on firearm safety as a new kind of cultural competence. Physician counseling concerning gun safety has been identified as a key component of the prevention of firearm injury and deaths. However, recently proposed or enacted state laws that are perceived as restricting physicians’ conversations with patients about firearms have spurred debates about the role of physicians in preventing firearm injury and death. In response, medical, legal, and public health organizations published a statement defending freedom in the physician-patient relationship and the right for physicians to be able to speak openly with patients about firearm safety. Patient-centered care, now a guiding principle in medicine, requires physician 'cultural competence' for patient populations as defined by ethnic heritage, religious beliefs, sexual orientation, or other factors. Cultural competence is a 'set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.' There is limited evidence on the perceptions of gun owners about communication with physicians. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: physicians; counseling; firearms safety; cultural competence; Counseling; Cultural Competency; Firearms; Humans; Leadership; Physician's Role; Physician-Patient Relations; Public Health; Safety; Wounds, Gunshot; Counseling; Cultural Sensitivity; Firearms; Physicians; Safety

Mental health implications in Mormon women’s experiences with same-sex attraction: A qualitative study - Jacobsen, Jeanna; Wright, Rachel (The Counseling Psychologist, 2014)
Given research suggesting that individuals in conservative religions experience conflict between religious beliefs and feelings of same-sex sexuality, this study explores the mental health impact of Mormon women who experience same-sex sexuality. Twenty-three Mormon women participated in semi-structured individual interviews about their experiences with same-sex sexuality. Interview questions asked about participants’ experiences with same-sex sexuality and the LDS Church (The Church of Jesus Christ of Latter-day Saints), how this experience affected their mental health, and what types of mental health treatment they engaged in during their process of reconciliation. Data were analyzed following phenomenological methodology. Themes included the following: experiences with mood disorders, self-worth, suicidality, treatment attempts, reparative therapy, counselor’s agenda, impact of family and community, and mental health recovery. When treating women who experience conflict, counselors should assess self-worth, suicidality, and the level of community and familial support. Referral to group counseling can support self-acceptance of same-sex sexuality through normalization. Future research should examine specific practice interventions and explore impacts of other intersecting identities. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental health implications; Mormon women; lesbian; same sex attraction; religion; Human Females; Religion; Sexuality; Mormons; Lesbianism; Mental Health; Religious Beliefs; Sexual Attraction; Sexual Orientation

In the wake of Don’t Ask Don’t Tell: Suicide prevention and outreach for LGB service members - Wilder, Heather; Wilder, Jami (Military Psychology, 2012)
It is estimated that lesbian, gay, and bisexual (LGB) individuals are three to five times more likely to attempt suicide than their heterosexual counterparts. Factors linked to increased LGB suicide risk are overt and covert discrimination, internalized oppression, nondisclosure of sexual orientation, and lack of adequate social support. As the U.S. military adjusts to the repeal of Don’t Ask Don’t Tell (DADT), it will be imperative to understand and support service people who are struggling with many of these same issues. This article explores factors linked to suicidality and provides education for professionals working with LGB service people. Emphasis is placed on strategies for the provision of support and suicide prevention for members of this population. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: suicide prevention; lesbians; bisexuality; gays; military personnel; legislation; Bisexuality; Homosexuality; Laws; Military Personnel; Suicide Prevention

Prevalence of gender identity disorder and suicide risk among transgender veterans utilizing Veterans Health Administration care - Blosnich, John R.; Brown, George R.; Shipherd, Jillian C.; Kauth, Michael; Piegari, Rebecca I.; Bossarte, Robert M. (American Journal of Public Health, 2013)
Objectives: We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis. Methods: We examined VHA electronic medical records from 2000 through 2011 for 2 official ICD-9 diagnosis codes that indicate transgender status. We generated annual period prevalence estimates and calculated incidence using the prevalence of GID at 2000 as the baseline year. We cross-referenced GID cases with available data (2009–2011) of suicide-related events among all VHA users to examine suicide risk. Results: GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population. Conclusions: The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans. Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gender identity disorder diagnosis; prevalence; suicide risk; transgender veterans; veterans health administration care; Confidence Intervals; Electronic Health Records; Female; Gender Identity; Hospitals, Veterans; Humans; Male; Prevalence; Risk Assessment; Suicide; Transsexualism; United States; United States Department of Veterans Affairs; Veterans; Health Care Services; Military Veterans; Suicide; Transgender; Gender Dysphoria; Diagnosis; Risk Factors

Comparing trans-spectrum and same-sex-attracted youth in Australia: Increased risks, increased activisms - Jones, Tiffany; Hillier, Lynne (Journal of LGBT Youth, 2013)
Tran-spectrum youth include those who are gender questioning, transgender, intersex, genderqueer, and androgynous. Drawing on data from an Australian study of more than 3,000 same-sex-attracted and trans-spectrum youth aged 14 to 21, this article compares a group of 91 trans-spectrum youth from the study to 'cisgender' same-sex-attracted peers (who feel their gender identity aligns more fully with their ascribed sex). Comparisons are made on topics including identity disclosure and support; experience of abuse; suicide and self-harm; and school experiences. The trans-spectrum respondents particularly reported experiencing homophobic abuse and suicide attempts in response to homophobia and cissexism significantly more often than their cisgender counterparts. However, an exciting finding of the study was that some of these youth were able to reframe social rejection of their identities using a variety of self-affirming strategies. They were also more likely to respond to discrimination through activism, and many held high hopes for the ways in which they might impact their worlds in the future. The article finally reflects on the special provisions needed for this group in areas such as youth services and education, and the need for individuals to be supportive of trans-spectrum youth who disclose their identities to them. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: trans-spectrum; same-sex-attraction; increased activisms; increased risks; gender identity; Activism; At Risk Populations; Gender Identity; Sexual Attraction; Transgender

Unmet mental health and substance abuse treatment needs of sexual minority elders - Jessup, Martha; Dibble, Suzanne (Journal of Homosexuality, 2012)
In a survey exploring the reliability and validity of a screening tool, we explored the substance abuse and mental health issues among 371 elders; 74 were sexual minorities. Analyses by age group indicated that elders 55–64 years had significantly more problems with substance abuse, posttraumatic stress disorder (PTSD), depression, anxiety, and suicidal thoughts compared to those 65 and older. Bisexuals reported significantly greater problems with depression, anxiety, and suicidality than either heterosexual or lesbian or gay elders. Mental health and substance abuse treatment utilization was low among all elders with problems. Implications for assessment, access to care, and group-specific services delivery are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: unmet mental health needs; substance abuse treatment needs; sexual minority elders; screening tools; Aged; Bisexuality; Female; Health Services Needs and Demand; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Disorders; Mental Health Services; Middle Aged; Minority Groups; Psychological Tests; Reproducibility of Results; Sexuality; Substance-Related Disorders; Surveys and Questionnaires; Drug Abuse; Geriatrics; Health Service Needs; Mental Health; Screening; Bisexuality; Homosexuality; Minority Groups; Sexual Minority Groups

Determinants of suicide and accidental or violent death in the Australian HIV Observational Database - McManus, Hamish; Petoumenos, Kathy; Franic, Teo; Kelly, Mark D.; Watson, Jo; O'Connor, Catherine C.; Jeanes, Mark; Hoy, Jennifer; Cooper, David A.; Law, Matthew G. (PLoS ONE, 2014)
Background: Rates of suicide and accidental or violent death remain high in HIV-positive populations despite significantly improved prognosis since the introduction of cART. Methods: We conducted a nested case-control study of suicide and accidental or violent death in the Australian HIV Observational Database (AHOD) between January 1999 and March 2012. For each case, 2 controls were matched by clinic, age, sex, mode of exposure and HIV-positive date to adjust for potential confounding by these covariates. Risk of suicide and accidental or violent death was estimated using conditional logistic regression. Results: We included 27 cases (17 suicide and 10 violent/accidental death) and 54 controls. All cases were men who have sex with men (MSM) or MSM/ injecting drug use (IDU) mode of exposure. Increased risk was associated with unemployment (Odds Ratio (OR) 5.86, 95% CI: 1.69–20.37), living alone (OR 3.26, 95% CI: 1.06–10.07), suicidal ideation (OR 6.55, 95% CI: 1.70–25.21), and >2 psychiatric/cognitive risk factors (OR 4.99, 95% CI: 1.17–30.65). CD4 cell count of >500 cells/μL (OR 0.25, 95% CI: 0.07–0.87) and HIV-positive date ≥1990 (1990–1999 (OR 0.31, 95% CI: 0.11–0.89), post-2000 (OR 0.08, 95% CI: 0.01– 0.84)) were associated with decreased risk. CD4 cell count ≥500 cells/μL remained a significant predictor of reduced risk (OR 0.15, 95% CI: 0.03–0.70) in a multivariate model adjusted for employment status, accommodation status and HIV-positive date. Conclusions: After adjustment for psychosocial factors, the immunological status of HIV-positive patients contributed to the risk of suicide and accidental or violent death. The number of psychiatric/cognitive diagnoses contributed to the level of risk but many psychosocial factors were not individually significant. These findings indicate a complex interplay of factors associated with risk of suicide and accidental or violent death. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: suicide; accidental death; violent death; HIV: men who have sex with men; risk factors; Accidents; Adult; Australia; Case-Control Studies; Cause of Death; Databases, Factual; HIV Infections; HIV-1; Homicide; Homosexuality, Male; Humans; Male; Middle Aged; Suicide; Violence; Young Adult; Death and Dying; HIV; Suicide; Violence; Same Sex Intercourse; Risk Factors

Suicidality and self-harm among sexual minorities in Japan - DiStefano, Anthony S. (Qualitative Health Research, 2008)
In this study, I used ethnographic methods to examine suicidality and non suicidal self-harm among gay, lesbian, bisexual, and transgender persons in Japan. Participants (N = 84) indicated that suicidality and self-harm are serious problems among sexual minorities and tend to be driven by (a) a homophobic/transphobic environment and the negative consequences of sexual minorities either disclosing their true selves or remaining hidden and silent within such an environment; (b) various antecedents to poor mental health; and (c) factors not directly related to being a sexual minority, particularly unemployment and debt in the context of a protracted national economic decline in Japan prior to the study period of 2003–2004. Participants also perceived a potentially higher risk for suicidality and self-harm among sexual minority adolescents and persons in their early 20s; those who work in the entertainment, bar, or sex industries; and survivors of violence perpetrated by intimate partners or family members. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidality; self-harm; sexual minorities; gays; lesbians; bisexuals; transgender persons; Adult; Bisexuality; Female; Homosexuality; Humans; Japan; Male; Middle Aged; Self-Injurious Behavior; Suicide; Transsexualism; Bisexuality; Lesbianism; Self-Destructive Behavior; Suicidal Ideation; Transgender; Suicidality

Suicidality and depression disparities between sexual minority and heterosexual youth: A meta-analytic review - Marshal, Michael P.; Dietz, Laura J.; Friedman, Mark S.; Stall, Ron; Smith, Helen A.; McGinley, James; Thoma, Brian C.; Murray, Pamela J.; D'Augelli, Anthony R.; Brent, David A. (Journal of Adolescent Health, 2011)
Purpose: To examine disparities between sexual minority youth (SMY) and heterosexual youth in rates of suicidality and depression symptoms. Methods: Separate meta-analyses were conducted to examine suicidality and depression disparities. Studies were included if the average age of the participants was < 18 years, and if suicidality or depression symptoms were compared across SMY and heterosexual youth. Results: SMY reported significantly higher rates of suicidality (odds ratio [OR] = 2.92) and depression symptoms (standardized mean difference, d = .33) as compared with the heterosexual youth. Disparities increased with the increase in the severity of suicidality (ideation [OR = 1.96], intent/plans [OR = 2.20], suicide attempts [OR = 3.18], suicide attempts requiring medical attention [OR = 4.17]). Effects did not vary across gender, recruitment source, and sexual orientation definition. Conclusions: Disparities in suicidality and depression may be influenced by negative experiences including discrimination and victimization. Clinicians should assess sexual orientation, analyze psychosocial histories to identify associated risk factors, and promote prevention and intervention opportunities for SMY and their families. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidality; depression disparities; sexual minority; heterosexual youths; Adolescent; Bisexuality; Depression; Female; Heterosexuality; Homosexuality; Humans; Male; Odds Ratio; Sexuality; Suicide; Suicide, Attempted; Major Depression; Sexual Orientation; Suicidal Ideation; Suicidality; Sexual Minority Groups; Bisexuality; Heterosexuality; Lesbianism; Male Homosexuality; Symptoms; Transgender

Exploring a Dutch paradox: An ethnographic investigation of gay men's mental health - Aggarwal, Sanjay; Gerrets, Rene (Culture, Health & Sexuality, 2014)
Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North America. These findings have been the focus of a blossoming psychological literature, inspired by minority stress theory and deploying quantitative methods. Our investigation aims to complement this body of work by adopting an ethnographic approach. Drawing from fieldwork conducted in the Netherlands from 2009 to 2010, we explore sociocultural and contextual factors that have received relatively little attention with respect to gay mental health. In the Netherlands—considered a model for gay equality—how can one understand high rates of psychiatric disorders among gay men? This study points to heteronormativity, complex dynamics involving long-term relationships and processes within gay subcultures as key issues. Notwithstanding their putative socioeconomic, legal and political equality, gay men struggled—at various stages of the life cycle – with internalised norms that they found difficult to fulfil. The desire to embody these ideals, and structural constraints in meeting them, could be potent sources of disappointment and distress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gay men; mental health; stigma; sociocultural factors; contextual factors; Netherlands; Adult; Anthropology, Cultural; Civil Rights; Homosexuality, Male; Humans; Male; Men; Mental Health; Middle Aged; Minority Groups; Netherlands; Qualitative Research; Self Concept; Social Conformity; Social Stigma; Male Homosexuality; Mental Health; Sociocultural Factors; Stigma

A syndemic of psychosocial health disparities and associations with risk for attempting suicide among young sexual minority men - Mustanski, Brian; Andrews, Rebecca; Herrick, Amy; Stall, Ron; Schnarrs, Phillip W. (American Journal of Public Health, 2014)
Objectives: We examined a syndemic of psychosocial health issues among young men who have sex with men (MSM), with men and women (MSMW), and with women (MSW). We examined hypothesized drivers of syndemic production and effects on suicide attempts. Methods: Using a pooled data set of 2005 and 2007 Youth Risk Behavior Surveys from 11 jurisdictions, we used structural equation modeling to model a latent syndemic factor of depression symptoms, substance use, risky sex, and intimate partner violence. Multigroup models examined relations between victimization and bullying experiences, syndemic health issues, and serious suicide attempts. Results: We found experiences of victimization to increase syndemic burden among all male youths, especially MSMW and MSM compared with MSW (variance explained = 44%, 38%, and 10%, respectively). The syndemic factor was shown to increase the odds of reporting a serious suicide attempt, particularly for MSM (odds ratio [OR] = 5.75; 95% confidence interval [CI] = 1.36, 24.39; P < .001) and MSMW (OR = 5.08; 95% CI = 2.14, 12.28; P < .001) compared with MSW (OR = 3.47; 95% CI = 2.50, 4.83; P < .001). Conclusions: Interventions addressing multiple psychosocial health outcomes should be developed and tested to better meet the needs of young MSM and MSMW. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: psychosocial health disparities; suicide attempt risk; sexual minority men; Adolescent; Crime Victims; Depression; Health Status Disparities; Homosexuality, Male; Humans; Male; Sexual Behavior; Sexuality; Spouse Abuse; Substance-Related Disorders; Suicide, Attempted; United States; Violence; Attempted Suicide; Minority Groups; Risk Factors; Sexual Orientation; Health Disparities; Psychosocial Factors; Sexual Minority Groups; Social Health

Are there still too few suicides to generate public outrage? - Lytle, Megan C.; Silenzio, Vincent M. B.; Caine, Eric D. (JAMA Psychiatry, 2016)
This opinion article argues that there must be public debate and discussion if we are going to move beyond the view that suicide is a private matter rather than a public health challenge. If we consider suicide a 'public health problem,' it is inevitable that there will be tensions involving individual vs broader public needs—exactly as we have seen for smoking, drinking, and sexual behavior. Franklin Roosevelt tried to hide his disease; Betty Ford talked about hers. The successes in combating AIDS grew directly from individuals talking about their sexual orientation and the need for a broader social understanding that embraced diversity. Such public discussion is essential for promoting individual, family, and social well-being and suicide prevention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide; public health; Public Health; Suicide

Special issue introduction: New research on lesbian, gay, bisexual, and transgender youth: Studying lives in context - Horn, Stacey S.; Kosciw, Joseph G.; Russell, Stephen T. (Journal of Youth and Adolescence, 2009)
In the past three decades there has been growing attention to lesbian, gay, bisexual, and transgender (LGBT) youth among adolescence researchers. Beginning with a few seminal studies on the risk-factors, particularly suicide, faced by lesbian and gay youth, research on these populations has emerged over the past 30 years as an important and critical area within the study of adolescence. With this special issue we propose a paradigm that moves beyond studying LGBT youth as either at-risk OR resilient, but rather that focuses on understanding the ways in which LGBT youth negotiate their development within various social contexts. In this collection of articles, authors cover a range of topics that contribute to our understanding of the lives of LGBT youth in context. Not surprisingly, several studies focus on the experience of harassment and victimization. Two of the papers in this issue provide a counterpoint to the papers on victimization by examining the context of school environment for LGBT students through understanding sexual prejudice among heterosexual students. With this special issue, we have attempted a contextual focus on the lives of LGBT youth, while exploring differences within this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: lesbianism; gay; bisexuality; transgender youth; risk factors; suicide; harassment; victimization; school environment; sexual prejudice; Achievement; Adolescent; Bisexuality; Crime Victims; Female; Health Status; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Disorders; Research; Risk Factors; Sexual Behavior; Social Environment; Temperament; Transsexualism; Harassment; Homosexuality (Attitudes Toward); Prejudice; Risk Factors; Victimization; Bisexuality; Lesbianism; Male Homosexuality; School Environment; Suicide; Transgender

Structural stigma and all-cause mortality in sexual minority populations - Hatzenbuehler, Mark L.; Bellatorre, Anna; Lee, Yeonjin; Finch, Brian K.; Muennig, Peter; Fiscella, Kevin (Social Science & Medicine, 2014)
[Correction Notice: An Erratum for this article was reported in Vol 200 of Social Science & Medicine (see record [rid]2018-15858-033[/rid]). Following the publication of Regnerus's (2017) paper, we hired an independent research group, led by Dr. Katherine Keyes, to replicate the results of our paper entitled 'Structural Stigma and All-Cause Mortality in Sexual Minority Populations'. A coding error was discovered. Specifically, the data analyst mis-specified the time variable for the survival models, which incorrectly addressed the censoring for individuals who died. The time variable did not correctly adjust for the time since the interview to death due to a calculation error, which led to improper censoring of the exposure period. Once the error was corrected, there was no longer a significant association between structural stigma and mortality risk among the sample of 914 sexual minorities.] Stigma operates at multiple levels, including intrapersonal appraisals (e.g., self-stigma), interpersonal events (e.g., hate crimes), and structural conditions (e.g., community norms, institutional policies). Although prior research has indicated that intrapersonal and interpersonal forms of stigma negatively affect the health of the stigmatized, few studies have addressed the health consequences of exposure to structural forms of stigma. To address this gap, we investigated whether structural stigma-operationalized as living in communities with high levels of anti-gay prejudice-increases risk of premature mortality for sexual minorities. We constructed a measure capturing the average level of anti-gay prejudice at the community level, using data from the General Social Survey, which was then prospectively linked to all-cause mortality data via the National Death Index. Sexual minorities living in communities with high levels of anti-gay prejudice experienced a higher hazard of mortality than those living in low-prejudice communities (Hazard Ratio [HR] = 3.03, 95% Confidence Interval [CI] = 1.50, 6.13), controlling for individual and community-level covariates. This result translates into a shorter life expectancy of approximately 12 years (95% C.I.: 4-20 years) for sexual minorities living in high-prejudice communities. Analysis of specific causes of death revealed that suicide, homicide/violence, and cardiovascular diseases were substantially elevated among sexual minorities in high-prejudice communities. Strikingly, there was an 18-year difference in average age of completed suicide between sexual minorities in the high-prejudice (age 37.5) and low-prejudice (age 55.7) communities. These results highlight the importance of examining structural forms of stigma and prejudice as social determinants of health and longevity among minority populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: mortality; sexual minority; stigma; communities; Adult; Bisexuality; Cause of Death; Female; Health Surveys; Homosexuality; Humans; Male; Minority Groups; Residence Characteristics; Risk Assessment; Social Determinants of Health; Social Stigma; United States; Communities; Death and Dying; Minority Groups; Mortality Rate; Stigma; Sexual Minority Groups

Student service members and veterans who access pastoral care for the purposes of mental health support - Kopacz, Marek S.; Karras, Elizabeth (Journal of American College Health, 2015)
Objectives: (1) Describe the demographic characteristics of student service members and veterans (SSM/V) who seek pastoral care for mental health support; and (2) evaluate patterns of access to mental health care providers among pastoral care users and nonusers. Participants: Respondents to the Fall 2011 National College Health Assessment who reported a history of military service and ever having sought mental health care (n = 331). Methods: Differences between groups were examined using chi-square and Student's t tests. Adjusted odds ratios were estimated using ordinal logistic regression. Results: One-third of participants used pastoral care. Users were more likely to be male and older. No significant differences were noted for race/ethnicity, sexual orientation, or exposure to hazardous duty. Users had a greater than 6-fold increase in proportional odds of accessing multiple providers. Conclusions: Many SSM/V look to pastoral care for mental health support. Colleges should consider incorporating a pastoral care component into specialized health care programs provided to SSM/V. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: counseling; mental health; pastoral care; Health Care Seeking Behavior; Mental Health Services; Military Veterans; Pastoral Counseling; Health Behavior; Student Characteristics

Suicidality and sexual orientation among men in Switzerland: Findings from 3 probability surveys - Wang, Jen; Häusermann, Michael; Wydler, Hans; Mohler-Kuo, Meichun; Weiss, Mitchell G. (Journal of Psychiatric Research, 2012)
Few population-based surveys in Europe have examined the link between suicidality and sexual orientation. The objective of this study was to assess the prevalences of and risk for suicidality by sexual orientation, especially among adolescent and young adult men. Data came from three probability-based surveys in Switzerland from 2002: 1) Geneva Gay Men’s Health Survey (GGMHS) with 571 gay/bisexual men, 2) Swiss Multicenter Adolescent Survey on Health (SMASH) with 7,428 16-20 year olds, and 3) Swiss Recruit Survey (ch-x) with 22,415 new recruits. In GGMHS, suicidal ideation (12 months/lifetime) was reported by 22%/55%, suicide plans 12%/38%, and suicide attempts 4%/19%. While lifetime prevalences and ratios are similar across age groups, men under 25 years reported the highest 12-month prevalences for suicidal ideation (35.4%) and suicide attempts (11.5%) and the lowest attempt ratios (1:1.5 for attempt to plan and 1:3.1 for attempt to ideation). The lifetime prevalence of suicide attempts among homo/bisexual men aged 16-20 years varies from 5.1% in ch-x to 14.1% in SMASH to 22.0% in GGMHS. Compared to their heterosexual counterparts, significantly more homo/bisexual men reported 12-month suicidal ideation, plans, and attempts (OR = 2.09-2.26) and lifetime suicidal ideation (OR = 2.15) and suicide attempts (OR = 4.68-5.36). Prevalences and ratios vary among gay men by age and among young men by both sexual orientation and study population. Lifetime prevalences and ratios of non-fatal suicidal behaviors appear constant across age groups as is the increased risk of suicidality among young homo/bisexual men. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidality; sexual orientation; men; Switzerland; Adolescent; Adult; Age Factors; Community Health Planning; Female; Health Surveys; Humans; Male; Middle Aged; Odds Ratio; Prevalence; Probability; Sexual Behavior; Suicidal Ideation; Suicide, Attempted; Switzerland; Young Adult; Attempted Suicide; Human Males; Sexual Orientation; Suicidal Ideation; Suicidality

Employment, mental health, internalized stigma, and coping with transphobia among transgender individuals - Mizock, Lauren; Mueser, Kim T. (Psychology of Sexual Orientation and Gender Diversity, 2014)
Transgender individuals encounter stigma related to nonconforming gender identity, contributing to elevated symptoms of depression, anxiety, and suicidality. Stigma toward transgender individuals (i.e., transphobia) poses significant barriers to employment and other areas of functioning. Transgender individuals with a history of mental health concerns may encounter double stigma. The present 2-part study was conducted to investigate experiences of double stigma, internalized stigma, and coping strategies for dealing with transphobia. In Study 1, quantitative findings with 55 transgender participants indicated that employed participants reported higher levels of stigma (both internalized and external). Higher levels of coping with stigma were associated with lower levels of stigma (both internalized and external). Higher levels of coping were reported by participants utilizing psychiatric medication, with lower levels of coping with mental health stigma in particular found among those receiving outpatient mental health services. In Study 2, a grounded theory analysis was conducted with 45 of these participants to identify coping strategies that transgender individuals use to deal with transphobia. Coping strategies were categorized into individual factors (gender normative coping, self-affirmative coping, emotional regulation coping, cognitive reframe coping); interpersonal factors (social-relational coping, preventative-preparative coping, disengagement coping); and systemic factors (resource access coping, spiritual and religious coping, and political empowerment coping). Findings of Study 2 also revealed the presence of disclosure strategies—decisions to reveal or conceal one’s transgender identity, and anticipatory stigma—expecting and preparing for prejudice and discrimination. Results suggest the need for interventions for transgender individuals to enhance coping with stigma and reduce internalized stigma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: coping; internalized stigma; qualitative; transgender; transphobia; grounded theory; Coping Behavior; Phobias; Stigma; Transgender; Grounded Theory; Symptoms

Risk behaviors, suicidal ideation and suicide attempts in a nationally representative French sample - Husky, Mathilde M.; Guignard, Romain; Beck, François; Michel, Grégory (Journal of Affective Disorders, 2013)
Background: Data from large nationally representative samples are needed to provide the empirical foundation to inform health policies for the prevention of suicide risk and risk behaviors in men and women. Methods: Data were extracted from the 2010 Health Barometer, a large telephone survey on a representative sample of the general population aged 15–85 years living in France (n = 27,653), carried out by the National Institute for Health Promotion and Health Education. Data were collected between October 2009 and July 2010. A computer-assisted telephone interview (CATI) system was used. Results: Overall, 3.9% of respondents aged 15 to 85 reported past year suicidal ideation, and 0.5% reported a suicide attempt in that time period. Increased rates of risky sexual behavior are associated with ideation and attempt in both men and women, after controlling for sociodemographic variables. Homosexuality or bisexuality are associated with suicidal ideation for both men and women, but not with attempts. Substance misuse, physical and sexual assaults are strongly associated with suicidal symptoms for both men and women. Early first experiences with sex, tobacco, and alcohol are associated with suicidal symptoms though somewhat differentially for men and women. Limitations: Cross-sectional survey. Conclusion: The findings underscore associations between suicidal thoughts and behaviors and risk behaviors such as unprotected sex and substance use in men and women throughout the lifespan. These associations highlight the need for preventive strategies such as screening for risk behaviors in order to identify men and women particularly at risk for suicidal behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: risk behavior; suicidal ideation; suicide attempts; homosexuality; substance misuse; physical assault; Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; France; Humans; Male; Middle Aged; Risk-Taking; Sexual Behavior; Substance-Related Disorders; Suicidal Ideation; Suicide, Attempted; Young Adult; Attempted Suicide; Risk Factors; Suicidal Ideation; Drug Abuse; Homosexuality; Physical Abuse

Disproportionate exposure to early-life adversity and sexual orientation disparities in psychiatric morbidity - McLaughlin, Katie A.; Hatzenbuehler, Mark L.; Xuan, Ziming; Conron, Kerith J. (Child Abuse & Neglect, 2012)
Objectives: Lesbian, gay, and bisexual (LGB) populations exhibit elevated rates of psychiatric disorders compared to heterosexuals, and these disparities emerge early in the life course. We examined the role of exposure to early-life victimization and adversity—including physical and sexual abuse, homelessness, and intimate partner violence—in explaining sexual orientation disparities in mental health among adolescents and young adults. Methods: Data were drawn from the National Longitudinal Study of Adolescent Health, Wave 3 (2001–2002), a nationally representative survey of adolescents. Participants included gay/lesbian (n = 227), bisexual (n = 245), and heterosexual (n = 13,490) youths, ages 18–27. We examined differences in the prevalence of exposure to child physical or sexual abuse, homelessness or expulsion from one's home by caregivers, and physical and sexual intimate partner violence according to sexual orientation. Next we examined the associations of these exposures with symptoms of psychopathology including suicidal ideation and attempts, depression, binge drinking, illicit drug use, tobacco use, alcohol abuse, and drug abuse. Finally, we determined whether exposure to victimization and adversity explained the association between sexual orientation and psychopathology. Results: Gay/lesbian and bisexual respondents had higher levels of psychopathology than heterosexuals across all outcomes. Gay/lesbian respondents had higher odds of exposure to child abuse and housing adversity, and bisexual respondents had higher odds of exposure to child abuse, housing adversity, and intimate partner violence, than heterosexuals. Greater exposure to these adversities explained between 10 and 20% of the relative excess of suicidality, depression, tobacco use, and symptoms of alcohol and drug abuse among LGB youths compared to heterosexuals. Exposure to victimization and adversity experiences in childhood and adolescence significantly mediated the association of both gay/lesbian and bisexual orientation with suicidality, depressive symptoms, tobacco use, and alcohol abuse. Conclusions: Exposure to victimization in early-life family and romantic relationships explains, in part, sexual orientation disparities in a wide range of mental health and substance use outcomes, highlighting novel targets for preventive interventions aimed at reducing these disparities. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: early life adversity; sexual orientation disparities; psychiatric disorders; victimization; physical abuse; sexual abuse; homelessness; intimate partner violence; age differences; morbidity; Adolescent; Adult; Bisexuality; Child Abuse; Crime Victims; Depression; Domestic Violence; Family Health; Female; Heterosexuality; Homeless Youth; Homosexuality; Humans; Life Change Events; Longitudinal Studies; Male; Sex Factors; Sexuality; Substance-Related Disorders; Young Adult; Early Experience; Mental Disorders; Sexual Abuse; Sexual Orientation; Morbidity; Age Differences; Homeless; Intimate Partner Violence; Physical Abuse; Victimization; Adversity

Family acceptance in adolescence and the health of LGBT young adults - Ryan, Caitlin; Russell, Stephen T.; Huebner, David; Diaz, Rafael; Sanchez, Jorge (Journal of Child and Adolescent Psychiatric Nursing, 2010)
Issue: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. Methods: A quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N = 245). Findings: Family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. Conclusions: Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: family acceptance; adolescence; health; lesbian; gay; bisexual; transgender; young adults; protective factor; Adaptation, Psychological; Adolescent; Adult; Bisexuality; Family Relations; Female; Health Behavior; Homosexuality, Female; Homosexuality, Male; Humans; Male; Retrospective Studies; Social Support; Transsexualism; Young Adult; Adolescent Psychology; Family Relations; Health; Protective Factors; Sexual Orientation; Bisexuality; Lesbianism; Male Homosexuality; Transgender

Parental acceptance and illegal drug use among gay, lesbian, and bisexual adolescents: Results from a national survey - Padilla, Yolanda C.; Crisp, Catherine; Rew, Donna Lynn (Social Work, 2010)
Although gay, lesbian, and bisexual (GLB) adolescents face many of the same developmental challenges as do heterosexual adolescents, they must also deal with the stress of being part of a stigmatized group. The purpose of this study was to examine the extent to which family support and involvement with the queer community may buffer the effects of life stress on substance use among GLB youths. Drawing on a large national online survey, the authors examined drug use in 1,906 GLB youths 12 to 17 years of age. Overall, 20 percent of the youths reported using illegal substances in the past 30 days. Results from multivariate analyses revealed that stress, as measured by suicidal ideation, significantly increased the risk of drug use. A positive reaction from the mother to the youth's coming out served as a significant protective factor, whereas involvement in a queer youth group had no effect. The authors found evidence that, for GLB adolescents, parental acceptance of sexual identity is an important aspect of a strong family relationship and, thus, has important ramifications for their healthy development. Implications of the findings for social work practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: parental acceptance; illegal drug use; gay; lesbian; bisexual adolescents; family support; queer community; family involvement; Adolescent; Adult; Bisexuality; Child; Data Collection; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Parent-Child Relations; Substance-Related Disorders; United States; Young Adult; Bisexuality; Drug Usage; Heterosexuality; Lesbianism; Parental Involvement; Family

Dissociative symptoms in individuals with gender dysphoria: Is the elevated prevalence real? - Colizzi, Marco; Costa, Rosalia; Todarello, Orlando (Psychiatry Research, 2015)
This study evaluated dissociative symptomatology, childhood trauma and body uneasiness in 118 individuals with gender dysphoria, also evaluating dissociative symptoms in follow-up assessments after sex reassignment procedures were performed. We used both clinical interviews (Dissociative Disorders Interview Schedule) and self-reported scales (Dissociative Experiences Scale). A dissociative disorder of any kind seemed to be greatly prevalent (29.6%). Moreover, individuals with gender dysphoria had a high prevalence of lifetime major depressive episode (45.8%), suicide attempts (21.2%) and childhood trauma (45.8%), and all these conditions were more frequent in patients who fulfilled diagnostic criteria for any kind of dissociative disorder. Finally, when treated, patients reported lower dissociative symptoms. Results confirmed previous research about distress in gender dysphoria and improved mental health due to sex reassignment procedures. However, it resulted to be difficult to ascertain dissociation in the context of gender dysphoria, because of the similarities between the two conditions and the possible limited application of clinical instruments which do not provide an adequate differential diagnosis. Therefore, because the body uneasiness is common to dissociative experiences and gender dysphoria, the question is whether dissociation is to be seen not as an expression of pathological dissociative experiences but as a genuine feature of gender dysphoria. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Transsexualism; Gender dysphoria; Gender reaffirming treatment; Dissociative symptoms; Childhood trauma; Body uneasiness; Adult; Comorbidity; Dissociative Disorders; Female; Humans; Longitudinal Studies; Male; Prevalence; Transsexualism; Childhood Neurosis; Hormone Therapy; Human Sex Differences; Major Depression; Symptoms; Patients; Transsexualism; Trauma

Experiences of community and parental violence among HIV-positive young racial/ethnic minority men who have sex with men - Phillips, Gregory II; Hightow-Weidman, Lisa B.; Fields, Sheldon D.; Giordano, Thomas P.; Outlaw, Angulique Y.; Halpern-Felsher, Bonnie; Wohl, Amy R. (AIDS Care, 2014)
Adolescents and young adults (ages 13–24) in the USA are frequently exposed to violence in their community and home. While studies have examined the prevalence and impact of violence exposure among adolescents, there is a lack of data focusing specifically on adolescent men of color who have sex with men. Eight demonstration sites funded through a Special Projects of National Significance (SPNS) Initiative recruited 363 HIV-positive racial/ethnic minority young men who have sex with men (YMSM) for a longitudinal study between 2006 and 2009. Over two-thirds of participants (83.8%) had witnessed community violence, 55.1% in the prior three months. Witnessing violence committed with a deadly weapon was significantly associated with being African-American, having ever used drugs, and drinking alcohol in the prior two weeks. Fear of violence in the community was significantly associated with depressive symptomatology, having less than a high school degree, not possessing health insurance, and site of enrollment. Having been emotionally or physically abused by a parent or caretaker was significantly associated with depressive symptomatology, attempting suicide, site of enrollment, and increased age. Witnessing violence with a deadly weapon was significantly associated with alcohol and drug use but not with high-risk sexual behaviors. As this was one of the first studies on the prevalence and correlates of violence exposure among racial/ethnic minority YMSM living with HIV, the findings can be used to inform the development of culturally appropriate resilience-focused interventions to address the aftereffects of violence exposures and help develop social support systems outside of the family. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: community experiences; parental violence; HIV; racial/ethnic minority; adolescents; men who have sex with men; Adolescent; Adult; African Americans; Cohort Studies; Ethnic Groups; HIV Infections; Hispanic Americans; Homosexuality, Male; Humans; Male; Minority Groups; Odds Ratio; Parents; United States; Violence; Young Adult; HIV; Minority Groups; Racial and Ethnic Groups; Violence; Same Sex Intercourse; Adolescent Development

Gender assignment dysphoria in the DSM-5 - Lawrence, Anne A. (Archives of Sexual Behavior, 2014)
The clinical experience with transsexual patients has made it clear to me that some persons who have undergone 'successful' sex reassignment continue to fulfill two or more of the A1–A6 criteria for GD in Adolescents and Adults and continue to experience associated clinically significant distress or impairment. By any meaningful standard, these persons continue to suffer from GD. Accordingly, I believe it is appropriate that the diagnosis of GD continue to apply to them—especially because their unresolved GD is probably at least partly responsible for the increased risks of psychiatric comorbidity and excess mortality, especially death by suicide, that they experience. To regard these persons as having automatically lost the GD diagnosis simply by virtue of having undergone gender transition is the height of irresponsibility: It is an attitude the GID Sub workgroup members should have had the good sense not to encourage. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Gender assignment dysphoria; sex reassignment; transsexual patients; DSM; distress; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Transsexualism; Diagnostic and Statistical Manual; Distress; Human Sex Differences; Transsexualism; Virtue; Gender Reassignment

Review of Queer youth suicide, culture and identity: Unliveable lives? - Pullen, Christopher (Sexualities, 2013)
Reviews the book, Queer Youth Suicide, Culture and Identity: Unliveable Lives? by Rob Cover (2012). This book aims to relate queer theory to expressions of vulnerability within queer youth. The book offers a sophisticated and developed discussion of key writers within queer theory. The book suggests that although media representations have evolved and more people are talking about queer youth, as evident in a number of films and dramas that he also references, many of these representations, are founded on a need to relate normality of type, and the means of commodity. Hence the care of queer youth is determined as a performative trait, rather than constructed as a necessary component of community. However the book is an essential read, as it offers excellent insight into possible connections that could be made between queer theories, and the issue of queer youth suicide. While it is to argue that there is determination to focus on queer theory, his critical thinking will stimulate many readers. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: queer; suicide; social identity; films; sexual behavior; Homosexuality; Psychosexual Behavior; Social Identity; Films; Suicide

Influences on loneliness, depression, sexual-risk behaviour and suicidal ideation among Thai transgender youth - Yadegarfard, Mohammadrasool; Ho, Robert; Bahramabadian, Fatemeh (Culture, Health & Sexuality, 2013)
This study examined the influence of age, education level and number of sex partners on levels of loneliness, depression, suicidal ideation and sexual-risk behaviour in Thai male-to-female transgender youth. A total of 190 participants filled in the study’s questionnaire, designed to tap the primary variables of age, level of education, number of sex partners, loneliness, depression, suicidal ideation and sexual-risk behaviour. Results reveal that level of education has a significant influence on depression and loneliness, the number of sex partners has a significant influence on sexual-risk behaviour and suicidal ideation and age has a significant influence on sexual-risk behaviour and suicidal ideation. Participants with higher levels of education reported more loneliness than participants who did not graduate from high school. In addition, participants who did not graduate from high school reported more depression than participants with some university credit. Furthermore, participants aged 15 to 19 years, compared with those of 20 to 25 years, reported higher level of sexual-risk behaviour and higher levels of suicidal ideation. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: loneliness; major depression; sexual risk behavior; suicidal ideation; transgender; Adolescent; Age Factors; Analysis of Variance; Depression; Education; Humans; Loneliness; Male; Sexual Partners; Suicidal Ideation; Surveys and Questionnaires; Thailand; Transgender Persons; Unsafe Sex; Young Adult; Loneliness; Major Depression; Sexual Risk Taking; Suicidal Ideation; Transgender

Mental health of the non-heterosexual population of England - Chakraborty, Apu; McManus, Sally; Brugha, Terry S.; Bebbington, Paul; King, Michael (The British Journal of Psychiatry, 2011)
Background: There has been little research into the prevalence of mental health problems in lesbian, gay and bisexual (LGB) people in the UK with most work conducted in the USA. Aims: To relate the prevalence of mental disorder, self-harm and suicide attempts to sexual orientation in England, and to test whether psychiatric problems were associated with discrimination on grounds of sexuality. Method: The Adult Psychiatric Morbidity Survey 2007 (n = 7403) was representative of the population living in private UK households. Standardised questions provided demographic information. Neurotic symptoms, common mental disorders, probable psychosis, suicidality, alcohol and drug dependence and service utilisation were assessed. In addition, detailed information was obtained about aspects of sexual identity and perceived discrimination on these grounds. Results: Self-reported identification as non-heterosexual (determined by both orientation and sexual partnership, separately) was associated with unhappiness, neurotic disorders overall, depressive episodes, generalised anxiety disorder, obsessive– compulsive disorder, phobic disorder, probable psychosis, suicidal thoughts and acts, self-harm and alcohol and drug dependence. Mental health-related general practitioner consultations and community care service use over the previous year were also elevated. In the non-heterosexual group, discrimination on the grounds of sexual orientation predicted certain neurotic disorder outcomes, even after adjustment for potentially confounding demographic variables. Conclusions: This study corroborates international findings that people of non-heterosexual orientation report elevated levels of mental health problems and service usage, and it lends further support to the suggestion that perceived discrimination may act as a social stressor in the genesis of mental health problems in this population. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: prevalence rate; mental disorders; self-harm; suicide attempts; sexual orientation; psychiatric problems; sex discrimination; sexuality; mental health; Adult; Bisexuality; England; Female; Happiness; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Interview, Psychological; Male; Mental Disorders; Mental Health Services; Prejudice; Prevalence; Self-Injurious Behavior; Epidemiology; Mental Disorders; Mental Health; Sexual Orientation; Sexuality; Attempted Suicide; Sex Discrimination

Health disparities among sexual minority women veterans - Blosnich, John; Foynes, Melissa Ming; Shipherd, Jillian C. (Journal of Women's Health, 2013)
Background: Lesbian and bisexual (i.e., sexual minority) identity is more common among women veterans than among male veterans. Unique health issues have been identified among women veterans and among sexual minority women, but little is known about women who are both sexual minorities and veterans. This study aimed to compare demographic and health information from sexual minority women veterans with sexual minority women non-veterans and heterosexual women veterans. Methods: Behavioral Risk Factor Surveillance Survey data were pooled from ten U.S. states that elected to ask sexual identity during 2010. The analytic sample was comprised of women who identified both their sexual identity and veteran status (n = 1,908). Mental health indicators were frequent mental distress, sleep problems, low social/emotional support, and low stagflation with life. Health risk indicators included current smoking, overweight, and obesity. Physical health status was defined by three components: disability requiring assertive equipment, > 14 days of poor physical health in the past 30 days, and activity limitations. Results: Compared with heterosexual women veterans, sexual minority women veterans had higher odds of mental distress (odds ratio [OR] = 3.03, 95% confidence interval [CI]: 1.61-5.70) and smoking (OR = 2.31, 95%CI: 1.19-4.48). After adjusting for demographic correlates, sexual minority women veterans had three times the odds of poor physical health (OR = 3.01, 95%CI: 1.51-5.99) than their sexual minority non-veteran peers. Conclusions: Results suggest sexual minority women veterans may experience unique health disparities relevant to provision of care in both Veterans Affairs (VA) and non-VA healthcare systems. Future research requires availability of data that include sexual minority status. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: health disparities; sexual minority; veterans; risk factors; Behavioral Risk Factor Surveillance System; Bisexuality; Female; Health Status Disparities; Health Status Indicators; Heterosexuality; Homosexuality, Female; Humans; Middle Aged; Surveys and Questionnaires; United States; Veterans; Military Veterans; Minority Groups; Risk Factors; Health Disparities; Sexual Minority Groups; Psychosexual Behavior

Putting stigma in context: Do perceptions of group stigma interact with personally experienced discrimination to predict mental health? - McGarrity, Larissa A.; Huebner, David M.; McKinnon, Ryan K. (Group Processes & Intergroup Relations, 2013)
Research has linked experiences of personal discrimination with negative mental health consequences, but less is known about the role of group stigma (perceived stigma against one’s group as a whole). The theoretical literature has offered mixed predictions. The present study examined the independent and interactive effects of group stigma and personal discrimination on depressive symptoms and suicidal ideation in a sample of gay and bisexual men (N = 986). Experiences of personal discrimination predicted depressive symptoms and suicidal ideation regardless of group stigma. However, group stigma was associated with depressive symptoms contextually—only when level of perceived personal discrimination was low. Personal discrimination may be a relatively more powerful force in the lives of stigmatized group members that overwhelms the influence of group stigma in harming mental health. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: stigma; gay; group discrimination; mental health; personal discrimination; Group Differences; Male Homosexuality; Stigma; Discrimination; Mental Health

Risk and protective factors that distinguish adolescents who attempt suicide from those who only consider suicide in the past year - Taliaferro, Lindsay A.; Muehlenkamp, Jennifer J. (Suicide and Life-Threatening Behavior, 2014)
Data from the 2010 Minnesota Student Survey was analyzed to identify risk and protective factors that distinguished adolescents across three groups: no suicidality, suicidal ideation only, and suicide attempt. The population‐based sample included 70,022 students in grades 9 and 12. Hopelessness and depressive symptoms emerged as important risk factors to distinguish youth who reported suicidal ideation or behavior from those without a history of suicidality. However, these factors were not as important in differentiating adolescents who attempted suicidal from those who considered suicide but did not act on their thoughts. Instead, for both genders, self‐injury represented the most important factor to distinguish these youth. Other risk factors that differentiated the latter groups, but not the former groups, for males were dating violence victimization and cigarette smoking, and for females was a same‐sex sexual experience. Running away from home also seemed to increase the risk of a suicide attempt among youth in this study. Parent connectedness and academic achievement emerged as important protective factors to differentiate all the groups, yet neighborhood safety appeared to protect against the transition from suicidal thoughts to behavior. Findings from this study suggest risk and protective factors practitioners should target in clinical assessments and intervention programs to help prevent suicidal behavior among youth at greatest risk. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: protective factors; risk factors; adolescents; attempted suicide; suicidal ideation; Adolescent; Age Factors; Cross-Sectional Studies; Female; Humans; Male; Minnesota; Prevalence; Psychology, Adolescent; Risk Factors; Sex Factors; Suicidal Ideation; Suicide, Attempted; Attempted Suicide; Protective Factors; Risk Factors; Suicidal Ideation

Relationship between female sex workers and gatekeeper: The impact on female sex worker’s mental health in China - Zhang, Chen; Li, Xiaoming; Hong, Yan; Su, Shaobing; Zhou, Yuejiao (Psychology, Health & Medicine, 2014)
Global literature suggests that gatekeepers exert enormous influences on lives of female sex workers (FSWs). However, virtually no available studies have examined the FSW–gatekeeper relationship (F–G relationship) and its impact on FSW’s mental health. The current study was conducted in 2008–2009 in two cities of southwest China. A total of 1022 FSW were recruited through community outreach from nine different types of commercial sex establishments. Both bivariate and multivariate analyses were employed to depict the association between F–G relationship and measures of FSW’s mental health. Findings of the current study revealed that FSW with a close relationship with their gatekeepers reported a better mental health status. After adjusting for demographics and potential confounders of mental health, F–G relationship was positively associated with hopefulness ( β = .09, 95% CI = .01, .16), but negatively associated with perceived stigma ( β = −.25, 95% CI = −.44, −.07), suicidal intention or attempt (aOR = .90, 95% CI = .83, .99), and loneliness ( β = −.29, 95% CI = −.47, −.12). F–G relationship is an independent predictor of mental health of FSW over and above potential confounders including partner violence and substance use. Future health promotion programs targeting FSW need to recognize the role of gatekeepers in the life of FSW and engage them in a socially and legally acceptable way in safeguarding or improving mental health status of FSW in China. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: mental health; gatekeeper; commercial sex; China; female sex worker; Adolescent; Adult; China; Depression; Employment; Female; Hope; Humans; Interpersonal Relations; Loneliness; Middle Aged; Prostitution; Sex Workers; Social Stigma; Suicide; Young Adult; Mental Health; Sex Work; Commercialization; Human Females

Connecting the invisible dots: Reaching lesbian, gay, and bisexual adolescents and young adults at risk for suicide through online social networks - Silenzio, Vincent M. B.; Duberstein, Paul R.; Tang, Wan; Lu, Naiji; Tu, Xin; Homan, Christopher M. (Social Science & Medicine, 2009)
Young lesbian, gay, and bisexual (young LGB) individuals report higher rates of suicide ideation and attempts from their late teens through early twenties. Their high rate of Internet use suggests that online social networks offer a novel opportunity to reach them. This study explores online social networks as a venue for prevention research targeting young LGB. An automated data collection program was used to map the social connections between LGB self-identified individuals between 16 and 24 years old participating in an online social network. We then completed a descriptive analysis of the structural characteristics known to affect diffusion within such networks. Finally, we conducted Monte Carlo simulations of peer-driven diffusion of a hypothetical preventive intervention within the observed network under varying starting conditions. We mapped a network of 100,014 young LGB. The mean age was 20.4 years. The mean nodal degree was 137.5, representing an exponential degree distribution ranging from 1 through 4309. Monte Carlo simulations revealed that a peer-driven preventive intervention ultimately reached final sample sizes of up to 18,409 individuals. The network's structure is consistent with other social networks in terms of the underlying degree distribution. Such networks are typically formed dynamically through a process of preferential attachment. This implies that some individuals could be more important to target to facilitate the diffusion of interventions. However, in terms of determining the success of an intervention targeting this population, our simulation results suggest that varying the number of peers that can be recruited is more important than increasing the number of randomly-selected starting individuals. This has implications for intervention design. Given the potential to access this previously isolated population, this novel approach represents a promising new frontier in suicide prevention and other research areas. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: lesbians; gays; bisexual adolescents; at risk populations; suicide; online social networks; suicide ideation; attempted suicide; prevention; Adolescent; Adolescent Behavior; Adult; Age Factors; Algorithms; Confidence Intervals; Female; Homosexuality, Female; Homosexuality, Male; Humans; Internet; Male; Monte Carlo Method; Pilot Projects; Risk Assessment; Risk Factors; Social Support; Suicide; United States; Young Adult; At Risk Populations; Prevention; Sexual Orientation; Suicide; Online Social Networks; Attempted Suicide; Bisexuality; Lesbianism; Male Homosexuality; Suicidal Ideation

The contribution of school to the feeling of acceptance and the risk of suicide attempts among Austrian gay and bisexual males - Plöderl, Martin; Faistauer, Gregor; Fartacek, Reinhold (Journal of Homosexuality, 2010)
School-related factors contributing to the suicidality of lesbian, gay, and bisexual individuals are understudied, especially in German-speaking Europe. Among our Web-based sample of 468 Austrian gay or bisexual adults, 18% attempted suicide and about one half of them reported that hard times at school related to one’s homosexuality partly or mainly caused the attempt. Such suicide attempts were associated with a lack of acceptance at school and harassment experiences. In contrast to suicide attempts, acceptance at school was significantly associated with protective factors such as teachers intervening against homophobia or presence of openly homosexual teachers or peers. These findings may be important for consideration in school-based suicide prevention programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: school contribution; peer acceptance; risk factors; suicide attempts; Austrians; gay males; bisexual males; Adult; Austria; Bisexuality; Emotions; Faculty; Homosexuality, Male; Humans; Male; Middle Aged; Risk Factors; Schools; Social Distance; Social Environment; Suicide, Attempted; Young Adult; Attempted Suicide; Bisexuality; Male Homosexuality; Social Acceptance; Peers; Risk Factors; School Environment

Disparities in adverse childhood experiences among sexual minority and heterosexual adults: Results from a Multi-State probability-based sample - Andersen, Judith P.; Blosnich, John (PLoS ONE, 2013)
Background: Adverse childhood experiences (e.g., physical, sexual and emotional abuse, neglect, exposure to domestic violence, parental discord, familial mental illness, incarceration and substance abuse) constitute a major public health problem in the United States. The Adverse Childhood Experiences (ACE) scale is a standardized measure that captures multiple developmental risk factors beyond sexual, physical and emotional abuse. Lesbian, gay, and bisexual (i.e., sexual minority) individuals may experience disproportionately higher prevalence of adverse childhood experiences. Purpose: To examine, using the ACE scale, prevalence of childhood physical, emotional, and sexual abuse and childhood household dysfunction among sexual minority and heterosexual adults. Methods: Analyses were conducted using a probability-based sample of data pooled from three U.S. states’ Behavioral Risk Factor Surveillance System (BRFSS) surveys (Maine, Washington, Wisconsin) that administered the ACE scale and collected information on sexual identity (n = 22,071). Results: Compared with heterosexual respondents, gay/lesbian and bisexual individuals experienced increased odds of six of eight and seven of eight adverse childhood experiences, respectively. Sexual minority persons had higher rates of adverse childhood experiences (IRR = 1.66 gay/lesbian; 1.58 bisexual) compared to their heterosexual peers. Conclusions: Sexual minority individuals have increased exposure to multiple developmental risk factors beyond physical, sexual and emotional abuse. We recommend the use of the Adverse Childhood Experiences scale in future research examining health disparities among this minority population. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: child abuse; household dysfunction; Adverse Childhood Experiences Scale; sexual minority adults; Adult; Aged; Behavioral Risk Factor Surveillance System; Child; Child Abuse; Female; Humans; Incidence; Male; Middle Aged; Minority Groups; Odds Ratio; Risk Factors; Sexuality; United States; Child Abuse; Dysfunctional Family; Early Experience; Homosexuality; Minority Groups; Bisexuality; Lesbianism; Male Homosexuality; Childhood Adversity; Sexual Minority Groups

'Suicide in prisons: An international study of prevalence and contributory factors': Correction - Fazel, Seena; Ramesh, Taanvi; Hawton, Keith (The Lancet Psychiatry, 2018)
Reports an error in 'Suicide in prisons: An international study of prevalence and contributory factors' by Seena Fazel, Taanvi Ramesh and Keith Hawton (The Lancet Psychiatry, 2017[Dec], Vol 4[12], 946-952). In the original article in figure 1, the p values were not listed in the correct order. This correction has been made to the online version as of Dec 21, 2017. (The following abstract of the original article appeared in record [rid]2017-54229-025[/rid]). Background: Prison suicide rates, rate ratios, and associations with prison-related factors need clarification and updating. We examined prison suicide rates in countries where reliable information was available, associations with a range of prison-service and health-service related factors, how these rates compared with the general population, and changes over the past decade. Methods: We collected data for prison suicides in 24 high-income countries in Europe, Australasia, and North America from their prison administrations for 2011–14 to calculate suicide rates and rate ratios compared with the general population. We used meta-regression to test associations with general population suicide rates, incarceration rates, and prison-related factors (overcrowding, ratio of prisoners to prison officers or health-care staff or education staff, daily spend, turnover, and imprisonment duration). We also examined temporal trends. Findings: 3906 prison suicides occurred during 2011–14 in the 24 high-income countries we studied. Where there was breakdown by sex (n = 2810), 2607 (93%) were in men and 203 (7%) were in women. Nordic countries had the highest prison suicide rates of more than 100 suicides per 100 000 prisoners apart from Denmark (where it was 91 per 100 000), followed by western Europe where prison suicide rates in France and Belgium were more than 100 per 100 000 prisoners. Australasian and North American countries had rates ranging from 23 to 67 suicides per 100 000 prisoners. Rate ratios, or rates compared with those in the general population of the same sex and similar age, were typically higher than 3 in men and 9 in women. Higher incarceration rates were associated with lower prison suicide rates (b = –0·504, p = 0·014), which was attenuated when adjusting for prison-level variables. There were no associations between rates of prison suicide and general population suicide, any other tested prison-related factors, or differing criteria for defining suicide deaths. Changes in prison suicide rates over the past decade vary widely between countries. Interpretation: Many countries in northern and western Europe have prison suicide rates of more than 100 per 100 000 prisoners per year. Individual-level information about prisoner health is required to understand the substantial variations reported and changes over time. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: suicide; prisons; prevalence rate; incarceration rates; gender differences; Epidemiology; Human Sex Differences; Incarceration; Prisons; Suicide

Correlates of depressed mood among young stimulant-using homeless gay and bisexual men - Nyamathi, Adeline; Branson, Catherine; Idemundia, Faith; Reback, Cathy; Shoptaw, Steven; Marfisee, Mary; Keenan, Colleen; Khalilifard, Farinaz; Liu, Yihang; Yadav, Kartik (Issues in Mental Health Nursing, 2012)
Homeless gay and bisexual (G/B) men are at risk for suicide attempts and have high risk of depressed mood, defined as elevated level of depressive symptoms. This study describes baseline socio-demographic, cognitive, psychosocial, and health- and drug-related correlates of depressed mood in 267 stimulant-using homeless G/B young men who entered a study designed to reduce drug use. G/B men without social support were 11 times more likely to experience depressed mood than their counterparts who had support; those who reported severe body pain were almost six times more likely to report depressed mood than those without pain. Other factors that increased risk of depressed mood included being homeless in the last four months, injecting drugs, reporting poor or fair health status, and high levels of internalized homophobia. This study is one of the first studies to draw a link between pain experienced and depressed mood in homeless young G/B men. Understanding the correlates of depressed mood among homeless G/B young men can help service providers design more targeted treatment plans and provide more appropriate referrals to ancillary care services. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: depressed mood; young stimulant; homeless gay; bisexual men; demographic correlates; psychosocial correlates; Adolescent; Amphetamine-Related Disorders; Bisexuality; California; Cocaine-Related Disorders; Crack Cocaine; Cross-Sectional Studies; Depression; Health Knowledge, Attitudes, Practice; Homeless Persons; Homosexuality, Male; Humans; Logistic Models; Male; Methamphetamine; Middle Aged; Multivariate Analysis; Pain; Risk Factors; Social Support; Suicide; Young Adult; Bisexuality; Emotional States; Homeless; Major Depression; Male Homosexuality; Demographic Characteristics; Psychosocial Factors

Non‐suicidal self‐injury in patients with eating disorder: Associations with identity formation above and beyond anxiety and depression - Claes, Laurence; Luyckx, Koen; Bijttebier, Patricia; Turner, Brianna; Ghandi, Amarendra; Smets, Jos; Norre, Jan; Van Assche, Leen; Verheyen, Els; Goris, Yvienne; Hoksbergen, Ingrid; Schoevaerts, Katrien (European Eating Disorders Review, 2015)
In the present study, we investigated the association between non‐suicidal self‐injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self‐report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: non‐suicidal self‐injury; eating disorders; identity confusion; identity synthesis; anxiety; depression; Adult; Anxiety; Comorbidity; Cross-Sectional Studies; Depression; Feeding and Eating Disorders; Female; Humans; Male; Personality; Personality Inventory; Psychiatric Status Rating Scales; Self Report; Self-Injurious Behavior; Suicidal Ideation; Surveys and Questionnaires; Comorbidity; Eating Disorders; Identity Formation; Self-Injurious Behavior; Anxiety; Major Depression

Sexual orientation, parental support, and health during the transition to young adulthood - Needham, Belinda L.; Austin, Erika L. (Journal of Youth and Adolescence, 2010)
Some recent studies suggest that sexual minorities may have worse health-related outcomes during adolescence because they report lower levels of family connectedness, a key protective resource. Using data from wave 3 of the National Longitudinal Study of Adolescent Health (n=11,153; 50.6% female; mean age=21.8 years), this study extends prior research on adolescents to young adults. We examine whether lesbian, gay, and bisexual (LGB) young adults report lower levels of parental support than their heterosexual peers and whether differences in parental support help explain why LGB young adults tend to have worse health-related outcomes. We find that lesbian and bisexual women report lower levels of parental support than heterosexual women and that gay men report lower levels of parental support than bisexual and heterosexual men. Compared to heterosexual women, lesbian and bisexual women have higher odds of suicidal thoughts and recent drug use; bisexual women also have higher odds of elevated depressive symptomatology and heavy drinking. Gay men have higher odds of suicidal thoughts than heterosexual men. With the exception of heavy drinking, parental support either partially or fully mediates each of the observed associations. Even though the transition from adolescence to young adulthood is characterized by increased independence from parents, parental support remains an important correlate of health-related outcomes during this stage of life. Sexual minorities report lower levels of parental support during young adulthood, which helps explain why they have worse health-related outcomes. Interventions designed to strengthen relationships between LGB young adults and their parents could lead to a reduction in health disparities related to sexual orientation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: sexual orientation; parental support; health outcomes; transition to adulthood; young adults; lesbian; gay; bisexual; heterosexual; health disparities; Adolescent; Adolescent Behavior; Adult; Anxiety Disorders; Bisexuality; Comorbidity; Female; Health Status; Homosexuality, Female; Homosexuality, Male; Humans; Interpersonal Relations; Male; Parent-Child Relations; Prejudice; Psychosexual Development; Sex Distribution; Sexuality; Social Support; Substance-Related Disorders; Suicide, Attempted; Young Adult; Health; Homosexuality; Parent Child Relations; Sexual Orientation; Social Support; Adolescent Development; Adult Development; Bisexuality; Heterosexuality; Lesbianism; Life Changes; Male Homosexuality; Health Disparities

Coming together in pain and joy: A multicultural and arts-based suicide awareness project - Silverman, Yehudit; Smith, Fiona; Burns, Mary (The Arts in Psychotherapy, 2013)
The issue of suicide is still taboo in many cultures and the silence surrounding this problem is often destructive. Those affected by suicide have few opportunities to express their pain and their communities are left feeling helpless. The creative arts therapies have been used to address the emotions surrounding suicide, however few projects have studied the use of the arts to promote suicide awareness. Furthermore, there is a lack of multicultural research in this area. This article describes a two-day arts-based symposium that brought together members from diverse cultural communities including Inuit, Mohawk, Jewish, Christian, Baha’i, South-Asian Canadian, Senior and LGBTQ (Lesbian, Gay, Bisexual, Trans-gendered, Queer) communities. Through drama, music, art-making and writing, participants explored this difficult subject, expressed complex feelings and shared their perspectives. An instrumental case study design was employed for this research project. The objectives were to gather information on participants’ experience of exploring the issue of suicide within an arts-based approach and to determine if cross-cultural themes would emerge. The findings indicate that using the arts helped to facilitate dialogue and communication and specific cross-cultural themes did emerge. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: multiculturalism; arts-based suicide awareness; feelings; cultural communities; Awareness; Cross Cultural Differences; Emotions; Suicide Prevention; Multiculturalism

Polyamory: A call for increased mental health professional awareness - Graham, Nicole (Archives of Sexual Behavior, 2014)
Presents a case report of a 21-year-old female student with a history of depression and anxiety who presented with recurrent suicidal thoughts and recent engagement in self-cutting behaviors in the context of increasing academic demands, treatment non-adherence, relative social isolation, and a recent move from out of state. She reported worsening depression marked by thoughts of self-harm and recent self-cutting behaviors with an onset of 2 months prior following her decision to discontinue treatment secondary to 'she [her psychiatrist] blamed all my issues on polyamory.' The patient reported cutting over her left clavicle as recent as 2 weeks prior and fleeting thoughts of 'giving up' due to the stress related to her recent move, the increased academic rigor of her new school, and her inability to make friends at school despite efforts to do so. She reported that her only local social supports were members of the polyamorous community. Polyamory, more than one intimate relationship at a time, is becoming a more common relationship pattern within the United States. Unfortunately,most standard mental health curricula do not cover polyamory in any depth. A lack of appreciation for polyamory and other non-traditional relationship patterns could result in a damaged therapeutic alliance; such damage has been shown to negatively impact patient outcomes. The case presented highlights the deleterious impact such ignorance can have on patient care. Therefore, all mental health professionals need to become familiar with polyamory and other non-traditional relationship practices in order to provide the best possible treatment to our patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: polyamory; mental health professional awareness; self injurious behavior; social supports; treatment non-adherence; Adult; Bisexuality; Depression; Female; Humans; Psychotherapy; Self-Injurious Behavior; Sexual Behavior; Sexual Partners; Suicidal Ideation; Young Adult; Intimacy; Major Depression; Psychosexual Behavior; Social Isolation; Interpersonal Relationships; Anxiety Disorders; Mental Health Personnel; Self-Injurious Behavior; Suicidal Ideation

SAHM—2015 annual meeting: Platform research abstracts (Journal of Adolescent Health, 2015)
Abstracts from the proceedings of Society for Adolescent Health and Medicine-2015 annual meeting are presented The articles focus on the youths perspective on health insurance, suicide attempts, childhood maltreatment, sexual health, LGBT & health disparities, mental health and eating disorders, HIV and various health issues and its promotion and transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: mental health; childhood maltreatment; suicide attempts; health insurance; Attempted Suicide; Child Abuse; Health Insurance; Health Disparities; Mental Health; Scientific Communication

The intersectionality of discrimination attributes and bullying among youth: An applied latent class analysis - Garnett, Bernice Raveche; Masyn, Katherine E.; Austin, S. Bryn; Miller, Matthew; Williams, David R.; Viswanath, Kasisomayajula (Journal of Youth and Adolescence, 2014)
Discrimination is commonly experienced among adolescents. However, little is known about the intersection of multiple attributes of discrimination and bullying. We used a latent class analysis (LCA) to illustrate the intersections of discrimination attributes and bullying, and to assess the associations of LCA membership to depressive symptoms, deliberate self harm and suicidal ideation among a sample of ethnically diverse adolescents. The data come from the 2006 Boston Youth Survey where students were asked whether they had experienced discrimination based on four attributes: race/ethnicity, immigration status, perceived sexual orientation and weight. They were also asked whether they had been bullied or assaulted for these attributes. A total of 965 (78 %) students contributed to the LCA analytic sample (45 % Non-Hispanic Black, 29 % Hispanic, 58 % Female). The LCA revealed that a 4-class solution had adequate relative and absolute fit. The 4-classes were characterized as: low discrimination (51 %); racial discrimination (33 %); sexual orientation discrimination (7 %); racial and weight discrimination with high bullying (intersectional class) (7 %). In multivariate models, compared to the low discrimination class, individuals in the sexual orientation discrimination class and the intersectional class had higher odds of engaging in deliberate self-harm. Students in the intersectional class also had higher odds of suicidal ideation. All three discrimination latent classes had significantly higher depressive symptoms compared to the low discrimination class. Multiple attributes of discrimination and bullying co-occur among adolescents. Research should consider the co-occurrence of bullying and discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: discrimination attributes; bullying; youth; intersectionality; depressive symptoms; deliberate self harm; suicidal ideation; race; ethnicity; immigration status; perceived sexual orientation; weight; Adolescent; Adolescent Behavior; Boston; Bullying; Cross-Sectional Studies; Depression; Female; Health Surveys; Humans; Male; Models, Psychological; Models, Statistical; Multivariate Analysis; Psychology, Adolescent; Self-Injurious Behavior; Social Discrimination; Suicidal Ideation; Major Depression; Self-Destructive Behavior; Social Discrimination; Suicidal Ideation; Bullying; Adolescent Attitudes; Body Weight; Demographic Characteristics; Immigration; Race and Ethnic Discrimination; Self-Injurious Behavior; Sexual Orientation; Latent Class Analysis

Suicidality among Gay, Lesbian and Bisexual Youth: The Role of Protective Factors - Eisenberg, Marla E.; Resnick, Michael D. (Journal of Adolescent Health, 2006)
Purpose: Many reports have indicated that gay, lesbian and bisexual (GLB) youth are particularly vulnerable to poor outcomes, including suicide. Certain protective factors are likely to reduce this risk. The present study examines four protective factors (family connectedness, teacher caring, other adult caring, and school safety) and their association with suicidal ideation and attempts among adolescents with same-gender experience. Methods: Data come from the 2004 Minnesota Student Survey of 9th and 12th grade students; 21,927 sexually active youth were grouped according to the gender of their sex partner(s) into GLB and non-GLB groups. Four protective factors and suicidal ideation and attempts were compared across groups. Logistic regression was used to examine the influence of protective factors on suicide, and predicted probabilities of suicidal ideation and attempts were estimated using general linear modeling. Results: There were 2,255 respondents who reported same-gender experience. Over half of GLB students had thought about suicide and 37.4% reported a suicide attempt. GLB youth reported significantly lower levels of each protective factor than their non-GLB peers. Family connectedness, adult caring, and school safety were significantly protective against suicidal ideation and attempts. Risk associated with a GLB sexual orientation is largely mediated through protective factors. Conclusions: Sexual orientation alone accounts for only a small portion of variability in suicidal ideation and attempts. If protective factors were enhanced among GLB youth, suicide in this population is expected to be considerably lower. Protective factors examined here are amenable to change and should be targeted in interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidality; gay; lesbian; bisexual youth; protective factors; family connectedness; teacher caring; adult caring; school safety; Adolescent; Bisexuality; Empathy; Family; Female; Homosexuality; Humans; Logistic Models; Male; Minnesota; Suicide; Surveys and Questionnaires; Bisexuality; Lesbianism; Male Homosexuality; Protective Factors; Suicidal Ideation; Adult Attitudes; Safety; Schools; Teacher Attitudes; School Safety; Suicidality

Childhood abuse and depressive vulnerability in clients with gender dysphoria - Firth, Malcolm T. (Counselling & Psychotherapy Research, 2014)
Background: Childhood abuse in the early lives of gender variant people has been under-reported, although higher psychiatric morbidity, particularly depression and suicidality, than in the general population is more widely recognised. There are increasing numbers of people seeking advice and treatment for gender dysphoria (GD) some of whose experiences of depression and childhood abuse may be additional treatment considerations. Aim: To illuminate the issues relating to childhood abuse, depression and GD via case examples underpinned by a summary review of the relevant literature, for their combined relevance to therapeutic practice and service provision. Methods: A review of relevant online literature was conducted and two case examples were developed subsequently to capture the core review themes from a practice perspective. Results: Nine studies met the inclusion criteria. Gender variant children and adolescents may experience abuse by peers and teachers, as well as parents and caregivers. Emotional abuse and neglect may have more adverse consequences than more active forms of abuse. Conclusions: This is an under-researched area, and inconsistencies of design, definition, measurement and controls were evident in the literature. While no clear association between depressive vulnerability and childhood abuse could be found, prevalence of such abuse was high. A case is made for clients with GD to have the opportunity to explore the influence and meaning of their adverse childhood experiences on their social and psychological development, and for additional training and education for practitioners. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gender dysphoria; childhood abuse; mental health; depression; Child Abuse; Major Depression; Mental Health; Psychological Development; Gender Dysphoria; Early Experience

Minority stress factors for same-sex attracted Mormon adults - Grigoriou, Jennifer A. (Psychology of Sexual Orientation and Gender Diversity, 2014)
In recent years, the institutionalized discrimination of religious individuals with same-sex attraction has been at the forefront of much debate; especially within the Church of Jesus Christ of Latter Day Saints (LDS). Research has turned out myriad studies on the effects of conservative religious attitudes on same-sex attracted (SSA) individuals, linking negative societal responses to poorer mental health outcomes and suicide (North Star, n.d.). Under the framework of minority stress theory, the current study presents an empirically validated rationale outlining the impact that (a) SSA identity, (b) Mormon identity, (c) perceptions of stigmatization in the LDS society (i.e., stigma consciousness), and (d) difficulty in speaking with Mormon social supports about sexual orientation (i.e., social constraints) had on an adult sample of SSA Mormons (n = 142). This study contributes new information linking social constraints, Mormon identity, and SSA identity to symptoms of anxiety and depression. Results show that the social constraint variable was the best predictor for symptoms of anxiety and depression. SSA and Mormon identity were linked to fewer symptoms of anxiety and depression compared with those who could not choose which aspect of their identity was most salient. SSA identity was also moderately and positively associated with perceptions of stigmatization. Contrary to expectations, stigma consciousness was not found to be predictive of mental health outcomes for this sample of SSA Mormon adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: minority stress; Mormon identity; same-sex attraction; social constraints; stigma consciousness; Minority Groups; Sexual Attraction; Sexual Orientation; Stress; Mormons; Religion; Self-Concept; Social Support; Stigma; Minority Stress

A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa - Stoloff, Kevin; Joska, John A.; Feast, Dorothy; De Swardt, Glenn; Hugo, Johan; Struthers, Helen; McIntyre, James; Rebe, Kevin (AIDS and Behavior, 2013)
Men who have sex with men (MSM) have a higher prevalence of common mental disorders (CMD), as compared with heterosexual men. HIV infection is independently associated with higher rates of CMD. Given this context, and the high background community prevalence of HIV in South Africa, MSM are at even greater risk of developing CMD. The aim of this research was to investigate neuropsychiatric symptoms and disorders in MSM who were referred for assessment and management of mental health problems, in an MSM Clinic in urban Cape Town, South Africa. Twenty-five men were screened using the MINI, AUDIT, DUDIT, and IPDE Screener. Depression, suicidality, as well as alcohol and drug use disorders were highly prevalent in this group (44, 56, 48, and 56 %respectively). The personality disorder screening was suggestive of a high prevalence of personality disorders. The high prevalence of neuropsychiatric disorders in this sample supports the idea that integrated mental health services are needed to address the complex needs of this population. Adequate input into the mental health needs of this population could reduce the potential for HIV acquisition and transmission, improve adherence to treatment and care, and ensure the provision a comprehensive health service for MSM. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental disorders; men who have sex with men; disease prevalence; South Africa; Adolescent; Adult; Aged; Depressive Disorder, Major; HIV Infections; Homosexuality, Male; Humans; Interview, Psychological; Male; Mental Disorders; Middle Aged; Prevalence; Psychiatric Status Rating Scales; Referral and Consultation; Risk Factors; Socioeconomic Factors; South Africa; Substance-Related Disorders; Suicide; Surveys and Questionnaires; Young Adult; Epidemiology; Male Homosexuality; Mental Disorders; African Cultural Groups

Mental health resources for LGBT collegians: A content analysis of college counseling center web sites - Wright, Paul J.; McKinley, Christopher J. (Journal of Homosexuality, 2011)
This study content analyzed a randomly selected stratified national sample of 203 four-year United States colleges' counseling center Web sites to assess the degree to which such sites feature information and reference services for lesbian, gay, bisexual, and transgender (LGBT) collegians. Results revealed that LGBT-targeted communications were infrequent. For instance, fewer than one third of counseling center Web sites described individual counseling opportunities for LGBT students, fewer than 11% mentioned group counseling opportunities, and fewer than 6% offered a university crafted pamphlet with information about LGBT issues and resources. Findings are interpreted within the context of prior LGBT student health research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental health resources; content analysis; college counseling center web sites; lesbian; gay; bisexual; and transgender students; Bisexuality; Counseling; Female; Health Services Accessibility; Homosexuality; Humans; Internet; Male; Mental Health Services; Referral and Consultation; Student Health Services; Transsexualism; United States; Content Analysis; Mental Health Services; School Counseling; Sexual Orientation; Websites; Bisexuality; College Students; Lesbianism; Male Homosexuality

Suicidal ideation and attempt among adolescents reporting 'unsure' sexual identity or heterosexual identity plus same-sex attraction or behavior: Forgotten groups? - Zhao, Yue; Montoro, Richard; Igartua, Karine; Thombs, Brett D. (Journal of the American Academy of Child & Adolescent Psychiatry, 2010)
Objective: To compare risk of suicide ideation and attempts in adolescents with 1) gay, lesbian, or bisexual (GLB) identity, 2) 'unsure' identity, or 3) heterosexual identity with same-sex attraction/fantasy or behavior, to heterosexual identity without same-sex attraction/fantasy or behavior. Method: A total of 1,856 students 14 years of age and older from 14 public and private high schools in Montreal, Quebec, were surveyed anonymously. The survey included items assessing sexual orientation, health risk behaviors, and suicidal ideation and attempts. Multiple logistic regression models were used to assess risk factors for suicidal ideation and attempts. Results: In all, 58 (3.1%) adolescents self-identified as GLB, 59 (3.2%) as unsure, and 115 (6.2%) as heterosexual with same-sex attraction/fantasy or behavior. Compared with heterosexually identified youth without same-sex attraction/fantasy or behavior (N = 1,624; 87.5%), in multivariable analyses, 12-month suicidal ideation was significantly higher for both GLB (odds ratio [OR] = 2.31, 95% confidence interval [CI] = 1.22-4.37) and unsure youth (OR = 2.64,95% CI = 1.38-5.08). Twelve-month suicide attempts were significantly elevated for GLB youth (OR = 2.23,95% CI = 1.15-4.35) and high, although not statistically significant, for unsure youth (OR = 1.61, 95% CI = 0.77-3.36). Heterosexual identity with same-sex attraction/fantasy or behavior was not significantly associated with increased suicidal ideation (OR = 1.26, 95% CI = 0.76-2.08) or attempts (OR = 1.03, 95% CI = 0.55-1.91) in multivariable analyses. Conclusion: Compared with heterosexual youth without same-sex attraction/fantasy or behavior, adolescents with GLB and unsure identities were at greater risk of suicidality. However, youth who reported same-sex attraction or behavior but a heterosexual identity were not at elevated risk. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; suicide attempt; sexual identity; heterosexual identity; same sex attraction; risk factors; gays; lesbians; adolescent attitudes; Adolescent; Aggression; Child Abuse; Child Abuse, Sexual; Cross-Sectional Studies; Depressive Disorder; Female; Gender Identity; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Likelihood Functions; Male; Quebec; Risk Factors; Sexual Behavior; Statistics as Topic; Substance-Related Disorders; Suicide, Attempted; Unsafe Sex; Attempted Suicide; Bisexuality; Heterosexuality; Lesbianism; Suicidal Ideation; Adolescent Attitudes; Adolescent Development; Gender Identity; Male Homosexuality; Risk Factors; Sexual Attraction

Special issue in translation: Clinical dialogues spanning the transgender spectrum - Powell, Gordon; Jacobson, Gary; Schwartz, Alan; Barber, Mary E. (Journal of Gay & Lesbian Mental Health, 2011)
This issue of Journal of Gay & Lesbian Mental Health discusses about clinical dialogues spanning. This issue presents most of the papers from Transgender Symposium in 2008, allowing to bring a number of the spontaneous and sophisticated talks from this symposium to readership. This issue of includes two qualitative research studies. In the first, 'How Depressed and Suicidal Sexual Minority Adolescents Understand the Causes of Their Distress,' Diamond and colleagues interviewed ten sexual and gender minority adolescents being treated for depression. Among the top major stressors identified by these young people were rejection byfamily due to their lesbian, gay, bisexual, and transgender (LGBT) identity and family conflict around other issues. The second original research paper is 'Policies and Practices for LGBT Clients, Perspectives of Mental Health Services Administrators.' In this study, Israel and colleagues interviewed nine mental health administrators across the country about how their agencies had treated LGBT patients. Both the original research and conference proceedings in this issue are aimed at improving the quality of care in a diverse array of settings and thus the quality of life of gay, lesbian, and gender-non conforming people of all ages. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: mental health; lesbianism; family conflict; transgender; major depression; Family Conflict; Lesbianism; Major Depression; Mental Health; Transgender

A systematic review of parental influences on the health and well-being of lesbian, gay, and bisexual youth: Time for a new public health research and practice agenda - Bouris, Alida; Guilamo-Ramos, Vincent; Pickard, Angela; Shiu, Chengshi; Loosier, Penny S.; Dittus, Patricia; Gloppen, Kari; Waldmiller, J. Michael (The Journal of Primary Prevention, 2010)
Relatively little is known about how parents influence the health and well-being of lesbian, gay, and bisexual (LGB) adolescents and young adults. This gap has led to a paucity of parent-based interventions for LGB young people. A systematic literature review on parental influences on the health of LGB youth was conducted to better understand how to develop a focused program of applied public health research. Five specific areas of health among LGB young people aged 10–24 years old were examined: (a) sexual behavior; (b) substance use; (c) violence and victimization; (d) mental health; and (e) suicide. A total of 31 quantitative articles were reviewed, the majority of which were cross-sectional and relied on convenience samples. Results indicated a trend to focus on negative, and not positive, parental influences. Other gaps included a dearth of research on sexual behavior, substance use, and violence/victimization; limited research on ethnic minority youth and on parental influences identified as important in the broader prevention science literature; and no studies reporting parent perspectives. The review highlights the need for future research on how parents can be supported to promote the health of LGB youth. Recommendations for strengthening the research base are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: parental influences; public health research; well being; lesbian youth; bisexual youth; gay youth; practice agenda; Adaptation, Psychological; Adolescent; Adult; Age Factors; Bisexuality; Child; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Health Services Research; Health Status; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Health; Parents; Psychometrics; Public Health; Public Health Practice; Risk-Taking; Sexual Behavior; Sexually Transmitted Diseases; Stress, Psychological; Suicide; United States; Young Adult; Bisexuality; Lesbianism; Parent Child Relations; Public Health; Well Being; Experimentation; Male Homosexuality; Practice; Public Health Research

Factors associated with current versus lifetime self‐injury among high school and college students - Taliaferro, Lindsay A.; Muehlenkamp, Jennifer J. (Suicide and Life-Threatening Behavior, 2015)
We sought to identify factors associated with current versus lifetime nonsuicidal self‐injury (NSSI) and factors that show consonant and distinct relationships with current NSSI for adolescents and young adults. Data came from a population‐based survey of high school students (n = 9,985) and a national survey of college students (n = 7,801). Among both samples, factors associated with current NSSI included male gender, younger age, greater depressive symptoms, more hopelessness, and being the victim of a verbal or physical assault. For high school students, greater anxiety, and for college students, identifying as non‐White, negative perceptions of one's weight, a same‐sex sexual experience, and involvement in dating violence also distinguished the groups. Findings suggest that clinical and research assessments of lifetime NSSI might not extend to current behavior, and some differences exist in the factors associated with current behavior between adolescents and young adults. Clinical practice and prevention programming efforts should target certain intrapersonal and interpersonal factors associated with current NSSI among younger students during stressful transition periods in their lives, such as entering high school or college, when they might consider initiating or continuing this behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: non-suicidal self‐injury; high school students; college students; Adolescent; Age Factors; Crime Victims; Depression; Ethnic Groups; Female; Homosexuality; Hope; Humans; Male; Risk Factors; Schools; Self Concept; Self-Injurious Behavior; Sex Factors; Spouse Abuse; Students; United States; Universities; Young Adult; College Students; High Schools; Self-Injurious Behavior

Stress-related growth, coming out, and internalized homonegativity in lesbian, gay, and bisexual youth An examination of stress-related growth within the minority stress model - Cox, Nele; Dewaele, Alexis; van Houtte, Mieke; Vincke, John (Journal of Homosexuality, 2011)
This study investigates how young lesbian, gay, and bisexual (LGB) individuals deal with coming out and how perceived personal growth may result from that experience. We considered stress-related growth as a mediator between coming-out experiences and internalized homonegativity (IH). Our sample was taken from an online survey and is comprised of 502 LGBs aged 14-30. The social environment's acceptance of an individual's sexual orientation and the individual's social identification influence stress-related growth. Several coming-out indicators influence internalized homonegativity and, although growth perception does not function as a mediator between coming out and internalized homonegativity, it has a direct effect on IH. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: stress related growth; coming out; internalized homonegativity; lesbian; gay; and bisexual youth; minority stress model; Adaptation, Psychological; Adolescent; Adult; Belgium; Bisexuality; Disclosure; Female; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Male; Models, Psychological; Prejudice; Regression Analysis; Self Concept; Stereotyping; Stress, Psychological; Homosexuality (Attitudes Toward); Internalization; Self-Disclosure; Sexual Orientation; Stress; Bisexuality; Lesbianism; Male Homosexuality; Minority Stress

Psychosocial health problems associated with increased HIV risk behavior among men who have sex with men in Nepal: A cross-sectional survey - Deuba, Keshab; Ekström, Anna Mia; Shrestha, Rachana; Ionita, George; Bhatta, Laxmi; Karki, Deepak Kumar (PLoS ONE, 2013)
Background: Men who have sex with men (MSM) are marginalized, hidden, underserved and at high risk for HIV in Nepal. We examined the association between MSM sub-populations, psychosocial health problems and support, access to prevention and non-use of condoms. Methods: Between September-November of 2010, a cross-sectional survey on HIV-related risk behavior was performed across Nepal through snowball sampling facilitated by non-governmental organizations, recruiting 339 MSM, age 15 or older. The primary outcomes were: (a) non-use of condoms at least once in last three anal sex encounters with men and (b) non-use of condoms with women in the last encounter. The secondary outcome was participation in HIV prevention interventions in the past year. Results: Among the 339 MSM interviewed, 78% did not use condoms at their last anal sex with another man, 35% did not use condoms in their last sex with a woman, 70% had experienced violence in the last 12 months, 61% were experiencing depression and 47% had thought of committing suicide. After adjustment for age, religion, marital status, and MSM subpopulations (bisexual, ta, meti, gay), non-use of condoms at last anal sex with a man was significantly associated with non-participation in HIV interventions, experience of physical and sexual violence, depression, repeated suicidal thoughts, small social support network and being dissatisfied with social support. Depression was marginally associated with non-use of condoms with women. The findings suggest that among MSM who reported non-use of condoms at last anal sex, the ta subgroup and those lacking family acceptance were the least likely to have participated in any preventive interventions. Conclusions: MSM in Nepal have a prevalence of psychosocial health problems in turn associated with high risk behavior for HIV. Future HIV prevention efforts targeting MSM in Nepal should cover all MSM subpopulations and prioritize psychosocial health interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: psychosocial health problems; support; prevention; access; condom use; HIV risk behavior; men who have sex with men; condoms; Adolescent; Adult; Condoms; Cross-Sectional Studies; Female; Gender Identity; Geography, Medical; HIV Infections; Humans; Male; Middle Aged; Nepal; Risk-Taking; Sex Offenses; Sexual Behavior; Sexual Partners; Surveys and Questionnaires; Young Adult; Human Males; Mental Health; Psychosocial Factors; Sexual Risk Taking; Same Sex Intercourse; AIDS Prevention; Condoms; HIV; Social Support; Social Health

Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: Role of experiencing violence, feeling safe on campus, and perceived stress - Reed, Elizabeth; Prado, Guillermo; Matsumoto, Atsushi; Amaro, Hortensia (Addictive Behaviors, 2010)
Objective: To examine differences between gay, lesbian, and bisexual (GLB) and non-GLB university students in alcohol and other drug use (AOD) and related consequences as well as the relevance of violence, perceived safety, and stress to any such differences in AOD use and related concerns. Methods: A random representative sample of university students (n =988) were recruited via email for an online survey. Linear regression models assessed associations between identifying as GLB and AOD use and related consequences. Results: Regression models (adjusted for gender) indicated that, in comparison to heterosexual students, GLB students were more likely to report recent illicit drug use (AOR=2.0; 95% CI: 1.1–3.9), more frequent negative AOD consequences (β =5.5, SE=1.4, p <0.0001), and having seriously thought about/attempted suicide due to AOD use in the past year (AOR=6.6; 95% CI: 3.0–14.3). Study findings also suggested that violence, safety, and stress variables partially contribute to AOD use and related concerns among GLB students. Conclusions: Findings highlight the need for future efforts to investigate and address mechanisms, including aspects of campus life, which contribute to AOD related risks among GLB students. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: alcohol use; drug use; gays; lesbians; bisexuals; college students; violence; safety; campus; perceived stress; Alcohol Drinking; Bisexuality; Boston; Case-Control Studies; Cross-Sectional Studies; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Perception; Social Environment; Stress, Psychological; Students; Substance-Related Disorders; Suicidal Ideation; Suicide, Attempted; Universities; Violence; Young Adult; Alcohol Drinking Patterns; Bisexuality; College Students; Homosexuality; Drug Usage; Lesbianism; Male Homosexuality; Safety; Stress; Violence; Consequence

A psychocultural comparison of male street prostitutes in Dublin and San Francisco - McCabe, Ian; Mills, Rónán; Murphy, Donnchadh; Winders, Sarah-Jane; Hayden, Judy; Reynolds, Deirdre; McCabe, Jenny; McQuaid, Anne (The Irish Journal of Psychology, 2014)
The present study examined and compared the profiles, demographics and mental health characteristics of male street prostitutes (MSPs) in Dublin, Ireland and San Francisco, USA. A total of twenty-three participants were recruited using a non-random direct approach and a snowball sampling technique. Participants took part in a semi-structured interview. Analysis revealed that, in both cities, the principal predisposing factor for entry into male street-based prostitution was drug addiction, with childhood abuse and early school leaving also reported to act as contributing factors. Several differences were observed, particularly in relation to family circumstances, sexual orientation, access to support and experience of violence. Participants also completed the Beck Depression Inventory, Beck Scale for Suicidal Ideation, Drug Assessment Screening Test, CAGE questionnaire and Coopersmith Self-Esteem Inventory. Results showed statistically significant higher levels of depression amongst the Dublin MSPs compared to those in San Francisco. There were no statistically significant differences in self-esteem, suicidal ideation, or alcohol or other drug dependencies. Similarities and differences between MSPs in Dublin and San Francisco are discussed with reference to the relevant literature. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: male street prostitution; sex work; abuse; drug dependency; sexual orientation; Cross Cultural Differences; Human Males; Mental Health; Sexual Orientation; Sex Work; Demographic Characteristics

How depressed and suicidal sexual minority adolescents understand the causes of their distress - Diamond, Gary M.; Shilo, Guy; Jurgensen, Erin; D'Augelli, Anthony; Samarova, Valeria; White, Khendi (Journal of Gay & Lesbian Mental Health, 2011)
This study examined how lesbian, gay, and bisexual (LGB) adolescents reporting clinically significant depressive and suicidal symptoms understand the causes of their psychological distress. The role of the quality of the adolescent-parent relationship as a risk or protective factor was explored. Ten qualitative interviews were analyzed using the Consensual Qualitative Research method. Results showed that adolescents viewed family rejection of sexual orientation, extra-familial LGB related victimization, and non-LGB related negative family life events as the most common causes of their psychological distress. Most of the adolescents also reported experiencing support from at least one family member, and half reported experiencing significant extra-familial (e.g., peers, school counselor) support. Almost all of the adolescents reported wishing that their relationships with their parents were closer and characterized by more acceptance, as well as a willingness to participate in family therapy to improve their relationships with their parents. Clinical implications are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: adolescent development; bisexuality; major depression; lesbianism; suicide; Bisexuality; Lesbianism; Major Depression; Suicide; Sexual Minority Groups; Adolescent Development

Mediating suicide: Print journalism and the categorization of queer youth suicide discourses - Cover, Rob (Archives of Sexual Behavior, 2012)
This article undertakes textual analysis to examine some of the ways in which knowledge around sexuality-related youth suicide and its causes are produced and made available through news media discourses and news-making processes. Four categories of sexuality-related suicide discourses were identified in news stories and features over the past 20 years: statistical research that makes non-heterosexuality implicit as a cause of suicide; stories about deviancy, guilt, and shame; suicide survivor stories; and bullying/harassment of non-heterosexual persons by individuals in schools and other institutions as suicide cause. Through processes of news production and meaning-making, use of expert opinions of primary definers, experiential accounts, reliance on citations of quantitative data, private accounts given as entertainment, and the newsworthiness of suicide as drama, public knowledge on queer youth suicide is guided by contemporary journalism. In all cases, the underlying relationship between heteronormativity, mental health, depression, and despair were frequently excluded in news journalism on queer youth suicide. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: queer; youth suicide discourses; sexuality; news media; print journalism; Adolescent; Bisexuality; Bullying; Depression; Female; Guilt; Homosexuality; Humans; Male; Mass Media; Newspapers as Topic; Sexuality; Shame; Suicide; Young Adult; Discourse Analysis; News Media; Sexuality; Suicide

Trajectories of depressive symptoms and suicidality among heterosexual and sexual minority youth - Marshal, Michael P.; Dermody, Sarah S.; Cheong, JeeWon; Burton, Chad M.; Friedman, Mark S.; Aranda, Frances; Hughes, Tonda L. (Journal of Youth and Adolescence, 2013)
Sexual minority youth report higher rates of depression and suicidality than do heterosexual youth. Little is known, however, about whether these disparities continue as youth transition into young adulthood. The primary goals of this study were to describe and compare trajectories of adolescent depressive symptoms and suicidality among sexual minority and heterosexual youth, examine differences in depressive symptoms and suicidality trajectories across sexual orientation subgroups, and determine whether there are gender differences in these longitudinal disparities. Four waves of data from the National Longitudinal Study of Adolescent Health were analyzed using latent curve modeling (N = 12,379; 53 % female). Results showed that the rates of depressive symptoms and suicidality in early adolescence were higher among sexual minority youth than among heterosexual youth, and that these disparities persisted over time as participants transitioned into young adulthood. Consistent with previous cross-sectional studies, the observed longitudinal disparities were largest for females and for bisexually- identified youth. Sexual minority youth may benefit from childhood and early adolescent prevention and intervention programs. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: depressive symptoms; suicidality; heterosexual; sexual minority youth; gender differences; Adolescent; Adolescent Behavior; Comorbidity; Depression; Female; Heterosexuality; Humans; Interpersonal Relations; Longitudinal Studies; Male; Minority Groups; Minority Health; Suicide, Attempted; United States; Heterosexuality; Human Sex Differences; Minority Groups; Sexual Orientation; Suicide; Depression (Emotion); Symptoms; Suicidality; Sexual Minority Groups

Effects of violence on transgender people - Testa, Rylan J.; Sciacca, Laura M.; Wang, Florence; Hendricks, Michael L.; Goldblum, Peter; Bradford, Judith; Bongar, Bruce (Professional Psychology: Research and Practice, 2012)
While recent research on transgender populations has demonstrated high rates of experiencing violence, there has been little research attention to the mental health implications of these experiences. This study utilized data collected from the Virginia Transgender Health Initiative Survey (THIS) of transgender people (individuals who described their gender identity as different from their sex assigned at birth) collected from 2005–2006. Current study analyses were limited to two subgroups: trans women (n = 179) and trans men (n = 92). We hypothesized that, as in the general population, exposure to physical and sexual violence would be related to suicidal ideation, suicide attempts, and substance abuse. Both trans women and trans men in this sample were at high risk for physical and sexual violence, as well as suicidal ideation and suicide attempt. Logistic regression analyses indicated that among both trans women and trans men, those who had endured physical and/or sexual violence were significantly more likely than those who had not had such experiences to report a history of suicide attempt and multiple suicide attempts. In addition, among trans men, history of physical and sexual violence were each related to alcohol abuse. Among trans women, history of sexual violence was related to alcohol abuse and illicit substance use. Patterns of violence against transgender people were identified and are discussed, including frequent gender-related motivation for violence, low prevalence of reporting violence to police, and variety of perpetrators of violence. Clinical implications and recommendations are provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: physical violence; sexual violence; substance abuse; suicide attempt; transgender; mental health; suicidal ideation; suicide attempts; Mental Health; Victimization; Violence; Transgender; Attempted Suicide; Drug Abuse; Physical Abuse; Sexual Abuse; Suicidal Ideation

Gay children and suicidality: The importance of professional nurturance - McAndrew, Sue; Warne, Tony (Issues in Mental Health Nursing, 2012)
Suicidality among young people is a global concern, with international studies demonstrating an increased prevalence among young gay men. Being gay is not inevitably linked to mental illness, but growing up gay in a heterosexist society can compromisemental well being. This qualitative study, using free association narrative interviewing, offers an in-depth understanding of gay men’s experience. One shared experience that emerged was 'knowing and not knowing,' the story of gay children growing up in a heterosexist society. This story provides valuable insights for mental health nurses becoming more attuned to the importance of providing professional nurturing of gay children. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gay children; suicidality; professional nurturance; mental illness; well being; health promotion; Adult; Awareness; Free Association; Heterosexuality; Homosexuality, Male; Humans; Male; Narration; Nurse-Patient Relations; Prejudice; Psychoanalytic Theory; Psychosexual Development; Rejection (Psychology); Self Concept; Social Isolation; Social Support; Social Values; Stereotyping; Suicidal Ideation; Suicide; Suicide, Attempted; Health Promotion; Male Homosexuality; Sexual Risk Taking; Well Being; Suicidality; Mental Disorders; Nurturance