Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland - McLafferty, Margaret; Lapsley, Coral R.; Ennis, Edel; Armour, Cherie; Murphy, Sam; Bunting, Brendan P.; Bjourson, Anthony J.; Murray, Elaine K.; O'Neill, Siobhan M. (PLoS ONE, 2017)
Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI), was conducted as part of this initiative (wave 1, n = 739), using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: mental health problems; ADHD; suicidal behavior; treatment seeking; college students; Adolescent; Adult; Female; Humans; Male; Mental Disorders; Mental Health; Northern Ireland; Young Adult; Attempted Suicide; Attention Deficit Disorder with Hyperactivity; Health Care Seeking Behavior; Mental Disorders; Suicidal Ideation; College Students

A moderated mediation analysis of suicide proneness among lesbian, gay, and bisexual community members - Cramer, Robert J.; Burks, Alixandra C.; Stroud, Caroline H.; Bryson, Claire N.; Graham, James (Journal of Social and Clinical Psychology, 2015)
Internalized homophobia is common among lesbian, gay, and bisexual (LGB) persons; moreover, it can be associated with suicide proneness, among other mental health concerns. The present paper hypothesized cognitions concerning perceived burdensomeness, but not thwarted belongingness, as mediating pathways of the association of internalized homophobia and suicide proneness in a community sample of LGB persons. Further, prior hate crime victimization experiences, suicide attempt history, level of depressive symptoms, and gender were tested as moderators of the above mediation pathway. Participants consisted of 336 LGB community members from an urban primary care clinic. Results indicated that perceived burdensomeness, but not thwarted belongingness, mediated the relationship between internalized homophobia and suicide proneness Further, the following moderation patterns were observed: both gender (significant for males only) and depressive symptoms (significant for those with mild-to-severe levels of depressive symptoms) moderated the perceived burdensomeness pathway. Implications for theory and future research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Suicide Proneness; LGB Persons; Internalized Homophobia; Thwarted Belongingness; Perceived Burdensomeness; Homosexuality (Attitudes Toward); Sexual Orientation; Suicide; Bisexuality; Lesbianism; Male Homosexuality

Innovations in the practice of culturally competent suicide risk management - Chu, Joyce; Hoeflein, Brandon T. R.; Goldblum, Peter; Bongar, Bruce; Heyne, Genevieve M.; Gadinsky, Natasha; Skinta, Matthew D. (Practice Innovations, 2017)
Although guidelines for culturally competent suicide risk management are sparse, recent advances in theory and assessment provide direction for culturally competent practice. The Cultural Theory and Model of Suicide (Chu, Goldblum, Floyd, & Bongar, 2010) was one of the first comprehensive efforts to provide a framework that guides an understanding of how culture influences suicide risk across multiple cultural identities. The Cultural Assessment of Risk for Suicide (CARS), a 39-item self-report measure assessing culturally specific suicide risk factors, was developed based on the Cultural Theory and Model of Suicide. These theoretical and measurement works, although foundational in their importance for synthesizing a broad literature, have not been tested and translated into applied clinical practice. The current case study is a translational effort that applies these approaches to culturally competent suicide practice with 'Zoe,' an Asian American veteran trans woman in her early thirties with moderate-high suicide risk. Application of the Cultural Theory and Model of Suicide and the CARS illuminated cultural risk factors that were not considered in Zoe’s original safety plan (e.g., family conflict, minority stress; hidden suicidal ideation and behaviors; and cultural expressions of suicidal distress as anger, fatigue, and shame). These results yielded differences in Zoe’s risk management plan and created a culturally informed approach that corresponded with a concomitant decrease in suicidal symptoms. This study demonstrated that the CARS may detect alternative cultural expressions of suicidal distress and behaviors and yield important implications for suicide risk assessment and management planning for culturally diverse clients. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: culture; suicide; practice; LGBTQ; Asian American; Clinical Practice; Cross Cultural Differences; Risk Management; Suicidal Ideation; Suicide; Asians; Military Veterans; Risk Factors; Suicide Prevention; Transgender; LGBTQ

Bullying victimization and emotional distress: Is there strength in numbers for vulnerable youth? - Eisenberg, Marla E.; McMorris, Barbara J.; Gower, Amy L.; Chatterjee, Debanjana (Journal of Psychosomatic Research, 2016)
Objective: The present study examines whether the prevalence of vulnerable peers in school protects the emotional health of youth who are lesbian, gay, bisexual or questioning (LGBQ), overweight, or have a disability, and if the adverse emotional effects of bullying victimization are mitigated by the presence of these peers. Methods: Survey data come from a large school-based sample of adolescents attending 505 schools. The primary independent variable was the percent of students in school with each vulnerability characteristic. Multilevel logistic regression models estimated the odds of internalizing problems, self-harm, suicidal ideation and suicide attempts among students who were LGBQ, overweight or had a disability. Cross-level interaction terms were added to determine if the association between being victimized and emotional distress was moderated by the presence of vulnerable peers. Results: Greater presence of similar students was, on average, protective against emotional distress for LGBQ girls and overweight boys. In contrast, greater presence of students with a disability was, on average, a risk factor among girls with a disability. Several tests of effect modification indicated that odds of emotional distress for those who had been victimized were lower in schools with a higher proportion of vulnerable youth. Conclusions: The presence of a similar peer group may increase the likelihood that a bystander or witness to bullying will react in a helpful way. School personnel, health care providers and other youth service professionals should inquire about social relationships at school, including experiences of harassment and perceptions of peer support, to buffer negative experiences. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: adolescence; disability; mental health; obesity; school health; sexual orientation; Adolescent; Bullying; Crime Victims; Disabled Children; Female; Humans; Male; Mental Health; Overweight; Peer Group; Sexual and Gender Minorities; Stress, Psychological; Students; Suicidal Ideation; Suicide, Attempted; Surveys and Questionnaires; Distress; Victimization; Bullying; Mental Health; Obesity; Sexual Orientation; Suicidal Ideation; Adolescent Characteristics

Outcomes associated with anxiety and depression among men who have sex with men in Estonia - Parker, R. David; Lõhmus, Liilia; Valk, Anti; Mangine, Cara; Rüütel, Kristi (Journal of Affective Disorders, 2015)
Background: Evidence supports that gay, lesbian, and transgender populations are at increased risk for mental health problems. The current study was conducted to estimate the prevalence of anxiety and depressive symptoms and related factors among men who have sex with men (MSM) in Estonia. This is the only known study of its type in the Eastern European region. Methods: In 2013, an Internet-based survey was conducted among men who have sex with men, collecting data on socio-demographics, sexuality, drug and alcohol use, mental health, suicidality, and internalized homonegativity. Results: 265 MSM completed the questionnaire (median age 31 years, 90% Estonian, 71% from the capital; 73% employed full-time, 42% with at least college education; 44% in a steady relationship; 72% gay, 23% bisexual; 23% reported illegal drug use in the last 12 months). One third met criteria for problem drinking and depressive symptoms with one quarter for anxiety symptoms. Suicidality was 44% reported lifetime suicidal thoughts and 11% with at least one suicide attempt. Limitations: The study instruments, EST-Q and CAGE, only measure symptoms and are not diagnostic tests. A non-random sample which could possibly include persons with easier internet access. Self-reported data and cross-sectional study design are prone to issues with recall bias and temporality. Conclusions: With demonstrated high rates of anxiety, depression, drinking, and drug use among MSM which is consistent with similar studies in Western countries, further research could help determine effective MSM focused interventions to address the broad spectrum of issues among MSM. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Men who have sex with men; Depression; Anxiety; Substance use; Estonia; Adult; Anxiety; Comorbidity; Cross-Sectional Studies; Depression; Estonia; Gender Identity; Homosexuality, Male; Humans; Internet; Male; Middle Aged; Substance-Related Disorders; Suicidal Ideation; Suicide; Surveys and Questionnaires; Young Adult; Anxiety; At Risk Populations; Depression (Emotion); Psychiatric Symptoms; Same Sex Intercourse; Drug Abuse; Human Males

Perceived microaggressions and mental health in a sample of black youths experiencing homelessness - Gattis, Maurice N.; Larson, Andrea (Social Work Research, 2017)
The effects of microaggressions targeted at sexual minorities and racial minorities have been well documented. Lesbian, gay, bisexual, and transgender (LGBT) youths and black youths are more likely to experience homelessness than their heterosexual, cisgender, and white peers, and yet little is known about how microaggressions may affect youths during instances of homelessness. This study examines whether perceived LGBT racial microaggressions and perceived racial microaggressions are associated with depressive symptoms and suicidality in a sample of black youths experiencing homelessness. This study uses a cross-sectional design with structured face-to-face interviews of a convenience sample of 89 black youths (ages 16 to 24 years) experiencing homelessness. Results show that whereas both types of perceived microaggressions are positively associated with depressive symptoms, neither form of microaggression is independently associated with suicidality. Depressive symptoms and suicidality are common experiences among black youths dealing with homelessness, and the perception of microaggressions targeted at sexual or racial minority statuses is associated with depressive symptomology. Results underscore the importance of social workers comprehensively addressing how subtle, pervasive forms of heterosexism, gender normativity, and racism affect mental health outcomes among homeless youths. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: black or African Americans; homelessness; lesbian; gay; bisexual; and transgender people; mental health; microaggressions; Blacks; Homeless; Mental Health; Transgender

Amphetamine-type-stimulants (ATS) use and homosexuality-related enacted stigma are associated with depression among men who have sex with men (MSM) in two major cities in Vietnam in 2014 - Vu, Nga Thi Thu; Holt, Martin; Phan, Huong Thi Thu; La, Lan Thi; Tran, Gioi Minh; Doan, Tung Thanh; Nguyen, Trang Nguyen Nhu; de Wit, John (Substance Use & Misuse, 2017)
Background: Men who have sex with men (MSM) are disproportionately affected by mental health concerns, including depression. Amphetamine-type-stimulants (ATS) use and homosexuality-related stigma and discrimination have been found associated with depression among MSM. Objectives: To assess the prevalence of depression and its associations with ATS use and homosexuality-related stigma and discrimination among MSM in Vietnam. Methods: 622 MSM were conveniently recruited in Hanoi and Ho Chi Minh city, Vietnam, from September to December 2014. We collected information on demographic characteristics, ATS, alcohol and other drug use, sexual behaviors, homosexuality-related and discrimination stigma, and sexual sensation-seeking. Depression and suicidal thoughts were assessed by the Patient Health Questionnaire (PHQ-9). We assessed associations of depression with ATS use and homosexuality-related stigma and discrimination using logistic regression. Results: Of 622 sampled MSM, 11.3% were classified as having major depression, 9.8% reported any suicidal thoughts in the last two weeks, 30.4% ever had used any ATS, 88.8% ever ad drank alcohol and 21.5% had ever used any other drugs. In multivariate analysis, depression was significantly associated with ATS use (Adjusted Odds Ratio [AOR: 2.20; (95% Confidence Interval (CI): 1.32–3.67], younger age of sexual debut with another man (AOR: 0.09; 95% CI: 0.02–0.50), and greater enacted homosexuality-related stigma (AOR: 1.97; 95% CI: 1.19–3.26). Conclusions: We found a moderate prevalence of depression among sampled MSM, which was associated with ATS use and enacted homosexuality-related stigma. We recommend integrating assessment and interventions regarding depression and methamphetamine use into gay-friendly, culturally adapted holistic HIV prevention for MSM in Vietnam. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Men who have sex with men; amphetamine-type-stimulants; homosexuality-related stigma and discrimination; depression; Vietnam; Major Depression; Amphetamine; Homosexuality; Same Sex Intercourse

Exploring the affirmative role of gay icons in coming out - Forenza, Brad (Psychology of Popular Media Culture, 2017)
Coming out is a process experienced by many sexual minorities that necessitates the individual disclosure of a personal attribute (i.e., sexual orientation) about him or herself that may otherwise go unnoticed. Compounded by myriad stressors of youth, the coming out process can yield a host of negative outcomes (suicide, depression, etc.) for questioning young people. This research utilized sense of community and collective identity frameworks (specifically, the attribute of symbols that is explicated in both literatures) to explore the affirmative role that gay icons can have in individual coming out processes. Retrospective, open-ended interviews were conducted with 10 'out and proud' gay men in the northeast region of the United States. Interviews were video-recorded, transcribed, and content-analyzed to identify themes. Three themes emerged from the data inductively. Sense of Self refers to the strongest link that participants perceived among all gay icons, Shared Identity refers to the connectedness that participants felt with the icons they mentioned, and Enabler of Coming Out refers to the belief among participants that they received validating messages about their emerging sexualities from the icons with whom they identified. Implications for policy, practice, and future research are also discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved)
Keywords: LGBT; symbols; sense of community; collective identity; coming out; Homosexuality; Role Models; Self-Concept; Self-Disclosure; Sense of Community; Celebrities; Collective Behavior; Minority Groups; Sexual Orientation; Symbolism

Military sexual assault in transgender veterans: Results from a nationwide survey - Beckman, Kerry; Shipherd, Jillian; Simpson, Tracy; Lehavot, Keren (Journal of Traumatic Stress, 2018)
There is limited understanding about the frequency of military sexual assault (MSA) in transgender veterans, characteristics associated with MSA, or subsequent mental and behavioral health problems. To address this gap, we used an online national survey of 221 transgender veterans to identify prevalence of MSA and to assess its association with demographic characteristics, past history of sexual victimization, and stigma‐related factors. We also evaluated the association between MSA and several mental and behavioral health problems. Overall, 17.2% of transgender veterans experienced MSA, but rates differed significantly between transgender women (15.2%) and transgender men (30.0%). Using adjusted regression models, MSA was associated with adult sexual assault prior to military service, odds ratio (OR) = 4.05, 95% CI [1.62, 10.08], and distal minority stress during military service, OR = 2.98, 95% CI [1.28, 6.91]. With respect to health outcomes, MSA was associated with past‐month posttraumatic stress disorder (PTSD) symptom severity, B = 10.18, 95% CI [3.45, 16.91]; current depression symptom severity, B = 3.71, 95% CI [1.11, 6.30]; and past‐year drug use, OR = 3.17, 95% CI [1.36, 7.40]. Results highlight the vulnerability of transgender veterans to MSA, and the need for military prevention programs that acknowledge transgender individuals’ heightened risk. Furthermore, clinicians should consider clinical screening for PTSD, depression, and drug use in transgender veterans who have a history of MSA. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: military sexual assault; transgender veterans; sexual victimization; stigma; mental health problems; behavioral health problems; Mental Disorders; Military Veterans; Sex Offenses; Transgender; Major Depression; Posttraumatic Stress Disorder; Stigma; Victimization; Substance Use Disorder

Prevalence and correlates of suicidal ideation among transgender youth in California: Findings from a representative, population-based sample of high school students - Perez-Brumer, Amaya; Day, Jack K.; Russell, Stephen T.; Hatzenbuehler, Mark L. (Journal of the American Academy of Child & Adolescent Psychiatry, 2017)
Objective: No representative population-based studies of youth in the United States exist on gender identity-related disparities in suicidal ideation or on factors that underlie this disparity. To address this, this study examined gender identity-related disparities in the prevalence of suicidal ideation; evaluated whether established psychosocial factors explained these disparities; and identified correlates of suicidal ideation among all youth and stratified by gender identity. Method: Data were derived from the 2013 to 2015 California Healthy Kids Survey (CHKS; N = 621,189) and a weighted subsample representative of the Californian student population (Biennial Statewide California Student Survey [CSS], N = 28,856). Results: Prevalence of past 12-month self-reported suicidal ideation was nearly twice as high for transgender compared with non-transgender youth (33.73% versus 18.85%; χ² = 35.48, p < .001). In fully adjusted models within the representative sample, transgender youth had 2.99 higher odds (95% CI 2.25–3.98) of reporting past-year suicidal ideation compared with non-transgender youth. Among transgender youth, only depressive symptoms (adjusted odds ratio 5.44, 95% CI 1.81–16.38) and victimization (adjusted odds ratio 2.66, 95% CI 1.26–5.65) remained significantly associated with higher odds of suicidal ideation in fully adjusted models. In multiple mediation analyses, depression attenuated the association between gender identity and suicidal ideation by 17.95% and victimization by 14.71%. Conclusion: This study uses the first representative population-based sample of youth in the United States that includes a measurement of gender identity to report on gender identity-related disparities in suicidal ideation and to identify potential mechanisms underlying this disparity in a representative sample. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: suicide; gender-identity disparities; youth mental health; LGBT; Adolescent Development; Suicidal Ideation; Transgender; High School Students

Initial assessment and screening with LGBTQ clients: A critical perspective - Moe, Jeffry L.; Finnerty, Peter; Sparkman, Narketta; Yates, Chad (Journal of LGBT Issues in Counseling, 2015)
Counseling with people that identify as lesbian, gay, bisexual, transgender, queer (LGBTQ), or who are otherwise nonheterosexual or cisgender identified, should be based on a critical approach to assessment. Although general competencies have been articulated, further guidance is needed to help counselors avoid hetero-normative and cisgender biases in their assessment practice. The authors provide recommendations, based on critical review of the literature, for how counselors can address biases in assessment and screening tools in work with LGBTQ clients. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGBTQ issues; prejudice; queer theory; social justice; treatment; Counseling; Health Screening; Psychological Assessment; Sexual Orientation; LGBTQ; Bisexuality; Lesbianism; Male Homosexuality; Transgender

Personality, spirituality, suicide, and self-injury proneness among lesbian, gay, and bisexual adults - Stroud, Caroline H.; Cramer, Robert J.; La Guardia, Amanda C.; Crosby, James W.; Henderson, Craig E. (Mental Health, Religion & Culture, 2015)
The present study sought to clarify gaps in current knowledge integrating personality, spirituality, and risk for suicide/self-harm among sample of 336 lesbian, gay, and bisexual community members. It was hypothesised that Neuroticism would positively predict, and Extraversion and Agreeableness would negatively predict, measures of suicide and self-injury proneness. Additionally, it was predicted that spirituality, defined as Spiritual Life Integration (SLI) and Social Justice Commitment, would interact with personality traits to attenuate risk for suicide and self-injury. Results supported the role of Neuroticism, and identified an unexpected predictor of Conscientiousness, at the main effect level. Moderation patterns were observed such that Agreeableness and Extraversion interacted with SLI to attenuate risk, such that high levels of each trait and high levels of spirituality were protective against suicide and self-injury proneness. Theoretical and practical implications with emphasis on counselling intervention implementation and future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide; self-injury; physical unhealthiness; lesbian; gay; bisexual (LGB); personality; Five-Factor Model; spirituality; Bisexuality; Injuries; Lesbianism; Social Justice; Spirituality; Five Factor Personality Model; Male Homosexuality; Personality; Suicide

Transgender youth and suicidal behaviors: Applying the interpersonal psychological theory of suicide - Grossman, Arnold H.; Park, Jung Yeon; Russell, Stephen T. (Journal of Gay & Lesbian Mental Health, 2016)
The interpersonal psychological theory of suicide (IPTS) was used to examine suicidal thoughts and behaviors among 129 transgender and gender nonconforming (TGNC) youth. Youth were categorized according to their gender identities: female to male (FTM), male to female (MTF), female to different gender (FTDG), and male to different gender (MTDG). Higher percentages of suicidal ideation were reported by FTDG and FTM youth; higher percentages of suicide attempts were reported by FTDG and MTDG youth. Perceived burdensomeness and thwarted belongingness were significantly related to suicidal ideation and/or suicide attempts. Experiences of painful, provocative, and harmful events and acquired capability significantly predicted suicide attempts. The findings support IPTS in explaining suicidal behaviors among TGNC youth. Implications for prevention and intervention efforts are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Female to different gender (FTDG); female to male (FTM); gender nonconforming; interpersonal psychological theory of suicide (IPTS); male to female (MTF); male to different gender (MTDG); suicidal ideation; suicide attempt; transgender; youth; thwarted belongingness; Gender Identity; Human Sex Differences; Suicidal Ideation; Transgender; Gender Nonconforming; Interpersonal Interaction

Non-suicidal self-injury and suicidal thoughts and behaviors in heterosexual and sexual minority young adults - Tsypes, Aliona; Lane, Robert; Paul, Elise; Whitlock, Janis (Comprehensive Psychiatry, 2016)
Objective: Despite consistently greater rates of non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs; i.e., suicidal ideation, method/plan, and attempts) in lesbian, gay, and bisexual (LGB) individuals, prevalence, characteristics, and relations between these dangerous thoughts and behaviors are equivocal. The present study sought to examine and compare the rates of NSSI and STBs in a large sample of sexual minority and majority young adults. Methods: Participants were 12,422 college students (ages 18–29; 57.3% female) who self-reported demographic characteristics, NSSI frequency, the number of NSSI forms used, the number of NSSI functions, as well as STB history (i.e., ideation, method/plan, and attempts). Each participant’s degree of SA was assessed via a 7-point scale (i.e., K0–K6) from Alfred Kinsey’s research of sexual attraction and sexual experiences. This scale was collapsed to create five categories of SA: exclusively other SA (K0), mostly other SA (K1/2), equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6). Results: Consistent with previous research, we found that being a sexual minority young adult was associated with significantly higher odds of STBs compared to being a heterosexual young adult. In addition, compared to the exclusively other SA group (K0), being in the mostly other SA group (K1/2), equally other and same SA group (K3), or mostly same SA group (K4/5) was associated with significantly higher odds of NSSI engagement. Among those with NSSI, we found that the number of NSSI forms was significantly associated with suicide attempts, but was not associated with either suicidal ideation or suicide method/plan in the mostly other SA group (K1/2) or in the equally other and same SA group (K3). We also found a significant curvilinear relation between NSSI frequency and STBs in the mostly other SA group (K1/2) and between NSSI frequency and suicide method/plan and attempt in the exclusively other SA group (K0). In addition, we revealed specificity with regard to the relation between the number of lifetime NSSI episodes and risk for STBs among the equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6) groups. Conclusion: Our findings suggest that among sexual minority young adults, equally other and same SA individuals may be at higher risk of NSSI and STBs than their sexual minority counterparts. In addition, these findings extend previous research by suggesting that the relations between NSSI frequency, number of forms, and number of functions and STBs might vary according to SA. A multi-theory based explanation is provided to explain the key findings and the study implications are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: non-suicidal self-injury; suicidal thoughts; heterosexuality; sexual minority young adults; Adult; Female; Heterosexuality; Homosexuality; Humans; Male; Minority Groups; Prevalence; Risk Factors; Self-Injurious Behavior; Sexual Behavior; Students; Suicidal Ideation; Suicide, Attempted; Transgender Persons; United States; Young Adult; Heterosexuality; Psychosexual Behavior; Self-Destructive Behavior; Suicide; Sexual Minority Groups

A trait‐interpersonal analysis of suicide proneness among lesbian, gay, and bisexual community members - Cramer, Robert J.; Stroud, Caroline H.; Fraser, Theresa; Graham, James (Suicide and Life-Threatening Behavior, 2014)
Suicide remains a concerning issue for lesbian, gay, and bisexual (LGB) persons. The integrated effects of five‐factor model personality traits and interpersonal‐psychological theory of suicide (IPTS) constructs on suicide proneness in a community sample of 336 LGB adults were examined. Results supported a model inclusive of all five‐factor model domains predicting IPTS constructs leading to suicide proneness. Effects of neuroticism and extraversion were both mediated by perceived burdensomeness and thwarted belongingness. Thwarted belongingness mediated the effect of agreeableness on suicide proneness. Identified mediation pathways build on existing trait‐interpersonal theory and may inform clinical services for sexual minority persons. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: personality traits; interpersonal relationships; suicide proneness; lesbians; gays; bisexuals; Adult; Bisexuality; Female; Homosexuality, Female; Homosexuality, Male; Humans; Interpersonal Relations; Male; Middle Aged; Personality; Psychological Theory; Risk Factors; Suicidal Ideation; Suicide; At Risk Populations; Personality Traits; Sexual Orientation; Suicide; Interpersonal Relationships; Bisexuality; Lesbianism; Male Homosexuality

Early sexual debut and associated risk behaviors among sexual minority youth - Lowry, Richard; Dunville, Richard; Robin, Leah; Kann, Laura (American Journal of Preventive Medicine, 2017)
Introduction: Early sexual debut, sexual risk taking, substance use, violent victimization, and suicidal behaviors are more prevalent among sexual minority than sexual nonminority youth. Although associations between early sexual debut and these risk behaviors exist, little is known about such associations among sexual minority youth. This study examined these associations among sexual minority U.S. high school students and their sexual nonminority peers. Methods: In 2015, the national Youth Risk Behavior Survey included questions assessing sexual orientation for the first time. In 2016, data from this nationally representative sample of 15,624 U.S. high school students were analyzed to determine if associations between early sexual debut and other health risk behaviors varied by sexual orientation, by calculating adjusted (for sex, race/ethnicity, and age) prevalence ratios (APRs). Results: Associations between early sexual debut and other health risk behaviors did not vary significantly by sexual orientation. Early sexual debut (first sexual intercourse before age 13 years) was associated with sexual risk taking, substance use, violent victimization, and suicidal thoughts/attempts among students identifying as lesbian, gay, or bisexual (LGB) and among students identifying as heterosexual, for example, being currently sexually active (LGB students: APR = 1.82, 95% CI = 1.35, 2.45; heterosexual students: APR = 2.50, 95% CI = 2.22, 2.81) and not using a condom at last sexual intercourse (LGB students: APR = 1.50, 95% C I = 1.18, 1.91; heterosexual students: APR = 1.29, 95% CI = 1.09, 1.52). Conclusions: School-based sexual health programs might appropriately utilize strategies that are inclusive of sexual minority students, encourage delay of sexual intercourse, and coordinate with violence and substance use prevention programs. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: early sexual debut; associated risk behaviors; sexual minority; Adolescent; Adolescent Behavior; Age Factors; Crime Victims; Female; Health Surveys; Heterosexuality; Humans; Male; Prevalence; Risk-Taking; School Health Services; Sexual Behavior; Sexual and Gender Minorities; Students; Substance-Related Disorders; Suicidal Ideation; United States; Violence; Minority Groups; Psychosexual Behavior; Risk Assessment; Sexual Minority Groups

On my terms: Sharing a story of hypocrisy and transformation - Clauss‐Ehlers, Caroline S.; Parham, William D. (Journal of Multicultural Counseling and Development, 2017)
The 4th interviewee for the Hearing Our Elders series is Mr. Bob Zellner. Mr. Zellner's experience growing up in the segregated South underscores a commitment to stand up to obstacles and societal norms, even when to do so was life threatening. His experiences remind us of a historical time not too long ago that, to hear, one might think could never happen. And yet, witnessing his experience in the context of modern‐day struggles portrayed in the civil rights movement; the 2016 Tennessee denial of service law for lesbian, gay, bisexual, transgender, and queer individuals; and the 2016 Orlando shooting outside a gay nightclub reminds us that the historical events of Mr. Zellner's past are not too distant from the present. The interview captures 6 themes: being nonconforming in the face of punitive measures, living a purposeful life, pushing beyond comfort zones, early experiences as resilience building, self‐evaluation as a cornerstone for commitment, and giving meaning to grief. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Bob Zellner; Hearing Our Elders; a purposeful life; Civil Rights Movement; Grief; Life Experiences; Resilience (Psychological); Social Norms; Self-Evaluation

The influence of intersecting identities on self‐harm, suicidal behaviors, and depression among lesbian, gay, and bisexual individuals - Lytle, Megan C.; De Luca, Susan M.; Blosnich, John R. (Suicide and Life-Threatening Behavior, 2014)
Individuals with lesbian, gay, and bisexual (LGB) identities have higher prevalence of self‐directed violence, but very little is known about racial/ethnic differences between LGB populations. This study aimed to examine racial/ethnic differences in self‐harm, suicidal ideation, suicide attempt, and depression among LGB and heterosexual emerging adults. Data are compiled from the Fall 2008 and Spring 2009 National College Health Assessment and limited to respondents within emerging adulthood (ages 18–24) who indicated their sexual orientation and racial/ethnic identities (n = 89,199). Within each racial/ethnic group, LGB individuals were significantly more likely to report self‐harm, suicidal ideation, suicide attempt, and depression than non‐LGB individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; depression; racial and ethnic differences; bisexual individuals; suicide attempt; lesbian; Adolescent; Bisexuality; Continental Population Groups; Depression; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Self-Injurious Behavior; Suicidal Ideation; Suicide, Attempted; Young Adult; Attempted Suicide; Bisexuality; Lesbianism; Major Depression; Suicidal Ideation; Racial and Ethnic Differences

Suicidal risk and sexual orientation in adolescence: A population-based study in Iceland - Arnarsson, Arsaell; Sveinbjornsdottir, Sigrun; Thorsteinsson, Einar B.; Bjarnason, Thoroddur (Scandinavian Journal of Public Health, 2015)
Aim: Suicidality is an important public health problem, particularly among lesbian, gay, and bisexual (LGB) adolescents and young adults. The purpose of the present study is to compare the rate of suicide ideations and attempts among LGB adolescent to that of non-LGB adolescents in a population-based sample, and to identify important protective factors as well as risk factors. Method: We used the Icelandic data set from the 2009/2010 Health Behaviour in School-aged Children (HBSC) study. The sample consisted of 3813 grade 10 Icelandic adolescents; 1876 girls and 1937 boys. The participants were asked about attraction and/or activity, as well as about suicidal ideation and/or attempts. The questionnaire also included various other items regarding health and lifestyle. Results: LGB adolescents were five to six times more likely to have had frequent suicidal ideations. Factors that were associated with less suicide ideations and fewer attempts were easy communication and liking school. The LGB girls were six times more likely to have had frequent suicide attempts, whilst the LGB boys were 17 times more likely to have attempted suicide that often. No specific protective or risk factors were identified for suicidality in LGB adolescents other than bullying. Conclusions: Adolescents that had engaged in heterosexual activity and those that had LGB attraction had similarly heightened risk for suicidality, but sexually active LGB adolescents were far more likely to have suicidal ideations or to have attempted suicide. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Adolescent; sexuality; homosexuality; suicide; LGB; Adolescent; Bisexuality; Female; Heterosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Iceland; Male; Protective Factors; Risk Assessment; Risk Factors; Sexual Behavior; Suicidal Ideation; Suicide, Attempted; Homosexuality; Risk Factors; Suicide; Public Health

Self-reported benefits and costs of research participation by sexual minority and heterosexual youth - Kuyper, Lisette; Bos, Henny (Psychology of Sexual Orientation and Gender Diversity, 2017)
Decision making about the balance of costs and harms experienced by research participants should be based on empirical data and not on subjective points of view. These data are scarce for young people in general and virtually nonexistent for sexual minority youth. The current study examines the effects of research participation on sexual minority and heterosexual youth and the explanations for potential differences in effects. Participants (N = 447, 16–20 years old) completed an online questionnaire about their well-being (psychological distress, loneliness, and suicidality) and self-perceived effects of research participation. Sexual minority youth reported significantly higher levels of perceived benefits and perceived costs than heterosexual participants. Participants who reported higher levels of psychological distress and loneliness experienced more costs from their research participation. When controlling for the aspects of well-being and sociodemographics, sexual minority youth still reported elevated levels of benefits from their participation, while the differences in the experienced costs disappeared. Implications for policymakers and researchers are discussed in addition to the limitations of the current study. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: lesbian; gay; bisexual; ethics; participation effects; Ethics; Minority Groups; Participation; Self-Report; Sexual Orientation; Bisexuality; Heterosexuality; Lesbianism; Male Homosexuality; Sexual Minority Groups

‘Not becoming mother’: A phenomenological exploration of the therapeutic relationship with transgender clients - Harmon, Kevin; Donohue, Gráinne (Issues in Mental Health Nursing, 2018)
LGBTI clients present specific challenges for the mental health profession with key issues for transgender people identified as including isolation, fear, stigma, and family rejection, all of which contribute to the transgender community's high levels of depression, anxiety, substance misuse, self-harm, and suicide. This qualitative research paper explores the experiences of Irish psychotherapists working with transgender clients to explore specifically the nature of the therapeutic relationship. Using an interpretive phenomenological approach, it examines the subjective experience of three participant psychotherapists and endeavours to make sense of the phenomenology that emerged from semi-structured interviews. The phenomenological analysis of the data collected resulted in three salient themes emerging: (i) Therapeutic identification, (ii) Maternal countertransference, and (iii) Confusion. It is hoped that these findings which relate to the therapeutic relationship will be of utmost importance to others working within the mental health profession where recovery is dependent on the strength of this relationship. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: mental health; therapeutic processes; client counselor interaction; transgender; Mental Health; Psychotherapeutic Processes; Therapeutic Processes; Transgender

Increasing interest of mass communication media and the general public in the distribution of tweets about mental disorders: Observational study - Alvarez-Mon, Miguel Angel; del Barco, Angel Asunsolo; Lahera, Guillermo; Quintero, Javier; Ferre, Francisco; Pereira-Sanchez, Victor; Ortuño, Felipe; Alvarez-Mon, Melchor (Journal of Medical Internet Research, 2018)
Background: The contents of traditional communication media and new internet social media reflect the interests of society. However, certain barriers and a lack of attention towards mental disorders have been previously observed. Objective: The objective of this study is to measure the relevance of influential American mainstream media outlets for the distribution of psychiatric information and the interest generated in these topics among their Twitter followers. Methods: We investigated tweets generated about mental health conditions and diseases among 15 mainstream general communication media outlets in the United States of America between January 2007 and December 2016. Our study strategy focused on identifying several psychiatric terms of primary interest. The number of retweets generated from the selected tweets was also investigated. As a control, we examined tweets generated about the main causes of death in the United States of America, the main chronic neurological degenerative diseases, and HIV. Results: In total, 13,119 tweets about mental health disorders sent by the American mainstream media outlets were analyzed. The results showed a heterogeneous distribution but preferential accumulation for a select number of conditions. Suicide and gender dysphoria accounted for half of the number of tweets sent. Variability in the number of tweets related to each control disease was also found (5998). The number of tweets sent regarding each different psychiatric or organic disease analyzed was significantly correlated with the number of retweets generated by followers (1,030,974 and 424,813 responses to mental health disorders and organic diseases, respectively). However, the probability of a tweet being retweeted differed significantly among the conditions and diseases analyzed. Furthermore, the retweeted to tweet ratio was significantly higher for psychiatric diseases than for the control diseases (odds ratio 1.11, CI 1.07-1.14; P < .001). Conclusions: American mainstream media outlets and the general public demonstrate a preferential interest for psychiatric diseases on Twitter. The heterogeneous weights given by the media outlets analyzed to the different mental health disorders and conditions are reflected in the responses of Twitter followers. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: mass communication media; Twitter; social media; psychiatry; mental health; Communication; Female; Humans; Male; Mass Media; Mental Disorders; Social Media; Interests; Mass Media; Mental Disorders; Social Media; Digital Content Analysis

Suicide ideation and bullying among US adolescents: Examining the intersections of sexual orientation, gender, and race/ethnicity - Mueller, Anna S.; James, Wesley; Abrutyn, Seth; Levin, Martin L. (American Journal of Public Health, 2015)
Objectives: We examined how race/ethnicity, gender, and sexual orientation shape adolescents’ likelihood of being bullied and vulnerability to suicide ideation. Methods: We analyzed pooled data from the 2009 and 2011 Youth Risk Behavior Surveys (n = 75 344) to assess race/ethnicity, gender, and sexual orientation variation in being bullied and suicide ideation. Results: White and Hispanic gay and bisexual males, White lesbian and bisexual females, and Hispanic bisexual females were more likely to be bullied than were White heterosexual adolescents. Black lesbian, gay, and bisexual youths’ vulnerability to being bullied was not significantly different from that of White heterosexual youths. Black and Hispanic heterosexual youths were less likely to be bullied than were White heterosexual youths. Despite differences in the likelihood of being bullied, sexual minority youths were more likely to report suicide ideation, regardless of their race/ethnicity, their gender, or whether they have been bullied. Conclusions: Future research should examine how adolescents’ intersecting identities shape their experience of victimization and suicidality. School personnel should develop antibullying and antihomophobia policies in response to the disproportionate risk of being bullied and reporting suicidality among sexual minority youths. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide ideation; bullying; US adolescents; sexual orientation; race; ethnicity; Hispanics; bisexuals; minority groups; gender; Ethnic Identity; Gender Identity; Race (Anthropological); Sexual Orientation; Suicidal Ideation; Bisexuality; Minority Groups; Bullying; Risk Assessment; Latinos/Latinas

Supporting LGBT Lives? Complicating the suicide consensus in LGBT mental health research - Bryan, Audrey; Mayock, Paula (Sexualities, 2017)
This article locates itself within an emergent, counter-discursive body of scholarship that is critical of universalizing depictions portraying queer-identified or LGBT youth as vulnerable and ‘at-risk’ of a range of negative mental health outcomes, including self-harm and suicidality. Drawing on key findings from a large-scale, mixed-methods study exploring the mental health and well-being of LGBT people, we seek to contribute to the development of a more expansive understanding of LGBT lives by demonstrating the diverse ways people engage with their sexuality and gender identity and illuminating the complex meanings that those LGBT people who have experienced psychological and suicidal distress ascribe to their feelings, thoughts and actions. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Discourse; heteronormativity; LGBT youth; mixed-methods; suicidality; Mental Health; Suicide; Suicidality; Homosexuality

Depression and suicidality in gay men: Implications for health care providers - Lee, Carrie; Oliffe, John L.; Kelly, Mary T.; Ferlatte, Olivier (American Journal of Men's Health, 2017)
Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gay men’s health; depression; suicidality; men’s health; men’s help seeking; Adult; Depression; Homosexuality, Male; Humans; Male; Masculinity; Men's Health; Mental Health; Middle Aged; Patient Acceptance of Health Care; Professional Role; Suicide; Health Care Services; Male Homosexuality; Suicide; Suicidality

Factors associated with suicidality among a national sample of transgender veterans - Lehavot, Keren; Simpson, Tracy L.; Shipherd, Jillian C. (Suicide and Life-Threatening Behavior, 2016)
Correlates of past‐year suicidal ideation and lifetime suicide risk among a national sample of transgender veterans were examined. An online, convenience sample of 212 U.S. transgender veterans participated in a cross‐sectional survey in February–May 2014. We evaluated associations between sociodemographic characteristics, stigma, mental health, and psychosocial resources with past‐year suicidal ideation and lifetime suicide plans and attempts. Participants reported high rates of past‐year suicidal ideation (57%) as well as history of suicide plan or attempt (66%). Transgender‐related felt stigma during military service and current posttraumatic stress disorder and depressive symptoms were associated with suicide outcomes as were economic and demographic factors. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicide; stigma; military veterans; symptoms; Adult; Cross-Sectional Studies; Demography; Depression; Female; Humans; Male; Mental Health; Middle Aged; Risk Factors; Social Stigma; Socioeconomic Factors; Stress Disorders, Post-Traumatic; Suicidal Ideation; Suicide; Suicide, Attempted; Transgender Persons; United States; Veterans; Military Veterans; Suicidal Ideation; Suicide; Transgender; Suicidality; Attempted Suicide; Stigma; Symptoms; Risk Assessment

Differences in parental monitoring components and their associated health indicators between sexual-minority and heterosexual girls - Montano, Gerald T.; McCauley, Heather L.; Miller, Elizabeth; Chisolm, Deena J.; Marshal, Michael P. (Journal of GLBT Family Studies, 2017)
Our study sought to assess whether parental monitoring and their associations with health behaviors differed for heterosexual girls compared to sexual-minority girls (girls who identified as lesbian or bisexual, endorsed same-sex attraction, or had same-sex romantic or sexual partners). We analyzed three components of parental monitoring—adolescent disclosure, parental solicitation, and parental knowledge—between heterosexual and sexual-minority girls. We also tested if the associations between these three constructs and adolescent relationship abuse, suicidality, heavy drinking, binge drinking, anxiety symptoms, and depressive symptoms were different for heterosexual girls compared to sexual-minority girls. Sexual-minority girls were less likely to disclose accurately to their parents their location and activities and perceived their parents asked less and knew less about their location and activities than did heterosexual girls. Heterosexual girls who reported higher levels of adolescent disclosure were less likely than were sexual-minority girls to report suicidality and anxiety symptoms. Additionally, heterosexual girls who reported higher levels of parental knowledge were also less likely than were sexual-minority girls to report anxiety and depressive symptoms. These findings suggest that parental monitoring may not be as protective for sexual-minority girls as it is for heterosexual girls. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Familial relationships; mental health; sexual-minority girls; parental monitoring; substance use; Adolescent Psychopathology; Human Females; Parent Child Relations; Psychosexual Development; Sexual Orientation; Adolescent Development; Drug Abuse; Family Relations; Lesbianism; Mental Health; Monitoring; Psychosexual Behavior; Self-Disclosure; Sexual Attraction; Sexual Minority Groups

Factors related to suicide in LGBT populations: A psychological autopsy case-control study in Australia - Skerrett, Delaney Michael; Kõlves, Kairi; De Leo, Diego (Crisis: The Journal of Crisis Intervention and Suicide Prevention, 2016)
Background: There is evidence of heightened vulnerability to nonfatal suicidal behaviors among LGBT populations yet a paucity of studies into fatal behaviors. Aim: The specific aim of this article was to identify factors related to suicide in LGBT individuals in Australia. Method: The psychological autopsy (PA) method with a matched case-control study design was used. PA interviews were conducted with 27 next-of-kin of an LGBT person that had died by suicide. Three living LGBT controls per suicide case, matched by age and gender, were also interviewed. Results: The key factors relating to suicide in LGBT people were a lack of acceptance by family and self (reflected in higher internalized homophobia and shame), negative feelings about own sexuality/gender, and dissatisfaction with appearance. LGBT people who died by suicide also tended to go through coming out milestones 2 years earlier than controls. There was a higher prevalence of aggressive behaviors and a more predominant history of physical and sexual abuse. Additionally, there was greater incidence of depression and anxiety and alcohol and substance use disorders. Conclusion: Specific predictive factors for suicide in LGBT populations in Australia were identified, including significantly poorer mental health outcomes and more violence across an array of measures. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: LGBT; suicide; psychological autopsy; risk factors; Adult; Case-Control Studies; Depressive Disorder, Major; Employment; Female; Humans; Male; Middle Aged; Risk Factors; Sexual and Gender Minorities; Substance-Related Disorders; Suicidal Ideation; Suicide; Suicide, Attempted; Young Adult; Psychological Autopsy; Risk Factors; Sexual Orientation; Suicide; Bisexuality; Lesbianism; Male Homosexuality; Transgender

Prevalence and risk factors for lifetime suicide ideation, plan and attempt in Chinese men who have sex with men - Mu, Huijuan; Li, Yanxia; Liu, Li; Na, Jun; Yu, Liya; Bi, Xuejuan; An, Xiaoxia; Gu, Yuan; Zhou, Yan; Li, Shuang; Zhang, Rui; Jiang, Chao; et al. (BMC Psychiatry, 2016)
Background: To describe the level and risk factors for suicidal behaviors in Chinese men who have sex with men (MSM). Methods: A total of 807 MSM were recruited using a respondent-driven sampling method from Anshan, Benxi, Dandong, and Shenyang cities in northeastern China. Results: Chinese MSM had lifetime prevalences of suicide ideation (18.3 %), plan (8.7 %) and attempt (4.6 %) that were about 2.8, 5.8 and 5.8 times greater than that of male adults in the general population of China. The MSM with any psychiatric disorders were 4–7 times more likely to think about, plan or attempt suicide than those MSM with no disorder, and there was a clear relationship between the number of comorbid disorders and suicidal behaviors. Multiple regression analysis showed that major depression, bipolar disorder, dysthymia and alcohol use disorder significantly increased the risk for suicide ideation, but not for suicide attempt. Drug dependence disorder, panic disorder and generalized anxiety disorder significantly increased the risk for suicide attempt, but not for suicide ideation. More advanced education reduced the risk of suicidal behaviors, sexual orientations revealed to or discovered by family members or friends significantly increased risk of these suicidal behaviors. Conclusions: Chinese MSM have significantly increased risk for suicidal behaviors, mental disorders and their comorbidities could be the largest risk factors for the elevated suicidal behaviors in Chinese MSM. Reducing the family and social stigma and rejection of homosexual behavior and early detection and effective treatment of psychiatric disorders and their comorbidities in MSM may help to decrease suicidal behaviors of Chinese MSM. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Men who have sex with men; Suicidal behavior; Psychiatric disorder; Comorbidity; Attempted Suicide; Mental Disorders; Risk Factors; Suicidal Ideation; Same Sex Intercourse; Comorbidity; Epidemiology

Social connectedness, stressful life events, and self-injurious thoughts and behaviors among young adults - Macrynikola, Natalia; Miranda, Regina; Soffer, Ariella (Comprehensive Psychiatry, 2018)
Objectives: Preventing self-injurious thoughts and behaviors (SITBs) is particularly challenging on commuter campuses, given lower social cohesion and higher levels of stress than among traditional college populations. The present study examined the relationship between stressful life events (SLEs) and risk for different forms of SITBs, along with the potential buffering role of social connectedness, in a diverse sample of young adults from a commuter college. Methods: Participants were 1712 (81% female; 61% racial/ethnic minority; 20% sexual minority) undergraduate and graduate students from a public commuter college in New York City. Participants completed an anonymous survey that inquired about lifetime and recent (past 12months) history of suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI), along with social connectedness and lifetime history of SLEs. Results: Lower levels of social connectedness and exposure to a higher number of SLEs were associated with engaging in SITBs in the past year, particularly both suicide attempts and non-suicidal self-injury. However, social connectedness did not buffer against the impact of SLEs on SITBs. Limitations: Data are cross-sectional, limiting conclusions about directionality, and females were overrepresented. Conclusions: Identifying ways to increase social connectedness on diverse commuter campuses may help decrease risk of SITBs. However, it may not buffer against the impact of SLEs on risk of SITBs. Future studies should examine contextual variables (e.g., type and timing of social support) that may play a role in protecting against SITBs, particularly for those with a history of adversity. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Social connectedness; stressful life events; risk for self-injurious thoughts and behaviors among young adults; undergraduate and graduate students; Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Male; Self Report; Self-Injurious Behavior; Social Support; Students; Suicidal Ideation; Suicide, Attempted; Surveys and Questionnaires; Thinking; Universities; Young Adult; Social Networks; Adversity; College Students; Predisposition; Risk Factors; Self-Injurious Behavior; Stress

Addressing the social determinants of suicidal behaviors and poor mental health in LGBTI populations in Australia - Skerrett, Delaney Michael; Mars, Michelle (LGBT Health, 2014)
The purpose of this article is to describe and assess—as well as identify and rectify gaps in—intervention and prevention initiatives that specifically address poor mental health outcomes and suicidal behaviors in lesbian, gay, bisexual, transgender, and intersex (LGBTI) populations in Australia. It begins with an overview of the evidence base for heightened vulnerability to suicidal behaviors among LGBTI people in Australia. It then provides a discussion on the public health implications for LGBTI-targeted mental health initiatives and the prevention of and timely intervention in LGBTI suicidal behaviors. We conclude that the literature supports an increased risk for poorer mental health outcomes and suicidal behaviors in LGBTI populations in the Australian context. Psychological distress and suicidal behaviors in LGBTI people in Australia have social determinants that can and have been addressed through the provision of interventions with a strong evidence base in reducing these outcomes, implemented at a nationwide level, including training of health professionals and gatekeepers to mental health services and the general public. We conclude that the current Australian focus appears to address many of the social determinants of suicidal behaviors and poor mental health in LGBTI people but requires sustained and uniform government support if it is to continue and to produce measurable results. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: access to care; gay; intersex; lesbian; mental health needs; public policy and advocacy; suicide; Bisexuality; Lesbianism; Mental Health; Suicide; Transgender; Attempted Suicide; Health Service Needs; Intervention; Prevention; Suicidal Ideation; Intersex Conditions

Perceived parental monitoring and sexual orientation moderate lifetime acts of non-suicidal self-injury - Benau, Erik M.; Jenkins, Abigail L.; Conner, Bradley T. (Archives of Suicide Research, 2017)
Being non-heterosexual, particularly bisexual, is associated with high rates of engagement in NSSI amongst young adults. The goal of the present study was to determine if parenting practices, specifically parental monitoring, and sexual orientation moderate engagement with NSSI. Undergraduates (N = 1,353) completed a survey on sexual orientation, non-suicidal self-injury (NSSI) acts, and multiple aspects of perceived parental monitoring during high school. Moderation analyses revealed that most facets of parental monitoring were similarly negatively correlated with NSSI for both individuals whose sexual orientation where nearly, or entirely, gay and heterosexual youth. Youth who were neither exclusively heterosexual nor exclusively gay (mixed sexual orientation) reported the most NSSI acts, and no facet of parental monitoring predicted reduced NSSI acts for this group. While previous literature shows that many aspects of parental monitoring may be protective against engagement in health risk behaviors, the present study adds to these findings that similar aspects are negatively associated with self-injurious behavior for some, but not all, individuals. More research is needed to better understand the causes of increased NSSI for individuals with a mixed sexual orientation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: bisexuality; college students; family relationships; LGB; resilience; Family Relations; Monitoring; Resilience (Psychological); Self-Injurious Behavior; Sexual Orientation; Parents

Buried above ground: A university-based study of risk/protective factors for suicidality among sexual minority youth in Canada - Peter, Tracey; Taylor, Catherine (Journal of LGBT Youth, 2014)
This study examined differences in suicidal behavior between lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) and non-LGBTQ university students as well as investigated the importance of risk and protective factors in the prediction of suicidality between these two groups. A total of 1,205 university students participated in the survey. Findings show, compared to non-LGBTQ respondents, sexual minority youth are at a greater risk for serious suicidal ideation (8.9% versus 23%, respectively) and suicide attempt (3.5% versus 26.2%). Among LGBTQ respondents, significant risk covariates for suicidality were depressive symptoms, socioeconomic status, being bullied, age, and childhood trauma. The only significant protective factor was self-esteem. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidal behavior; lesbian; gay; bisexual; transgender; queer; questioning; LGBTQ; non-LGBTQ; university students; risk factors; protective factors; suicidality; sexual minority youth; Homosexuality; Minority Groups; Protective Factors; Risk Factors; Suicidal Ideation; Bisexuality; Heterosexuality; Lesbianism; Male Homosexuality; Questioning; Transgender; Suicidality; Sexual Minority Groups; LGBTQ

Clinician competencies: Strengths and limitations for work with transgender and gender non-conforming (TGNC) clients - Whitman, Chassitty N.; Han, Heather (International Journal of Transgenderism, 2017)
Individuals who identify as transgender or gender nonconforming (TGNC) face a number of health disparities compared to individuals who identify as cisgender (those who self-identify with the sex they were assigned at birth). For example, TGNC individuals experience heightened rates of clinical depression, anxiety, general psychological distress, suicidal ideation, and suicide attempts. Despite these troubling disparities, many TGNC individuals report hesitance to seek mental health services due to concerns regarding culturally insensitive or even overtly discriminatory services from providers. In addition to decreasing service utilization among TGNC populations, discriminatory services impair intervention effectiveness even when TGNC individuals persist in seeking mental health services. The American Psychological Association (APA) and the World Professional Association for Transgender Health (WPATH) provide guidelines for culturally competent work with TGNC clients; however, research indicates a profound lack of TGNC-specific training and resources among mental health care providers. To address this gap, the present investigation utilized a mixed-method design to assess training experiences, understanding of terminology, and TGNC competence among mental health care providers at various training levels. Participants were current mental health clinicians across the United States. Implications for improving reported and demonstrated weaknesses are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Transgender; gender nonconforming; TGNC; mental health; competence; Clinicians; Human Sex Differences; Mental Health Services; Psychological Stress; Transgender; Competence; Gender Nonconforming

Lifetime prevalence of suicide attempts among sexual minority adults by study sampling strategies: A systematic review and meta-analysis - Hottes, Travis Salway; Bogaert, Laura; Rhodes, Anne E.; Brennan, David J.; Gesink, Dionne (American Journal of Public Health, 2016)
Background. Previous reviews have demonstrated a higher risk of suicide attempts for lesbian, gay, and bisexual (LGB) persons (sexual minorities), compared with heterosexual groups, but these were restricted to general population studies, thereby excluding individuals sampled through LGB community venues. Each sampling strategy, however, has particular methodological strengths and limitations. For instance, general population probability studies have defined sampling frames but are prone to information bias associated with underreporting of LGB identities. By contrast, LGB community surveys may support disclosure of sexuality but overrepresent individuals with strong LGB community attachment. Objectives. To reassess the burden of suicide-related behavior among LGB adults, directly comparing estimates derived from population- versus LGB community–based samples. Search methods. In 2014, we searched MEDLINE, EMBASE, PsycInfo, CINAHL, and Scopus databases for articles addressing suicide-related behavior (ideation, attempts) among sexual minorities. Selection criteria. We selected quantitative studies of sexual minority adults conducted in nonclinical settings in the United States, Canada, Europe, Australia, and New Zealand. Data collection and analysis. Random effects meta-analysis and meta-regression assessed for a difference in prevalence of suicide-related behavior by sample type, adjusted for study or sample-level variables, including context (year, country), methods (medium, response rate), and subgroup characteristics (age, gender, sexual minority construct). We examined residual heterogeneity by using t2. Main results. We pooled 30 cross-sectional studies, including 21 201 sexual minority adults, generating the following lifetime prevalence estimates of suicide attempts: 4% (95% confidence interval [CI] = 3%, 5%) for heterosexual respondents to population surveys, 11% (95% CI = 8%, 15%) for LGB respondents to population surveys, and 20% (95%CI = 18%, 22%) for LGB respondents to community surveys (Figure 1). The difference in LGB estimates by sample type persisted after we accounted for covariates with meta-regression. Sample type explained 33% of the between-study variability. Author’s conclusions. Regardless of sample type examined, sexual minorities had a higher lifetime prevalence of suicide attempts than heterosexual persons; however, the magnitude of this disparity was contingent upon sample type. Community-based surveys of LGB people suggest that 20% of sexual minority adults have attempted suicide. Public health implications. Accurate estimates of sexual minority health disparities are necessary for public health monitoring and research. Most data describing these disparities are derived from 2 sample types, which yield different estimates of the lifetime prevalence of suicide attempts. Additional studies should explore the differential effects of selection and information biases on the 2 predominant sampling approaches used to understand sexual minority health. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: lifetime prevalence; suicide attempts; sexual minority; Attempted Suicide; Minority Groups; Risk Factors; Sexuality; Sexual Minority Groups

Transgender adults’ access to college bathrooms and housing and the relationship to suicidality - Seelman, Kristie L. (Journal of Homosexuality, 2016)
Transgender and gender non-conforming people frequently experience discrimination, harassment, and marginalization across college and university campuses (Bilodeau, 2007; Finger, 2010; Rankin et al., 2010; Seelman et al., 2012). The minority stress model (Meyer, 2007) posits that experiences of discrimination often negatively impact the psychological wellbeing of minority groups. However, few scholars have examined whether college institutional climate factors—such as being denied access to bathrooms or gender-appropriate campus housing—are significantly associated with detrimental psychological outcomes for transgender people. Using the National Transgender Discrimination Survey, this study analyzes whether being denied access to these spaces is associated with lifetime suicide attempts, after controlling for interpersonal victimization by students or teachers. Findings from sequential logistic regression (N = 2,316) indicate that denial of access to either space had a significant relationship to suicidality, even after controlling for interpersonal victimization. This article discusses implications for higher education professionals and researchers. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Bathrooms; campus housing; harassment; higher education; minority stress model; suicidality; transgender; Housing; Stress; Suicidal Ideation; Well Being; Transgender; Colleges; Minority Groups; Suicidality; Minority Stress

Older age associated with mental health resiliency in sexual minority US veterans - Monin, Joan K.; Mota, Natalie; Levy, Becca; Pachankis, John; Pietrzak, Robert H. (The American Journal of Geriatric Psychiatry, 2017)
Objectives: Objectives were to: (a) identify the mental health needs of older and younger sexual minority and heterosexual U.S. veterans and (b) examine whether sexual minority status confers vulnerability or resiliency in older adulthood. Support and trauma exposure were examined as potential mechanisms for age by sexual orientation differences. Methods: Participants were a nationally representative sample of 3,095 U.S. veterans (ages 21 to 96 years). Measures included demographics, military characteristics, sexual orientation (lesbian, gay, or bisexual; LGB), social support, trauma, and mental health indicators (lifetime and present depression and post-traumatic stress disorder (PTSD); lifetime anxiety and suicidal ideation). Results: Younger LGB veterans were most likely to report lifetime depression and/or PTSD and current depression compared with older LGB and younger and older heterosexual veterans. Older LGB veterans had low levels of mental health problems, but they reported the smallest social support networks. Conclusions: Older and younger LGB veterans have different mental health challenges. Younger LGB veterans are more vulnerable to mental health problems than their older LGB peers. Older LGB veterans are resilient, but they may be at greater risk of social isolation than their younger LGB peers. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Sexual minority status; veterans; mental health; aging; Adult; Age Factors; Aged; Aged, 80 and over; Depression; Female; Humans; Male; Middle Aged; Resilience, Psychological; Sexual and Gender Minorities; Stress Disorders, Post-Traumatic; United States; Veterans; Young Adult; Aging; Heterosexuality; Mental Health; Military Veterans; Minority Groups; Sexual Minority Groups

Hidden rainbows: Gay bars as safe havens in a socially conservative area since the Pulse Nightclub Massacre - Croff, Julie M.; Hubach, Randolph D.; Currin, Joseph M.; Frederick, Amanda F. (Sexuality Research & Social Policy: A Journal of the NSRC, 2017)
Gay and lesbian bars are considered a safe haven. Safe havens exist because of the larger cultural environment that makes safe places necessary. Some communities have noted reductions in the need for gay and lesbian bars due to growing acceptance within the community. However, many states and communities within the South and Bible Belt continue to propose and pass bills which target or restrict the freedoms of LGBT persons. These cultural overtones may support or encourage targeted violence, including the Pulse Nightclub Massacre which was the deadliest incidence of violence targeted at LGBT persons in the USA. This manuscript presents two studies: one at gay bars in Tulsa, Oklahoma, a socially conservative city/state, and the other examines four US communities following the Pulse Nightclub Massacre. Study 1 included interviews at entrance to the bar, exit from the bar, and within a week of leaving the bar in order to identify feelings of safety and comfort. Study 2 seeks to compare gay bar attendance and feelings of comfort and safety in gay bars in regions of the USA with varying structural stigma. Results of study 1 suggest that the participants felt safe (82.4%, n = 42) and comfortable (72.5%, n = 37). In study 2, individuals from Tulsa, Oklahoma were compared to individuals in New York and the DC metro area and were significantly less likely to attend gay bars after the Pulse shooting (t = 2.53 and 3.66, p ≤ 0.01 and p ≤ 0.001, respectively). Moreover, compared to individuals living in the DC metro area and Philadelphia, participants residing in the city in a conservative state felt significantly less safe attending gay bars (t = −2.03 and −2.30, respectively; p ≤ 0.05). No differences across the communities were noted by comfort within the gay bar space. In light of a changing political landscape, additional programming efforts may be necessary at gay bars in communities with high structural stigma. These efforts may include supporting the naturally occurring feelings of community connectedness and facilitating community building. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Gay bar; Gay; Prevention; Community participatory research; Psychosexual Behavior; Safety; Stigma; Violence; Communities; Action Research

'Without this, I would for sure already be dead': A qualitative inquiry regarding suicide protective factors among trans adults - Moody, Chérie; Fuks, Nate; Peláez, Sandra; Smith, Nathan Grant (Psychology of Sexual Orientation and Gender Diversity, 2015)
Despite an alarmingly high rate of attempted suicide among trans adults, few studies have investigated suicide protective factors among this population. The current study was aimed at identifying suicide protective factors among trans adults using a qualitative methodology. A sample of self-identified trans adults (N = 133) was recruited from LGBT LISTSERVs across Canada. Participant were predominantly White and ranged in age from 18 to 75 years old (M = 37). Qualitative data were collected online via open-ended questions and analyzed using thematic network analysis. A hybrid inductive–deductive coding framework was created by combining published suicide protective factors and participants’ responses. Five organizing themes were identified, namely social support, gender identity-related factors, transition-related factors, individual difference factors, and reasons for living. Results provide important insights for suicide prevention workers and mental/medical health professionals who work to promote the health and well-being of trans clients and their families. Clinical implications are discussed, such as the importance of aiding trans clients who seek transition-related care to gain access to care in a timely manner. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide; trans; transgender; transsexual; protective factors; Protective Factors; Suicidal Ideation; Suicide; Transgender

Mental health concerns and insurance denials among transgender adolescents - Nahata, Leena; Quinn, Gwendolyn P.; Caltabellotta, Nicole M.; Tishelman, Amy C. (LGBT Health, 2017)
Purpose: Transgender youth are at high risk for mental health morbidities. Based on treatment guidelines, puberty blockers and gender-affirming hormone therapy should be considered to alleviate distress due to discordance between an individual's assigned sex and gender identity. The goals of this study were to examine the: (1) prevalence of mental health diagnoses, self-injurious behaviors, and school victimization and (2) rates of insurance coverage for hormone therapy, among a cohort of transgender adolescents at a large pediatric gender program, to understand access to recommended therapy. Methods: An IRB-approved retrospective medical record review (2014–2016) was conducted of patients with ICD 9/10 codes for gender dysphoria referred to pediatric endocrinology within a large multidisciplinary gender program. Researchers extracted the following details: demographics, age, assigned sex, identified gender, insurance provider/coverage, mental health diagnoses, self-injurious behavior, and school victimization. Results: Seventy-nine records (51 transgender males, 28 transgender females) met inclusion criteria (median age: 15 years, range: 9–18). Seventy-three subjects (92.4%) were diagnosed with one or more of the following conditions: depression, anxiety, post-traumatic stress disorder, eating disorders, autism spectrum disorder, and bipolar disorder. Fifty-nine (74.7%) reported suicidal ideation, 44 (55.7%) exhibited self-harm, and 24 (30.4%) had one or more suicide attempts. Forty-six (58.2%) subjects reported school victimization. Of the 27 patients prescribed gonadotropin-releasing hormone analogues, only 8 (29.6%) received insurance coverage. Conclusion: Transgender youth face significant barriers in accessing appropriate hormone therapy. Given the high rates of mental health concerns, self-injurious behavior, and school victimization among this vulnerable population, healthcare professionals must work alongside policy makers toward insurance coverage reform. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: adolescents; disparities; insurance coverage; mental health; transgender; Health Care Psychology; Mental Health; Transgender

The buffering role of social support on the associations among discrimination, mental health, and suicidality in a transgender sample - Trujillo, Michael A.; Perrin, Paul B.; Sutter, Megan; Tabaac, Ariella; Benotsch, Eric G. (International Journal of Transgenderism, 2017)
Introduction: Per the minority stress framework, trans individuals often experience psychological distress given the unique stress engendered by gender identity–related discrimination. Prior research has identified social support as particularly important for psychological distress and has suggested that social support may moderate this relationship. The purpose of the current study was to explore the patterns of connections among discrimination, mental health, and suicidal ideation in trans individuals and whether social support moderates these relationships. Methods: Participants (N = 78) completed measures of these constructs as part of a national online survey. Results: A series of simultaneous multiple regressions found that harassment/rejection discrimination was a unique positive predictor of mental health symptoms and suicidal ideation, with depression positively predicting suicidal ideation. A mediational model indicated that the association between harassment/rejection discrimination and suicidal ideation was fully mediated by depression. Three moderated meditational models were run, and one yielded a significant interaction, such that discrimination predicted suicidal ideation most strongly when participants had low social support from a significant other in comparison to participants who had moderate or high support. Further, conditional direct effects identified that discrimination led to ideation only for individuals with low support from friends or a significant other but not for those with moderate or high support. Conclusions: Helping trans individuals cope with harassment and rejection, particularly by drawing on social support, may promote better mental health, which could help reduce suicidality in this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Discrimination; mental health; social support; suicide; Discrimination; Mental Health; Social Support; Suicide; Transgender; Suicidality

Self-reported changes in attractions and social determinants of mental health in transgender adults - Katz-Wise, Sabra L.; Reisner, Sari L.; White Hughto, Jaclyn M.; Budge, Stephanie L. (Archives of Sexual Behavior, 2017)
This study examined associations between changes in self-reported attractions and mental health in a community-based sample of self-identified transgender adults. Participants were purposively recruited in 2013 using bimodal sampling methods and completed a one-time survey. Multivariable logistic regression models estimated adjusted risk ratios and 95 % confidence intervals to examine associations between changes in attractions and mental health outcomes (lifetime self-harm, suicide attempts, depression diagnosis; past-week clinically significant depressive distress assessed via CES-D 10) among the entire sample (N = 452; 285 female-to-male spectrum, 167 male-to-female spectrum) and after gender transition among those who had socially transitioned (n = 205; 156 female-to-male spectrum, 49 male-to-female spectrum). Models were adjusted for known population social determinants (age, race/ethnicity, gender identity, socioeconomic status, sexual orientation identity), transgender-specific determinants (age of transgender realization, social transition, medical transition, visual gender nonconformity, non-binary gender identification), and survey mode (online vs. in-person sampling). Lifetime changes in attractions were significantly associated with increased probability of all mental health outcomes; individuals reporting any change in attractions were more likely than individuals not reporting changes to indicate lifetime self-harm, suicide attempts, depression diagnosis, and current depressive distress (all ps < .05). Changes in attractions post-social transition were not significantly associated with mental health outcomes. Many, but not all, population and transgender-specific social determinants were significantly associated with mental health in the full sample and among those who had socially transitioned. Clinical implications of findings about changes in attractions and mental health are discussed for transgender individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: gender minority; transgender; sexual fluidity; mental health; sexual orientation; Mental Health; Self-Report; Sexual Attraction; Transgender

Interrelationships between LGBT-based victimization, suicide, and substance use problems in a diverse sample of sexual and gender minorities - Mereish, Ethan H.; O'Cleirigh, Conall; Bradford, Judith B. (Psychology, Health & Medicine, 2014)
Research has documented significant relationships between sexual and gender minority stress and higher rates of suicidality (i.e. suicidal ideation and attempts) and substance use problems. We examined the potential mediating role of substance use problems on the relationship between sexual and gender minority stress (i.e. victimization based on lesbian, gay, bisexual, or transgender identity [LGBT]) and suicidality. A nonprobability sample of LGBT patients from a community health center (N = 1457) ranged in age from 19–70 years. Participants reported history of lifetime suicidal ideation and attempts, substance use problems, as well as experiences of LGBT-based verbal and physical attacks. Substance use problems were a significant partial mediator between LGBT-based victimization and suicidal ideation and between LGBT-based victimization and suicide attempts for sexual and gender minorities. Nuanced gender differences revealed that substance use problems did not significantly mediate the relationship between victimization and suicide attempts for sexual minority men. Substance use problems may be one insidious pathway that partially mediates the risk effects of sexual and gender minority stress on suicidality. Substances might be a temporary and deleterious coping resource in response to LGBT-based victimization, which have serious effects on suicidal ideation and behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: LGBT victimization; suicide; substance use problems; sexual & gender minorities; stress; Adaptation, Psychological; Adult; Aged; Crime Victims; Cross-Sectional Studies; Female; Health Status Disparities; Humans; Male; Middle Aged; Minority Groups; Regression Analysis; Sex Distribution; Sexuality; Social Discrimination; Social Identification; Stress, Psychological; Substance-Related Disorders; Suicide; Transgender Persons; Young Adult; Drug Abuse; Homosexuality; Human Sex Differences; Suicide; Victimization; Bisexuality; Lesbianism; Male Homosexuality; Stress; Transgender

Religious anti-gay prejudice as a predictor of mental health, abuse, and substance use - Sowe, Babucarr J.; Taylor, Alan J.; Brown, Jac (American Journal of Orthopsychiatry, 2017)
Anti-gay, or homonegative, prejudice is generally considered harmful to the wellbeing of sexual minority individuals. However, the origins or nature of such prejudice may vary. Despite a sizable body of literature suggesting homonegative prejudice is frequently religious-based, the psychological impact of exposure to religious anti-gay prejudice remains largely undetermined. Addressing this research gap, the authors examined whether opposition to same-sex sexuality on religious grounds predicted detrimental outcomes among same- and both-sex attracted individuals, as well as their heterosexual counterparts. A nationwide U.S. sample of 1600 individuals—recruited using contemporary online crowd-sourcing techniques designed to limit selection bias—completed a novel inventory assessing interpersonal exposure to religious (as well as nonreligious) homonegative disapproval. Outcome variables assessed included a number of clinically relevant measures spanning general mental health, social support, suicidality, abuse, and substance use. Analyses revealed that greater exposure to religious anti-gay prejudice predicted higher levels of anxiety, stress, and shame; more instances of physical and verbal abuse; and more problematic alcohol use. Furthermore, while sexual minority individuals tended to fare more poorly than their heterosexual counterparts on almost every outcome measure assessed, homonegative prejudice predicted poorer outcomes among all respondents regardless of their sexual orientation or religious identification. Hence, results are among the first to demonstrate that anti-gay religious exposure is associated with substantial threats to wellbeing, and that such effects may be observed beyond religious sexual minorities. Overall, findings imply that homonegative religious social conditions may be of broader health and mental health concern than is conventionally recognized. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: religion; anti-gay prejudice; mental health; sexual minority; substance use; Anxiety; Female; Humans; Male; Mental Health; Prejudice; Religion; Sexual and Gender Minorities; Social Support; Stress, Psychological; Substance-Related Disorders; Surveys and Questionnaires; Homosexuality (Attitudes Toward); Mental Health; Prejudice; Religious Beliefs; Well Being; Drug Usage; Minority Groups; Physical Abuse; Sexual Abuse; Sexual Orientation; Verbal Abuse; Sexual Minority Groups

Interventions for LGBTQ youth suicide: A review of two books - Gandy, Megan E. (Journal of LGBT Youth, 2015)
Reviews the books, Queer Youth Suicide, Culture, and Identity: Unliveable Lives? by Rob Cover (2012) and Safe Spaces: Making Schools and Communities Welcoming to LGBT Youth by Annemarie Vaccaro, Gerri August, and Megan S. Kennedy (2012). Despite trends in society toward more inclusive and affirming environments for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) persons, youth who identify as LGBTQ remain a vulnerable population. This paper reviews two recent books that address intervention in the lives of LGBTQ youth for the purpose of decreasing vulnerabilities to risk factors that contribute to unwanted mental health outcomes such as suicide, and increasing youth resiliency in the face of those vulnerabilities: Queer Youth Suicide, Culture, and Identity: Unliveable Lives? by Rob Cover (2012), and Safe Spaces: Making Schools and Communities Welcoming to LGBT Youth by Annemarie Vaccaro, Gerri August, and Megan S. Kennedy (2012). This review begins by providing a description of the content and style of each book, then moves into comparing and contrasting the books’ strengths and weaknesses and their respective approaches to addressing interventions with LGBTQ youth. The review concludes with implications for an audience of youth work practitioners, researchers, educators, and policymakers. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Adolescents; book review; intervention strategies; LGBT youth; mental health; suicide; Intervention; Suicide; LGBTQ; Bisexuality; Homosexuality; Lesbianism; Transgender

Sexual and gender minority youth suicide: Understanding subgroup differences to inform interventions - McManama O'Brien, Kimberly H.; Putney, Jennifer M.; Hebert, Nicholas W.; Falk, Amy M.; Aguinaldo, Laika D. (LGBT Health, 2016)
Sexual and gender minority (SGM) youth are disproportionately affected by suicide-related thoughts and behaviors relative to their heterosexual and/or non-transgender peers. Theory and empirical evidence suggest that there are unique factors that contribute to this elevated risk, with distinguishable differences among SGM subgroups. Although SGM youth suicide prevention research is in its nascence, initial findings indicate that interventions which focus on family support and acceptance may be beneficial. It is critical that we develop and test tailored interventions for SGM youth at risk for suicide, with specific attention to subgroup differences and reductions in suicide-related thoughts and behaviors as outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: adolescence; gender identity; intervention research; sexual orientation; suicide; Suicidal Ideation; Suicide; Transgender

A retrospective examination of completed sexual and gender minority youth suicides in the United States: What can be learned from written online media? - Wolff, Joshua R.; Allen, Kenneth D.; Himes, Heather L.; Fish, Ashley E.; Losardo, Jennifer R. (Journal of Gay & Lesbian Mental Health, 2014)
Due to several high profile suicides and increased social acceptance of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) persons in the United States, significant media attention has focused on the occurrence of and factors that contribute to sexual and gender minority youth (SGMY) suicide. Although previous research has established an increased likelihood of suicidal ideation among SGMY, no data exist on completed SGMY suicides in the United States or subsequent media coverage. This study examines variables related to completed SGMY suicides in the United States from written electronic media (N = 78) reports from 2004–12 using a mixed-method content analysis. Qualitative results indicate the presence of three major content domains: warning signs, denial of the problem, and conflicting reports. Quantitative results suggest a lack of contextual information but also increased media citation of prevention resources between 2010 and 2012. Clinical and public health implications of SGMY suicide media coverage are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: sexual and gender minority youth; suicide; online media coverage; suicidal ideation; social acceptance; lesbians; gays; bisexuality; transgendered; queer; Human Sex Differences; Mass Media; Minority Groups; Suicidal Ideation; Suicide; Bisexuality; Lesbianism; Male Homosexuality; Social Acceptance; Transgender

Minority stress in lesbian, gay, and bisexual young adults in Australia: Associations with psychological distress, suicidality, and substance use - Lea, Toby; de Wit, John; Reynolds, Robert (Archives of Sexual Behavior, 2014)
Lesbian, gay, bisexual, and other same-sex attracted young people have been shown to be at a higher risk of mental health problems, including depression, anxiety, suicidality, and substance abuse, compared to their heterosexual peers. Homophobic prejudice and stigma are often thought to underlie these disparities. In this study, the relationship between such experiences of social derogation and mental health and substance use in same-sex attracted young people was examined using Meyer’s minority stress theory. An online survey recruited 254 young women and 318 young men who identified as same-sex attracted, were aged 18–25 years, and lived in Sydney, Australia. Multivariate logistic regression analyses showed that internalized homophobia, perceived stigma, and experienced homophobic physical abuse were associated with higher levels of psychological distress and self-reported suicidal thoughts in the previous month. Furthermore, perceived stigma and homophobic physical abuse were associated with reporting a lifetime suicide attempt. The association between minority stress and substance use was inconsistent. While, as expected, higher levels of perceived stigma were associated with club drug dependence, there was an inverse association between internalized homophobia and club drug use, and between perceived stigma and hazardous alcohol use. The findings of this study provide support for the minority stress theory proposition that chronic social stress due to sexual orientation is associated with poorer mental health. The high rates of mental health and substance use problems in the current study suggest that same-sex attracted young people should continue to be a priority population for mental health and substance use intervention and prevention. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Sexual orientation; Minority stress; Mental health; Alcohol; Drugs; Substance use; Adolescent; Adult; Anxiety Disorders; Australia; Bisexuality; Depression; Female; Gender Identity; Heterosexuality; Homophobia; Homosexuality, Female; Homosexuality, Male; Humans; Logistic Models; Male; Minority Groups; Multivariate Analysis; Prejudice; Social Perception; Stress, Psychological; Substance-Related Disorders; Suicide; Young Adult; Drug Abuse; Mental Health; Sexual Orientation; Stress; Suicide; Anxiety; Distress; Ethanol; Stigma; Suicidality; Minority Stress

Sexual orientation and symptoms of common mental disorder or low wellbeing: Combined meta-analysis of 12 UK population health surveys - Semlyen, Joanna; King, Michael; Varney, Justin; Hagger-Johnson, Gareth (BMC Psychiatry, 2016)
Background: Previous studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults. Our aims were to determine an estimate of the association between sexual orientation identity and poor mental health and wellbeing among adults from 12 population surveys in the UK, and to consider whether effects differed for specific subgroups of the population. Methods: Individual data were pooled from the British Cohort Study 2012, Health Survey for England 2011, 2012 and 2013, Scottish Health Survey 2008 to 2013, Longitudinal Study of Young People in England 2009/10 and Understanding Society 2011/12. Individual participant meta-analysis was used to pool estimates from each study, allowing for between-study variation. Results: Of 94,818 participants, 1.1 % identified as lesbian/gay, 0.9 % as bisexual, 0.8 % as ‘other’ and 97.2 % as heterosexual. Adjusting for a range of covariates, adults who identified as lesbian/gay had higher prevalence of common mental disorder when compared to heterosexuals, but the association was different in different age groups: apparent for those under 35 (OR = 1.78, 95 % CI 1.40, 2.26), weaker at age 35–54.9 (OR = 1.42, 95 % CI 1.10, 1.84), but strongest at age 55+ (OR = 2.06, 95 % CI 1.29, 3.31). These effects were stronger for bisexual adults, similar for those identifying as ‘other’, and similar for 'low wellbeing'. Conclusions: In the UK, LGB adults have higher prevalence of poor mental health and low wellbeing when compared to heterosexuals, particularly younger and older LGB adults. Sexual orientation identity should be measured routinely in all health studies and in administrative data in the UK in order to influence national and local policy development and service delivery. These results reiterate the need for local government, NHS providers and public health policy makers to consider how to address inequalities in mental health among these minority groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Anxiety disorders; Depression; Health surveys; Homosexuality; Mental disorders; Meta-analysis; Mood disorders; Neurotic disorders; Sexual orientation; Sexuality; Adolescent; Adult; Aged; Female; Health Surveys; Humans; Longitudinal Studies; Male; Mental Disorders; Middle Aged; Prevalence; Sexual Behavior; Sexuality; United Kingdom; Young Adult; Mental Disorders; Sexual Orientation; Well Being; Population Health; Anxiety Disorders; Homosexuality; Major Depression

The impact of intimate partner relationships on suicidal thoughts and behaviours: A systematic review - Kazan, Dominique; Calear, Alison L.; Batterham, Philip J. (Journal of Affective Disorders, 2016)
Background: A systematic review was conducted to identify the impact of intimate partner relationships on suicidality. The aim of the review was to identify factors within intimate partner relationships that influence suicidal ideation, attempts and completion. Method: Fifty-one articles were identified through Scopus, PubMed and PsycINFO databases. Due to the high heterogeneity of the included studies, a narrative data synthesis was conducted. Results: The research drew attention to specific contingents of the population, for example examining suicide risk in individuals under the age of 35 or lesbian, gay, bisexual and transgender (LGBT) individuals who are experiencing relationship discord, and in males who have recently separated. Limitations: Interpretation of these findings is constrained by methodological limitations prevalent in much of the literature. Limitations of the existing literature and corresponding directions for future research are discussed. Conclusions: Relationship separation and poor quality relationships are likely to be important risk factors for suicidal thoughts and behaviours and are frequent triggers for a suicide attempt. This review highlights intimate partner relationships as a significant component in a suicide risk assessment, regardless of the clinical setting. Consequently, clinicians should be aware that individuals reporting relationship problems are likely to be at increased risk of suicidal thoughts and behaviours. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Intimate partner relationships; suicide; conflict; separation; systematic review; risk factors; Risk Factors; Suicide; Literature Review

Suicidal ideation among Italian and Spanish young adults: The role of sexual orientation - Baiocco, Roberto; Ioverno, Salvatore; Lonigro, Antonia; Baumgartner, Emma; Laghi, Fiorenzo (Archives of Suicide Research, 2015)
The purpose of the current study was to identify demographic, social, and psychological variables associated with suicidal ideation in an Italian sample and a Spanish sample, taking into account the relevance of sexual orientation as a risk factor for suicide. Three hundred twenty gay and bisexual men, 396 heterosexual men, 281 lesbians and bisexual women, and 835 heterosexual women were recruited. In chi-square and multivariable logistic regression analyses we identified several consistent cross-national risk factors for suicidal ideation: having lower education, not being religious, being homosexual or bisexual, not being engaged in a stable relationship, having lower level of peer and parental attachment, and having depressive symptoms. Interestingly, the strongest risk factor in both samples, after depression symptoms, was sexual orientation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gay; lesbian; sexual orientation; suicidal ideation; suicide; young adults; Adolescent; Adult; Bisexuality; Educational Status; Female; Homosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Italy; Logistic Models; Male; Multivariate Analysis; Religion; Risk Factors; Spain; Suicidal Ideation; Suicide, Attempted; Young Adult; Risk Factors; Sexual Orientation; Suicidal Ideation; Suicide; Homosexuality; Lesbianism

Correlates of suicide ideation among LGBT Nebraskans - Irwin, Jay A.; Coleman, Jason D.; Fisher, Christopher M.; Marasco, Vincent M. (Journal of Homosexuality, 2014)
The aim of this investigation is to outline correlates of suicide ideation among LGBT individuals living in Nebraska. A community-based participatory research approach was utilized to develop a 30-minute, online anonymous survey. Almost half of the sample had seriously considered suicide at some point in their lives. Significant correlates of increased likelihood of suicide ideation are age, gender, transgender identity, income, depression, and discrimination. Suicide ideation is a serious concern for the health of LGBT Nebraskans. Steps should be taken to incorporate individuals who fall into these high-risk categories in suicide outreach programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: bisexual; gay; lesbian; mental health; suicide; transgender; Adult; Age Factors; Aged; Bisexuality; Data Collection; Delivery of Health Care; Depression; Female; Homophobia; Homosexuality; Homosexuality, Female; Homosexuality, Male; Humans; Income; Male; Middle Aged; Nebraska; Sex Factors; Suicidal Ideation; Transgender Persons; Young Adult; Homosexuality; Rural Environments; Suicidal Ideation; Suicide; Transgender; Bisexuality; Lesbianism; Mental Health

A longitudinal investigation of syndemic conditions among young gay, bisexual, and other MSM: The P18 Cohort Study - Halkitis, Perry N.; Kapadia, Farzana; Bub, Kristen L.; Barton, Staci; Moreira, Alvaro D.; Stults, Christopher B. (AIDS and Behavior, 2015)
The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n = 600) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gay and bisexual men; emerging adulthood; syndemic; HIV; structural equation modeling; prospective cohort study; Adolescent; Adult; Alcohol Drinking; Bisexuality; Cohort Studies; Condoms; Data Interpretation, Statistical; HIV Infections; Health Knowledge, Attitudes, Practice; Homosexuality, Male; Humans; Male; Mental Health; Models, Statistical; Prospective Studies; Risk-Taking; Sexual Behavior; Sexual Partners; Social Support; Socioeconomic Factors; Substance-Related Disorders; Unsafe Sex; Young Adult; Bisexuality; HIV; Male Homosexuality; Risk Factors; Sexual Risk Taking; Same Sex Intercourse; Emerging Adulthood

A content analysis of literature on trans people and issues: 2002–2012 - Moradi, Bonnie; Tebbe, Elliot A.; Brewster, Melanie E.; Budge, Stephanie L.; Lenzen, Alex; Ege, Engin; Schuch, Elena; Arango, Sarah; Angelone, Nicholas; Mender, Eli; Hiner, Dylan L.; Huscher, Kileigh; et al. (The Counseling Psychologist, 2016)
This study provides a content analysis of more than a decade (2002–2012) of academic scholarship about trans people and issues. A total of 960 trans-focused publications were coded; there was a close balance of nonempirical (54%) and empirical (46%) publications. The analyses revealed that the literature on trans people and issues is growing, although many publications include trans people and issues nominally without substantive attention. The analyses also pointed to underutilized research designs and methodologies, the need for more clear assessment and more consistent reporting of demographic characteristics, and topics that warrant further attention. Specifically, literature on trans people and issues continues to be needed on the topics of focus thus far, such as psychological and identity-related distress. Scholarship is also needed to address important topics that have been understudied, including self-harm and suicide, positive functioning and mental health promoting factors, developmental issues across the life span, school and workplace experiences, and the training and competencies of health care providers to ensure affirmative and effective services for trans people. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gender identity; gender nonconforming; gender dysphoria; transgender; transsexual; Gender Identity; Transgender; Gender Nonconforming; Major Depression; Methodology; Transsexualism

Adverse childhood experiences and suicide attempts among those with mental and substance use disorders - Choi, Namkee G.; DiNitto, Diana M.; Marti, C. Nathan; Segal, Steven P. (Child Abuse & Neglect, 2017)
Using the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions data, we examined the associations of ten types of adverse childhood experiences (ACEs) with (1) lifetime suicide attempts and (2) number and age of attempts among U.S. adults aged 18+. In a case-control design, suicide attempters (5.14% of the full sample) were matched with never attempters (matched sample N = 3912) on nine mental and substance use disorders. ACE rates were higher among attempters (3.30 [SE = 0.07]) than their matched controls (2.19 [SE = 0.06]). Results from multivariable logistic regression analyses showed that sexual abuse and parental/other family member’s mental illness were associated with increased odds of having attempted suicide among both genders, and emotional neglect was also a factor for men. Population attributable risk fractions for sexual abuse were 25.75% for women and 8.56% for men. Sexual abuse and a higher number of ACEs were also related to repeated suicide attempts. A higher number of ACEs was associated with a younger first attempt age. Gay/bisexual orientation in men and the lack of college education in both genders were significant covariates. In conclusion, this study underscores that ACEs are significantly associated with lifetime suicide attempts even when mental and substance use disorders are controlled. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Adverse childhood experiences; Sexual abuse; Mental disorders; Substance use disorders; Suicide attempts; Adolescent; Adult; Aged; Bisexuality; Child; Databases, Factual; Female; Humans; Life Change Events; Male; Mental Disorders; Middle Aged; Risk Factors; Sex Offenses; Sexual Behavior; Substance-Related Disorders; Suicide, Attempted; Surveys and Questionnaires; Young Adult; Attempted Suicide; Human Sex Differences; Mental Disorders; Substance Use Disorder; Childhood Adversity

Non-suicidal self-injury and suicidality in trans people: A systematic review of the literature - Marshall, Ellen; Claes, Laurence; Bouman, Walter Pierre; Witcomb, Gemma L.; Arcelus, Jon (International Review of Psychiatry, 2016)
Literature has described high levels of mental health problems among trans people, such as depression, resulting in increased levels of non-suicidal self-injury (NSSI) behaviour and suicidality (suicidal thoughts, suicide attempts and suicide rates). With the aim of systematically reviewing the available literature in this field, this study identifies 31 papers that explore the rates of NSSI and suicidality in trans people. From reviewing the literature, it was revealed that trans people have a higher prevalence of NSSI and suicidality compared to the cisgender (non-trans) population. There appear to be some gender differences within these rates, with trans men at a greater risk for NSSI behaviour. Prevalence rates differ depending on the different stages of transition, but they are still overall greater than the cisgender population. The study concludes that trans individuals are at a greater risk of NSSI behaviour and suicidality than the cisgender population, and discusses risk factors and the need to develop effective preventative interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: non-suicidal self-injury; suicidality; transgender; mental health; risk factors; Female; Humans; Male; Protein Precursors; Self-Injurious Behavior; Suicidal Ideation; Suicide; Suicide, Attempted; Transgender Persons; Viral Envelope Proteins; Mental Health; Risk Factors; Self-Injurious Behavior; Suicide; Transgender; Suicidality

Queer youth suicide and the psychopolitics of 'It Gets Better' - Grzanka, Patrick R.; Mann, Emily S. (Sexualities, 2014)
This article investigates a mass-mediated campaign against a perceived increase in suicides among gay (or presumed-to-be-gay) youth in the USA since September 2010. 'It Gets Better' (IGB) became a rallying cry for 'anti-bullying' activists, politicians, celebrities and ordinary people who created YouTube videos addressed to gay, lesbian, bisexual and transgender (LGBT) youth who might be considering suicide. A critical discourse analysis of a sample of IGB videos reveals a neoliberal frame that places the burden of a 'better' life onto the emotional lives of LGBT youth, who are instructed to endure suffering in the interest of inevitable happiness. Drawing on Foucault and Orr's work on the construction and management of mental illness, we use the concept of 'psychopower' to explore how these IGB videos render queer youth suicide both a psychological disorder and a sociological crisis for which the only viable solution is 'homonormative' subjectivity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Homonormativity; mental health; neoliberalism; suicide; youth; Audiovisual Communications Media; Lesbianism; Male Homosexuality; Suicide; Transgender; Mental Health; Social Issues

Syndemic indicators predict poor medication adherence and increased healthcare utilization for urban HIV-positive men who have sex with men - Pantalone, David W.; Valentine, Sarah E.; Woodward, Eva N.; O'Cleirigh, Conall (Journal of Gay & Lesbian Mental Health, 2018)
Research on men who have sex with men (MSM) has uncovered psychosocial factors (syndemic indicators) that are associated additively with poor health. To test these relations in a sample of HIV-positive MSM, we enrolled 166 patients from two HIV clinics. We investigated relations between syndemic indicators and outcomes, including medication nonadherence, condomless anal sex (CAS), and healthcare utilization. A large proportion of participants reported each syndemic indicator: polysubstance use 43%, suicide attempt 28%, childhood sexual abuse 39%, partner abuse 64%. Analyses confirmed an additive effect, whereby endorsing 1 + indicator was associated with increased odds of medication nonadherence and medical hospitalization. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: Healthcare utilization; HIV; medication adherence; men who have sex with men; syndemic indicators; Health Care Utilization; HIV; Psychosocial Factors; Treatment Compliance; Same Sex Intercourse

Mental health service use among youth with mental health need: Do school-based services make a difference for sexual minority youth? - Williams, Kelly A.; Chapman, Mimi V. (School Mental Health: A Multidisciplinary Research and Practice Journal, 2015)
Evidence suggests that despite higher rates of mental health service use, sexual minority youth (SMY) have greater unmet mental health need than peers. Using a representative subsample of students with a mental health need from the National Longitudinal Study of Adolescent Health (n = 8,034), a multilevel analysis was conducted to explore whether: (1) Availability of school mental health services affects the odds that youth with a mental health need will use mental health services; and whether (2) sexual minority status (SMS) interacts with availability of school mental health services to moderate the relationship between SMS and mental health service use. SMY accounted for 10.3 % (n = 766) of the subsample. Mental health need was defined using measures for physical and sexual victimization, anxiety, depression, and suicidality. A hierarchical logistical regression tested for cross-level interaction (SMS × school mental health services). SMY had 82 % higher odds of using mental health services in any sector than their heterosexual peers (OR = 1.82, p < .001). Overall, youth with a mental health need had 40 % higher odds of using any type of mental health services if they attended schools offering mental health services (OR = 1.40, p < .001). The cross-level interaction test between SMS and service use was nonsignificant. Model-predicted probabilities are presented to better understand the findings. School-based mental health services are a crucial gateway to mental health service use in any sector for youth with a mental health need regardless of SMS. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: School-based mental health services; Sexual minority youth; Lesbian; gay; bisexual; and transgender (LGBT); Adolescents; Multilevel analysis; Mental health service use; Health Care Utilization; Mental Health Services; Minority Groups; School Based Intervention; Sexual Orientation; Bisexuality; Lesbianism; Male Homosexuality; Peers; Psychosexual Behavior; Schools; Transgender; Sexual Minority Groups

Queer conversations: Improving access to, and quality of, mental health services for same-sex-attracted clients - Semp, David; Read, John (Psychology & Sexuality, 2015)
Lesbian, gay and bisexual (LGB) people have a higher prevalence of psychiatric problems. This is considered as a consequence of marginalisation of homosexuality. Despite much research and literature on lesbian and gay mental health, important questions remain largely unexplored regarding public mental health services (PMHS) for LGB. Two such questions are: Do clients feel able to disclose issues regarding sexual orientation to psychiatric services? How do PMHS services enable or hinder this? Foucauldian discourse analysis was used to explore these questions. Interviews were conducted with 13 same-sex-attracted male clients and 12 LGB staff in PMHS in New Zealand. Findings were that staff in PMHS rarely ask clients about sexual orientation. Correspondingly many clients report considerable difficulty disclosing their sexual orientation in PMHS, even when it is relevant to their mental health issues. The social and systemic conditions which create this barrier to effective treatment for LGB clients are explored. Practical suggestions are made for how staff in PMHS can raise the topic of sexual orientation with clients thereby improving access to and quality of treatment to LGB clients. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: gay men; mental health services; suicide; discourse analysis; Homosexuality; Lesbianism; Mental Health Services

Nonsuicidal self‐injury, suicidal thoughts and suicide attempts among sexual minority youth in Ireland during their emerging adult years - Power, Emmet; Coughlan, Helen; Clarke, Mary; Kelleher, Ian; Lynch, Fionnuala; Connor, Dearbhla; Fitzpatrick, Carol; Harley, Michelle; Cannon, Mary (Early Intervention in Psychiatry, 2016)
Aim: This study aimed to examine whether or not sexual minority youth constitute an at-risk group for nonsuicidal self-injury, suicidal ideation or suicide attempts during their emerging adult years. Methods: Using data from the Challenging Times Study, a population-based study of psychopathology and suicide in Ireland, analyses were conducted to test the associations between sexual minority status and the odds of any lifetime experience of nonsuicidal self-injury, suicidal thoughts or suicide attempts among Irish youth aged 19–24 years. Results: Sexual minority youth had 6.6-fold (95% CI 1.7–24.7) increased risk of nonsuicidal self-injury, a 5.0- fold (95% CI 1.3–18.3) increased risk of suicidal ideation, a 7.7-fold (95% CI 1.8–32.0) increased risk of suicide intent and a 6.8-fold (95% CI 1.6–27.6) increased risk of a suicide attempt during their lifetime compared to their heterosexual peers. Conclusions: This study shows that emerging adulthood is a period of risk for suicide and nonsuicidal self-injurious behaviour among sexual minority youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: emerging adult; minority group; nonsuicidal self‐injury; public health; suicide; Case-Control Studies; Female; Humans; Ireland; Male; Risk Factors; Self-Injurious Behavior; Sexual and Gender Minorities; Suicidal Ideation; Suicide, Attempted; Young Adult; Minority Groups; Self-Injurious Behavior; Sexual Orientation; Suicide Prevention; Emerging Adulthood; Sexual Minority Groups

Suicide risk among lesbian, gay, bisexual, and transgender military personnel and veterans: What does the literature tell us? - Matarazzo, Bridget B.; Barnes, Sean M.; Pease, James L.; Russell, Leah M.; Hanson, Jetta E.; Soberay, Kelly A.; Gutierrez, Peter M. (Suicide and Life-Threatening Behavior, 2014)
Research suggests that both the military and veteran and the lesbian, gay, bisexual, and transgender (LGBT) populations may be at increased risk for suicide. A literature review was conducted to identify research related to suicide risk in the LGBT military and veteran populations. Despite the paucity of research directly addressing this issue, themes are discussed evident in the literature on LGBT identity and suicide risk as well as LGBT military service members and veterans. Factors such as social support and victimization appear to be particularly relevant. Suggestions are made with respect to future research that is needed on this very important and timely topic. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: suicide risk; lesbian; gays; bisexuals; transgenders; military personnel; veterans; Adolescent; Adult; Bisexuality; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Middle Aged; Military Personnel; Risk Assessment; Sexuality; Suicide; Transgender Persons; Veterans; Young Adult; Military Personnel; Military Veterans; Risk Factors; Sexual Orientation; Suicide; Bisexuality; Lesbianism; Male Homosexuality; Transgender

Archetypal hatred: Orlando consciousness - Gleason, Brian (Psychological Perspectives, 2017)
The massacre at the gay nightclub Pulse in Orlando, Florida, which killed 49 and wounded 53 people on June 12, 2016, has been termed a terrorist act, another example of the rampant issue of gun control in America, and, of course, a tragedy. It has also been called a hate crime, but most media and other commentary have shied away from a focus on the gay aspect. This article focuses on why the gay community seemed specifically targeted, and what that intentionality represents from a Jungian perspective. Jung's essay on Wotan (a god in Germanic mythology), with a focus on the archetypal underpinnings of Nazi Germany, as well as his thoughts on taboo, specifically relationship taboo in tribal cross-cousin marriages explored in Aion, are examined in an attempt to underscore the importance of an underlying hatred and hostility toward gay men that existed in the unconscious of the shooter, and which may exist in the culture at large. Backlashes from religious groups that occur as gay rights are extended, as well as specific hate crimes like the Orlando shooting, point toward this underlying hostility toward gay men. This hostility is part of a dangerous unconsciousness suffered by the so-called modern world, a reminder of the thin veil of civility we live under: vulnerable, in moments like Orlando, or in larger contexts such as Nazi Germany, to explosion in the form of massacre, despotism, and other tragic and hideous manifestations. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: massacre; hate crime; gay community; unconsciousness; Hate Crimes; Male Homosexuality; Mass Murder

Homonegativity and associated factors among men who have sex with men in Estonia - Parker, R. David; Lõhmus, Liilia; Mangine, Cara; Rüütel, Kristi (Journal of Community Health: The Publication for Health Promotion and Disease Prevention, 2016)
Men who have sex with men (MSM) continue to be at higher risk for negative health outcomes including HIV, STIs, depression, substance use, suicidality, and anxiety. Associative relationships between homonegativity (internal and external) and these outcomes are used to explain the observed disproportionate impact. The current study assessed associations between internalized homonegativity and high-risk behaviours, markers of substance use and symptoms of mental illness as well as openness and level of same sex attraction. A 2013 Internet-based survey was conducted among MSM, collecting data on socio-demographics, sexuality, drug and alcohol use, mental health, suicidality, and internalized homonegativity. The sample (n = 265) had a median age of 31 years, with 85 % employed at least part-time; at least a college-level education in 43 %; and 87 % lived in an urban setting. Sexual orientation was reported as: gay, 72 %; bisexual 23 %; other 5 %. Almost all men (97 %) reported ever having sex with a man, with more than one-third (36 %) having a steady male partner. Statistically significant higher homonegativity scores were detected among men reporting any level of opposite sex attraction compared to men attracted to only men; mostly men (p = 0.001), men and women equally (p = 0.002), and mostly women (p = 0.004), as well as less openness of same sex attraction to family and friends; >50 % family (p = 0.032), no family knowing (p = 0.042), and few friends knowing (p = 0.011). Anxiety risk and increased homonegativity also had a statistically significant increasing relationship. The identified associations between homonegativity and opposite sex attraction among MSM warrants further exploration as well as the relationship with increased anxiety risk. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Men who have sex with men; Internalized homonegativity; Risk behaviours; Eastern Europe; Drug Abuse; Homosexuality (Attitudes Toward); Psychiatric Symptoms; Risk Taking; Same Sex Intercourse; Human Males

Depression and oral FTC/TDF pre-exposure prophylaxis (PrEP) among men and transgender women who have sex with men (MSM/TGW) - Defechereux, Patricia A.; Mehrotra, Megha; Liu, Albert Y.; McMahan, Vanessa M.; Glidden, David V.; Mayer, Kenneth H.; Vargas, Lorena; Amico, K. Rivet; Chodacki, Piotr; Fernandez, Telmo; Avelino-Silva, Vivian I.; Burns, David; et al. (AIDS and Behavior, 2016)
We conducted a longitudinal and cross-sectional analysis of depressive symptomology in iPrEx, a randomized, placebo-controlled trial of daily, oral FTC/TDF HIV pre-exposure prophylaxis (PrEP) in men and transgender women who have sex with men. Depression-related adverse events (AEs) were the most frequently reported severe or life-threatening AEs and were not associated with being randomized to the FTC/TDF arm (152 vs. 144 respectively OR 0.66 95 % CI 0.35–1.25). Center for Epidemiologic Studies Depression scale (CES-D) and a four questions suicidal ideation scale scores did not differ by arm. Participants reporting forced sex at anal sexual debut had higher CES-D scores (coeff: 3.23; 95 % CI 1.24–5.23) and were more likely to have suicidal ideation (OR 2.2; 95 % CI 1.09–4.26). CES-D scores were higher among people reporting non-condom receptive anal intercourse (ncRAI) (OR 1.46; 95 % CI 1.09–1.94). We recommend continuing PrEP during periods of depression in conjunction with provision of mental health services. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Depression; Men who have sex with men; HIV prevention; PrEP; FTC/TDF; iPrEx; Adolescent; Adult; Anti-HIV Agents; Cross-Sectional Studies; Depression; Emtricitabine; Female; HIV Infections; Homosexuality, Male; Humans; Longitudinal Studies; Male; Middle Aged; Pre-Exposure Prophylaxis; Sexual Behavior; Tenofovir; Transgender Persons; HIV; Major Depression; Prevention; Same Sex Intercourse; Pre-Exposure Prophylaxis; Transgender

The association of multiple identities with self‐directed violence and depression among transgender individuals - Lytle, Megan C.; Blosnich, John R.; Kamen, Charles (Suicide and Life-Threatening Behavior, 2016)
Transgender individuals have a high prevalence of self‐directed violence; however, there is scant literature focusing on their unique experiences. The differences in self‐harm, suicidal ideation, suicide attempt, and depression based on racial/ethnic identity and sexual orientation were examined among transgender individuals. Data were gathered from the Fall 2008 and Spring 2009 National College Health Assessment. Across racial/ethnic identities, greater proportions of transgender students endorsed self‐directed violence than their cisgender peers. Among transgender individuals, sexual minorities were more likely to report suicidal ideation than their heterosexual peers, and racial/ethnic minorities had higher odds of attempting suicide than non‐Hispanic White individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: transgender; violence; racial and ethnic differences; Suicide; Violence; Transgender; Racial and Ethnic Differences

Experiences of homophobia among gay and bisexual men: Results from a cross-sectional study in seven countries - Chard, Anna N.; Finneran, Catherine; Sullivan, Patrick S.; Stephenson, Rob (Culture, Health & Sexuality, 2015)
Experiences of homophobic discrimination are associated with an increased prevalence of psychological disorders and increased odds of reporting suicidal ideation among gay and bisexual men. We examine two domains of homophobia—external homophobic discrimination and internalised homophobia—and their associations with sexual orientation, demographic characteristics, relationships and social support among a sample of gay and bisexual men from seven countries. Sexually active gay and bisexual men aged over 18 and residing in Australia, Brazil, Canada, South Africa, Thailand, the UK and the USA were recruited through banner advertisements on Facebook. Two outcomes were examined: reporting experiences of homophobic discrimination and reporting feelings of internalised homophobia. No covariates were consistently significantly associated with experiencing external homophobic discrimination across countries. Across all countries, bisexually identifying respondents reported significantly greater feelings of internalised homophobia. Respondents in Brazil and the UK reporting a main partner, and respondents in Australia, Brazil, Canada, South Africa, Thailand and the USA reporting a larger gay/bisexual social network, reported significantly fewer feelings of internalised homophobia. Results suggest an ameliorative effect of social networks on experiencing homophobia. Additional research should focus on the mechanisms through which social networks reduce feelings of internalised homophobia. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gay/bisexual men; minority stress; social support; homophobia; Adult; Australia; Bisexuality; Brazil; Canada; Cross-Sectional Studies; Homophobia; Homosexuality, Male; Humans; Male; Middle Aged; Sexual Behavior; Sexual Partners; Social Perception; South Africa; Thailand; United Kingdom; United States; Young Adult; Bisexuality; Cross Cultural Differences; Discrimination; Homosexuality (Attitudes Toward); Male Homosexuality; Countries; Human Males; Suicidal Ideation; Suicide; Minority Stress

Suicide and HIV as leading causes of death among gay and bisexual men: A comparison of estimated mortality and published research - Hottes, Travis Salway; Ferlatte, Olivier; Gesink, Dionne (Critical Public Health, 2015)
Gay and bisexual men experience numerous health disparities relative to heterosexual men, including high rates of HIV and suicidal behavior. Systematic community health assessments could provide direct comparisons of the burden of mortality across diseases and thus facilitate the prioritization of public health activities; however, such assessments have been precluded by the absence of sexual orientation information in vital statistics records. In this context, we used population attributable fraction to derive and compare indirect estimates of mortality for both HIV and suicide. Assuming that 2% of Canadian men are gay or bisexual, and that these men are 42 times more likely to die from HIV and 4 times more likely to die from suicide, we estimated that in 2011, suicide resulted in 46 deaths per 100,000 gay and bisexual men, while HIV resulted in 30 deaths per 100,000. Based on these estimates, suicide surpassed HIV as a leading cause of premature mortality for gay and bisexual men in 2007. Despite the large burden of suicide among gay and bisexual men, research attending to the issue in biomedical, psychology, and social science literatures is sparse, with at least 10 times fewer citations than for HIV between 2003 and 2012. We urge researchers, practitioners, and community leaders to broaden the scope of gay and bisexual men’s public health priorities to include suicide and other high burden health inequities. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gay; HIV/AIDS; suicide; mortality; Death and Dying; HIV; Male Homosexuality; Mortality Rate; Suicide; Bisexuality

Youth Experiences Survey (YES): Exploring the scope and complexity of sex trafficking in a sample of youth experiencing homelessness - Middleton, Jennifer S.; Gattis, Maurice N.; Frey, Laura M.; Roe-Sepowitz, Dominique (Journal of Social Service Research, 2018)
In the United States, sex trafficking victims have been identified at ages across the lifespan but young persons (under age 25) have been found to have unique vulnerabilities. At-risk youth, such as those who run away from home or those experiencing homelessness, are also at an increased risk of sexual exploitation. To better understand the scope and complexity of sex trafficking among these at-risk youth, a convenience sample of 131 homeless youth aged 12 to 25 years old experiencing homelessness recruited from Kentuckiana youth service providers completed an enhanced version of the Youth Experiences Survey (YES). Univariate and bivariate analyses were conducted. Results indicated that 41.2% of the homeless youth were victims of sex trafficking. The sex trafficked youth were more likely to report previous self-harm behaviors, suicide attempts, and substance use. This study not only provides support for improved service delivery, but also provides essential statistics that should inform internal policy and procedures for youth serving agencies in Kentucky and Indiana. Findings highlight a need for trauma-informed interventions designed to treat not only females but also males and LGBTQ youth. Additionally, service providers should consider partnering with victim providers and clinicians to offer therapeutic groups, individual therapy, and supportive services that increase prevention, education, and wraparound care for clients. In regards to future research, findings point towards a need to better understand the role that trauma and adverse childhood experiences may play in making young people vulnerable to sex trafficking, and encourage the need for testing prevention and early intervention practices among vulnerable youth. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: at-risk youth; homeless youth; human trafficking; sex trafficking; sexual exploitation; trauma; Crime Victims; Homeless; Human Trafficking; Sexual Abuse; At Risk Populations

Exploring the relationship between transgender-inclusive providers and mental health outcomes among transgender/gender variant people - Kattari, Shanna K.; Walls, N. Eugene; Speer, Stephanie Rachel; Kattari, Leonardo (Social Work in Health Care, 2016)
Using a statewide survey of transgender and gender variant individuals (N = 417), this study examines the association between having a transgender-inclusive provider and three mental health concerns: current experience of depression, lifetime experience of anxiety disorder, and suicidality within the last year. Findings suggest that having a transgender-inclusive provider is associated with decreased rates of depression and suicidality, but not with lifetime experience of having anxiety. Implications for future research and education of providers are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Anxiety; cultural competence; depression; mental health; suicidal thoughts; transgender; Client Characteristics; Health Personnel Attitudes; Mental Health Personnel; Mental Health Services; Transgender; Anxiety Disorders; Major Depression; Suicide; Health Outcomes

Discrimination, stigma, and hate: The impact on the mental health and well-being of LGBT people - Bialer, Philip A.; McIntosh, Christopher A. (Journal of Gay & Lesbian Mental Health, 2016)
This article provides an introduction to the articles published in the current issue of Journal of Gay & Lesbian Mental Health. The articles of this issue discuss about the impact on the mental health and well-being of LGBT people due to discrimination, stigma, and hate. The first article look at a scale called the Homonegative Microaggressions Scale and determine that this is a valid instrument to explain 'short, everyday verbal, behavioral, and environmental slights of minority populations'. Second article examined the stress associated with the coming-out process in a cohort of French LGBT young adults. Third article employ the interpersonal psychological theory of suicide (IPTS) to examine suicidal thoughts and behaviors in transgender youth, including those identifying with a non binary alternate gender. Fourth article examined the effects of nondiscrimination laws for transgender and gender-non conforming people. Fifth article was associated with better emotional regulation and better mental health outcomes. The sixth is a fascinating case report of a trans woman with serious mental illness who presented to an emergency department with self-mutation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: discrimination; stigma; hate; mental health; well-being; LGBT; Homosexuality; Mental Health; Social Discrimination; Stigma; Well Being; Bisexuality; Hate; Lesbianism

Mental health among UK inner city non-heterosexuals: The role of risk factors, protective factors and place - Woodhead, C.; Gazard, B.; Hotopf, M.; Rahman, Q.; Rimes, K. A.; Hatch, S. L. (Epidemiology and Psychiatric Sciences, 2016)
[Correction Notice: An Erratum for this article was reported in Vol 28(1) of Epidemiology and Psychiatric Sciences (see record [rid]2019-02393-015[/rid]). In the original article, there are errors in the tables. The correct versions of the tables and details of the corrections are given in the erratum.] Background: Sexual minorities experience excess psychological ill health globally, yet the UK data exploring reasons for poor mental health among sexual minorities is lacking. This study compares the prevalence of a measure of well-being, symptoms of common mental disorder (CMD), lifetime suicidal ideation, harmful alcohol and drug use among inner city non-heterosexual and heterosexual individuals. It is the first UK study which aims to quantify how much major, everyday and anticipated discrimination; lifetime and childhood trauma; and coping strategies for dealing with unfair treatment, predict excess mental ill health among non-heterosexuals. Further, inner city and national outcomes are compared. Methods: Self-report survey data came from the South East London Community Health study (N = 1052) and the Adult Psychiatric Morbidity Survey (N = 7403). Results: Adjustments for greater exposure to measured experiences of discrimination and lifetime and childhood trauma had a small to moderate impact on effect sizes for adverse health outcomes though in fully adjusted models, non-heterosexual orientation remained strongly associated with CMD, lifetime suicidal ideation, harmful alcohol and drug use. There was limited support for the hypothesis that measured coping strategies might mediate some of these associations. The inner city sample had poorer mental health overall compared with the national sample and the discrepancy was larger for non-heterosexuals than heterosexuals. Conclusions: Childhood and adult adversity substantially influence but do not account for sexual orientation-related mental health disparities. Longitudinal work taking a life course approach with more specific measures of discrimination and coping is required to further understand these associations. Sexual minorities should be considered as a priority in the design and delivery of health and social services. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Cross cultural psychiatry; discrimination; epidemiology; mental health; minority issues; Mental Disorders; Protective Factors; Risk Factors; Sexual Orientation; Well Being; Suicidal Ideation

Correlation of minority status, cyberbullying, and mental health: A cross-sectional study of 1031 adolescents - Duarte, Cassandra; Pittman, Sarah K.; Thorsen, Margaret M.; Cunningham, Rebecca M.; Ranney, Megan L. (Journal of Child & Adolescent Trauma, 2018)
Adolescent cyberbullying is increasingly prevalent. Depression and suicidal ideation are also common, particularly among minority adolescents and cyberbullied adolescents. Little data exists to establish whether minority cyberbullied adolescents are at greater risk of negative mental health outcomes associated with cyberbullying. This cross-sectional study of 1031 adolescents presenting to an emergency room examines the prevalence of cyberbullying in minority and non-minority populations. Using logistic regression, we compared mental health symptoms between minority and non-minority cyberbullying-involved adolescents (accounting for demographic factors), and examined the correlation between use of multiple forms of online technology, minority status, and prevalence of cyberbullying. Sexual orientation was the only demographic factor to strongly correlate with cyberbullying involvement or to correlate with negative mental health symptoms. Increased use of social media platforms also correlated with cyberbullying involvement. This analysis provides a baseline for future work around targeted cyberbullying interventions for minority adolescent populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Cyberbullying; Adolescent; Demographics; Social media; Mental health; Minorities; Mental Health; Minority Groups; Risk Factors; Cyberbullying

Sexual (minority) trajectories, mental health, and alcohol use: A Longitudinal Study of youth as they transition to adulthood - Fish, Jessica N.; Pasley, Kay (Journal of Youth and Adolescence, 2015)
Lesbian, gay, bisexual, and queer/questioning youth health disparities are well documented; however, study limitations restrict our understanding of how the temporal interplay among domains of sexuality (attraction, behavior, and identity) situate individuals to be more or less at risk for poor mental health and alcohol use across the transition to adulthood. Four waves of data from the National Longitudinal Study of Adolescent to Adult Health (n = 12,679; 51.29 % female) were used with repeated measures latent class analysis to estimate sexual trajectory groups designated by prospective reports of romantic attraction, sexual/romantic behavior, and sexual identity from adolescence to adulthood. Five unique trajectories emerged: two heterosexual groups (heterosexual early daters [58.37 %] and heterosexual later daters [29.83 %]) and three sexual minority groups (heteroflexible [6.44 %], later bisexually identified [3.32 %], and LG[B] identified [2.03 %]). These sexual trajectories differentiate risk for depressive symptomology, suicidal thoughts and behaviors, and alcohol use during adolescence and early adulthood. Groups where individuals first reported same-sex attraction and sexual minority identities in adulthood (heteroflexible and later bisexually identified) had similar levels of depression, suicidality, and greater substance use than those who largely reported same-sex attraction and behavior during adolescence (the LG[B] identified group). These later recognition groups showed greater risk for poor outcomes in waves where they also first reported these changes in attraction, behaviors, and identities. The emergence of three sexual minority groups reveal within-group differences in sexuality and sexual trajectories and how these experiences relate to risk and timing of risk across the transition to adulthood. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGB youth; Sexual development; Mental health; Depression; Suicide; Alcohol use; Adolescent; Adolescent Behavior; Alcohol-Related Disorders; Comorbidity; Depression; Female; Health Status; Humans; Longitudinal Studies; Male; Mental Health; Minority Groups; Minority Health; Sex Distribution; Sexuality; Surveys and Questionnaires; Young Adult; Alcohol Drinking Patterns; Life Changes; Mental Health; Sexual Development; Health Disparities; Adolescent Development; Bisexuality; Sexuality; Sexual Minority Groups

Prevalence and correlates of lifetime suicide attempts among transgender persons in Argentina - Marshall, Brandon D. L.; Socías, María Eugenia; Kerr, Thomas; Zalazar, Virginia; Sued, Omar; Arístegui, Inés (Journal of Homosexuality, 2016)
This study examined the lifetime prevalence and correlates of attempted suicide among transgender persons in Argentina. Data were derived from a nation-wide, cross-sectional survey conducted in 2013. We assessed individual, social, and structural correlates of reporting a history of attempting suicide using logistic regression. Among 482 participants, the median age was 30, 91% identified as transwomen, and 32% resided in the Buenos Aires metropolitan area. A lifetime suicide attempt was reported by 159 (33%), among whom the median age at first attempt was 17. In a multivariate model, internalized stigma was positively associated with a history of suicidal behavior, while participants with stable housing had reduced odds of prior suicide attempt(s). These findings suggest that reducing stigma and mitigating structural vulnerabilities (through, for example, the enactment and enforcement of laws that prohibit discrimination based on gender identity to ensure equitable access to housing) could be effective targets for intervention to reduce suicide attempts among transgender individuals in Argentina. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Argentina; mental health; stigma; suicide; transgender; violence; Attempted Suicide; Epidemiology; Suicide; Transgender; Latinos/Latinas

Psychological pathway to suicidal ideation among men who have sex with men in Shanghai, China: A structural equation model - Li, Rui; Cai, Yong; Wang, Ying; Gan, Feng; Shi, Rong (Journal of Psychiatric Research, 2016)
We aimed to explore the relationships and develop an inter-theoretical model among psychological variables in the progression to suicidal ideation among men who have sex with men (MSM). A cross-sectional study was conducted among 547 MSM in four districts in Shanghai from March to May in 2014. Socio-demographic, psychological, and behavioral information of the participants was collected. A structural equation model (SEM)-Path Analysis was constructed to interpret the intricate relationships among various psychological variables. Suicidal ideation among MSM during the past year was 10.6%. The developed model agreed well with existing suicide models and had a good fit to the data (χ²/df = 2.497, comparative fit index = 0.983, root mean squared error of approximation = 0.052). Suicidal ideation was predicted by perceived defeat and entrapment (β = 0.21, p < 0.001), which was in turn predicted by temperament (β = 0.60, p < 0.001) and perceived social support (β = 0.34, p < 0.001). Perceived social support fully mediated the relationships among mood states, perceived social status, and perceived defeat and entrapment. MSM with certain types of temperament might be predisposed to a higher perception of defeat and entrapment. Perceived social support can effectively alleviate the negative appraisals and emotions and lower the risk for suicidal ideation among MSM. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Men who have sex with men; Suicidal ideation; Psychological pathway; Structural equation model; Adolescent; Adult; Age Factors; China; Emotions; Factor Analysis, Statistical; Homosexuality, Male; Humans; Male; Middle Aged; Models, Psychological; Prevalence; Psychiatric Status Rating Scales; Social Support; Socioeconomic Factors; Suicidal Ideation; Surveys and Questionnaires; Young Adult; Suicidal Ideation; Same Sex Intercourse; Emotional Adjustment

The relationship between sexual history, bullying victimization, and poor mental health outcomes among heterosexual and sexual minority high school students: A feminist perspective - Dunn, Hailee K.; Clark, Melissa A.; Pearlman, Deborah N. (Journal of Interpersonal Violence, 2017)
This study uses a feminist theoretical framework to extend the literature on the relationship between sexual history, bullying victimization, and poor mental health outcomes. First, we examined whether an association between the sexual double standard and bullying victimization would apply to sexual minority youth the same way it applies to heterosexual youth. A second aim was to assess whether sexual minority boys, typically stereotyped as effeminate, would report the highest odds of bullying victimization. A third and final aim of our study was to look at the joint effect of sex and sexual intercourse on depression and suicidal ideation. Our analytic sample (N = 9,300) was from the 2009, 2011, and 2013 Rhode Island Youth Risk Behavior Surveys. Findings demonstrated that heterosexual girls who engaged in sexual intercourse had significantly higher adjusted odds of bullying victimization than heterosexual boys who engaged in the same behavior. Similar results were not found for sexual minority adolescents, suggesting the sexual double standard may not apply to sexual minority adolescents in the same way it applies to heterosexual adolescents. Consistent with our second hypothesis, sexual minority boys reported the highest odds of being recently bullied compared with heterosexual boys. Among students who were recently bullied, sexual minority girls displayed the highest adjusted odds of recent depression and suicidal ideation. Our study demonstrated that using a feminist theoretical framework broadens our understanding of why girls and sexual minority boys are particularly vulnerable to bullying victimization and the sequel of depression and suicidal ideation. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: bullying; sexual violence; adolescence; feminism; sexual orientation; Feminism; High School Students; Mental Health; Sexual Abuse; Bullying; Sexual Orientation; Victimization; Sexual Minority Groups; Health Outcomes

The presence of self-stigma, perceived stress, and suicidal ideation among selected LGBT Filipinos - Reyes, Marc Eric S.; Davis, Roger D.; Dacanay, Patricia Mikaela L.; Antonio, Anton Stephen B.; Beltran, Justin Seann R.; Chuang, Marivic D.; Leoncito, Alyssa Lynn I. (Psychological Studies, 2017)
Minority group members experience what is known as 'minority stress,' by which individuals suffer stress because of their membership in stigmatized social categories. In turn, minority stress may lead to self-stigmatization. This occurs when minority group members experience a sense of shame created by the view of the majority culture and then incorporate the majority opinion into their self-image. Because it is cumulative with the stress an individual is already experiencing, self-stigmatization may become a significant stressor itself, possibly contributing to the development of suicidal ideation. A total of 609 self-identified LGBT individuals were asked to answer a battery of psychological tests to assess the interrelationships between self-stigma, perceived stress, and suicidal ideation. As expected, perceived stress predicted suicidal ideation, whereas self-stigmatization predicted both perceived stress and suicidal ideation. Structural equation modeling confirms the predictive value of self-stigma together with perceived stress in determining the suicidal ideation present among LGBT Filipinos. Self-stigma exerted a direct effect upon suicidal ideation not accounted for by perceived stress. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Self-stigma; Perceived stress; Suicidal ideation; LGBT Filipinos; Self-Concept; Sexual Orientation; Stigma; Stress; Suicidal Ideation; Self-Stigma

Mental health in non-heterosexuals: Minority stress theory and related explanation frameworks review - Pitoňák, Michal (Mental Health and Prevention, 2017)
Compared to heterosexuals, non-heterosexuals report: a) higher overall prevalence of internalizing mental disorders such as depression and anxiety; b) several-fold higher levels of suicidal behavior; c) elevated rates of tobacco, alcohol, and substance (ab)use; d) higher rates of risky-sexual behaviors that include higher risks of contracting STD's. This review explicates two of the most salient explanatory frameworks – Meyer's Minority Stress Theory (MST) and Hatzenbuehler's Psychological Mediation Framework (PMF) available for explaining these health outcomes. Prospects for future transdiagnostic interventions are outlined. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Minority stress; Mental health; Stigma; LGBTQ psychology; Sexual orientation; Syndemics; Disorders; Etiology; Psychological Stress; Psychological Theories; Sexual Orientation; Epidemiology; Mental Health; Risk Factors; Stigma; LGBTQ; Minority Stress

'Do you love me?': The question of the queer child of psychoanalysis - Cavitch, Max (Psychoanalysis, Culture & Society, 2016)
Queer children and LGBT youth often continue to find in the psychotherapeutic setting and the clinical literature an ill-prepared and even aversive reception. Suicidality among such children draws especially sharp attention to the need for better alternatives to current treatment modalities—the focus here is chiefly on the relational area, with its emphasis on the coupling norm and attachment theory—and, more broadly, for the further comprehensive development of queer- and LGBT-affirmative psychoanalytic theory and practice. In advocating for at-risk queer children, I also argue that the queer child is a meaningful transferential figure for the improved life-chances of psychoanalysis itself and for the enhanced role of psychoanalytic theory and practice in the realm of social transformation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: children; homosexuality; gender; queer; relationalism; suicide; Homosexuality; Psychoanalysis; Suicide; Attachment Theory; Psychoanalytic Theory; Adolescent Characteristics; Child Characteristics

The relationship between social support and suicide risk in a national sample of ethnically diverse sexual minority women - Tabaac, Ariella R.; Perrin, Paul B.; Rabinovitch, Annie E. (Journal of Gay & Lesbian Mental Health, 2016)
This study examined the relationship between three types of social support and suicidal ideation and lifetime attempts among a national sample of ethnically diverse sexual minority women (SMW). Participants (N = 150) completed measures of social support and suicidal ideation/attempts. After controlling for socioeconomic status, social support explained 12.3% of the variance in past suicidal ideation and 10.7% in lifetime suicide attempts. Social support from family and significant other were both inversely associated with suicidal ideation, and social support from family inversely with lifetime attempts. Interventions that strengthen family relationships could be a buffer of suicidality in this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Bisexual; family; lesbian; suicide; Bisexuality; Lesbianism; Risk Factors; Social Support; Suicide; Family; Sexual Minority Groups

Suicidal ideation, resilience, and healthcare implications for newly diagnosed HIV-positive men who have sex with men in China: A qualitative study - Li, Haochu; Tucker, Joseph; Holroyd, Eleanor; Zhang, Jie; Jiang, Baofa (Archives of Sexual Behavior, 2017)
Globally, suicidal ideation and behavior have been widely reported among people living with human immunodeficiency virus (HIV). Knowledge gaps exist regarding the longer life and resilience-related experiences of people living with HIV (PLWH). Specifically, there is a dearth of data about the interaction of perceived risk and resilient factors resulting in a wide spectrum of intentional suicidal ideation outcomes in a Chinese cultural context. This qualitative research drew from a larger ethnographic study of newly diagnosed HIV-positive men who have sex with men (MSM) in Mainland China. Interviews were conducted with 31 MSM within 6 months of diagnosis of HIV infection. Initial suicidal ideation was commonly reported with participants subsequently feeling more resilient to these thoughts through gaining a greater understanding of their prognosis and treatment. Post-HIV diagnosis, some participants reported forming new relationships and receiving increased support from their partners, friends, peers, families, and community-based organizations. At follow-up, these participants generally reported suicidal ideation had declined. However, participants who continued to express suicidal ideation perceived extended pressure from their families’ expectations for them to engage in heterosexual marriages and parenthood. Furthermore, these men reported ongoing hardships in their daily life, unemployment, lack of social support, and isolation. Among this Mainland Chinese cohort of HIV-positive MSM, suicidal ideation may be a transient phenomenon experienced initially following HIV diagnosis that resolves with increased and specific familial, social, and service-based support. It is crucial to identify the causes of stress and social suffering associated with HIV diagnosis in order to reduce suicidal ideation. In China, action is needed to develop routine mental health screening and to increase services that support PLWH. Important services mechanism to accomplish this are promoting resilience through intentional activities as well as continued public health campaigns to reduce stigma toward HIV-positive MSM. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Suicidal ideation; Resilience; HIV; Sexual orientation; Men who have sex with men; China; HIV; Human Males; Resilience (Psychological); Suicidal Ideation; Same Sex Intercourse; Diagnosis

Age at exposure to parental suicide and the subsequent risk of suicide in young people - Lee, Kuan-Ying; Li, Chung-Yi; Chang, Kun-Chia; Lu, Tsung-Hsueh; Chen, Ying-Yeh (Crisis: The Journal of Crisis Intervention and Suicide Prevention, 2018)
Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: suicide; offspring; age; sex/gender; developmental stage; parental suicide; Offspring; Parents; Risk Factors; Suicide; Exposure; Age Differences; Developmental Stages; Human Sex Differences

Mental health of sexual minorities A systematic review - Plöderl, Martin; Tremblay, Pierre (International Review of Psychiatry, 2015)
Many studies, reviews, and meta-analyses have reported elevated mental health problems for sexual minority (SM) individuals. This systematic review provides an update by including numerous recent studies, and explores whether SM individuals are at increased risk across selected mental health problems as per dimensions of sexual orientation (SO), genders, life-stages, geographic regions, and in higher quality studies. A systematic search in PubMed produced 199 studies appropriate for review. A clear majority of studies reported elevated risks for depression, anxiety, suicide attempts or suicides, and substance-related problems for SM men and women, as adolescents or adults from many geographic regions, and with varied SO dimensions (behaviour, attraction, identity), especially in more recent and higher quality studies. One notable exception is alcohol-related problems, where many studies reported zero or reversed effects, especially for SM men. All SM subgroups were at increased risk, but bisexual individuals were at highest risk in the majority of studies. Other subgroup and gender differences are more complex and are discussed. The review supports the long-standing mental health risk proposition for SM individuals, overall and as subgroups. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Mental health; suicide; depression; anxiety; substance abuse; sexual minority; bisexuality; sexual orientation; homosexuality; systematic review; Mental Health; Sexual Orientation; Sexual Minority Groups; Anxiety; Bisexuality; Drug Abuse; Homosexuality; Lesbianism; Major Depression; Suicide; Transgender

A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth - Mustanski, Brian; Liu, Richard T. (Archives of Sexual Behavior, 2013)
This short-term prospective study examined general and lesbian, gay, bisexual, and transgender (LGBT)-specific risk and protective factors for suicide attempts in an ethnically diverse sample of LGBT youth (N = 237, 47.7 % male). A structured psychiatric interview assessed clinical depression and conduct disorder symptoms, as well as past and prospective suicide attempts over a 1-year follow-up period (91 % retention). Participants completed questionnaires measuring general risk factors for suicide attempts, including hopelessness, impulsiveness, and perceived social support. They also completed measures of LGBT-specific suicide risk factors, including gender nonconformity, age of first same-sex attraction, and LGBT victimization. Correlation and multivariate regression analyses were conducted to examine the relations between predictors and suicide attempt, and to identify mediators. Of nine variables examined, seven were related to lifetime history of attempted suicide: hopelessness, depression symptoms, conduct disorder symptoms, impulsivity, victimization, age of first same-sex attraction, and low family support. Depressive symptoms and hopelessness mediated the relation between multiple risk and resilience factors and suicide attempts. Suicide attempt history was the strongest predictor of prospective suicide attempts. Participants who previously attempted suicide (31.6 % of the sample) had more than 10 times greater odds of making another attempt in the 1-year follow-up period than were those who had made no previous attempt. These results highlight the need for suicide prevention programs for LGBT youth and suggest the importance of addressing depression and hopelessness as proximal determinants and family support and victimization, which have more distal effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicide attempts; lesbianism; gay; bisexuality; transgender; at risk populations; risk factors; Adolescent; Bisexuality; Crime Victims; Female; Follow-Up Studies; Homosexuality; Humans; Impulsive Behavior; Longitudinal Studies; Male; Social Support; Suicide, Attempted; Surveys and Questionnaires; Transsexualism; Young Adult; Bisexuality; Lesbianism; Transgender; At Risk Populations; Attempted Suicide; Male Homosexuality; Risk Factors; Suicide

Mental health and suicidal ideation among Chinese women who have sex with men who have sex with men (MSM) - Li, Xianhong; Zhang, Beichuan; Li, Yang; Antonio, Anna Liza Malazarte; Chen, Yunliang; Williams, Ann Bartley (Women & Health, 2016)
In China, men who have sex with men (MSM) are the fastest growing population at risk for HIV. They face social stigma due to both MSM behavior and HIV. In addition, concern has been raised about the mental health of wives of MSM. In this cross-sectional study, the authors examine the mental health status of a sample of 135 of these women. Participants completed an Internet-administered questionnaire in Xi’an from April to June, 2012. Most were unaware at the time of marriage that their husbands were MSM. Physical abuse was frequently reported; depressive symptom and mental health (Symptom Checklist, SCL–90) scores were significantly higher than those of the general Chinese adult female population. A majority (59.8%) of women reported suicidal thoughts after discovering their husbands’ MSM behavior; about 10% had attempted suicide. Multiple logistic regression revealed that women’s experience with anal sex was associated with 7.8 times (95% CI: 1.3–65.9) greater odds of suicidal ideation. Also, women who demonstrated mental symptoms on the SCL–90 had 2.3 times (95% CI: 1.04–5.2) the odds of suicidal ideation. These results suggest that wives of MSM have a significant need for mental health care, suicide prevention, HIV education, and social support. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: China; HIV; mental health; men who have sex with men; spouses; suicidal ideation; Mental Health; Suicidal Ideation; Same Sex Intercourse

Suicidality among veterans: Implications of sexual minority status - Blosnich, John R.; Mays, Vickie M.; Cochran, Susan D. (American Journal of Public Health, 2014)
Using the California Quality of Life surveys, we examined suicidal ideation and attempts in 129 lesbian, gay, and bisexual (LGB) veterans and in 315 heterosexual veterans in 2008–2009 and 2012– 2013. Although there were no significant differences in the past 12-month suicidal ideation and lifetime attempts, LGB veterans had higher odds of lifetime suicidal ideation than heterosexual veterans (adjusted odds ratio = 3.00; 95% confidence interval = 1.38, 6.53). Suicide assessment and prevention efforts in LGB veterans could benefit from a life-course perspective regarding suicide risk. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidality; veterans; sexual minority; lesbian; gay; bisexual; quality of life; Age Factors; California; Female; Humans; Male; Middle Aged; Minority Groups; Sex Factors; Sexuality; Socioeconomic Factors; Suicidal Ideation; Suicide; Suicide, Attempted; Veterans; Homosexuality; Military Veterans; Quality of Life; Suicidal Ideation; Bisexuality; Heterosexuality; Lesbianism; Suicidality; Sexual Minority Groups

Vulnerability and resilience among gender-nonconforming children and adolescents: Mental health professionals have a key role to play - Bockting, Walter O. (Journal of the American Academy of Child & Adolescent Psychiatry, 2016)
The editorial briefs the issues related to vulnerability and resilience among gender-nonconforming children and adolescents. Gender-nonconforming and transgender children and adolescents remain a vulnerable population that can benefit from support and therapeutic assistance. New evidence indicates that children with gender dysphoria are at increased risk for suicidal ideation, self harm, or suicide attempts. Social stigma remains a challenge for their development and adaptation. However, social stigma does not appear to be the sole cause of their distress. Gender dysphoria appears to be inherently distressing. Even when meeting criteria for a formal DSM-5 diagnosis of gender dysphoria, (early) social and medical transition (through hormones and surgery) is not routinely indicated; rather, each individual and his or her psychosocial context is unique and is best served by an individualized treatment plan that addresses barriers to the development of each person’s full potential, contributing to a greater appreciation of the spectrum of diversity in gender identity and expression. Mental health professionals can play a key role in facilitating such development, alleviating gender dysphoria, and creating a supportive family and social environment. The role of mental health professionals is not to change gender identity but, rather, to assist children, adolescents, and their families to explore identity and expression, including but not limited to making fully informed decisions about the available medical and social interventions and their timing. Affirmation should not only be affirmation of gender identity, but should include affirmation of a transgender identity as distinct from non-transgender female and male identities. A better phenomenological understanding of gender dysphoria and gender diversity is needed to inform interventions aimed at facilitating the development of gender identity, mental health, and resilience. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: resilience; dysphoria; gender identity; mental health; health personnel; Adolescent; Child; Gender Identity; Humans; Mental Health; Resilience, Psychological; Transgender Persons; Gender Identity; Major Depression; Mental Health; Resilience (Psychological); Gender Nonconforming; Scientific Communication; Health Personnel

School connectedness and suicidal thoughts and behaviors: A systematic meta-analysis - Marraccini, Marisa E.; Brier, Zoe M. F. (School Psychology Quarterly, 2017)
Among the protective factors associated with reduced risk for suicide, scientific inquiries into school connectedness are especially important considering that schools are ideally situated to provide interventions reaching the vast majority of youth. Although there is a wealth of research that supports the association between school connectedness and reduced self-report of adolescents having a suicidal thought or making a suicide attempt, inconsistencies in the way studies have measured and operationalized school connectedness limit synthesis across findings. This meta-analytic study investigates the literature exploring associations between school connectedness and suicidal thoughts and behaviors across general and subpopulations (high risk and sexual minority youth) using a random effects model. Eligible studies examined a measure of school connectedness explicitly referred to as 'school connectedness' or 'connections at school' in relation to suicidal ideation or suicide attempts among youth enrolled in school (Grades 6–12). Multiple metaregression analyses were conducted to explore the influence of school connectedness measurement variation, as well as participant characteristics. Results, including 16 samples, support that higher school connectedness is associated with reduced reports of suicidal thoughts and behaviors across general (odds ratio [OR] = 0.536), high-risk (OR = 0.603), and sexual minority (OR = 0.608) adolescents. Findings are consistent when analyzed separately for suicidal ideation (OR = 0.529) and suicide attempts (OR = 0.589) and remain stable when accounting for measurement variability. Although limited by its cross-sectional nature, findings support recent calls to increase school connectedness and proffer important implications for screening and intervention efforts conducted in schools. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: suicide; adolescent; meta-analysis; school connectedness; sexual minority; Adolescent; Adolescent Behavior; Female; Humans; Interpersonal Relations; Male; Suicidal Ideation; Suicide, Attempted; Attempted Suicide; School Environment; Student Characteristics; Student Engagement; Suicidal Ideation; Minority Groups; Protective Factors; Risk Factors; Sexual Orientation; Student Attitudes; Belonging; Sexual Minority Groups

Collecting sexual orientation and gender identity data in suicide and other violent deaths: A step towards identifying and addressing LGBT mortality disparities - Haas, Ann P.; Lane, Andrew (LGBT Health, 2015)
Sexual orientation and gender identity (SO/GI) are not systematically recorded at time of death, limiting identification of mortality disparities in lesbian, gay, bisexual, and transgender (LGBT) people. LGBT populations are thought to have elevated risk of suicide based on high rates of reported lifetime suicide attempts. Lack of data on suicide deaths, however, hinders understanding of the prevalence and patterns of suicide among LGBT populations and development of targeted interventions and prevention programs. This report describes recent efforts to address this knowledge gap by systematically collecting SO/GI information in the investigation of suicide and other violent deaths. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: gender identity; health disparities; LGBT mortality; mortality disparities; postmortem data collection; sexual orientation; suicide; violent death; Death and Dying; Gender Identity; Sexual Orientation; Suicide; Health Disparities; Bisexuality; Lesbianism; Male Homosexuality; Transgender

Major depressive disorder, suicidal thoughts and behaviours, and cannabis involvement in discordant twins: A retrospective cohort study - Agrawal, Arpana; Nelson, Elliot C.; Bucholz, Kathleen K.; Tillman, Rebecca; Grucza, Richard A.; Statham, Dixie J.; Madden, Pamela A. F.; Martin, Nicholas G.; Heath, Andrew C.; Lynskey, Michael T. (The Lancet Psychiatry, 2017)
Background: Early and frequent cannabis use are associated with an increased likelihood of major depressive disorder (MDD) as well as suicidal thoughts and behaviours. We identify associations between aspects of cannabis use, MDD, and suicidal thoughts and behaviours and examine whether such associations persist after accounting for those predisposing factors, including genetic liability and early family environment, that are shared by identical twins who are discordant for cannabis exposure. Any residual association in such identical pairs might be indicative of individual-specific pathways that might be of a causal nature. Methods: We did a logistic regression analysis of cannabis use from retrospective data on same-sex male and female twin pairs drawn from 3 studies that had recruited twins from the Australian Twin Registry, 1992–93 (sample 1), 1996–2000 (sample 2), and 2005–09 (sample 3). We studied associations between early use and frequent use of cannabis and MDD, suicidal ideation (ever and persistent), and suicide plan and attempt in the full sample as well as in pairs of monozygotic and dizygotic twins that were discordant for each measure of cannabis involvement at a single timepoint. Significant monozygotic associations were further adjusted for covariates, such as early alcohol or nicotine use, early dysphoric or anhedonic mood, conduct disorder, and childhood sexual abuse. Interactions between each cannabis measure and sex, sample or study effects, and birth year category were also examined as covariates. Findings: In 13 986 twins (6181 monozygotic and 7805 dizygotic), cannabis use ranged from 1345 (30·4%) of 4432 people in sample 1 to 2275 (69·0%) of 3299 in sample 3. Mean age of first cannabis use ranged from 17·9 years (SD 3·3) in sample 3 to 21·1 years (5·2) in sample 1, and frequent use (≥100 times) was reported by 214 (15·9%) of 1345 users in sample 1 and 499 (21·9%) of 2275 in sample 3. The prevalence of suicidal ideation ranged from 1102 (24·9%) of 4432 people in sample 1 to 1644 (26·3%) of 6255 people in sample 2 and 865 (26·2%) of 3299 people in sample 3. Prevalence of MDD ranged from 901 (20·3%) people in sample 1 to 1773 (28·3%) in sample 2. The monozygotic twin who used cannabis frequently was more likely to report MDD (odds ratio 1·98, 95% CI 1·11–3·53) and suicidal ideation (2·47, 1·19–5·10) compared with their identical twin who had used cannabis less frequently, even after adjustment for covariates. For early cannabis use, the monozygotic point estimate was not significant but could be equated to the significant dizygotic estimate, suggesting a possible association with suicidal ideation. Interpretation: The increased likelihood of MDD and suicidal ideation in frequent cannabis users cannot be solely attributed to common predisposing factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: major depressive disorder; suicidal thoughts & behaviors; cannabis involvement; discordant twins; Cannabis; Major Depression; Suicidal Ideation; Twins; Involvement

Differential reports of suicidal ideation and attempts of questioning adults compared to heterosexual, lesbian, gay, and bisexual individuals - Woodward, Eva N.; Pantalone, David W.; Bradford, Judith (Journal of Gay & Lesbian Mental Health, 2013)
Many sexual minority individuals attempt suicide each year, but little is known about the suicidality of individuals who are questioning their sexual orientation. This study assessed suicidal ideation and attempts of questioning individuals compared with lesbian/gay, bisexual, and heterosexual individuals. This cross-sectional study enrolled participants (N = 2,841) from a community health center. Questioning (OR = 4.286, 95% CI [2.119–8.671]), lesbian/gay (OR = 3.024, 95% CI [2.351–3.890]), and bisexual (OR = 4.389, 95% CI [2.942–6.575]) individuals had significantly greater odds of considering suicide compared to heterosexuals. However, questioning individuals had non-significant odds of attempting suicide compared to heterosexuals. We discuss possible explanations for these findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; adults; heterosexual individuals; lesbian individuals; gay individuals; bisexual individuals; sexual orientation; Bisexuality; Heterosexuality; Homosexuality; Lesbianism; Suicidal Ideation; Adult Development; Sexual Orientation

Self-harm and suicidality in children referred for gender dysphoria - Aitken, Madison; VanderLaan, Doug P.; Wasserman, Lori; Stojanovski, Sonja; Zucker, Kenneth J. (Journal of the American Academy of Child & Adolescent Psychiatry, 2016)
Objective: This study examined rates of self-harm and suicidality (ideation and behavior) in children referred clinically for gender dysphoria compared with their siblings, and referred and nonreferred children from the Child Behavior Checklist (CBCL) standardization sample. Predictors or correlates of self-harm/suicidality were also examined. Method: The sample consisted of 572 gender-referred children, 425 siblings, 878 referred children, and 903 nonreferred children. Parent report for 2 CBCL items was used to assess self-harm and suicidality. CBCL total behavior problems and a metric of peer relationship problems were also used. Results: The gender-referred children and the referred children from the standardization sample had significantly higher scores than siblings and nonreferred children in terms of self-harm/suicidality, total behavior problems, and poor peer relations. Based on logistic regression analyses, gender-referred children were 5.1 times more likely than nonreferred children to talk about suicide and 8.6 times more likely to self-harm/attempt suicide, even after overall behavior problems and peer relationship problems were accounted for. In the final models, group, older age, and more total behavior problems, but not poor peer relations, were significantly associated with an increased likelihood of self-harm/suicidality. Conclusion: By parent report, children with gender dysphoria show an increased rate of self-harm/suicidality as they get older. This risk was not simply an artifact of the presence of behavioral and emotional problems, although these problems were significant correlates of self-harm/suicidality. Clinicians should routinely screen for the presence of suicidal ideation and behavior in children with gender dysphoria, particularly during the second half of childhood. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gender dysphoria; suicidality; Child Behavior Checklist; Child; Child Behavior; Child, Preschool; Female; Gender Dysphoria; Humans; Male; Problem Behavior; Suicidal Ideation; Suicide, Attempted; Major Depression; Self-Injurious Behavior; Suicide; Suicidality

Suicide in prisons: An international study of prevalence and contributory factors - Fazel, Seena; Ramesh, Taanvi; Hawton, Keith (The Lancet Psychiatry, 2017)
[Correction Notice: An Erratum for this article was reported in Vol 5(2) of The Lancet Psychiatry (see record [rid]2018-05109-006[/rid]). 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.] 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

Digital self-harm among adolescents - Patchin, Justin W.; Hinduja, Sameer (Journal of Adolescent Health, 2017)
Purpose: Despite increased media and scholarly attention to digital forms of aggression directed toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital aggression directed toward oneself. 'Digital self-harm' is the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself. The current study examined the extent of digital self-harm among adolescents. Methods: Survey data were obtained in 2016 from a nationally representative sample of 5,593 American middle and high school students (12–17 years old). Logistic regression analysis was used to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed to better understand motivations for digital self-harm. Results: About 6% of students have anonymously posted something online about themselves that was mean. Males were significantly more likely to report participation (7.1% compared to 5.3%). Several statistically significant correlates of involvement in digital self-harm were identified, including sexual orientation, experience with school bullying and cyberbullying, drug use, participation in various forms of adolescent deviance, and depressive symptoms. Conclusions: Digital self-harm is a new problem that demands additional scholarly attention. A deeper inquiry as to the motivations behind this behavior, and how it correlates to offline self-harm and suicidal ideation, can help direct mental health professionals toward informed prevention approaches. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: Cyberbullying; Self-cyberbullying; Digital self-harm; Self-harm; Suicide; Depressive symptoms; Adolescent; Adolescent Behavior; Aggression; Bullying; Child; Depression; Female; Humans; Internet; Male; Self-Injurious Behavior; Sexual Behavior; Surveys and Questionnaires; United States; Psychiatric Symptoms; Self-Destructive Behavior; Cyberbullying

Internalized heterosexism and psychological distress: The mediating roles of self-criticism and community connectedness - Puckett, Jae A.; Levitt, Heidi M.; Horne, Sharon G.; Hayes-Skelton, Sarah A. (Psychology of Sexual Orientation and Gender Diversity, 2015)
Internalized heterosexism refers to the development of a negative view of one’s own and others’ sexual minority identities as a product of living within a heterosexist society. Various negative mental health outcomes have been associated with internalized heterosexism (IH), such as anxiety, depression, and suicidality. However, little is known about the actual processes through which these outcomes take place. The current study examined the role of self-criticism (a psychological process) and lack of connectedness with other sexual minorities (a social process) in explaining the relation between IH and psychological distress. Data were collected via an online survey (N = 436) and analyzed using structural equation modeling. Results supported previous research, showing a significant direct positive relationship between IH and psychological distress. In addition, higher self-criticism (β = .28, p < .001; 95% CI: .22, .36) and lower connectedness with sexual minorities (β = .10, p < .01; 95% CI: .04, .16) partially explained the shared variance between IH and psychological distress. The final model, which included both mediators of the relation between IH and psychological distress, accounted for a significant amount of the variance in psychological distress (64.3%) and fit the data well. Both self-criticism and connectedness to a sexual minority community are mechanisms that could be targeted within therapy when working to improve the mental health of clients with high IH and specific therapeutic suggestions are presented. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGB; internalized heterosexism; mental health; minority stress; sexual minorities; Community Involvement; Distress; Homosexuality (Attitudes Toward); Self-Perception; Sexual Orientation; Bisexuality; Internalization; Lesbianism; Mental Health; Minority Groups; Minority Stress

Family rejection as a predictor of suicide attempts and substance misuse among transgender and gender nonconforming adults - Klein, Augustus; Golub, Sarit A. (LGBT Health, 2016)
Purpose: We examined associations between family rejection and risk of suicide attempts and substance misuse among a national sample of transgender and gender nonconforming adults. Methods: Data were drawn from the National Transgender Discrimination Survey (N = 6456). This secondary analysis was restricted to 3458 individuals who self-identified as transgender or gender nonconforming and provided complete data on study variables. We used multivariable logistic regression to examine health risks by level of reported family rejection (low/moderate/high), controlling for relevant sociodemographic characteristics. Results: Overall, 42.3% of the sample reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection. Conclusions: Family rejection related to gender identity is an understudied interpersonal stressor that may negatively affect health outcomes for transgender and gender nonconforming individuals. A better understanding of the role of close relationships in both risk and resilience for transgender individuals is critical in the development of effective public health interventions for this community. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: family rejection; substance use; suicide; transgender; Adolescent; Adult; Aged; Aged, 80 and over; Discrimination (Psychology); Family; Female; Humans; Internet; Logistic Models; Male; Middle Aged; Odds Ratio; Rejection (Psychology); Socioeconomic Factors; Substance-Related Disorders; Suicide, Attempted; Surveys and Questionnaires; Transgender Persons; Young Adult; Attempted Suicide; Drug Abuse; Family; Human Sex Differences; Transgender; Gender Nonconforming

Physical and/or sexual abuse is associated with increased psychological and emotional distress among transgender women - Kussin-Shoptaw, Alexandra L.; Fletcher, Jesse B.; Reback, Cathy J. (LGBT Health, 2017)
Purpose: Transgender women have consistently reported elevated rates of lifetime physical and sexual abuse. This study examined the associations between reported physical and/or sexual abuse and symptoms of psychological and emotional distress among a sample of urban, high-risk transgender women. Methods: From June 2005 through July 2012, 99 transgender women enrolled in a Comprehensive Risk Counseling and Services program in Hollywood, CA. Seemingly unrelated regression equations (SURE) were used to simultaneously regress psychiatric symptom reports on participant sociodemographic characteristics and self-reported history of physical/sexual abuse. Results: Participants were African American/Black (33.3%), Caucasian/White (28.3%), or Hispanic/Latina (24.2%). Average age was 35 years (standard deviation [SD] = 9), and 37.4% of participants self-reported an HIV-positive status. Most (84.9%) participants reported experiencing physical or sexual abuse at some point in their lifetime, and symptoms of psychological and emotional distress (as measured by the Brief Symptom Inventory) among those who reported abuse were more severe than those observed in cisgender psychiatric in-patient populations. After controlling for participant sociodemographics, prior experience of physical and/or sexual abuse was associated with significantly increased psychological and emotional distress across all measured symptom domains except psychoticism [χ²(9) = 17.56; p < 0.05]. Conclusion: Given these associations as well as the high prevalence of physical and/or sexual abuse among transgender women, mental health professionals and social service providers working with this population should be sensitive to the abuse history and mental health needs of the transgender women with whom they work. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: mental health; physical abuse; sexual abuse; suicide; transgender women; Distress; Mental Health; Physical Abuse; Sexual Abuse; Transgender; Victimization

Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp - Cuerda-Galindo, Esther; LoÂpez-Muñoz, Francisco; Krischel, Matthis; Ley, Astrid (PLoS ONE, 2017)
Living conditions in Nazi concentration camps were harsh and inhumane, leading many prisoners to commit suicide. Sachsenhausen (Oranienburg, Germany) was a concentration camp that operated from 1936 to 1945. More than 200,000 people were detained there under Nazi rule. This study analyzes deaths classified as suicides by inmates in this camp, classified as homosexuals, both according to the surviving Nazi files. This collective was especially repressed by the Nazi authorities. Data was collected from the archives of Sachsenhausen Memorial and the International Tracing Service in Bad Arolsen. Original death certificates and autopsy reports were reviewed. Until the end of World War II, there are 14 death certificates which state 'suicide' as cause of death of prisoners classified as homosexuals, all of them men aged between 23 and 59 years and of various religions and social strata. Based on a population of 1,200 prisoners classified as homosexuals, this allows us to calculate a suicide rate of 1,167/100,000 (over the period of eight years) for this population, a rate 10 times higher than for global inmates (111/100,000). However, our study has several limitations: not all suicides are registered; some murders were covered-up as suicides; most documents were lost during the war or destroyed by the Nazis when leaving the camps and not much data is available from other camps to compare. We conclude that committing suicides in Sachsenhausen was a common practice, although accurate data may be impossible to obtain. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: deaths; suicide; homosexual prisoners; concentration camps; Adult; Concentration Camps; Germany; Homosexuality, Male; Humans; Male; Middle Aged; Prisoners; Suicide; Concentration Camps; Death and Dying; Homosexuality; Prisoners; Suicide

Comprehensive screening for suicide risk in primary care - Diamond, Guy S.; Herres, Joanna L.; Ewing, E. Stephanie Krauthamer; Atte, Tita O.; Scott, Syreeta W.; Wintersteen, Matt B.; Gallop, Robert J. (American Journal of Preventive Medicine, 2017)
Introduction: Suicide is a major public health problem and a complex clinical challenge. Assessment and early identification could be enhanced with screening tools that look beyond depression. The purpose of this study was to identify profiles of risk behaviors and social stress associated with suicidal ideation and behavior using the Behavioral Health Screen. Methods: The study used screening data from 2,513 primary care patients (aged 14–24 years). Data were collected between 2008 and 2012, and were analyzed in 2016. Results: Latent class analysis identified a high and low risk profile. Domains of primary influence included substance use, sexual assault, same-sex behavior, and unsafe sex. The high-risk group was 11 times more likely to have made a suicide attempt, five times more likely to report a history of suicidal ideation and behavior, and three times more likely to report recent suicidal ideation and behavior. Conclusions: Risk behaviors and social stress contribute to the risk for suicide above and beyond depression and should be assessed during routine primary care visits with adolescents. The Behavioral Health Screen can screen all these domains and thus assist primary care providers in assessing for both psychiatric and social stress factors associated with youth suicide. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: risk behaviors; social stress; suicidal ideation; suicidal behavior; primary care patients; suicide risk; Adolescent; Adult; Behavioral Medicine; Depression; Female; Humans; Male; Primary Health Care; Risk Assessment; Risk Factors; Self-Injurious Behavior; Sexual Behavior; Stress, Psychological; Substance-Related Disorders; Suicide; Violence; Young Adult; Primary Health Care; Risk Factors; Risk Taking; Social Stress; Suicide; Attempted Suicide; Medical Patients; Suicidal Ideation

The role of gender affirmation in psychological well-being among transgender women - Glynn, Tiffany R.; Gamarel, Kristi E.; Kahler, Christopher W.; Iwamoto, Mariko; Operario, Don; Nemoto, Tooru (Psychology of Sexual Orientation and Gender Diversity, 2016)
High prevalence of psychological distress, including greater depression, lower self-esteem, and suicidal ideation, has been documented across numerous samples of transgender women and has been attributed to high rates of discrimination and violence. According to the gender affirmation framework (Sevelius, 2013), access to sources of gender-affirmative support can offset such negative psychological effects of social oppression. However, critical questions remain unanswered in regards to how and which aspects of gender affirmation are related to psychological well-being. The aims of this study were to investigate the associations among 3 discrete areas of gender affirmation (psychological, medical, and social) and participants’ reports of psychological well-being. A community sample of 573 transgender women with a history of sex work completed a 1-time self-report survey that assessed demographic characteristics, gender affirmation, and mental health outcomes. In multivariate models, we found that social, psychological, and medical gender affirmation were significant predictors of lower depression and higher self-esteem whereas no domains of affirmation were significantly associated with suicidal ideation. Findings support the need for accessible and affordable transitioning resources for transgender women to promote better quality of life among an already vulnerable population. However, transgender individuals should not be portrayed simplistically as objects of vulnerability, and research identifying mechanisms to promote wellness and thriving is necessary for future intervention development. As the gender affirmation framework posits, the personal experience of feeling affirmed as a transgender person results from individuals’ subjective perceptions of need along multiple dimensions of gender affirmation. Thus, personalized assessment of gender affirmation may be a useful component of counseling and service provision for transgender women. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: transgender women; gender affirmation; psychological well-being; Gender Identity; Well Being; Transgender; Discrimination; Distress; Self-Esteem; Suicidal Ideation; Violence

‘I thought I was the only one’: The misrecognition of LGBT youth in contemporary Vietnam - Horton, Paul (Culture, Health & Sexuality, 2014)
While recent LGBT rights demonstrations and discussions about same-sex marriage have thrust the issue of homosexuality into the spotlight, it was not long ago that the issue of homosexuality was notable by its absence in Vietnam. Drawing on semi-structured interviews with young gay, lesbian and bisexual people in Vietnam's capital city Hanoi, this paper considers the increasing visibility of homosexuality through the theoretical lens of recognition, and illustrates the heterosexist misrecognition that LGBT young people have been subjected to in legislation, the media, their families, and through the education system. Drawing on the narratives of LGBT young people, the paper highlights the potentially negative impact such misrecognition may have on psychological and social wellbeing. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: LGBT; Vietnam; sexuality; suicide; urban youth; Adult; Bisexuality; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Qualitative Research; Social Isolation; Vietnam; Young Adult; Bisexuality; Lesbianism; Male Homosexuality; Southeast Asian Cultural Groups; Transgender; Sexuality; Suicide

Effects of state nondiscrimination laws on transgender and gender-nonconforming individuals' perceived community stigma and mental health - Gleason, Hillary A.; Livingston, Nicholas A.; Peters, Marianne M.; Oost, Kathryn M.; Reely, Evan; Cochran, Bryan N. (Journal of Gay & Lesbian Mental Health, 2016)
In this study, we investigated the potential effects of statewide nondiscrimination laws on community stigma, as well as its relationship with psychosocial stressors and mental health outcomes. Gender minority individuals (N = 120) completed an online survey containing psychosocial and mental health outcome measures. The experiences of participants who resided in states with and without nondiscrimination laws were compared in regard to perceived community stigma. Hierarchical and logistic regression were used to test the hypothesized relationships between community stigma and lifetime discrimination and victimization; current depression, anxiety, and substance use; and lifetime suicide attempts. Approximately 60% of participants reported residing in a state without nondiscrimination laws (n = 74). These participants reported higher levels of perceived community stigma, and stigma was positively associated with reports of lifetime discrimination and victimization. The observed relationship between stigma and current anxiety symptoms was marginally significant. Logistic regression results indicate that stigma was positively related to the odds of reporting a lifetime suicide attempt. Analyses suggest that statewide nondiscrimination laws are associated with lower rates of perceived stigma at the community level, which, in turn, is associated with lower rates of discrimination, victimization, anxiety, and risk for attempted suicide. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Law; mental health; stigma; TGNC; transgender; Mental Health; Psychosocial Factors; Stigma; Transgender; Discrimination Laws; Gender Nonconforming

Out on the street: A public health and policy agenda for lesbian, gay, bisexual, and transgender youth who are homeless - Keuroghlian, Alex S.; Shtasel, Derri; Bassuk, Ellen L. (American Journal of Orthopsychiatry, 2014)
A disproportionate number of lesbian, gay, bisexual, and transgender (LGBT) youth experience homelessness each year in the United States. LGBT youth who are homeless have particularly high rates of mental health and substance use problems, suicidal acts, violent victimization, and a range of HIV risk behaviors. Given the intense needs of LGBT youth experiencing homelessness, it is imperative to understand their unique experiences and develop responsive practices and policies. The range and severity of health risks vary across subgroups of all homeless LGBT youth, and because the population is nonhomogeneous, their particular needs must be identified and addressed. Thus, the purpose of this article is to review the causes of homelessness among LGBT youth, discuss the mental health and victimization risks faced by this population, address differences among homeless LGBT subgoups, and recommend effective interventions and best practices. The authors conclude by discussing promising future research and public policy directions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: HIV risk behaviors; LGBT youth; depression; homelessness; substance use; public health policy; Adolescent; Adolescent Health Services; Bisexuality; Female; Homeless Youth; Homosexuality, Female; Homosexuality, Male; Humans; Male; Transsexualism; United States; At Risk Populations; HIV; Homeless; Public Health; Sexual Orientation; Bisexuality; Drug Usage; Lesbianism; Major Depression; Male Homosexuality; Health Care Policy; Transgender

Criterion and divergent validity of the sexual minority adolescent stress inventory - Goldbach, Jeremy T.; Schrager, Sheree M.; Mamey, Mary R. (Frontiers in Psychology, 2017)
Sexual minority adolescents (SMA) consistently report health disparities compared to their heterosexual counterparts, yet the underlying mechanisms of these negative health outcomes remain unclear. The predominant explanatory model is the minority stress theory; however, this model was developed largely with adults, and no valid and comprehensive measure of minority stress has been developed for adolescents. The present study validated a newly developed instrument to measure minority stress among racially and ethnically diverse SMA. A sample of 346 SMA aged 14–17 was recruited and surveyed between February 2015 and July 2016. The focal measure of interest was the 64-item, 11-factor Sexual Minority Adolescent Stress Inventory (SMASI) developed in the initial phase of this study. Criterion validation measures included measures of depressive symptoms, suicidality and self-harm, youth problem behaviors, and substance use; the general Adolescent Stress Questionnaire (ASQ) was included as a measure of divergent validity. Analyses included Pearson and tetrachoric correlations to establish criterion and divergent validity and structural equation modeling to assess the explanatory utility of the SMASI relative to the ASQ. SMASI scores were significantly associated with all outcomes but only moderately associated with the ASQ (r = −0.13 to 0.51). Analyses revealed significant associations of a latent minority stress variable with both proximal and distal health outcomes beyond the variation explained by general stress. Results show that the SMASI is the first instrument to validly measure minority stress among SMA. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: adolescents; LGBT; minority stress; mental health; behavioral health; Mental Health; Psychometrics; Test Construction; Stress; Test Validity

Consequences of runaway and thrownaway experiences for sexual minority health during the transition to adulthood - Pearson, Jennifer; Thrane, Lisa; Wilkinson, Lindsey (Journal of LGBT Youth, 2017)
Sexual minority youth are more likely to run away from home or experience homelessness, leaving them at increased risk of victimization and negative health outcomes. In this study, the authors use a developmental perspective that considers both vulnerable beginnings in families and the risky trajectories that follow to explore the connections between running away or being thrown out by parents and sexual minority women's and men's health in adulthood. Using four waves of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), the authors consider multiple dimensions of health and several potential intervening mechanisms. Findings suggest that runaway and thrown away experiences have persistent negative effects on health into adulthood, in part because of their association with sexual victimization, educational attainment, and relationships with parents. Sexual minority men who have been thrown out by parents report a greater likelihood of suicidal ideation, smoking, and substance use into adulthood. Sexual minority women with runaway experiences have poorer health and increased depressive symptoms, while women with thrown away experiences engage in more health risk behaviors. Sexual victimization stands out as a key mechanism for sexual minority women's health, as more than half of these young women report experiences of sexual victimization. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Sexual minorities; runaway youth; health; homelessness; transition to adulthood; Abandonment; Minority Groups; Runaway Behavior; Sexual Orientation; Transgender; Adolescent Development; Homeless; Sexual Minority Groups

Predictors of suicidal ideation among active duty military personnel with posttraumatic stress disorder - McLean, Carmen P.; Zang, Yinyin; Zandberg, Laurie; Bryan, Craig J.; Gay, Natalie; Yarvis, Jeffrey S.; Foa, Edna B. (Journal of Affective Disorders, 2017)
Background: Given the alarming rate of military suicides, it is critical to identify the factors that increase risk of suicidal thoughts and behaviors among active duty military personnel. Methods: This study examined a predictive model of suicidal ideation among 366 treatment-seeking active duty military personnel with posttraumatic stress disorder (PTSD) following deployments to or near Iraq or Afghanistan. Structural equation modeling was employed to examine the relative contribution of combat exposure, social support, PTSD severity, depressive symptoms, guilt, and trauma-related cognitions on suicidal ideation. Results: The final structural equation model had a highly satisfactory fit [χ² (2) = 2.023, p = .364; RMSEA = .006; CFI = 1; GFI = .998]. PTSD severity had an indirect effect on suicidal ideation via trauma-related cognitions. Depression had a direct positive effect on suicidal ideation; it also had an indirect effect via trauma-related cognitions and interpersonal support. Among participants who had made a previous suicide attempt, only depression symptom severity was significantly linked to suicidal ideation. Limitations: Data are cross-sectional, precluding causal interpretations. Findings may only generalize to treatment seeking active duty military personnel with PTSD reporting no more than moderate suicidal ideation. Conclusions: These findings suggest that depression and trauma-related cognitions, particularly negative thoughts about the self, play an important role in suicidal ideation among active duty military personnel with PTSD. Negative cognitions about the self and interpersonal support may be important targets for intervention to decrease suicidal ideation. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Posttraumatic stress disorder; Suicide; Depression; Trauma; Cognitions; Adult; Cross-Sectional Studies; Depression; Female; Humans; Male; Middle East; Military Personnel; Risk Factors; Stress Disorders, Post-Traumatic; Suicidal Ideation; Suicide, Attempted; United States; Major Depression; Posttraumatic Stress Disorder; Suicidal Ideation; Cognitions; Combat Experience; Guilt; Military Duty Status; Military Personnel; Self-Concept; Social Support

Help-seeking for nonsuicidal self-injury in sexual minority adolescent and young adult females - Zaki, Landon F.; Gross, Madeline; Pachankis, John E. (Journal of Gay & Lesbian Mental Health, 2017)
Subgroups of sexual minority adolescent and young adult females (e.g., lesbian, bisexual, questioning) have been underrepresented in youth health research. However, evidence suggests they experience compromised coping strategies compared to heterosexual female peers and may be reluctant to seek professional help due to stigma. An Internet survey (N = 482) examined nonsuicidal self-injury (NSSI), suicidal ideation, and help-seeking for NSSI in sexual minority and heterosexual adolescent and young adult females with histories of NSSI. Compared to heterosexual female youth, lesbian youth reported lower rates of NSSI and greater help-seeking from professionals, whereas bisexual youth reported greater suicidal ideation and a reluctance to seek professional help, favoring the help of romantic partners instead. Results extend research on help-seeking for risk behaviors in sexual minority female youth subgroups, while echoing the need to reduce sexual minority stigma in healthcare. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: help-seeking; nonsuicidal self-injury; sexual minority; youth; Coping Behavior; Help Seeking Behavior; Minority Groups; Self-Injurious Behavior; Sexual Minority Groups

Bisexuality and suicide: A systematic review of the current literature - Pompili, Maurizio; Lester, David; Forte, Alberto; Seretti, Maria Elena; Erbuto, Denise; Lamis, Dorian A.; Amore, Mario; Girardi, Paolo (Journal of Sexual Medicine, 2014)
Introduction: Many studies of lesbian, gay, and bisexual youth have demonstrated that individuals reporting a bisexual orientation have a particularly high risk of suicidal behavior and substance abuse. It has been also suggested that bisexual individuals (both men and women) have higher rates of depression and anxiety compared with homosexual and heterosexual groups. Aim: The aim of the present article was to determine whether or not an association between bisexuality and suicidal behavior exists and to analyze risk factors for suicidal behavior in bisexual individuals. Main Outcome Measures: The combined search strategies yielded a total of 339 records screened from PubMed, Scopus, and Web of Knowledge. Duplicate articles, articles that were not in English, and those that did not analyze bisexuality separately from homosexuality were excluded. A quality assessment was performed for each study included. Methods: A careful systematic review of the literature was conducted investigating the potential bisexuality‐suicidal behavior link. A total of 77 articles from peer‐reviewed journals were considered, and the most relevant (N = 19) were selected for this review. Results: Individuals reporting a bisexual orientation had an increased risk of suicide attempts and ideation compared with their homosexual and heterosexual peers. Risk factors included related victimization, peer judgments, and family rejection. Bisexual individuals also reported higher rates of mental illness and substance abuse. Conclusions: Bisexual individuals may experience more psychological distress and mental health problems than individuals who identify with a homosexual or heterosexual orientation. Clinicians should consider the potential for suicidal behaviors in bisexual individuals and be alert for increased mental health problems and poor social integration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Bisexuality; Prevention; Sexual Orientation; Suicide; Adolescent; Adult; Anxiety Disorders; Bisexuality; Crime Victims; Depressive Disorder; Female; Humans; Male; Risk Factors; Substance-Related Disorders; Suicidal Ideation; Suicide, Attempted; Bisexuality; Risk Factors; Sexual Orientation; Suicide; Suicide Prevention

Deconstructing homophobia through performance: A review of Ugly Ducklings: A national campaign to reduce bullying and harassment of lesbian, gay, bisexual, transgender, and questioning youth - Wilson, Anna (Journal of LGBT Youth, 2014)
Reviews the film, Ugly Ducklings: A National Campaign to Reduce Bullying and Harassment of LGBTQ Youth. This review critically examines Ugly Ducklings: A National Campaign to Reduce Bullying and Harassment of LGBTQ Youth through a DVD and educator’s guidebook. The Ugly Ducklings Community Action Kit has two parts: (1) a documentary about the harassment of lesbian youth and (2) short dialogues with Ugly Ducklings cast members, parents, lesbian teens, and others. The guidebook is divided into three broad areas: Educators, Parents, and Youth, with additional information on teen suicide risk and prevention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: homophobia reduction; Ugly Ducklings; performance review; bullying prevention; harassment; lesbians; gays; bisexuals; transgender; questioning youth; Films; Harassment; Homosexuality (Attitudes Toward); Sexual Orientation; Bullying; Attitude Change; Bisexuality; Lesbianism; Male Homosexuality; Transgender; Change Strategies

Needs of a silent minority: Mexican transgender asylum seekers - Gowin, Mary; Taylor, E. Laurette; Dunnington, Jamie; Alshuwaiyer, Ghadah; Cheney, Marshall K. (Health Promotion Practice, 2017)
Mexican male to female transgender asylum seekers in the United States suffer from serious health issues that can be attributed to stressors related to their transgender, ethnic minority, and socioeconomic status. This study explored these stressors, the resulting health issues, and the needs of this particularly vulnerable population. Asylum seekers’ (n = 45) sworn declarations and psychological evaluations were examined by a multidisciplinary research team using a systematic document review process. The review identified stressors that occurred both in Mexico and the United States: verbal, physical, and sexual assaults; unstable environments; fear for safety/security; hiding undocumented status; and economic insecurity. The health issues that resulted in part from these stressors include posttraumatic stress disorder, depression, anxiety, sleep issues, isolation, avoidance, drug/alcohol use, and suicidal tendencies. Despite suffering from multiple health issues, asylum seekers rarely sought health or social services. Health promotion practitioners can play an important role in serving this silent minority by (1) expanding community-based research focused on the intersection of transgender, ethnic minority, and socioeconomic status; (2) using trusted community members to connect this population to necessary resources; (3) providing communication training/resource development for health care providers; and (4) creating a network of service organizations that understand the needs of transgender asylum seekers. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: health disparities; qualitative research; health research; Latino; minority health; LGBT; social determinants of health; Health Behavior; Public Health; Health Disparities

Offsetting risks: High school gay-straight alliances and lesbian, gay, bisexual, and transgender (LGBT) youth - Heck, Nicholas C.; Flentje, Annesa; Cochran, Bryan N. (Psychology of Sexual Orientation and Gender Diversity, 2013)
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

Isolation of lesbian, gay, bisexual and transgender youth: A dimensional concept analysis - Johnson, Michael J.; Amella, Elaine J. (Journal of Advanced Nursing, 2014)
Abstract: Aim: To present the findings of a dimensional analysis of isolation in the context, and from the perspective, of lesbian, gay, bisexual and transgender youth. Background Lesbian, gay, bisexual and transgender youth are often at greater risk for negative health outcomes compared with heterosexual youth. Isolation is one risk factor cited throughout the literature; however, the concept is complicated and has many uses and thus warrants clarification. Design: Concept Analysis. Data Sources Sources comprise 35 English language research articles retrieved from CINAHL and EBSCOHost (1987–2012). Methods: A dimensional concept analysis was undertaken to analyse how the concept, isolation, is socially constructed. Results: This dimensional analysis revealed five socially constructed dimensions and four sub‐dimensions. These findings indicate that there is substantial variability in the concept of isolation. These differences and variations are most notably observed in the 20 articles (57%) that had more than one dimension. Although some of these articles were explicit with the different meanings and use of the concept, most of the papers had wide variability in the use and meaning of the concept. Conclusion: The disproportionately greater physical and mental health disparities between lesbian, gay, bisexual and transgender and heterosexual youth are a signal to conduct more research to clarify the concept of isolation, to develop instrumentation to identify at‐risk youth and to explore predictors and consequences of isolation. Nurses and others can lead the way in translating this knowledge into strategies that will improve the health and lives of these young people. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: bisexuality; homosexuality; nursing; suicide; transgendered persons; risk factors; health knowledge; health disparities; isolation concept; lesbian; Adolescent; Bisexuality; Cognition; Emotions; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Social Isolation; Transsexualism; Lesbianism; Risk Factors; Social Isolation; Health Disparities; Transgender; Bisexuality; Concept Formation; Health Knowledge; Homosexuality; Nursing; Suicide

Suicide risk among sexual minority college students: A mediated moderation model of sex and perceived burdensomeness - Silva, Caroline; Chu, Carol; Monahan, Kierstan R.; Joiner, Thomas E. (Psychology of Sexual Orientation and Gender Diversity, 2015)
Converging evidence suggests that individuals who identify as lesbian/gay or bisexual are consistently more likely to report suicidal ideation and attempts than heterosexual counterparts, and that these effects may be greater among males. The current study examined sex as a moderator of the relationship between sexual identity and suicidal ideation, and perceived burdensomeness as a mediator of this relationship, controlling for anxiety, and negative and positive affect. Undergraduates (n = 140; mean age, 19.59 years; 71.4% female; 58.6% White; 34.3% lesbian/gay/bisexual) completed measures assessing sexual identity, suicidal ideation and behaviors, anxiety symptom severity, and general negative and positive affect cross-sectionally. Sexual minority undergraduates reported significantly higher levels of perceived burdensomeness, anxiety, and suicidal ideation, attempts, and nonsuicidal self-injury, and lower positive affect, than heterosexual counterparts. Analyses suggested that most of these associations were strongly driven by bisexuals; a notion that was supported by finding a quadratic relationship between the Kinsey Scale and suicidal ideation. A mediated moderation analysis revealed that the relationship between sexual identity and suicidal ideation was only significant among females, and that this relationship was fully mediated by perceived burdensomeness, while controlling for anxiety, and negative and positive affect. Perceived burdensomeness may be an important malleable risk factor for suicide assessment, prevention, and intervention efforts to address, especially among female sexual minority college students. Implications and future directions are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: gender; interpersonal theory of suicide; perceived burdensomeness; sexual identity; suicide risk; Gender Identity; Psychological Theories; Risk Factors; Suicidal Ideation; Suicide; Attitudes; Bisexuality; Homosexuality; Human Sex Differences; Lesbianism; Minority Groups; Sexual Minority Groups

Sexuality and suicidality: Matched-pairs analyses reveal unique characteristics in non-heterosexual suicidal behaviors - Harris, Keith M. (Archives of Sexual Behavior, 2013)
The present findings offer new perspectives on differences between suicide-risk heterosexuals and non-heterosexuals (lesbian, gay, bisexual, and questioning: LGBQ). Results from an anonymous online survey, employing standardized scales, showed that LGBQ participants reported significantly greater suicide-risk than heterosexuals. Seventy-nine matched pairs of suicide-risk LGBQ and heterosexuals were examined by individual suicide risk factors. Results showed no significant differences on separate measures of suicidal ideation; however, LGBQ participants were more likely to report suicide attempts, disclosure of suicidal intentions, and prediction of future suicide attempts. The LGBQ group also indicated greater likelihood of going online to develop new personal relationships. Multiple regression modeling was conducted to guide outreach and support efforts, revealing unique factors predicting help-seeking denial of suicide-risk LGBQ.Implications include the importance of online support and considering sexual minorities not just as a potential high-risk group, but also as a population with unique suicide risks and behaviors. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: sexuality; suicidal behavior; sexual behavior; homosexual behavior; heterosexual behavior; suicide risk; Adolescent; Adult; Female; Humans; Internet; Male; Risk Factors; Self-Injurious Behavior; Sexuality; Social Support; Suicide; Suicide, Attempted; Violence; Psychosexual Behavior; Suicide; Suicidality; Heterosexuality; Homosexuality; Risk Factors

Perceived parental support as a protective factor against suicidal ideation of self-identified lesbian and gay Filipino adolescents - Reyes, Marc Eric S.; Victorino, Mase C.; Chua, Anna P.; Oquendo, Francine Y.; Puti, Arteliz S.; Reglos, Alyssa A.; McCutcheon, Lynn E. (North American Journal of Psychology, 2015)
This study aims to determine the relationship between perceived parental support and suicidal ideation among 340 self-identified Filipino lesbian and gay (LG) high school students. Findings showed that the greater the rejection of an LG adolescent, the higher the risk of suicidal ideation. Moreover, a rejecting maternal attitude is found to be more of a risk factor for suicidal ideation than a rejecting paternal attitude. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; parental support; parental intervention; lesbianism; gay; Lesbianism; Male Homosexuality; Parent Training; Southeast Asian Cultural Groups; Suicidal Ideation; Risk Factors

Review of In a queer voice: Journeys of resilience from adolescence to adulthood - Pauley, David (Journal of Gay & Lesbian Mental Health, 2014)
Reviews the book, In a Queer Voice: Journeys of Resilience from Adolescence to Adulthood by M. Sadowski (2013). If the current cohort of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth could speak collectively about their journey from middle school to young adulthood, what would they say about it? How would their stories vary from those of gay, lesbian, bisexual and transgender young people in previous generations? And crucially, at a time when anti-gay and anti-trans harassment proceeds unabated in most American schools and suicide rates among LGBTQ teens continue to dwarf those of their heterosexual peers, what factors would these young people identify as pivotal in helping them to make a safe passage through the riptides of adolescence into adulthood? These are the questions that lie at the heart of Michael Sadowski’s ambitious and illuminating new book. Sadowski approaches these questions from a deceptively simple starting point, interviewing a group of LGBTQ youth from across the country in their mid- to late-teens and then conducting follow-up discussions with six of them years later, by which time they were in their early- to midtwenties. Sadowski focuses on the broad sweep of his subjects’ evolving autobiographies, seeking in particular to tease out the ways in which these young people worked to integrate their LGBTQ identity into their lives, while simultaneously grappling with a relational context that was often far from supportive of their efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: resilience; adolescent; adulthood; lesbians; gays; bisexuality; transgender; LGBT identity; queer; Lesbianism; Life Changes; Male Homosexuality; Resilience (Psychological); Transgender; Adolescent Development; Adult Development; Bisexuality; Gender Identity

Risky sexual behaviors as correlates of depression and suicidal ideation among male HIV test-seekers at a voluntary counseling and testing facility in Taiwan - Lin, Chia-Chun; Lee, Yuan-Ti; Yang, Hao-Jan (Asia-Pacific Journal of Public Health, 2017)
This study aims at determining the level of depression and suicidal status of adult HIV test-seekers. Of the total enrolled 850 males, almost 50% reported some risk behaviors, 38.9% experienced depression, and 7.2% had suicidal ideation. Subjects with risky sexual behaviors in terms of repeated HIV test, had a history of sexually transmitted disease, engaged in one-night stands, or did not use condoms all the time with causal sexual partners were more likely to have depression. Furthermore, subjects who were bisexual/homosexual, engaged in Internet sex, engaged in one-night stands, or used addictive drugs within the past 6 months were more likely to experience suicidal ideation. The HIV testers are at risk of experiencing depression and suicidal ideation; each is associated with different types of risky sexual behaviors. It is essential for the health authority to further provide mental health services for HIV testers and to draw up an effective strategy in reducing unprotected sexual behaviors. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: HIV testing; risky sexual behavior; depression; suicidal ideation; psychological distress; correlates; Adult; Counseling; Depression; HIV Infections; Humans; Male; Mass Screening; Patient Acceptance of Health Care; Risk Factors; Risk-Taking; Sexual Behavior; Suicidal Ideation; Taiwan; Voluntary Programs; Young Adult; Counseling; HIV Testing; Major Depression; Sexual Risk Taking; Suicidal Ideation

Gang membership and suicidality in adolescents - Juan, Shao-Chiu; Hemenway, David (Journal of Gang Research, 2016)
Youth suicide and its association with gang membership is rarely examined in existing literature. Using a representative sample of Boston adolescents (n = 1,878) the present study found that gang youth have a higher proportion of suicidal ideation (20% vs. 11%), suicide attempt (6% vs. 4%), and self-harm (17% vs. 8%) than non-gang youth. Mediation analyses show that sexual and non-sexual victimizations significantly mediate the link between gang membership and suicidal ideation (p < .001). Multivariate analyses indicate that gang membership, homosexuality, low perceived safety, and sexual victimization are unique predictors of female suicidality. To prevent youth suicide, gang membership should be regularly assessed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: youth suicide; gang membership; suicide; gangs; self-harm; Juvenile Gangs; Suicide; Gangs; Suicidality; Attempted Suicide

Homophobic bullying in Mexico: Results of a national survey - Baruch-Dominguez, Ricardo; Infante-Xibille, Cesar; Saloma-Zuñiga, Claudio E. (Journal of LGBT Youth, 2016)
Homophobic and transphobic bullying, through teasing, physical violence, and other forms of aggression, is a problem that affects lesbian, gay, bisexual, and transgender students at all levels of education. Even though there have been legal changes in Mexico to protect human rights of lesbian, gay, bisexual, and transgender people, schools are spaces where discrimination and violence toward them are still common. In 2012, using an online survey asking participants about their experiences with bullying, its consequences, and responses from adults, the authors collected responses from 912 participants younger than 30 years of age who self-identified as lesbian, gay, bisexual, or transgender and who lived in the 32 states of Mexico. Two thirds of participants said that they were victims of bullying during their school years; the majority of these students indicated that they did not have support from teachers or parents to avoid or stop the violence. The consequences of bullying were truancy, dropouts, depression, and suicide attempts. Attitudes that normalize bullying may impede the effective prevention of or response to homophobic and transphobic bullying by teachers and parents. To eliminate homophobic bullying in school, there is a need for sexual diversity trainings for teachers and media campaigns for the general public. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Homophobia; bullying; teachers; LGBT; Aggressive Behavior; Schools; Violence; Bullying; Transgender

The bromance: Undergraduate male friendships and the expansion of contemporary homosocial boundaries - Robinson, Stefan; Anderson, Eric; White, Adam (Sex Roles: A Journal of Research, 2018)
The present study provides the first known qualitative examination of heterosexual undergraduate men’s conceptualization and experiences of the bromance, outside research on cinematic representations. Drawing on semi-structured interviews with 30 undergraduate men enrolled in one of four undergraduate sport-degree programs at one university in the United Kingdom, we find these heterosexual men to be less reliant on traditional homosocial boundaries, which have previously limited male same-sex friendships. Contrary to the repressive homosociality of the 1980s and 1990s, these men embrace a significantly more inclusive, tactile, and emotionally diverse approach to their homosocial relationships. All participants provided comparable definitions of what a bromance is and how it operates, all had at least one bromantic friend, and all suggested that bromances had more to offer than a standard friendship. Participants described a bromance as being more emotionally intimate, physically demonstrative, and based upon unrivalled trust and cohesion compared to their other friendships. Participants used their experiences with romances and familial relations as a reference point for considering the conditions of a bromance. Results support the view that declining homophobia and its internalization has had significantly positive implications for male expression and intimacy. Conclusions are made about the bromance’s potential to improve men’s mental health and social well-being because participants indicate these relationships provide a space for emotional disclosure and the discussion of potentially traumatic and sensitive issues. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Bromance; Homosocial; Homohysteria; Masculinity; Men; Stoicism; Suicide; Friendship; Human Males; Masculinity

A compensatory model of risk and resilience applied to adolescent sexual orientation disparities in nonsuicidal self-injury and suicide attempts - Reisner, Sari L.; Biello, Katie; Perry, Nicholas S.; Gamarel, Kristi E.; Mimiaga, Matthew J. (American Journal of Orthopsychiatry, 2014)
This study investigated and applied a compensatory model of risk and resilience to differences in past-year nonsuicidal self-injury (NSSI) and suicide attempts by sexual orientation using representative data from the 2007 Massachusetts Youth Risk Behavior Survey (n = 3,131). Self-identified lesbian, gay, bisexual, and questioning (LGBQ) adolescents comprised 7% of the sample, but accounted for 67% of NSSI and 80% of suicide attempts. Compared with heterosexuals, LGBQ adolescents had an increased odds of NSSI (adjusted Odds Ratio (aOR) = 2.76; 95% Confidence Interval (CI) [2.00, 3.81] and suicide attempts (aOR = 2.73; 95% CI [1.47, 5.08]. NSSI was highly associated with suicidality (aOR = 10.87; 95% CI [6.17, 19.18]. Family support was independently associated with a decreased odds of both NSSI (aOR = 0.56; 95% CI [0.35, 0.89] and suicidality (aOR = 0.48; 95% CI [0.29, 0.79] supporting a compensatory model of resilience. Screening and preventive interventions for LGBQ adolescents are warranted, including at the family level. Sexual orientation should be included as a standard demographic to monitor health disparities. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: adolescents; sexual minority; mental health; nonsuicidal self-injury; suicide attempts; protective factors; resilience; compensatory model; risk factors; lesbian; gay; bisexual; Adolescent; Bisexuality; Female; Homosexuality; Humans; Male; Massachusetts; Models, Psychological; Resilience, Psychological; Risk; Self-Injurious Behavior; Suicide, Attempted; Attempted Suicide; Protective Factors; Resilience (Psychological); Self-Inflicted Wounds; Sexual Orientation; Bisexuality; Lesbianism; Male Homosexuality; Mental Health; Models; Risk Factors; Self-Injurious Behavior; Sexual Minority Groups

Shattering core beliefs: Psychological reactions to mass shooting in Orlando - Ben-Ezra, Menachem; Hamama-Raz, Yaira; Mahat-Shamir, Michal; Pitcho-Prelorentzos, Shani; Kaniasty, Krzysztof (Journal of Psychiatric Research, 2017)
This article presents a study of psychological reactions to mass shooting in Orlando. On June 12, 2016, a combined terrorist and hate crime attack targeted a gay nightclub in Orlando, Florida, and tragically resulted in 49 dead and 53 wounded. This was the deadliest mass shooting by a single perpetrator in U.S. history and the deadliest terrorist attack on American soil since the tragedy of September 11, 2001. Examinations of associations between post-traumatic shifts in peoples’ political, social and world views, and psychological distress or acute stress disorder symptoms (ASD) are not researched frequently. The study's limitations are the lack assessments of pre-existing distress and ASD symptoms, as well as the absence of measures of sexual orientation and attitudes toward homosexuality. Disruption of world views and core life beliefs following a national trauma is associated with negative aspects of mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: core beliefs; psychological reactions; mass shooting; Emotional Adjustment; Terrorism; Attitudes

Psychotic panic and feared sexual assault—‘Homosexual panic’: The historical role of feared homosexual assault as a contributing factor to self-attack - Goldblatt, Mark J.; Maltsberger, John T. (The Scandinavian Psychoanalytic Review, 2016)
Some psychotic patients fall into acute persecutory panic, a subjective experience of helpless terror in the face of anticipated imminent annihilation or dismemberment. These states occur in a wide range of psychotic illnesses and are often associated with command hallucinations and fear of homosexual assault. In a desperate attempt to escape from imaginary enemies, such patients often attack themselves and imagine suicide is survivable. This article addresses the dread of homosexual assault, previously referred to as homosexual panic, and its relationship to patients who attack themselves in a state of desperate psychotic persecution. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Paranoia; homosexual panic; psychosis; terror; suicide; Homosexuality; Panic; Paranoia; Psychoanalytic Theory; Self-Injurious Behavior; Suicide

Risk factors for non-suicidal self-injury among trans youth - Arcelus, Jon; Claes, Laurence; Witcomb, Gemma L.; Marshall, Ellen; Bouman, Walter Pierre (Journal of Sexual Medicine, 2016)
Introduction: Previous research has reported high levels of non-suicidal self-injury (NSSI) in trans populations and younger age has been identified as a risk factor. Aims: To explore the prevalence of NSSI in a large group of young trans people and to identify risk factors for this group. Main Outcome Measures: Sociodemographic variables and measurements of NSSI (Self-Injury Questionnaire), psychopathology (Symptom Checklist-90–Revised), self-esteem (Rosenberg Self-Esteem Scale), victimization (Experiences of Transphobia Scale), interpersonal functioning (Inventory of Interpersonal Problems), and social support (Multidimensional Scale of Perceived Social Support). Methods: Two hundred sixty-eight young people attending a national gender clinic completed questionnaires assessing presence and frequency of NSSI and levels of general psychopathology, depression, anxiety, interpersonal problems, self-esteem, social support, transphobia, and information on hormone treatment. Results: A lifetime presence of NSSI was identified in 46.3% of patients and 28.73% reported currently engaging in NSSI (within at least the past few months). Analyses showed that those with a lifetime presence of NSSI had significantly greater general psychopathology, lower self-esteem, had suffered more transphobia, and experienced greater interpersonal problems than those without NSSI. Findings were similar when comparing current with non-current NSSI. Overall, natal male patients reported less social support than natal female patients, but current NSSI was more common in natal female patients. Regression analyses confirmed that natal female gender and greater general psychopathology predicted current and lifetime NSSI. Further analyses confirmed that general psychopathology itself could be predicted by transphobic experiences, low self-esteem, and interpersonal problems, but not by the use of cross-sex hormones. Conclusion: These findings confirm that NSSI is common in trans youth and emphasize the need for interventions that decrease transphobia, increase social support, and help trans youth navigate their relationships with others to decrease psychopathology and NSSI. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Gender Dysphoria; Trans; Transgender; Transsexual; Youth; Young People; Suicide; Non-Suicidal Self-Injury; Psychopathology; Adolescent; Anxiety; Checklist; Depression; Female; Humans; Interpersonal Relations; Male; Perception; Prevalence; Risk Factors; Self Concept; Self-Injurious Behavior; Social Support; Surveys and Questionnaires; Transgender Persons; United Kingdom; Young Adult; Risk Factors; Self-Injurious Behavior; Transgender; Psychopathology

Explaining the suicide risk of sexual minority individuals by contrasting the minority stress model with suicide models - Plöderl, Martin; Sellmeier, Maximilian; Fartacek, Clemens; Pichler, Eva-Maria; Fartacek, Reinhold; Kralovec, Karl (Archives of Sexual Behavior, 2014)
Many studies have found elevated levels of suicide ideation and attempts among sexual minority (homosexual and bisexual) individuals as compared to heterosexual individuals. The suicide risk difference has mainly been explained by minority stress models (MSTM), but the application of established suicidological models and testing their interrelations with the MSTM has been lacking so far. Therefore, we have contrasted two established models explaining suicide risk, the Interpersonal Psychological Theory (IPT) (Joiner, 2005) and the Clinical Model (CM) (Mann et al., 1999), with the MSTM (Meyer, 2003) in a Bavarian online-sample of 255 adult sexual minority participants and 183 heterosexual participants. The results suggested that the CM and the IPT model can well explain suicide ideation among sexual minorities according to the factors depression, hopelessness, perceived burdensomeness, and failed belongingness. The CM and the IPT were intertwined with the MSTM via internalized homophobia, social support, and early age of coming out. Early coming out was associated with an increased suicide attempt risk, perhaps through violent experiences that enhanced the capability for suicide; however, coming out likely changed to a protective factor for suicide ideation by enhanced social support and reduced internalized homophobia. These results give more insight into the development of suicide risk among sexual minority individuals and may be helpful to tailor minority-specific suicide prevention strategies. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Homosexuality; Gay; Lesbian; Bisexual; Sexual orientation; Suicide; Adult; Bisexuality; Depression; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Middle Aged; Minority Groups; Models, Psychological; Psychological Theory; Risk; Self-Injurious Behavior; Sexual Behavior; Stress, Psychological; Suicide; Surveys and Questionnaires; Young Adult; At Risk Populations; Psychological Theories; Sexual Orientation; Suicide; Clinical Models; Bisexuality; Homosexuality; Ideation; Minority Groups; Sexual Minority Groups; Minority Stress

Transgender and gender diverse clients with mental disorders: Treatment issues and challenges - Mizock, Lauren (Psychiatric Clinics of North America, 2017)
A number of transgender and gender diverse individuals face risks of mental health problems and suicidality, often as a result of transphobia and gender minority stress. There are many resilience and protective factors that transgender individuals use to cope with mental distress and thrive. In this article, a review of the literature on transgender and gender diverse individuals with mental health problems is provided, as well as a discussion of the protective factors that enhance resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: transgender; gender diversity; mental health; mental disorders; treatment; Health Care Services; Mental Disorders; Mental Health; Transgender

Oscar Pistorius: Disability discourses in homosexual forums - Brennan, Joseph (Disability & Society, 2017)
This article performs textual analysis of discourse on Oscar Pistorius that appears on the homosexual discussion forums DataLounge and JustUsBoys. ‘Before’ and ‘after’ discourses—divided by Pistorius’s 2013 fatal shooting of his girlfriend—read Pistorius and his crime along sexuality and disability lines. I argue that it is worthwhile analysing how disability is constructed from different positions of marginalisation, especially when this at times yields discriminatory narratives. Pistorius, his disability, and his infamy are read by a community that itself exists outside the realm of mainstream debate, offering insight into disability and (homo)sexuality, adding greater dimension to ‘intersectional’ approaches to both. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Oscar Pistorius; discourse; disability; homosexuality; cultural studies; Disabilities; Discourse Analysis; Homosexuality

Shame, guilt, and suicide ideation among bondage and discipline, dominance and submission, and sadomasochism practitioners: Examining the role of the interpersonal theory of suicide - Roush, Jared F.; Brown, Sarah L.; Mitchell, Sean M.; Cukrowicz, Kelly C. (Suicide and Life-Threatening Behavior, 2017)
To date, no study has examined rates of suicide ideation or theory-based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty-seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma-related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: shame; guilt; suicide ideation; dominance & submission; sadomasochism practitioners; risk factors; Adult; Behavioral Research; Depression; Female; Guilt; Humans; Interpersonal Relations; Male; Paraphilic Disorders; Perception; Risk Factors; Shame; Suicidal Ideation; Suicide; Dominance; Obedience; Risk Factors; Sadomasochism; Suicidal Ideation; Guilt; Psychological Theories; Psychosexual Behavior; Shame; Physical Discipline

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 (Psychology of Sexual Orientation and Gender Diversity, 2013)
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; Attachment Behavior; Bisexuality; Family Therapy; Homosexuality; Lesbianism; Adolescent Development; Family; Suicide; Treatment Effectiveness Evaluation

Men who have sex with men in Kampala, Uganda: Results from a bio-behavioral respondent driven sampling survey - Hladik, Wolfgang; Sande, Enos; Berry, Mark; Ganafa, Samuel; Kiyingi, Herbert; Kusiima, Joy; Hakim, Avi (AIDS and Behavior, 2017)
We report on the results of a respondent-driven sampling survey among men who have sex with men (MSM) in Kampala, Uganda, where same-sex behavior is criminalized and highly stigmatized. We enrolled 608 MSM aged 18 + years and residing in greater Kampala from June 2012-November 2013. Anonymous data were collected through audio-computer assisted self-interviews; blood was tested for HIV-1 antibodies, CD4 + T cell counts, and viral load. Estimated HIV prevalence was 12.2 % (95 % confidence interval [CI] 8.0–16.1), increasing with age. One in five (19.6 %) stated knowing their HIV-positive status and a similar proportion of HIV-infected MSM were virally suppressed (19.3 %; 95 % CI 3.3–33.1). HIV-related risk behaviors included unprotected anal sex (35.8 % at last sex act), selling sex (38.5 %), having multiple steady (54.3 %) or casual (63.6 %) partners, and ever injecting drugs (31.6 %). Forty percent experienced homophobic abuse; 44.5 % ever experienced suicide ideation. HIV prevalence among MSM remains high whereas knowledge of seropositive status and suppression of viral load remains low. MSM report a wide range of high risk behaviors, frequent homophobic abuse, poor mental health, as well as low levels of testing and treatment. Better access to tailored prevention and treatment services to improve population-level viral load suppression are warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: men who have sex with men; HIV; Uganda; Africa; respondent driven sampling; HIV; Sexual Risk Taking; Stigma; Same Sex Intercourse

Supporting transgender college students: Implications for clinical intervention and campus prevention - Swanbrow Becker, Martin A.; Nemeth Roberts, Stacey F.; Ritts, Sam M.; Branagan, William Tyler; Warner, Alia R.; Clark, Sheri L. (Journal of College Student Psychotherapy, 2017)
This study examines the experiences of transgender college students in coping with stress in comparison to their cisgender peers. Undergraduate and graduate students from 73 colleges, totaling 26,292 participants, of which 47 identified as transgender completed an online survey. Transgender students reported greater exposure to trauma and higher rates of suicidal experiences, as well as different precipitants to reported stressful periods and sources of support than their cisgender peers. Implications for individual and group counseling as well as outreach and prevention to better support transgender students are explored. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: college student; coping; suicide; transgender; trauma; Coping Behavior; Student Attitudes; Transgender; College Students; Trauma

LGBT mental health in the Trump era - Bialer, Philip A.; McIntosh, Christopher A. (Journal of Gay & Lesbian Mental Health, 2017)
The current article presents an overview of the papers which were featured in this issue of Journal of Gay & Lesbian Mental Health. The papers focus on the social support and emotional openness to increase resilience in gay men, support-seeking parents of transgender youth looking at the coming-out process, their perspective, and their views on their children’s level of support in the school environment, and increase in suicidal ideation and/or non-suicidal self-injury (NSSI) or behavior among adult minority women. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: lesbianism; gay; bisexuality; transgenders; mental health; social support; Bisexuality; Lesbianism; Mental Health; Social Support; Transgender; Male Homosexuality

Mental health disparities among Canadian transgender youth - Veale, Jaimie F.; Watson, Ryan J.; Peter, Tracey; Saewyc, Elizabeth M. (Journal of Adolescent Health, 2017)
Purpose: This study documented the prevalence of mental health problems among transgender youth in Canada and made comparisons with population-based studies. This study also compared gender identity subgroups and age subgroups (14–18 and 19–25). Methods: A nonprobability sample of 923 transgender youth from Canada completed an online survey. Participants were recruited through community organizations, health care settings, social media, and researchers' networks. Mental health measures were drawn from the British Columbia Adolescent Health Survey and the Canadian Community Health Survey. Results: Transgender youth had a higher risk of reporting psychological distress, self-harm, major depressive episodes, and suicide. For example, 65% of transgender 14- to 18-year olds seriously considered suicide in the past year compared with 13% in the British Columbia Adolescent Health Survey, and only a quarter of participants reported their mental health was good or excellent. Transgender boys/men and nonbinary youth were most likely to report self-harm and overall mental health remained stable across age subgroups. Conclusions: Although a notable minority of transgender youth did not report negative health outcomes, this study shows the mental health disparities faced by transgender youth in Canada are considerable. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Transgender; Mental health; Suicide; Depression; Self-harm; Age Differences; Mental Health; Health Disparities; Transgender; Gender Identity

Understanding linkages between bullying and suicidal ideation in a national sample of LGB and heterosexual youth in the United States - Ybarra, Michele L.; Mitchell, Kimberly J.; Kosciw, Joseph G.; Korchmaros, Josephine D. (Prevention Science, 2015)
While there is an extant research base regarding suicidal ideation in relation to bullying and peer harassment, how findings may be similar and different for lesbian, gay, and bisexual (LGB) and non-LGB youth is less well understood. To address this gap, we analyzed data from 5,542 13- to 18-year-old youth who were nationally surveyed online in the United States in 2010. Results suggest that the relative odds of suicidal ideation are elevated for youth who are victims of bullying (OR = 5.61, 95 % CI, 4.11, 7.64), as well as those who are victims of peer harassment (OR = 2.06, 95 % CI, 1.53, 2.79). Within the context of other important factors, bullying was associated with odds of suicidal ideation twice that of non-victimized youth (aOR = 2.02, 95 % CI, 1.30, 3.13). Within sexual identity, the relation between bullying and suicidal ideation was particularly strong for gay, lesbian, and queer youth, even after adjusting for other influential factors (aOR = 6.29, 95 % CI, 2.69, 14.66). Across sexual identities, the odds of suicidal ideation are higher for bisexual youth (aOR = 1.77, 95 % CI, 1.23, 2.55) but not for other sexual minority youth when compared with otherwise similar heterosexual youth. Other factors, including depressive symptomatology and low self-esteem, were also predictive of recent ideation across all sexual identities. Findings highlight the complexity of bullying and suicidal ideation. Furthermore, given the relation between bullying and suicidal ideation, and the disproportionate level of bullying experienced by LGB youth, our findings suggest the need for more protective environments for LGB youth. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Peer victimization; Bullying; Suicidal ideation; Adolescents; Lesbian; gay; bisexual (LGB); Adolescent; Bisexuality; Bullying; Crime Victims; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Minority Groups; Peer Group; Psychological Theory; Risk Factors; Sexuality; Suicidal Ideation; United States; Bisexuality; Heterosexuality; Homosexuality; Suicidal Ideation; Bullying; Peers; Victimization

Self‐injury among trans individuals and matched controls: Prevalence and associated factors - Davey, Amanda; Arcelus, Jon; Meyer, Caroline; Bouman, Walter Pierre (Health & Social Care in the Community, 2016)
This study aims to determine the prevalence rate of current non-suicidal self-injury (NSSI) among trans individuals, in comparison with a control sample of non-trans adults. It also aims to compare those with current NSSI and those with no history of NSSI in terms of psychological wellbeing, self-esteem, body dissatisfaction, social support and demographic factors. Participants were 97 adults, diagnosed with transsexualism (ICD- 10, F64.0), attending a national gender clinic in the United Kingdom, and a matched control group. Clinical participants were all engaged on the treatment pathway. Participants completed the following self-report measures: Self-Injury Questionnaire—Treatment Related (SIQ-TR), Symptom Checklist 90 Revised (SCL-90-R), Rosenberg Self-Esteem Scale (RSE), Hamburg Body Drawing Scale (HBDS) and Multidimensional Scale of Perceived Social Support (MSPSS). The results showed that the trans participants had a significantly higher prevalence of current NSSI behaviour than the non-trans group, with 19% currently engaging in NSSI. Current NSSI was also significantly more prevalent among trans men than trans women. Compared with both trans and non-trans participants with no history of NSSI, trans participants with current NSSI had significantly higher scores on SCL; significantly lower scores on RSE, HBDS and MSPSS; and were younger in age. The study concludes that trans men, specifically, are more at risk of NSSI than trans women and the general population, even when on the treatment pathway. Those who currently self-injure have greater psychopathology, lower body satisfaction, lower self-esteem, lower social support and tend to be younger, than those who do not engage in NSSI. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: prevalence; psychological well‐being; self‐injury; trans; Adult; Female; Humans; Male; Prevalence; Risk Factors; Self-Injurious Behavior; Social Support; Transgender Persons; United Kingdom; Young Adult; Epidemiology; Self-Injurious Behavior; Transsexualism; Mental Disorders; Self-Esteem

Mental health and the transgender population - Carmel, Tamar C.; Erickson-Schroth, Laura (Psychiatric Annals, 2016)
Although research has increased remarkably in recent years, exploration of mental health disparities faced by transgender and gender nonconforming (TGNC) populations has historically been limited. TGNC people experience disproportionate rates of discrimination, harassment, violence, and sexual assault, precipitating negative mental health outcomes, as explained by the Minority Stress Model. Further research substantiates an increased risk of depression, substance use disorders, self-injury, and suicidal ideation/attempts in transgender populations. Studies are less conclusive with regard to rates of anxiety disorders, posttraumatic stress disorder, bipolar disorder, psychotic disorders, eating disorders, body dysmorphic disorders, autism spectrum disorders, and personality disorders. Social and familial support are protective factors in this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: mental health; transgender; gender nonconforming; Gender Identity; Mental Health; Transgender; Gender Nonconforming

The role of help‐seeking in preventing suicide attempts among lesbians, gay men, and bisexuals - Meyer, Ilan H.; Teylan, Merilee; Schwartz, Sharon (Suicide and Life-Threatening Behavior, 2015)
One possible approach to prevention of suicide attempts is to encourage help‐seeking among individuals at risk. We assessed whether different forms of treatment were associated with lower odds of a suicide attempt in a diverse group of 388 lesbian, gay, and bisexual (LGB) adults aged 18–59, sampled from New York City venues. Of individuals who attempted suicide, 23% sought mental health or medical treatment and 14% sought religious or spiritual treatment prior to the suicide attempt. Black and Latino LGBs were underrepresented in mental health or medical treatment and Black LGBs were overrepresented in religious or spiritual treatment. Seeking mental health or medical treatment was not associated with lower odds of a suicide attempt; seeking religious or spiritual treatment was associated with higher odds of a suicide attempt. We discuss these results and posit hypotheses for further research of this understudied topic. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide attempt; mental health; gay men; lesbians; bisexuals; help seeking; Adolescent; Adult; African Americans; Bisexuality; Female; Health Services; Hispanic Americans; Homosexuality, Female; Homosexuality, Male; Humans; Male; Mental Health Services; Middle Aged; New York City; Patient Acceptance of Health Care; Religion; Risk Factors; Suicide, Attempted; Young Adult; Attempted Suicide; Help Seeking Behavior; Mental Health; Prevention; Male Homosexuality; Suicide

A 12-Month prospective study of the effects of PTSD-depression comorbidity on suicidal behavior in Iraq/Afghanistan-era veterans - Kimbrel, Nathan A.; Meyer, Eric C.; DeBeer, Bryann B.; Gulliver, Suzy B.; Morissette, Sandra B. (Psychiatry Research, 2016)
The present study used validated clinical interviews to assess the effect of comorbid PTSD-depression on suicidal behavior over the course of 12 months in 309 Iraq/Afghanistan-era veterans. Logistic regression models demonstrated that comorbid PTSD-depression was a statistically significant predictor of suicide attempts at the 12-month follow-up in both the total sample and in the subset of veterans with PTSD/depression (n = 98). In contrast, gender, age, race, sexual orientation, and baseline history of suicide attempts did not have significant effects. These findings suggest that comorbid PTSD-depression may be a significant risk factor for future suicidal behavior in veterans. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Posttraumatic stress disorder; Depression; Suicide attempts; Attempted Suicide; Depression (Emotion); Military Veterans; Posttraumatic Stress Disorder; Comorbidity; Suicidal Ideation

Baseline physiologic and psychosocial characteristics of transgender youth seeking care for gender dysphoria - Olson, Johanna; Schrager, Sheree M.; Belzer, Marvin; Simons, Lisa K.; Clark, Leslie F. (Journal of Adolescent Health, 2015)
Purpose: The purpose of this study was to describe baseline characteristics of participants in a prospective observational study of transgender youth (aged 12–24 years) seeking care for gender dysphoria at a large, urban transgender youth clinic. Methods: Eligible participants presented consecutively for care at between February 2011 and June 2013 and completed a computer-assisted survey at their initial study visit. Physiologic data were abstracted from medical charts. Data were analyzed by descriptive statistics, with limited comparisons between transmasculine and transfeminine participants. Results: A total of 101 youth were evaluated for physiologic parameters, 96 completed surveys assessing psychosocial parameters. About half (50.5%) of the youth were assigned a male sex at birth. Baseline physiologic values were within normal ranges for assigned sex at birth. Youth recognized gender incongruence at a mean age of 8.3 years (standard deviation = 4.5), yet disclosed to their family much later (mean = 17.1; standard deviation = 4.2). Gender dysphoria was high among all participants. Thirty-five percent of the participants reported depression symptoms in the clinical range. More than half of the youth reported having thought about suicide at least once in their lifetime, and nearly a third had made at least one attempt. Conclusions: Baseline physiologic parameters were within normal ranges for assigned sex at birth. Transgender youth are aware of the incongruence between their internal gender identity and their assigned sex at early ages. Prevalence of depression and suicidality demonstrates that youth may benefit from timely and appropriate intervention. Evaluation of these youth over time will help determine the impact of medical intervention and mental health therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: baseline characteristics; transgender; gender dysphoria; physiologic characteristics; psychosocial characteristics; care seeking; Adolescent; Female; Gender Dysphoria; Gender Identity; Health Behavior; Health Services for Transgender Persons; Humans; Male; Patient Acceptance of Health Care; Prospective Studies; Suicide; Transgender Persons; Young Adult; Health Care Seeking Behavior; Major Depression; Physiology; Psychosocial Factors; Transgender; Gender Identity

Suicidal ideation in gay men and lesbians in South Korea: A test of the interpersonal‐psychological model - Kim, SungYeon; Yang, Eunjoo (Suicide and Life-Threatening Behavior, 2015)
Gay men and lesbians in South Korea are alienated and stigmatized due to the country's low tolerance of social differences, resulting in distress and suicidal impulses. This study investigated the predictors of suicidal ideation in a gay and lesbian group in South Korea based on the interpersonal‐psychological theory of suicide. Differences between the gay and lesbian group and the heterosexual group were found in the direct path between perceived burdensomeness and suicidal ideation. The relationship was significant for both groups, but the path coefficient was greater for lesbians and gay men than for heterosexuals. These findings imply that perceived burdensomeness may be a more critical factor in suicidal ideation of lesbians and gay men. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; gay men; psychological model; lesbian group; Adult; Case-Control Studies; Female; Heterosexuality; Homosexuality, Female; Homosexuality, Male; Hope; Humans; Interpersonal Relations; Male; Models, Psychological; Republic of Korea; Self Concept; Social Distance; Social Stigma; Suicidal Ideation; Young Adult; Male Homosexuality; Suicidal Ideation; Interpersonal Relationships; Distress; Lesbianism; Suicide

Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital - Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Pitche, Vincent; Kouanda, Seni; Ceesay, Nuha; Ouedraogo, Henri G; Ky-Zerbo, Odette; Lougue, Marcel; Diouf, Daouda; Anato, Simplice; Tchalla, Jules; et al. (International Journal of Social Psychiatry, 2016)
Background: Suicidal ideation is understudied among men who have sex with men (MSM) across Sub-Saharan Africa. Aims: This study aimed to explore social capital and sexual behavior stigma associated with suicidal ideation among MSM in the West African nations of The Gambia, Burkina Faso and Togo. Methods: Participants were recruited using respondent-driven sampling and snowball sampling across multiple cities (n = 1555) from July 2011 to August 2013. During a single study visit, participants completed a survey. Logistic regression models were used to assess bivariate and multivariable associations with suicidal ideation. Results: The prevalence of lifetime suicidal ideation was 13% overall and ranged 6%–17% across study sites. After adjusting for potential confounders, MSM who reported stigma as a result of having sex with men were more likely to report suicidal ideation. Physical and sexual violence was strongly associated with suicidal ideation, including being physically harmed (adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI) = 1.91, 4.52), tortured (aOR = 3.86, 95% CI = 2.17, 6.86) and raped (aOR = 3.07, 95% CI = 2.05, 4.60). In contrast, increasing social participation with the broader community was associated with decreased report of suicidal ideation (aOR = 0.91, 95% CI = 0.85, 0.99). Conclusion: Sexual behavior stigma should be addressed to improve mental health among MSM in Western Sub-Saharan Africa. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Stigma; social capital; men who have sex with men; West Africa; suicidal ideation; Suicidal Ideation; Same Sex Intercourse; Stigma

Suicidal ideation in Spanish and Italian lesbian and gay young adults: The role of internalized sexual stigma - Baiocco, Roberto; Ioverno, Salvatore; Cerutti, Rita; Santamaria, Federica; Fontanesi, Lilybeth; Lingiardi, Vittorio; Baumgartner, Emma; Laghi, Fiorenzo (Psicothema, 2014)
Background: A growing body of research claims that sexual minority individuals have nearly twice the suicidal ideation rate of heterosexual individuals. Method: The main objective of the current study was to test a model wherein internalized sexual stigma (ISS) mediates the association between some gay-related stressors and suicidal ideation. The present cross-sectional survey involved two samples of lesbian and gay young adults from Spain (N = 209) and Italy (N = 345). The total sample included 316 gay men and 228 lesbian women. Path analysis was used to test the direct and indirect (mediated) effects of the variables from different domains on repulsion by life. Results: In both the Spanish and Italian samples, past victimization experiences and ISS had a significant direct effect on repulsion by life. In both samples, ISS acted as a significant mediator in the effect of the concealment of one's sexual orientation and the religious involvement of repulsion by life. Conclusion: The current study indicates that ISS is a potential moderator of the effect of concealing one's sexual orientation, religious involvement, and past experiences of victimization on suicidal attitudes. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidal ideation; internalized sexual stigma; homophobia; sexual minority; gay men; lesbians; Adolescent; Adult; Cross-Sectional Studies; Female; Homosexuality, Female; Homosexuality, Male; Humans; Italy; Male; Social Stigma; Spain; Suicidal Ideation; Young Adult; Internalization; Lesbianism; Male Homosexuality; Stigma; Suicidal Ideation; Heterosexuality; Homosexuality (Attitudes Toward); Latinos/Latinas; Sexual Minority Groups

Suicidal ideation and self-harm in lesbian, gay, bisexual, and transgender youth - Liu, Richard T.; Mustanski, Brian (American Journal of Preventive Medicine, 2012)
Background: Suicide is the third-leading cause of death among adolescents and nonsuicidal self-harm occurs in 13%–45% of individuals within this age group, making these phenomena major public health concerns. Lesbian, gay, bisexual, and transgender (LGBT) youth particularly are at risk for engaging in these behaviors. Nevertheless, relatively little is known about the specific risk factors associated with suicidal ideation and self-harm behaviors in the population. Purpose: This study provides a longitudinal evaluation of the relative contributions of general and LGBT-specific risk factors as well as protective factors to the occurrence of suicidal ideation and self-harm in an ethnically diverse sample of LGBT youth. Methods: A community sample of 246 LGBT youth (aged 16–20 years) was followed prospectively over five time points at regular 6-month intervals. Participants completed a baseline structured interview assessing suicide attempt history and questionnaires measuring gender nonconformity, impulsivity, and sensation-seeking. At follow-up assessments, participants completed a structured interview assessing self-harm and questionnaires for suicidal ideation, hopelessness, social support, and LGBT victimization. Data were collected from 2007 to 2011, and HLM analyses were conducted in 2011. Results: A history of attempted suicide (p = 0.05); impulsivity (p = 0.01); and prospective LGBT victimization (p = 0.03) and low social support (p = 0.02) were associated with increased risk for suicidal ideation. Suicide attempt history (p < 0.01); sensation-seeking (p = 0.04); female gender (p < 0.01); childhood gender nonconformity (p < 0.01); and prospective hopelessness (p < 0.01) and victimization (p < 0.01) were associated with greater self-harm. Conclusions: General and LGBT-specific risk factors both uniquely contribute to likelihood of suicidal ideation and self-harm in LGBT youth, which may, in part, account for the higher risk of these phenomena observed in this population.p (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicidal ideation; self-harm; lesbian; gay; bisexual; transgender youth; risk factors; LGBT youth; Adolescent; Bisexuality; Female; Follow-Up Studies; Homosexuality, Female; Homosexuality, Male; Humans; Impulsive Behavior; Longitudinal Studies; Male; Prospective Studies; Risk Factors; Self-Injurious Behavior; Social Support; Suicidal Ideation; Surveys and Questionnaires; Time Factors; Young Adult; Bisexuality; Lesbianism; Risk Factors; Self-Injurious Behavior; Suicidal Ideation; Adolescent Psychology; Suicide; Transgender

Substance-related coping, HIV-related factors, and mental health among an HIV-positive sexual minority community sample - Cramer, Robert J.; Colbourn, Scholar L.; Gemberling, Tess M.; Graham, James; Stroud, Caroline H. (AIDS Care, 2015)
HIV-positive status poses a unique set of social stressors, especially among lesbian, gay, and bisexual (LGB) persons. Among these difficulties are the internalization of HIV-related stigma and poor mental health. Unfortunately, substance use as a coping mechanism is also common, dependent on other demographic factors, among HIV-positive and LGB samples. The present study integrates these bodies of literature by examining main and interactive effects of HIV-related experiences (i.e., disclosure of HIV-positive status, fear of disclosure, HIV-related victimization, and internalized HIV-related stigma) and substance-related coping with discrimination as they impact mental health (i.e., stress, anxiety, depressive symptoms, and suicide and self-injury proneness). Participants were 216 HIV-positive LGB community members from an urban community medical clinic. Prominent results included: (1) robust negative effects of internalized HIV-related stigma on all mental health indicators when controlling for other HIV-related experiences and (2) a significant interaction in which substance-related coping significantly increases suicide proneness, only for those who have disclosed HIV-positive status to family or friends. Results are discussed with respect to theoretical perspectives of internalized stigma, implications for clinical work with LGB persons of HIV-positive status, and future research. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: HIV; stigma; lesbian; gay; and bisexual (LGB); substance abuse; coping; suicide; Adaptation, Psychological; Adult; Female; HIV Infections; Humans; Male; Mental Disorders; Minority Groups; Psychiatric Status Rating Scales; Sexual Behavior; Sexual and Gender Minorities; Social Stigma; Coping Behavior; HIV; Mental Health; Minority Groups; Sexual Minority Groups; Sexual Orientation

Self‑reported frequency of sex as self‑injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health - Fredlund, Cecilia; Svedin, Carl Göran; Priebe, Gisela; Jonsson, Linda; Wadsby, Marie (Child and Adolescent Psychiatry and Mental Health, 2017)
Background: Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct self-injury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury. Methods: A representative national sample of 5750 students in the 3rd year of Swedish high school, with a mean age of 18 years was included in the study. The study was questionnaire-based and the response rate was 59.7%. Mostly descriptive statistics were used and a final logistic regression model was made. Results: Sex as self-injury was reported by 100 (3.2%) of the girls and 20 (.8%) of the boys. Few correlations to sociodemographic factors were noted, but the group was burdened with more experiences of sexual, physical and emotional abuse. Non-heterosexual orientation, trauma symptoms, non-suicidal self-injury and healthcare for suicide attempts, depression and eating disorders were common. Conclusions: Sex used as self-injury seems to be highly associated with earlier traumas such as sexual abuse and poor mental health. It is a behavior that needs to be conceptualized in order to provide proper help and support to a highly vulnerable group of adolescents. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Sex as self-injury (SASI); Non-suicidal self-injury (NSSI); Sexual abuse; Revictimization; Trauma; Self-harm; Indirect self-injury; Selling sex; Adolescents; Mental Health; Psychosexual Behavior; Self-Injurious Behavior; Sexual Intercourse (Human); Self-Report; Sexual Abuse; Adolescent Characteristics

Religion and suicide risk in lesbian, gay and bisexual Austrians - Kralovec, Karl; Fartacek, Clemens; Fartacek, Reinhold; Plöderl, Martin (Journal of Religion and Health, 2014)
Religion is known to be a protective factor against suicide. However, religiously affiliated sexual minority individuals often report a conflict between religion and sexual identity. Therefore, the protective role of religion against suicide in sexual minority people is unclear. We investigated the effect of religion on suicide risk in a sample of 358 lesbian, gay and bisexual Austrians. Religion was associated with higher scores of internalized homophobia, but with fewer suicide attempts. Our data indicate that religion might be both a risk and a protective factor against suicidality in religiously affiliated sexual minority individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Homosexuality; Internalized homophobia; Religion; Suicide; Adult; Austria; Bisexuality; Conflict (Psychology); Female; Homophobia; Homosexuality; Humans; Male; Protective Factors; Religion and Psychology; Risk; Sexual Behavior; Suicide; Suicide, Attempted; Bisexuality; Lesbianism; Male Homosexuality; Religion; Suicide; Homosexuality; Homosexuality (Attitudes Toward)

Gender dysphoria and social anxiety: An exploratory study in Spain - Bergero-Miguel, Trinidad; García-Encinas, María A.; Villena-Jimena, Amelia; Pérez-Costillas, Lucía; Sánchez-Álvarez, Nicolás; de Diego-Otero, Yolanda; Guzman-Parra, Jose (Journal of Sexual Medicine, 2016)
Introduction: Social anxiety in gender dysphoria is still under investigation. Aim: To determine the prevalence and associated factors of social anxiety in a sample of individuals with gender dysphoria. Methods: A cross-sectional design was used in a clinical sample attending a public gender identity unit in Spain. The sample consisted of 210 individuals (48% trans female and 52% trans male). Main outcome measures: Mini-International Neuropsychiatric Interview (MINI) for diagnosis of social anxiety disorder, Structured Clinical Interview, Exposure to Violence Questionnaire (EVQ), Beck Depression Inventory (BDI-II), and Functional Social Support Questionnaire (Duke-UNC-11). Results: Of the total sample, 31.4% had social anxiety disorder. Social anxiety disorder was highly correlated with age (r = −0.181; CI = 0.061–0.264; P = .009) and depression (r = 0.345; CI = 0.213–0.468; P < .001); it is strongly associated to current cannabis use (relative risk [RR] = 1.251; CI = 1.070–1.463; P = .001) and lifetime suicidal ideation (RR = 1.902; CI 1.286–2.814; P < .001). Moreover, it is significantly associated to lifetime nonsuicidal self-injury (RR = 1.188; CI 1.018–1.386; P = .011), nationality (RR = 7.792; CI 1.059–57.392; P = .013), perceived violence at school during childhood and adolescence (r = 0.169; CI = 0.036–0.303; P = .014), unemployment (RR = 1.333; CI 1.02–1.742; P = .021), and hospitalization of parents in childhood (RR = 1.146; CI = 1.003–4.419; P = .046). Using multivariable analysis, the highly significant variables within the model were depression score (odds ratio [OR] = 1.083; CI = 1.045–1.123; P < .001) and current cannabis use (OR = 3.873; CI = 1.534–9.779, P = .004), also age (OR = 0.948; CI = 0.909–0.989; P = .012), hospitalization of parents during childhood (OR = 2.618; CI = 1.107–6.189; P = .028), and nationality (OR = 9.427; CI = 1.065–83.457; P = .044) were associated with social anxiety disorder. Conclusion: This study highlights the necessity of implementing actions to prevent and treat social anxiety in this high-risk population. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: social anxiety; social phobia; transsexuals; transgender; victimization; Epidemiology; Major Depression; Social Phobia; Gender Dysphoria

The impact of family rejection or acceptance among LGBT+ millennials in the Seventh-Day Adventist Church - VanderWaal, Curtis; Sedlacek, David; Lane, Lauren (Social Work & Christianity, 2017)
Coming to terms with one’s sexual identity is a particularly complex process for Christian LGBT+ youth, many of whom are at high risk for negative outcomes such as depression, substance abuse and suicide. Many Christian families are just beginning to actively wrestle with how to view and treat their LGBT+ children. This survey of 310 Seventh-day Adventist adult Millennials explored perceived levels of their families’ acceptance or rejection of their sexual orientation or gender identity during their teen years. Other variables included recent levels of self-esteem, social support, depression, substance abuse, high-risk sexual activity, and suicidal thinking or attempts. Findings showed generally low levels of family acceptance and support, as well as elevated rates of depression and at-risk thoughts and behaviors. A high proportion of respondents have retained strong spiritual commitment and moderate church involvement. We include recommendations for social workers who work with Christian families who have LGBT+ children. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGBT; family acceptance; risk behaviors; Seventh-day Adventist; Millennials; Drug Abuse; Family Relations; Risk Factors; Sexual Orientation

The impact of discrimination on the mental health of transfemale youth and the protective effect of parental support - Wilson, Erin C.; Chen, Yea-Hung; Arayasirikul, Sean; Raymond, H. Fisher; McFarland, Willi (AIDS and Behavior, 2016)
Significant health disparities exist for transgender female (transfemale) youth. We assessed differences in mental health outcomes based on exposure to discrimination among transgender female youth in the San Francisco Bay Area aged 16–24 years. Youth were recruited using a combination of respondent driven sampling with online and social media methods. Logistic regression models were used to estimate odds ratios for the mental health outcomes, comparing levels of discrimination and levels of resiliency promoting protective factors among sexually active youth in the sample (N = 216). High transgender-based discrimination was significantly associated with greater odds of PTSD (AOR, 2.6; 95 % CI 1.4–5.0), depression (AOR, 2.6; 95 % CI 1.2–5.9), and stress related to suicidal thoughts (AOR 7.7, 95 % CI 2.3–35.2). High racial discrimination was significantly associated with greater odds of psychological stress (AOR 3.6; 95 % CI 1.2–10.8), PTSD (AOR 2.1; 95 % CI 1.1–4.2) and stress related to suicidal thoughts (AOR 4.3, 95 % CI 1.5–13.3). Parental closeness was related to significantly lower odds of all four mental health outcomes measured, and intrinsic resiliency positively reduced risk for psychological stress, PTSD, and stress related to suicidal thoughts. Transgender and racial discrimination may have deleterious effects on the mental health of transfemale youth. Interventions that address individual and intersectional discrimination and build resources for resiliency and parental closeness may have success in preventing mental health disorders in this underserved population. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: transgender; discrimination; mental health; resiliency; parental support; Adolescent; Depression; Discrimination (Psychology); Female; Humans; Logistic Models; Mental Disorders; Mental Health; Odds Ratio; Parents; Prevalence; Risk Factors; San Francisco; Sexual Behavior; Social Stigma; Social Support; Stress, Psychological; Suicidal Ideation; Surveys and Questionnaires; Transgender Persons; Transsexualism; Young Adult; Mental Health; Resilience (Psychological); Social Support; Transgender; Parent Child Relations

Psychosocial syndemic associated with increased suicidal ideation among men who have sex with men in Shanghai, China - Li, Rui; Cai, Yong; Wang, Ying; Sun, Zhe; Zhu, Chengdi; Tian, Yilin; Jiang, Xueqin; Gan, Feng (Health Psychology, 2016)
Objective: We intended to verify the syndemic effect of psychosocial health conditions on suicidal ideation among men who have sex with men (MSM) in Shanghai, China; design a comprehensive framework for the identification of the MSM with suicidal ideation; and provide suggestion for suicidality intervention among MSM. Method: A cross-sectional study was conducted among 547 MSM in 4 districts in Shanghai. Sociodemographic, psychosocial, and suicidal ideation information of the participants was collected. Logistic regressions were performed to assess the relationship between psychosocial variables and suicidal ideation and to verify the syndemic effect of psychosocial factors. Results: Of the MSM sample, 10.6% reported suicidal thoughts in the past year. In univariate analysis, depression, anxiety, loneliness, impulsivity, involuntary subordination (IS), social support, and risky sex were associated with suicidal ideation. Multivariate analysis found that IS (ORm = 2.92, 95% confidence interval [CI] = 1.55–5.51) and risky sex (ORm = 3.79, 95% CI = 1.44–9.97) remained significant. The MSM with more than 5 psychosocial health problems were nearly 4 times more likely (adjusted odds ratio = 4.68, 95% CI = 2.23–9.80) to have had suicidal ideation in the past year. Conclusions: The study confirmed the syndemic effect of psychosocial health problems in magnifying the risk of suicidality among MSM. More integrated and holistic approaches in the identification of high-risk groups and intervention of suicidality among MSM are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: psychosocial; syndemic; men who have sex with men; suicidal ideation; Adolescent; Adult; Aged; Anxiety; China; Cross-Sectional Studies; Depression; Dominance-Subordination; Homosexuality, Male; Humans; Impulsive Behavior; Logistic Models; Loneliness; Male; Middle Aged; Risk Factors; Risk-Taking; Sexual Behavior; Social Support; Suicidal Ideation; Suicide; Young Adult; Human Males; Psychosocial Factors; Suicidal Ideation; Same Sex Intercourse

Strategies employed by sexual minority adolescents to cope with minority stress - Goldbach, Jeremy T.; Gibbs, Jeremy (Psychology of Sexual Orientation and Gender Diversity, 2015)
Sexual minority adolescents (SMA) experience disparities in health and behavioral health outcomes, including high rates of depression, anxiety, self-harm, substance use, HIV risk behavior, suicidal ideation, and suicide attempts. These outcomes are commonly attributed to minority stress. Stress experiences are different for SMA than their adult counterparts. For example, disclosing their sexual orientation may be more likely to result in homelessness because these youth more often live with parents or other family members. Although stress in this population has been explored in previous research, very little is known about how SMA cope. Relying on an adolescent coping model, this study examined the coping strategies, responses, and resources of SMA related to stress. Forty-eight racially and ethnically diverse SMA (age 14–19) were recruited for 90-min tape-recorded interviews. The semistructured interviews were guided by a life history calendar. Recordings were transcribed verbatim and entered into QSR NVivo. All transcripts were coded by 2 members of the research team and went through a consensus process. Forty-three unique coping statements emerged that fit with the Compas model of adolescent coping. SMA cope with minority stress in similar ways to heterosexual youth coping with general stress, but findings suggest that SMA may also use different kinds of coping resources. Although further research is needed, the present study identified a variety of ways SMA cope with stress and can inform future research on the development interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: coping; behavioral health; minority stress; sexual minority adolescents; Coping Behavior; Health Care Psychology; Minority Groups; Strategies; Stress; Sexual Orientation; Sexual Minority Groups; Minority Stress

Factors associated with suicidal ideation among university students - dos Santos, Hugo Gedeon Barros; Marcon, Samira Reschetti; Espinosa, Mariano Martínez; Baptista, Makilin Nunes; de Paulo, Paula Mirianh Cabral (Revista Latino-Americana de Enfermagem, 2017)
Objective: To analyze the factors associated with suicidal ideation in a representative sample of university students. Methods: Cross-sectional study, carried out with 637 students of the Federal University of Mato Grosso. The presence of suicidal ideation, demographic and socioeconomic variables, use of alcohol through the Alcohol, Smoking and Substance Involvement Screening Test, and depressive symptoms (Major Depression Inventory) were investigated. Bivariate analysis was performed with the Chi-square test and multivariate analysis using the Poisson regression model. Results: It was found that 9.9% of the students had suicidal thoughts in the previous 30 days and, in the bivariate analysis, the variables economic class, sexual orientation, religious practice, suicide attempts in the family and among friends, alcohol consumption and depressive symptoms were associated with suicidal ideation. In the multivariate analysis sexual orientation, suicide attempts in the family and the presence of depressive symptoms remained as associated factors. Conclusion: These findings constitute a situational diagnosis that enables the formulation of academic policies and preventive actions to confront this situation on the university campus. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: suicidal ideation; universities; students; adolescent; risk Factors; Risk Factors; Suicidal Ideation; Adolescent Attitudes; College Students

On psychotherapy, LGBT identity, and cultural visibility: In conversation with Alison Bechdel - Critchfield, Adam R.; Pula, Jack (Journal of Gay & Lesbian Mental Health, 2015)
Alison Bechdel is an acclaimed graphic novelist whose graphic memoirs have examined her closeted gay father's suicide, her own developing sexual and gender identity, and her experiences in psychoanalysis. The authors of this article interviewed Ms. Bechdel in order to explore her thoughts on the role of her early work in creating visibility for LGBT communities and the specific role of psychotherapy in her development and her artistic work. The article in turn examines Bechdel's work from the perspective of cultural representations of psychotherapy, development of gender identity and expression, and considers the implications of her work for the mental health practitioner caring for LGBT individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: cultural studies; graphic novel; LGBT; mental health; psychotherapy; psychoanalysis; transgender; Gender Identity; Psychoanalysis; Psychotherapy; Bisexuality; Lesbianism; Male Homosexuality; Transgender

A qualitative analysis of transgender veterans’ lived experiences - Chen, Jessica A.; Granato, Hollie; Shipherd, Jillian C.; Simpson, Tracy; Lehavot, Keren (Psychology of Sexual Orientation and Gender Diversity, 2017)
Transgender veterans (trans-vets) experience high rates of discrimination, family rejection, homelessness, and suicidality, yet little is known about trans-vets’ potentially positive experiences. There has been minimal qualitative research on the subjective experiences at the intersection of transgender and veteran identity. No study to date has focused on describing resilience among trans-vets. The aims of the current study were to identify major themes related to both challenges and strengths in the lived experiences of trans-vets, as well as advice they would give to their fellow trans-vets. A national convenience sample of 201 U.S. transgender veterans provided online responses to 3 open-ended questions asking about challenges, strengths, and advice related to trans-vet identity. Qualitative data were analyzed using thematic analysis and a hybrid of inductive and deductive approaches. Several recurring themes were identified, including health care access and providers, Veterans Health Administration (VA) and military experiences, discrimination, rejection versus acceptance, concealment versus authenticity, and the importance of community. Trans-vets also discussed feelings of personal strength, growth from adversity, and advocacy as important positive experiences. Findings demonstrated the centrality of military and VA experiences as unique aspects of transgender veteran identity. The present study was limited by the restricted nature of data collected from brief, open-ended online questions. Results point to the importance of provider training for trans-affirmative health care, especially in VA and military settings. Additionally, trans-vets reported that resilience can be fostered through advocacy and community building. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: LGBT; resilience; transgender; veterans; minority stress; Life Experiences; Military Veterans; Resilience (Psychological); Stress; Transgender; Minority Stress

A general strain approach comparing the effects of victimization, social support, and perceived self-efficacy on LGBQ and heterosexual youth suicidality - Button, Deeanna M. (Criminal Justice Studies: A Critical Journal of Crime, Law & Society, 2015)
LGBQ youth are more likely to consider, plan, and/or attempt suicide compared to their heterosexual peers. Evidence from the general population suggests that risky behaviors, like suicide, may be mediated by protective factors, including social support and self-efficacy. Using Agnew’s general strain theory and data from a statewide probability sample, the results of this study suggest that victimization, as a source of strain, is a risk factor for both LGBQ and heterosexual youth suicidality. While social support and self-efficacy reduce the risk of suicidality among heterosexual youth, they are not significant protective factors for LGBQ youth. Theoretical and policy implications are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGBQ youth; self-efficacy; social support; victimization; general strain theory; Attempted Suicide; Self-Efficacy; Sexual Orientation; Social Support; Victimization; Bisexuality; Homosexuality; Lesbianism; Peers; Transgender; Suicidality

Understanding suicide attempts among gay men from their self-perceived causes - Wang, Jen; Plöderl, Martin; Häusermann, Michael; Weiss, Mitchell G. (Journal of Nervous and Mental Disease, 2015)
Gay men are at higher risk of suicidality. This paper describes the causes of suicide attempts as perceived by the men themselves and analyzes their impact on severity and recidivism. Mental health surveys conducted among gay men in Geneva, Switzerland, from two probability-based time-space samples in 2007 and 2011, were merged to yield a combined sample N = 762. Suicide ideation, plans, and attempts were assessed, and respondents who had ever attempted suicide answered open questions about perceived causes which were coded and categorized for analysis within the framework of cultural epidemiology. In all, 16.7% of the respondents reported a suicide attempt in their lifetime (59.5% of them with multiple attempts). At their latest attempt, over two thirds asserted intent to die, and half required medical assistance. There was a wide variety of perceived causes, with most individuals reporting multiple causes and many of the most common causes cited at both the first and most recent subsequent attempts. Social/inter-personal problems constitute the most prominent category. Problems with love/relationship and accepting one’s homosexuality figure consistently among the top three causes. Whereas the former tend to be associated with weaker intent to die, the latter are associated with the strongest intent to die and reported at multiple attempts. Problems with family are among the most common perceived causes at first attempt but not at the most recent subsequent attempt. Nevertheless, they tend to be related to the strongest intent to die and the greatest medical severity of all the perceived causes. Ten percent of men attempting suicide cited depression as a cause. Although it tended to be associated with weaker intent to die, depression was most likely to be reported at multiple attempts. Respondent-driven assessment yielded both common and idiosyncratic causes of suicide and their distinct effects. Some of these perceived causes are not prominent in the current literature, yet they have important implications for understanding risk and preventing suicide among gay men. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Suicide; recidivism; cultural epidemiology; life events; homosexuality; Adaptation, Psychological; Adult; Anxiety Disorders; Attitude to Death; Causality; Depressive Disorder; Family Conflict; Gender Identity; Homosexuality, Male; Humans; Intention; Interpersonal Relations; Love; Male; Middle Aged; Motivation; Recurrence; Risk Factors; Self Concept; Social Adjustment; Suicidal Ideation; Suicide, Attempted; Switzerland; Attempted Suicide; Life Experiences; Male Homosexuality; Epidemiology; Recidivism; Self-Perception; Severity (Disorders)

Sociodemographic characteristics and psychological adjustment among transsexuals in Spain - Guzmán-Parra, José; Sánchez-Álvarez, Nicolás; Diego-Otero, Yolanda; Pérez-Costillas, Lucía; de Antonio, Isabel Esteva; Navais-Barranco, Miriam; Castro-Zamudio, Serafina; Bergero-Miguel, Trinidad (Archives of Sexual Behavior, 2016)
This study examined the sociodemographic characteristics and the psychological adjustment of transsexuals in Andalusia (Spain), and also analyzed the differences between female-to-male (FtM) and male-to-female (MtF) transsexuals. The sample included 197 transsexuals (101 MtF and 96 FtM) selected from those who visited the Transsexual and Gender Identity Unit at the Carlos Haya Hospital in Malaga between 2011 and 2012. Our analyses indicated that MtF transsexuals were more likely to have lower educational levels, live alone, have worked less frequently throughout their lifetime, and have engaged in prostitution. For FtM transsexuals, there were more frequent references to the mother’s psychiatric history and more social avoidance and distress. Multivariate analysis showed that the number of personality dysfunctional traits and unemployment status were associated with depression in the entire sample. The following three conclusions can be made: there are significant differences between MtF and FtM transsexuals (mainly related to sociodemographic variables), depression was high in both groups, and a remarkable percentage of transsexuals have attempted suicide (22.8 %) or have had suicidal thoughts (52.3 %). (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Transsexualism; Gender dysphoria; Sociodemographic characteristics; Psychosocial adjustment; Transgender; Adaptation, Psychological; Adult; Female; Gender Identity; Humans; Male; Sexual Behavior; Spain; Surveys and Questionnaires; Transsexualism; Young Adult; Demographic Characteristics; Major Depression; Sexual Orientation; Transsexualism; Gender Dysphoria; Psychosocial Factors

Bisexuality, mental health, and media representation - Johnson, Hannah J. (Journal of Bisexuality, 2016)
There is a mental health crisis in the bisexual community, and though the issues of mental health and media representation are analyzed separately in bisexual literature, they are rarely put side by side. Media such as television, film, and music often contribute to the perpetuation of negative stereotypes and stigmas about people who are bisexual. How do these issues contribute to the high rates of depression, anxiety, and suicide among individuals who are bisexual? What issues do individuals who are bisexual face when they choose to seek help? This research project contributes to bisexual literature by drawing connections between media representation and mental health by firstly examining existing literature on bisexual issues such as biphobia, bisexual erasure, media representation, and mental health, and secondly discussing the results of an online survey to determine how other people who identify as bisexual feel about media representation and its relationship to the mental health crisis in the bisexual community. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: bisexuality; mental health; mental illness; film; television; music; biphobia; Bisexuality; Mass Media; Mental Health

Sexual minority stress and suicide risk: Identifying resilience through personality profile analysis - Livingston, Nicholas A.; Heck, Nicholas C.; Flentje, Annesa; Gleason, Hillary; Oost, Kathryn M.; Cochran, Bryan N. (Psychology of Sexual Orientation and Gender Diversity, 2015)
Sexual minority-based victimization, which includes threats or enacted interpersonal violence, predicts elevated suicide risk among sexual minority individuals. However, research on personality factors that contribute to resilience among sexual minority populations is lacking. Using the Five-Factor Model, we hypothesized that individuals classified as adaptive (vs. at-risk) would be at decreased risk for a suicide attempt in the context of reported lifetime victimization. Sexual minority-identified young adults between the ages of 18 and 25 years (N = 412) were recruited nationally and asked to complete an online survey containing measures of personality, sexual minority stress, and lifetime suicide attempts. A 2-stage cluster analytic method was used to empirically derive latent personality profiles and to classify respondents as adaptive (lower neuroticism and higher extroversion, agreeableness, conscientiousness, and openness) or at-risk (higher neuroticism, lower extroversion, agreeableness, conscientiousness, and openness) on the basis of their Five-Factor Personality trait scores. Adaptive individuals were slightly older and less likely to conceal their sexual orientation, but they reported similar rates of victimization, discrimination, and internalized heterosexism as their at-risk counterparts. Logistic regression results indicate that despite reporting similar rates of victimization, which was a significant predictor of lifetime suicide attempt, adaptive individuals evidenced decreased risk for attempted suicide in the context of victimization relative to at-risk individuals. These findings suggest that an adaptive personality profile may confer resilience in the face of sexual minority-based victimization. This study adds to our knowledge of sexual minority mental health and highlights new directions for future research. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGB; suicide; personality; sexual minority; Five-Factor Model; Personality Traits; Resilience (Psychological); Risk Factors; Stress; Suicide; Minority Groups; Victimization; Sexual Minority Groups; Minority Stress

A relational view of gender: Queer youth in the 21st century - Nocita, Andrew (PsycCRITIQUES, 2016)
Reviews the book, Queer Youth, Suicide and Self-Harm: Troubled Subjects, Troubling Norms by Elizabeth McDermott and Katrina Roen (see record [rid]2016-24747-000[/rid]). The authors pull together results of their own qualitative research on queer youth, self-harm, and suicide to explore the role of self-harm in the development of self-identity. They wanted to go beyond the 'dominant psychomedical paradigm' (p. 2) that explores the topics of gender and self-harm from a positivist perspective and instead use an approach that is 'queer, material, and informed by discourse analysis' (p. 67). The writing is also informed by decades of theory and research around topics of homosexuality, gender identity, adolescence, and psychosocial development. This is not a book for the casual observer or the curious layperson. Its language is highly technical and heavily ideological. For the clinician willing to carefully and thoroughly consider gender in a nontraditional way, the book provides a thoughtful counterpoint to approaches that view gender nonconforming youths mainly as an a priori 'at-risk' group and self-harm as an individual problem of certain people. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: queer youth; suicide; self-harm; self-identity; gender nonconforming youths; gender identity; psychosocial development; Gender Identity; Homosexuality; Psychosocial Development; Self-Injurious Behavior; Suicide; Identity Formation; Gender Nonconforming

Individual- and structural-level risk factors for suicide attempts among transgender adults - Perez-Brumer, Amaya; Hatzenbuehler, Mark L.; Oldenburg, Catherine E.; Bockting, Walter (Behavioral Medicine, 2015)
This study assessed individual (ie, internalized transphobia) and structural forms of stigma as risk factors for suicide attempts among transgender adults. Internalized transphobia was assessed through a 26-item scale including four dimensions: pride, passing, alienation, and shame. State-level structural stigma was operationalized as a composite index, including density of same-sex couples; proportion of Gay–Straight Alliances per public high school; 5 policies related to sexual orientation discrimination; and aggregated public opinion toward homosexuality. Multivariable logistic generalized estimating equation models assessed associations of interest among an online sample of transgender adults (N = 1,229) representing 48 states and the District of Columbia. Lower levels of structural stigma were associated with fewer lifetime suicide attempts (AOR 0.96, 95% CI 0.92–0.997), and a higher score on the internalized transphobia scale was associated with greater lifetime suicide attempts (AOR 1.18, 95% CI 1.04–1.33). Addressing stigma at multiple levels is necessary to reduce the vulnerability of suicide attempts among transgender adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: transgender; suicide attempts; structural stigma; internalized transphobia; Adult; Cross-Sectional Studies; Female; Humans; Male; Risk Factors; Social Stigma; Suicide, Attempted; Surveys and Questionnaires; Transgender Persons; United States; Attempted Suicide; Risk Factors; Suicide; Transgender; Stigma

A comparison of health disparities among transgender adults in Colorado (USA) by race and income - Seelman, Kristie L.; Young, Sarah R.; Tesene, Megan; Alvarez-Hernandez, Luis R.; Kattari, Leo (International Journal of Transgenderism, 2017)
Transgender individuals face heightened risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health. However, few studies have thoroughly examined the general physical and mental health of transgender adults or within-group health differences by race/ethnicity and income. To that end, after controlling for health insurance status, age, and engagement in exercise, this study asks: (a) Are transgender people of color more likely than White transgender individuals to experience poor health outcomes? and (b) Is lower annual household income among transgender adults associated with poorer health outcomes? The study analyzes secondary data from a survey of transgender adults (N = 417) in one state in the western United States using multiple linear regression and logistic regression models. Results showed that transgender people of color had significantly greater odds than their White counterparts of having arthritis/rheumatoid arthritis/gout/lupus/fibromyalgia, or asthma but lower odds of being told by a provider that they had depression. Having a lower income was significantly associated with worse general health as well as multiple indicators of poor physical and mental health, including depression, anxiety, and suicidal ideation. We discuss implications for health care delivery for transgender people and for future research. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Transgender; health; mental health; race; income; Health Behavior; Income Level; Mental Health Services; Transgender

Diverse rates of depression among men who have sex with men (MSM) across India: Insights from a multi-site mixed method study - Tomori, Cecilia; McFall, Allison M.; Srikrishnan, Aylur K.; Mehta, Shruti H.; Solomon, Sunil S.; Anand, Santhanam; Vasudevan, Canjeevaram K.; Solomon, Suniti; Celentano, David D. (AIDS and Behavior, 2016)
Poor psychosocial health contributes to HIV risk behavior and reduced engagement in treatment and care. This study investigates depression and its correlates among 11,992 MSM recruited via respondent driven sampling in 12 cities across India using the Patient Health Questionnaire-9 and supplemented by analysis of qualitative research from 15 sites with 363 MSM. Overall prevalence of depression was 11 %, with substantial variation across sites and subgroups of MSM, and high prevalence of suicidal thoughts among depressed MSM. In multivariable analyses identification as a kothi (feminine sexual identity) [adjusted odds ratio (aOR) = 1.91], disclosure of being MSM to non-family (aOR = 1.7) and family (aOR = 2.4), disclosure of HIV-status (aOR = 5.6), and substance use were associated with significantly higher odds of depression. Qualitative results emphasized dire social consequences of disclosing MSM- and HIV-status, especially to family, including suicidality. Combination prevention interventions should include mental health services that address disclosure, suicidality, and substance use. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Men who have sex with men; HIV; Depression; Suicidality; India; HIV; Major Depression; Suicide; Same Sex Intercourse; Suicidality

Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality - Gattis, Maurice N.; Larson, Andrea (American Journal of Orthopsychiatry, 2016)
There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16–24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: homeless; racism; homophobia; discrimination; Black youth; mental health; Adolescent; Adult; African Americans; Depression; Female; Homeless Persons; Humans; Interviews as Topic; Male; Minority Groups; Racism; Sexuality; Social Stigma; Suicide; Young Adult; Gender Identity; Homeless; Major Depression; Race and Ethnic Discrimination; Suicidal Ideation; Blacks; Homosexuality (Attitudes Toward); Mental Health; Racism; Stigma; Symptoms; Suicidality

Increased risk of premature death following teenage abortion and childbirth—A longitudinal cohort study - Jalanko, Eerika; Leppälahti, Suvi; Heikinheimo, Oskari; Gissler, Mika (European Journal of Public Health, 2017)
Background: Teenage pregnancy is associated with an increased risk of premature death. However, it is not known whether the outcome of pregnancy, i.e. induced abortion or childbirth, affects this risk. Methods: A Finnish population-based register study involving a cohort of 13 691 nulliparous teenagers who conceived in 1987–89; 6652 of them underwent induced abortion and 7039 delivered. The control group consisted of 41 012 coeval women without teenage pregnancy. Follow-up started at the end of pregnancy and lasted until 6th June 2013. Results: Women with teenage pregnancy had a higher risk of overall mortality vs. controls (mortality rate ratio [MRR] 1.6, [95% CI 1.4–1.8]) and were more likely to die prematurely as a result of suicide, alcohol-related causes, circulatory diseases and motor vehicle accidents. A low educational level appeared to explain these excess risks, except for suicide (adj. MRR 1.5, [95% CI 1.1–2.0]). After adjusting for confounders, the childbirth group faced lower risks of suicide (adj. MRR 0.5, [95% CI 0.3–0.9]) and dying from injury and poisoning (adj. MRR 0.6, [95% CI 0.4–0.8]) compared with women who had undergone abortion. Conclusions: A low educational level is associated with the increased risk of premature death among women with a history of teenage pregnancy, except for suicide. Extra efforts should be made to encourage pregnant teenagers to continue education, and to provide psychosocial support to teenagers who undergo induced abortion. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: increased risk; premature death; teenage abortion; childbirth; Child Attitudes; Risk Factors; Abortion (Attitudes Toward)

Bullying and suicide: The mental health crisis of LGBTQ youth and how you can help - Ahuja, Amir; Webster, Cecil; Gibson, Nicole; Brewer, Athena; Toledo, Steven; Russell, Steven (Journal of Gay & Lesbian Mental Health, 2015)
Responding to increased awareness of the plight of lesbian, gay, bisexual, and transgender (LGBT) youth who may be isolated and subject to bullying, the Association of Gay and Lesbian Psychiatrists (AGLP) collaborated with the American Foundation for Suicide Prevention (AFSP), the Trevor Project and the Gay, Lesbian and Straight Education Network (GLSEN) to present a symposium on Bullying and Suicide at the American Psychiatric Association (APA) Annual Meeting in 2013. The objectives of the symposium were the following: to understand the link between anti-LGBTQ bullying and mental illness and to identify ways to help such patients. To identify the academic research being done on anti-LBGTQ bullying, and how this informs tactics to combat this problem. To identify areas of weakness in the approaches being used, ways to improve them, and areas of future research. To identify ways clinicians can be involved in furthering the awareness of bullying of all kinds, including research on prevention efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: LGBT; suicide; adolescents and young adults; bullying; public policy; Mental Health; Suicide; Suicide Prevention; Bullying; Transgender; Government Policy Making; Mental Disorders; LGBTQ

Gender minority stress, depression, and anxiety in a transgender high school student - Davies, Robert D.; Kessel, Barbara (The American Journal of Psychiatry, 2017)
Jamie’s experience is typical of the stressors gender minorities experience that have an impact on their mental health. Despite supportive parents and accommodation from his school, Jamie experienced bullying, a sense of noninclusiveness among his peers, and limited acceptance of his gender identity. Much of the anxiety he experienced coalesced around his use of the gender-based facilities that corresponded to his gender identity. Transgender individuals experience markedly higher rates of depression and suicidal ideation than the general population. The gender minority stress model posits that transgender individuals experience four distinct external stress types: victimization, rejection, discrimination, and identity nonaffirmation. A growing literature describes the internalization of these stressors and the resulting psychiatric pathology, including anxiety, depression, and suicidality. In the case of Jamie, his experiences of victimization, rejection, and identity nonaffirmation in the school setting likely played an important role in the development of his internalized transphobia (i.e., his feeling that his maleness was fraudulent) as well as his psychiatric symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gender minority stress; depression; anxiety; transgender; high school student; Adolescent; Anxiety; Depression; Female; Humans; Male; Schools; Students; Toilet Facilities; Transgender Persons; Anxiety; High School Students; Minority Groups; Stress; Transgender; Major Depression; Minority Stress

For colored kids who committed suicide, our outrage isn't enough: Queer youth of color, bullying, and the discursive limits of identity and safety - Pritchard, Eric Darnell (Harvard Educational Review, 2013)
In recent years anti-lesbian, gay, bisexual, transgender, and queer (LGBTQ) bullying has been a pervasive discussion in popular and scholarly discourse. While such a discussion has documented the negative impact of bullying on the physical, psychological, social, and emotional lives of young people, it has not had a critical and sustained analysis of the ways that race, ethnicity, class, and other identities complicate discussions of how bullying and bias-motivated violence affects a diversity of queer youth. In this article, Eric Darnell Pritchard begins with a framework that assumes that the intersections of LGBTQ identities with race, ethnicity, and class offer unexplored critical possibilities within current discussions of bullying. He argues that in order to be more creative and effective in responding to the epidemic of bullying, we, must expose and deeply engage the limits in the ways identity and safety are taken up in bullying discourse, which have resulted in flattened and less effective antibullying measures. Pritchard concludes with implications for practice in terms of curriculum, policy, and advocacy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: suicide; queer youth; bisexuality; transgender; youth of color; bullying; identity; safety; Bisexuality; Homosexuality; Suicide; Transgender; Blacks; Childhood Development; Safety; Self-Concept; Bullying

Suicide risk factors among trans feminine individuals in Lebanon - Kaplan, Rachel L.; Nehme, Simon; Aunon, Frances; de Vries, David; Wagner, Glenn (International Journal of Transgenderism, 2016)
Transgender women are disproportionately affected by high rates of depression and suicide attempts. It is therefore important to identify factors that influence suicidal risk, particularly in the Middle East, where little research has examined the mental health of transgender women. We examined risk factors associated with suicide attempts among 54 trans feminine individuals in Beirut, Lebanon. Data were collected using interviewer-administered questionnaires and were analyzed using bivariate statistics. Twenty-five (46%) participants reported having ever attempted suicide. Among them, only one participant had received some kind of counseling in response to the attempted suicide. Low general social support, low social integration, and low support from peers were significantly associated with a history of attempted suicide, as were being more open about transgender identity in public and any hormone use (past or current). These findings suggest that progression in gender transition can have unintended consequences related to mental health and suicide risk, while social support systems can mitigate the impact of mental health problems. Some of these findings mirror other contexts around the globe and can inform mental health services for trans feminine individuals in Lebanon, the greater Middle East region, and other international settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Lebanon; MENA; mental health; Middle East; suicide; trans feminine; Femininity; Risk Factors; Suicide; Transgender; Mental Health

Prevalence of suicidal ideation and associated factors among HIV-positive MSM in Anhui, China - Wu, Yi-Le; Yang, Hui-Yun; Wang, Jun; Yao, Hui; Zhao, Xue; Chen, Jian; Ding, Xiu-Xiu; Zhang, Hong-Bo; Bi, Peng; Sun, Ye-Huan (International Journal of STD & AIDS, 2015)
The aim of this study was to investigate the prevalence and factors associated with suicidal ideation among HIV-positive men who have sex with men (MSM) in Anhui, China. A cross-sectional study was conducted to recruit HIV-positive MSM in Anhui, China. A total of 184 HIV-positive MSM gave informed consent and completed the interview. Correlates of suicidal ideation were assessed using multivariable logistic regression. Fifty-seven (31%) of HIV-positive MSM had suicidal ideations within six months before the interview. Multivariable analyses showed that learning of their HIV status in the past 12 months (adjusted odds ratio (AOR) = 3.4, 95% CI = 1.6–7.3), perceived HIV stigma (AOR = 2.4, 95% CI = 1.1–5.2), depression symptoms (AOR = 2.6, 95% CI = 1.1–5.9) and anxiety symptoms (AOR = 2.7, 95% CI = 1.2–6.1) were significantly associated with the suicidal ideation among HIV-positive MSM. The results indicated that suicidal ideation was common among HIV-positive MSM in Anhui, China. There is an urgent need to establish psychological counselling services among HIV-positive MSM in China. Targeting of these potential risk factors could be an effective approach to reduce the suicide risk among this high-risk subgroup by the implementation of early intervention measurements. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Men who have sex with men; suicidal ideation; depression; anxiety; HIV; AIDS; Adult; Anxiety; China; Cross-Sectional Studies; Depression; HIV Infections; Homosexuality, Male; Humans; Male; Prevalence; Regression Analysis; Risk Factors; Self Concept; Socioeconomic Factors; Suicidal Ideation; Suicide, Attempted; Young Adult; Epidemiology; HIV; Human Males; Suicidal Ideation; Same Sex Intercourse; AIDS; Anxiety Disorders; Major Depression; Risk Factors; Suicide

Psychology in and out of the shadows - O'Neill, Patrick (Canadian Psychology/Psychologie canadienne, 2016)
The first few years of the new millennium have thrust an assortment of troublesome social issues on Western societies, from immigration to gun control to torture of military prisoners. Organized psychology has taken stands on some of these public matters. In this article I will discuss 3 such issues and the way they were handled by the Canadian Psychological Association and the American Psychological Association: capital punishment, marriage and adoption rights for gay and lesbian parents, and the relationship between ethics and international law regarding the treatment of prisoners. On the first 2 issues the 2 associations took similar stands, but on the third they diverged. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: ethics and international law; marriage rights; capital punishment; International Relations; Laws; Professional Ethics; Social Issues; American Psychological Association; Capital Punishment; Civil Rights; Marriage

Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: A controlled study - Exbrayat, Sophie; Coudrot, Clotilde; Gourdon, Xavier; Gay, Aurélia; Sevos, Jessica; Pellet, Jacques; Trombert-Paviot, Béatrice; Massoubre, Catherine (BMC Psychiatry, 2017)
Background: Attempted suicide is a major public health problem, and the efficacies of current postvention protocols vary. We evaluated the effectiveness of telephone follow-up of patients referred to an emergency psychiatric unit for attempted suicide on any further attempt/s over the following year. Method: In a single-center, controlled study with intent to treat, we evaluated the efficacy of a protocol of telephone follow-up of 436 patients at 8, 30, and 60 days after they were treated for attempted suicide. As controls for comparison, we evaluated patients with similar social and demographic characteristics referred to our emergency psychiatric unit in the year prior to the study who did not receive telephone follow-up after their initial hospitalization. Data were analyzed using logistic regression. Results: Very early telephone follow-up of our patients effectively reduced recidivism and seemed to be the only protective factor against repeated suicide attempt. Conclusions: Implementing a protocol of early telephone follow-up after attempted suicide could help prevent repeated attempt/s. More controlled studies are needed to assess optimal techniques to prevent such repetition. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Emergency; Follow-up; Nurse; Phone; Suicide attempts; Attempted Suicide; Posttreatment Followup; Psychiatric Patients; Treatment Effectiveness Evaluation; Emergency Services; Psychiatric Hospital Discharge; Suicide

Preliminary population size estimation of men who have sex with men in Kazakhstan: Implications for HIV testing and surveillance - Wu, Elwin; Terlikbayeva, Assel; Hunt, Timothy; Primbetova, Sholpan; Lee, Yong Gun; Berry, Mark (LGBT Health, 2017)
Purpose: The purpose of this study is to estimate the population size of men who have sex with men (MSM) in Kazakhstan and their HIV testing history. Methods: We conducted structured interviews with MSM in four geographically disparate cities—N = 400 (n = 100/city)—to implement four population estimation methods and ascertain HIV testing history. Results: Approximately 3.2% of men—corresponding to ∼154,000 individuals—in Kazakhstan aged 18–59 are MSM. The 49.9% of the sample who reported taking an HIV test far exceeds the < 1% reported as MSM in surveillance data. Conclusion: HIV testing surveillance in Kazakhstan has underestimated the number of MSM. This underscores the need to redress social and structural barriers to HIV testing and disclosure of sexual behavior experienced by MSM in Kazakhstan. Recommendations include promoting cultural sensitivity among testing staff through quality assurance and regular training, and increasing protection and public awareness through antidiscrimination policy development. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: health screening; HIV/AIDS; international research (research outside the US); men who have sex with men; Health Screening; HIV; Same Sex Intercourse

Bullying and quality of life in youths perceived as gay, lesbian, or bisexual in Washington state, 2010 - Patrick, Donald L.; Bell, Janice F.; Huang, Jon Y.; Lazarakis, Nicholas C.; Edwards, Todd C. (American Journal of Public Health, 2013)
Objectives. We examined the association between perceived sexual orientation (PSO), bullying, and quality of life (QOL) among US adolescents. Methods. We analyzed data from the 2010 Washington State Healthy Youth Survey collected in public school grades 8, 10, and 12 (n = 27 752). Bullying status was characterized as never bullied, bullied because of PSO, or bullied for other reasons. Survey-weighted regression examined differences in QOL, depressed mood, and consideration of suicide by bullying status. Results. Among male students, 14%, 11%, and 9% reported being bullied because of PSO in 8th, 10th, and 12th grades, respectively; and among female students, 11%, 10%, and 6%. In all gender and grade strata, being bullied because of PSO was associated with lower QOL scores and increased the odds of depressed mood or consideration of suicide. Moreover, the magnitudes of these associations were greater than for being bullied for other reasons. Conclusions. Bullying because of PSO is widely prevalent and significantly affects several facets of youth QOL. Bully-prevention or harm-reduction programs must address bullying because of PSO. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: bullying; quality of life; gay males; lesbians; bisexuality; public schools; Adolescent; Bisexuality; Bullying; Cohort Studies; Cross-Sectional Studies; Depression; Female; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Male; Quality of Life; Regression Analysis; Schools; Self Report; Sex Factors; Suicidal Ideation; Washington; Bisexuality; Male Homosexuality; Public School Education; Quality of Life; Bullying; Lesbianism

Expression of concern on 'Invisible victims: Delayed onset depression among adults with same-sex parents' (Depression Research and Treatment, 2017)
Reports an expression of concern about 'Invisible victims: Delayed onset depression among adults with same-sex parents' (Depression Research and Treatment, vol. 2016, Article ID 2410392, 8 pages, 2016). 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 following abstract of the original article appeared in record [rid]2016-57273-001[/rid].) 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) 2020 APA, all rights reserved)
Keywords: delayed disease onset; major depression; same-sex parents; same-sex marriage; Major Depression; Onset (Disorders); Parents; Same Sex Marriage

Effects of victimization and violence on suicidal ideation and behaviors among sexual minority and heterosexual adolescents - Bouris, Alida; Everett, Bethany G.; Heath, Ryan D.; Elsaesser, Caitlin E.; Neilands, Torsten B. (LGBT Health, 2016)
Purpose: Sexual minority youth (SMY) are at higher risk for victimization and suicide than are heterosexual youth (HY). Relatively little research has examined which types of victimization are most closely linked to suicide, which is necessary to develop targeted prevention interventions. The present study was conducted to address this deficit. Methods: The data come from the 2011 Chicago Youth Risk Behavior Survey (n = 1,907). Structural equation modeling (SEM) in Mplus evaluated the direct, indirect, and total effects of sexual orientation on a latent indicator of suicidal ideation and behaviors via seven types of victimization. Four indicators of victimization were school-specific (e.g., harassment due to sexual orientation or gender identity (SO/GID), bullying, threatened or injured with a weapon, and skipping school due to safety concerns), and three indicators assessed other types of victimization (e.g., electronic bullying, intimate partner violence, and sexual abuse). Results: Thirteen percent of youth were classified as SMY. Significantly more SMY than HY reported suicidal ideation (27.95% vs. 13.64%), a suicide plan (22.78% vs. 12.36%), and at least one suicide attempt (29.92% vs. 12.43%) in the past year (all P < .001). A greater percentage of SMY reported SO/GID-related harassment, skipping school, electronic bullying, and sexual abuse. Sexual orientation was not directly related to suicidal ideation and behaviors in SEM. Rather, SMY's elevated risk of suicidality functioned indirectly through two forms of school-based victimization: being threatened or injured with a weapon (B = .19, SE = .09, P ≤ .05) and experiencing SO/GID-specific harassment (B = .40, SE = .15, P ≤ .01). There also was a trend for SMY to skip school as a strategy to reduce suicide risk. Conclusion: Although SMY experience higher rates of victimization than do HY, school-based victimization that involves weapons or is due to one's SO/GID appear to be the most deleterious. That SMY may skip school to reduce their risk of suicidal ideation and behaviors is problematic, and schools should be encouraged to enact and enforce policies that explicitly protect SMY from victimization. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: child and adolescent development; LGBT youth; sexual orientation; suicide; Heterosexuality; Sexual Orientation; Suicide; Victimization; Sexual Minority Groups; Adolescent Development; Childhood Development

'It Gets Better' … but how? Exploring resilience development in the accounts of LGBTQ adults - Asakura, Kenta; Craig, Shelley L. (Journal of Human Behavior in the Social Environment, 2014)
As reports of bullying and suicide increase, research on lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth must expand its focus from vulnerabilities to resilience development. The purpose of this inductive qualitative study was to explore resilience development in the accounts of LGBTQ adults by analyzing videos posted for the It Gets Better social media campaign (n = 21). Four major themes emerged: (1) leaving hostile social environments; (2) experiencing 'coming out' in meaningful ways; (3) remembering the social environment; and (4) turning challenges into opportunities and strengths. These findings suggest that, despite the campaign's premise, life did not automatically get better for the LGBTQ participants. Rather, the findings offer a nuanced look at the pathways to resilience development. Implications for social work practice are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: resilience development; social media campaign; social environment; social work; LGBTQ; Bisexuality; Homosexuality; Lesbianism; Resilience (Psychological); Transgender; Male Homosexuality; Social Casework; LGBTQ

Case study: Analysis of a traumatized hemophiliac boy - Scharff, Jill Savege (The International Journal of Psychoanalysis, 2017)
The author presents a case study of a hemophiliac boy in four‐times‐a‐week analysis from the age of four to six and a half years. An extensive narrative of various phases of the analysis including the termination provides the reader access to the material for discussion of therapeutic action. Her analytic technique is based on a developmental point of view and illustrates the use of limits, play, and interpretation based on countertransference. She understands the boy's symptoms of preferring to be a girl, asking to cut his penis off, and wishing to die as defenses against the fear of castration, which in his case is aggravated by the actual threat of repeated medical interventions, and by the underlying fear of a lack of body composition. An unusual feature of the case is the illustration of the symptom, the analysis, and the recovery of the male self, captured in a complex collage that was made over the course of the relatively short analysis. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: child analysis; hemophilia; cross‐dressing; castration anxiety; body integrity anxiety; suicidality; Child; Hemophilia A; Humans; Male; Psychoanalytic Therapy; Psychological Trauma; Anxiety; Child Psychotherapy; Hemophilia; Psychoanalysis; Trauma; Castration Anxiety; Pediatrics; Suicidal Ideation; Transvestism; Suicidality

The intersection of interpersonal and self-directed violence among general adult, college student and sexually diverse samples - Cramer, Robert J.; Desmarais, Sarah L.; Johnson, Kiersten L.; Gemberling, Tess M.; Nobles, Matt R.; Holley, Sarah R.; Wright, Susan; Van Dorn, Richard (International Journal of Social Psychiatry, 2017)
Background: Suicide and interpersonal violence (i.e. victimization and perpetration) represent pressing public health problems, and yet remain mostly addressed as separate topics. Aims: To identify the (1) frequency and overlap of suicide and interpersonal violence and (2) characteristics differentiating subgroups of violence-related experiences. Methods: A health survey was completed by 2,175 respondents comprised of three groups: college students (n = 702), adult members of a sexuality special interest organization (n = 816) and a community adult sample (n = 657). Latent class analysis was used to identify subgroups characterized by violence experiences; logistic regression was used to identify respondent characteristics differentiating subgroups. Results: Overall rates of violence perpetration were low; perpetration, victimization and self-directed violence all varied by sample. Adults with alternative sexual interests reported high rates of victimization and self-directed violence. Analyses indicated two subgroups: (1) victimization + self-directed violence and (2) self-directed violence only. The victimization + self-directed violence subgroup was characterized by older, White, female and sexual orientation minority persons. The self-directed violence subgroup was characterized by younger, non-White, male and straight counterparts engaging with more sexual partners and more frequent drug use. Conclusion: Findings support the Centers for Disease Control and Prevention (CDC) definition of suicide as self-directed violence. Suicide intervention and prevention should further account for the role of violent victimization by focusing on the joint conceptualization of self-directed and interpersonal violence. Additional prevention implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: Self-directed violence; interpersonal violence; victimization; suicide; perpetration; physical assault; Adolescent; Adult; Crime Victims; Female; Humans; Interpersonal Relations; Logistic Models; Male; Middle Aged; Sexual Partners; Students; Suicide; Surveys and Questionnaires; United States; Violence; Young Adult; Suicide; Victimization; Violence; Interpersonal Relationships

Synergies in health and human rights: A call to action to improve transgender health - Winter, Sam; Settle, Edmund; Wylie, Kevan; Reisner, Sari; Cabral, Mauro; Knudson, Gail; Baral, Stefan (The Lancet, 2016)
Comments on the articles by S. L. Reisner et al. (see record [rid]2016-37101-039[/rid]), Sam Winter et al. (see record [rid]2016-37101-037[/rid]) and Kevan Wylie et al. (see record [rid]2016-37101-038[/rid]). Transgender people continue to face a range of challenges that deprive them of respect, opportunities, and dignity and have damaging eff ects on their mental and physical health and wellbeing, as shown in the article by Reisner et al. on transgender health. These 'situated vulnerabilities', as they are called by Reisner et al. can prompt or aggravate depression, anxiety, self-harm, and suicidal behavior among transgender people, which are exacerbated by biological risks, and social and sexual network-level risks, for HIV and other sexually transmitted infections. Winter et al. write of a 'slope leading from stigma to sickness'. Moving forward, these health needs and vulnerabilities can be better addressed through improved understanding of the legal and social policies that promote harms and diminish the potential impact of health programs. There is also a need for increased knowledge of the optimal content and models of clinical service provision, as highlighted by Wylie et al., and of the epidemiology of communicable and non-communicable diseases in transgender people globally. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: global health burden; transgender populations; health care needs; risk factors; Health Service Needs; Global Health; Transgender; Population; Risk Factors

A minority stress model for suicidal ideation in gay men - Michaels, Matthew S.; Parent, Mike C.; Torrey, Carrie L. (Suicide and Life-Threatening Behavior, 2016)
There is a dearth of research on mechanisms underlying higher rates of suicidal ideation among gay men compared to heterosexual men. The purpose of this study was to establish the link between social/psychological predictor variables and suicidal ideation by testing a hypothesized minority stress model. Structural equation modeling was used to assess the relationships posited in the model using data from a community sample of 167 gay men. Model fit was adequate and hypothesized relationships were partially supported. Also, depressive symptoms partially mediated the relationship between (less) outness predicting suicidal ideation. These findings imply that therapeutic approaches targeting the coming out process may be more effective than approaches targeting internalized homophobia when suicidal ideation is indicated in the clinical presentation of gay and bisexual men. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicidal ideation; gay men; minority stress model; depressive symptoms; Adult; Aged; Depression; Homosexuality, Male; Humans; Male; Middle Aged; Minority Groups; Models, Psychological; Stress, Psychological; Suicidal Ideation; Young Adult; Male Homosexuality; Minority Groups; Models; Stress; Suicidal Ideation; Major Depression; Self-Disclosure; Symptoms; Minority Stress

Moving beyond the basics of the binary: Addressing mental health needs and suicidality among transgender youth - Sitkin, Nicole A.; Murota, Dinora (Journal of the American Academy of Child & Adolescent Psychiatry, 2017)
Comments on an article by Amaya Perez-Brumer et al. (see record [rid]2017-36326-010[/rid]). Perez-Brumer et al. report that over one-third of trans youth surveyed with the California Healthy Kids Survey report past-year suicidal ideation in the first-ever representative, population-based sample of trans youth. Notably, measures of depressive symptoms and school-based victimization mediated the association between gender identity and suicidal ideation. As noted by the authors, however, these factors mediated a minority of that association, begging the question: what other influences might have an impact on mental health and suicidality among trans youth? (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: suicide; gender-identity disparities; youth mental health; LGBT; Adolescent Development; Suicidal Ideation; Transgender; Suicidality; High School Students

Interpersonal trauma and discriminatory events as predictors of suicidal and nonsuicidal self-injury in gay, lesbian, bisexual, and transgender persons - House, Amy S.; Van Horn, Elizabeth; Coppeans, Christopher; Stepleman, Lara M. (Traumatology, 2011)
Recent research suggests that gay, lesbian, bisexual, and transgender (GLBT) persons are at greater risk for mental health problems, including suicidal and nonsuicidal self-injury, than heterosexuals. However, few studies have investigated factors that may be linked to this increased risk. This study investigated interpersonal violence, victimization, and discriminatory events as possible predictors of suicidal and nonsuicidal self-injury in a sample of sexual minorities (i.e., a GLBT sample). Participants were 1,126 self-identified gay, lesbian, bisexual, and/or transgender (GLBT) individuals who responded to an Internet-based survey. Results indicated that both experiences of interpersonal trauma and sexual discrimination were associated with increased likelihoods of engaging in suicidal and nonsuicidal self-injury. In addition, participants at the greatest risk were those experiencing high levels of both interpersonal trauma and sexual discrimination. Clinical implications of these results are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: interpersonal trauma; suicide; self injury; transgender; gay; lesbian; bisexuality; Bisexuality; Lesbianism; Self-Injurious Behavior; Suicide; Trauma; Male Homosexuality; Transgender

Negative treatment by family as a predictor of depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use in vietnamese sexual minority women - Nguyen, Trang Quynh; Bandeen-Roche, Karen; German, Danielle; Nguyen, Nam T.T.; Bass, Judith K.; Knowlton, Amy R. (LGBT Health, 2016)
Purpose: Research linking family rejection and health outcomes in sexual minority people is mostly limited to North America. We assessed the associations between negative treatment by family members and depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use in sexual minority women (SMW) in Viet Nam. Methods: Data were from an anonymous internet survey (n = 1936). Latent class analysis characterized patterns of negative treatment by family members experienced by respondents. Latent class with distal outcome modeling was used to regress depressive symptoms, life satisfaction, suicidality, and tobacco/alcohol use on family treatment class, controlling for predictors of family treatment and for two other types of sexual prejudice. Results: Five latent family treatment classes were extracted, including four negative classes representing varying patterns of negative family treatment. Overall, more than one negative class predicted lower life satisfaction, more depressive symptoms, and higher odds of attempted suicide (relative to the non-negative class), supporting the minority stress hypothesis that negative family treatment is predictive of poorer outcomes. Only the most negative class had elevated alcohol use. The association between family treatment and smoking status was not statistically significant. The most negative class, unexpectedly, did not have the highest odds of having attempted suicide, raising a question about survivor bias. Conclusion: This population requires public health attention, with emphasis placed on interventions targeting the family to promote acceptance and to prevent negative treatment, and interventions supporting those SMW who encounter the worst types of negative family treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: family rejection; latent class model; mental health; sexual minority women (SMW); substance use; suicidality; Depression (Emotion); Drug Abuse; Life Satisfaction; Mental Health; Minority Groups; Human Females; Suicidality; Sexual Minority Groups

Evaluating thwarted belongingness and perceived burdensomeness as predictors of suicidal ideation in sexual minority adults - Woodward, Eva N.; Wingate, LaRicka; Gray, Taylor W.; Pantalone, David W. (Psychology of Sexual Orientation and Gender Diversity, 2014)
Research suggests that sexual minority individuals are at significantly higher risk of considering suicide than their heterosexual peers. Little data exist on the reasons for this disparity. We aimed to assess whether 2 interpersonal constructs—thwarted belongingness and perceived burdensomeness—were associated with higher levels of suicidal ideation (SI) in a sexual minority sample. Participants, recruited online from U.S. LGBQ support groups, completed a 1-time anonymous online survey. In this sample (N = 210, Mage = 36.11, SD = 13.9), 52.9% of participants identified as women, 47.1% as men, 77.6% as White, 7.1% as African American or Black, and 7.6% as Hispanic or Latino. Most participants identified as gay or lesbian (77.1%), with 22.9% identifying as bisexual. Measures assessed current SI, thwarted belongingness, and perceived burdensomeness. Approximately 21% of participants endorsed current SI. Perceived burdensomeness (Wald = 12.108, odds ratio [OR] = 3.456, 95% CI [1.719, 6.950]) was a significant predictor of SI, although thwarted belongingness was not (p = .494), even after controlling for demographic factors. Perceived burdensomeness was also a significant predictor of SI within subgroups of gay men (OR = 3.462, 95% CI [1.215, 9.863]), lesbian women (OR = 6.948, 95% CI [1.164, 41.46]), and bisexual women (OR = 5.785, 95% CI [1.199, 27.915]). Results provided support for perceived burdensomeness as a predictor of SI for sexual minority individuals, but requires replication. Perceived burdensomeness and SI should be addressed during medical or mental health visits for sexual minority individuals. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: burdensomeness; belongingness; SI; suicide; interpersonal; suicidal ideation; sexual minority; Interpersonal Interaction; Minority Groups; Sexual Orientation; Suicidal Ideation; Suicide; Sexual Minority Groups

Victimization and suicidality among Dutch lesbian, gay, and bisexual youths - van Bergen, Diana D.; Bos, Henny M. W.; van Lisdonk, Jantine; Keuzenkamp, Saskia; Sandfort, Theo G. M. (American Journal of Public Health, 2013)
We examined Netherlands Institute for Social Research data, collected between May and August 2009, on 274 Dutch lesbian, gay, and bisexual youths. The data showed that victimization at school was associated with suicidal ideation and actual suicide attempts. Homophobic rejection by parents was also associated with actual suicide attempts. Suicidality in this population could be reduced by supporting coping strategies of lesbian, gay, and bisexual youths who are confronted with stigmatization by peers and parents, and by schools actively promoting acceptance of same-sex sexuality. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: victimization; suicidality; lesbian; bisexual; gay; youths; peers; Adolescent; Bisexuality; Crime Victims; Cross-Sectional Studies; Female; Homosexuality, Female; Homosexuality, Male; Humans; Logistic Models; Male; Netherlands; Parents; Peer Group; Suicidal Ideation; Suicide; Suicide, Attempted; Bisexuality; Homosexuality; Lesbianism; Suicide; Victimization; Peers; Suicidality

Gay–Straight Alliances are associated with student health: A multischool comparison of LGBTQ and heterosexual youth - Poteat, V. Paul; Sinclair, Katerina O.; DiGiovanni, Craig D.; Koenig, Brian W.; Russell, Stephen T. (Journal of Research on Adolescence, 2013)
Few studies have examined school-based factors associated with variability in the victimization and health of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Among 15,965 students in 45 Wisconsin schools, we identified differences based on Gay–Straight Alliance (GSA) presence. Youth in schools with GSAs reported less truancy, smoking, drinking, suicide attempts, and sex with casual partners than those in schools without GSAs, with this difference being more sizable for LGBTQ than heterosexual youth. GSA-based differences were greatest for sexual minority girls on reported sex while using drugs. GSA effects were nonsignificant for general or homophobic victimization, grades, and school belonging. Findings suggest that GSAs could contribute to attenuating a range of health risks, particularly for LGBTQ youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: gay; heterosexual youth; victimization; lesbianism; bisexuality; transgender; gender differences; Bisexuality; Heterosexuality; Lesbianism; Male Homosexuality; Transgender; Human Sex Differences; Victimization; LGBTQ

Predictors of suicidal ideation in a statewide sample of transgender individuals - Rood, Brian A.; Puckett, Julia A.; Pantalone, David W.; Bradford, Judith B. (LGBT Health, 2015)
Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compared with individuals with no plans to transition, individuals with plans or who were living as their identified gender reported greater odds of lifetime SI. We discuss implications for SI disparities using Meyer’s minority stress model. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: discrimination; suicide; transgender; transition; violence.; Suicidal Ideation; Transgender; Distress; Psychological Stress; Social Discrimination; Stigma; Suicide

Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school - DeCamp, Whitney; Bakken, Nicholas W. (Journal of Injury and Violence Research, 2016)
Background: Research has suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI) among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behavior may help identify troubled students and initiate preventative measures. Methods: Bivariate probit regression analyses are performed using data from 7,326 high school students collected via the Delaware Youth Risk Behavior Survey. Results: Results indicate that bullying victimization, fighting, substance use, sexual behavior, depression, and unhealthy dieting behaviors were generally associated with NSSI and suicidal ideation. Some effects—including those from sexual activity, substance use, and unhealthy dieting behaviors—significantly differed based on gender and orientation. Conclusions: Risk factors for suicide and NSSI vary by gender and orientation. Both prevention/intervention specialists and researchers should consider the intersection of these risk factors with sexual orientation in their efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: Non-suicidal self injury; Suicide ideation; Sexual minority youth; High School Students; Self-Injurious Behavior; Sexual Orientation; Suicidal Ideation; Sexual Minority Groups

Suicide risk among college students: The intersection of sexual orientation and race - Shadick, Richard; Backus Dagirmanjian, Faedra; Barbot, Baptiste (Crisis: The Journal of Crisis Intervention and Suicide Prevention, 2015)
Background: Research on young adults in the general population has identified a relationship between sexual minority identification and risk for suicide. Differential rates of suicidal ideation and attempts have also been found across racial and ethnic groups. Aims: This study examined risk for suicide among university students, based on membership in one or more marginalized groups (sexual minority and racial minority identification). Method: Data were collected from first-year college students (N = 4,345) at an urban university. Structural equation modeling was employed to model a suicidality construct, based on which a 'risk for suicide' category system was derived. Chi-square and logistic regression analyses were then conducted to estimate the relationship between the background variables of interest and suicide risk. Results: Students who identified as lesbian, gay, or bisexual (LGB) were associated with higher suicide risk than their heterosexual peers. Students of color were slightly less at risk than their heterosexual peers. However, LGB students of color were associated with elevated suicide risk relative to heterosexual peers. Conclusion: Results indicate that belonging to multiple marginalized groups may increase one's risk for suicide, though these effects are not simply additive. Findings highlight the complexity of the intersection between marginalized identities and suicidality. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: ethnicity; suicide risk; college students; sexual orientation; College Students; Racial and Ethnic Groups; Risk Factors; Sexual Orientation; Suicide; Alaska Natives; Asians; At Risk Populations; Blacks; Pacific Islanders; Racial and Ethnic Differences; Religious Affiliation; Whites; Latinos/Latinas

Screening for depression among youth with HIV in an integrated care setting - St. John Walsh, Audra; Wesley, Katherine L.; Tan, Sim Yin; Lynn, Courtney; O'Leary, Kimberly; Wang, Yan; Nguyen, Diep; Chenneville, Tiffany; Rodriguez, Carina A. (AIDS Care, 2017)
Youth living with HIV (YLWH) are at risk for depression. Depressive symptoms can impact treatment engagement, health outcomes, and quality of life. Early identification of symptoms can guide treatment planning. This study aimed to identify trends in depressive symptoms for YLWH in a specialty-care clinic and follow-up clinical treatment procedures. An archival review of a clinical database provided depression screening information for a sample of 130 YLWH between 11 and 25 years old in the southeastern United States. Findings indicated that approximately 24% of the sample screened positive for depression-risk. Most commonly endorsed symptoms included fatigue (54.3%) and sleep difficulties (48.5%). Depressive symptoms did not differ significantly by age, gender, race, ethnicity, or sexual orientation. Youth who acquired HIV behaviorally were more likely to endorse the critical item (i.e., self-harm and/or suicidal ideation) than youth who acquired HIV perinatally. Forty-percent of the sample (i.e., 51 youth) had a follow-up treatment plan. YLWH who endorsed the critical item were more likely to receive follow-up action when compared to those who did not endorse the item. Despite limitations of the study, findings have important implications for clinical care and future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: Youth; HIV; depression; screening; mental health; Depression (Emotion); Health Screening; HIV; Integrated Services

Lesbian, gay, bisexual, and transgender issues in trauma psychology: A topic comes out of the closet - Brown, Laura S.; Pantalone, David (Traumatology, 2011)
This issue of the journal of Traumatology focuses on the psychology of trauma in lesbian, gay, bisexual and transgender (LGBT). LGBT people are more likely to be abused in their families of origin than are their heterosexual siblings. Rates of intimate partner violence appear to equal those found in heterosexual couples, but resources for both victims and perpetrators of such violence in same-sex pairs are few or nonexistent in most locales. One of the articles provides evidence from an Internet sample of more than 1,100 sexual and gender minority individuals, that both experiences of interpersonal trauma and sexual discrimination were associated with an increased likelihood of engaging in suicidal and non suicidal self-injury. Another article deals with the political and social discrimination faced by sexual and gender minority individuals. More and more sophisticated and thoughtful research about such questions as the relationship between lifetime trauma exposure, particularly trauma exposure that has been linked to an individuals LGBT status, and a range of mental health outcomes, will allow us to design interventions that are culturally competent, evidence based and effective. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: trauma psychology; lesbians; gay; bisexuality; transgender; intimate partner violence; suicide; self injury; Bisexuality; Lesbianism; Male Homosexuality; Trauma; Transgender; Intimate Partner Violence; Self-Injurious Behavior; Suicide

The social costs of gender nonconformity for transgender adults: Implications for discrimination and health - Miller, Lisa R.; Grollman, Eric Anthony (Sociological Forum, 2015)
Research suggests that transgender people face high levels of discrimination in society, which may contribute to their disproportionate risk for poor health. However, little is known about whether gender nonconformity, as a visible marker of one's stigmatized status as a transgender individual, heightens trans people's experiences with discrimination and, in turn, their health. Using data from the largest survey of transgender adults in the United States, the National Transgender Discrimination Survey (N = 4,115), we examine the associations among gender nonconformity, transphobic discrimination, and health‐harming behaviors (i.e., attempted suicide, drug/alcohol abuse, and smoking). The results suggest that gender nonconforming trans people face more discrimination and, in turn, are more likely to engage in health‐harming behaviors than trans people who are gender conforming. Our findings highlight the important role of gender nonconformity in the social experiences and well‐being of transgender people. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: discrimination; gender nonconformity; health; minority stress; stigma; transgender; Health; Society; Stigma; Transgender; Minority Stress; Discrimination; Stress

High levels of emotional distress, trauma exposure, and self-injurious thoughts and behaviors among military personnel and veterans with a history of same sex behavior - Ray-Sannerud, Bobbie N.; Bryan, Craig J.; Perry, Nicholas S.; Bryan, AnnaBelle O. (Psychology of Sexual Orientation and Gender Diversity, 2015)
Rates of suicide deaths and attempts among military personnel and veterans have risen over the past decade. Research on the relationship of sexual minority status (whether by attraction, identity, or behavior) with self-injurious thoughts and behaviors (SITB) among military personnel and veterans is sparse, despite considerable evidence suggesting sexual minority individuals are at increased risk in the general population. The current study examined the relationship of sexual minority status (i.e., those reporting a history of same-sex partners) with emotional distress, trauma exposure, and SITB in a sample of 422 military personnel and veterans enrolled in college classes. Results indicated that military personnel who had a history of same-sex partners reported more severe depression, posttraumatic stress, and trauma exposure than military personnel who reported only other-sex partners. Female military personnel with a history of same-sex partners reported the highest rates of physical (48.3%) and sexual (41.4%) assault, and nonsuicidal self-injury (31%) and suicide attempts (20.7%). Military personnel with a history of same-sex partners reported significantly increased rates of suicide ideation (OR = 2.08, p < .05), nonsuicidal self-injury (OR = 2.29, p < .05), and suicide attempts (OR = 2.89, p < .05). Results suggest sexual minority military personnel and veterans, especially women, report greater emotional distress and trauma exposure. They are also at increased risk for SITB, as a function of these high levels of psychological distress and trauma. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Keywords: LGB; military; suicide; veteran; sexual minority; Distress; Minority Groups; Self-Injurious Behavior; Sexual Orientation; Trauma; Bisexuality; Lesbianism; Male Homosexuality; Military Personnel; Military Veterans; Suicide; Sexual Minority Groups

Prevalence and mental health correlates of illegal cannabis use among bisexual women - Robinson, Margaret; Sanches, Marcos; MacLeod, Melissa A. (Journal of Bisexuality, 2016)
This study reports the prevalence of cannabis use among bisexual women in Ontario, Canada, and identifies correlations among levels of cannabis use (no use, some use, active use) and measures of mental health and social support. Analysis focused on 262 bisexual women from a bisexual mental health study using respondent-driven sampling. Among networked bisexual women in Ontario, Canada, the weighted prevalence of past-year cannabis use was 33.6%, with 13.8% of bisexual women using cannabis twice or more per week. Cannabis use was positively associated with social support, gay community involvement, outness to family, and depression. There was no significant association between cannabis use and anxiety, posttraumatic stress disorder, antibisexual experiences, or suicidal ideation. Bisexual women's rate of past-year cannabis use is more than 5 times that for Canadian women in general, and is consistent with rates for bisexual women found in U.S. studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Keywords: bisexuality; cannabis; sampling; internalized biphobia; biphobia; discrimination; mental health; Bisexuality; Cannabis; Drug Usage; Human Females; Mental Health; Social Support

Distress associated with being a sexual minority: Is there reason for hope? - Bialer, Philip A.; McIntosh, Christopher A. (Journal of Gay & Lesbian Mental Health, 2016)
This article provides an overview of the papers featured in this issue of Journal of Gay & Lesbian Mental Health. The papers included in this issue look at different populations considered to be sexual minorities and examine levels of distress suffered by the individuals in these groups. One of the paper is large-scale study that looked at levels of depression and anxiety in more than 2,700 lesbian, gay, bisexual, and transgender (LGBT)-identified individuals. Another paper confirmed the important role that family support plays in the mental health of sexual minority women. In particular, both peer and family supportwere found to be very important when it comes to suicidal ideation in this population. It is hoped that these papers will enhance the knowledge of its reader in the field of gay & lesbian's mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Keywords: sexual minorities; gay males; lesbians; mental health; family support; Lesbianism; Male Homosexuality; Mental Health; Sexual Orientation; Social Support; Family; Sexual Minority Groups

Unequal treatment of transgender individuals in domestic violence and rape crisis programs - Seelman, Kristie L. (Journal of Social Service Research, 2015)
Transgender people often face barriers in accessing culturally competent domestic violence and rape crisis services, yet few studies have used a national sample of transgender people to study this topic or examine differential rates of discrimination within this population. The National Transgender Discrimination Survey, conducted in 2008 to 2009 by the National Center for Transgender Equality and the National Gay and Lesbian Task Force, collected data about discrimination affecting transgender people across a variety of settings. The present study involves secondary data analysis of this data set to examine whether certain sociodemographic factors and psychosocial risks are significant predictors of unequal treatment of transgender people in domestic violence programs (N = 2,438) and rape crisis centers (N = 2,424). For both settings, findings indicate that transgender individuals who are low-income and not U.S. citizens are more likely to experience unequal treatment based upon being transgender or gender-nonconforming. Within domestic violence programs, transgender people of color, those with disabilities, and those more frequently perceived to be transgender by others are more likely to experience unequal treatment. Psychosocial risk factors (suicidality, sex work history, and disconnection from family) predict unequal treatment in both settings. The article concludes by discussing implications for social service practitioners and future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: Transgender; discrimination; domestic violence; sexual assault; social services; Crisis Intervention Services; Domestic Violence; Rape; Social Discrimination; Transgender; Demographic Characteristics; Psychosocial Factors; Social Equality

Sexual orientation and non-suicidal self-injury: A meta-analytic review - Batejan, Kristen L.; Jarvi, Stephanie M.; Swenson, Lance P. (Archives of Suicide Research, 2015)
The aim of this study was to conduct the first meta-analysis comparing risk for NSSI between sexual minority and heterosexual persons. Eleven published and 4 unpublished studies were reviewed, describing associations between sexual orientation and NSSI in 7,147 sexual minority and 61,701 heterosexual participants. The overall weighted effect size for the relationship between sexual orientation and NSSI using a random-effects model was OR = 3.00 (95% CI = 2.46–3.66), indicating a medium-to-large effect. Sexual minority adolescents and bisexuals were found to be at particularly high-risk. These findings highlight the need to examine mechanisms linking sexual orientation and NSSI in future research. Building on these findings can add to understanding the associations between sexual orientation, NSSI, and suicidality, as well as prevention/intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Keywords: LGBQ; meta-analysis; non-suicidal self-injury; NSSI; sexual orientation; Adolescent; Adult; Humans; Risk Assessment; Self-Injurious Behavior; Sexual Behavior; Sexuality; Suicidal Ideation; Self-Injurious Behavior; Sexual Orientation; Bisexuality; Heterosexuality; Lesbianism; Transgender

Conflating sexual orientation and gender identity—Authors' reply - Miranda-Mendizábal, Andrea; Alonso, Jordi (The British Journal of Psychiatry, 2017)
Reply by the current authors to the comments on Sexual orientation and suicidal behaviour in young people by Nick Meader & Melissa K. Y. Chan (2017) on the original article (see record [rid]2017-47011-003[/rid]). The authors thank Meader and Chan for their appreciation that our review updated and refined the evidence on risk of suicidal behavior in LGB youth. There is a lack of research about suicidal behavior among the LGBT population. Moreover, the authors firmly believe that there is a need for identifying specific risk and protective factors of suicidal behavior in this population, especially among transgender people, for better prevention. Although some factors may be common for the whole LGBT population, it is likely that different mechanisms may be operating. Longitudinal assessment of mediators such as victimization, stigmatization and discrimination might help to identify causal pathways for suicidal behaviors, specifically regarding sexual orientation and gender identity. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Keywords: sexual orientation; suicidal behavior; risk factors; age differences; Age Differences; Risk Factors; Sexual Orientation; Suicidal Ideation; Adolescent Development