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Background: Lesbian, gay, bisexual, and questioning (LGBQ) adolescents are at increased risk of poor mental health due to minority stress, a chronic stress associated discrimination, social rejection, and victimization brought on by prejudicial attitudes towards LGBQ individuals. To improve understanding of the differential impact of various kinds of victimization on mental health outcomes for LGBQ adolescents, we analyzed data from the 2015 Youth Risk Behavior Survey (YRBS) for victimization and mental health symptom clusters and associations high school youth and compared by sexual orientation and gender. Methods: Separate Latent Class Analysis (LCA) was conducted to identify profiles of both victimization and mental health symptoms for participants (N = 15,624). Subsequently, stratified weighted logistic regression models were used on an eligible analytic sample of 11,458 to assess differences in the association of victimization and mental health between LGBQ and heterosexual high school students. Results: In each LCA, participants were assigned to one of 3 classes for victimization (minimal, 81.3%; bullying, 12.5%; or physical/sexual violence, 6.2%) and 1 of 2 classes for mental health symptoms (minimal, 81.2%; severe, 18.8%). LGBQ participants were overrepresented in physical/sexual violence and bullying victimization profiles. Both bullying and physical/sexual violence profiles were associated with almost 5 times the odds of endorsing severe mental health symptoms. Conclusions: This study expands our understanding of the relationship between types and effect of peer victimization for LGBQ and heterosexual youth with implications for school health and prevention efforts through increased positive school climate for LGBQ students.

Faculty workload tension exists between espoused service and social justice-oriented university missions and neoliberal academic values of scholarship. The tension has significant consequences for attracting, advancing, and retaining faculty from minoritized racial, ethnic, and gender groups. A case study qualitative approach was conducted to investigate perspectives on the valuing of faculty service at a private university with a clearly articulated service and social justice-oriented mission. Interviews were conducted first with department chairs (n = 26). Themes from these interviews were then shared with faculty (n = 153) and leadership (i.e. deans and provosts) via a web-based survey for comments on refining themes. Final analysis yielded a meta-theme (Values in tension), four themes (The paradox of faculty service, we are stretched thin, workload nimbleness and confusion, and inequity in burden and advancement) with diverging perspectives based on race and gender of participants. Implications are drawn for university leadership and culture related to faculty workload and advancement. [ABSTRACT FROM AUTHOR]

Clinical education programs are positioned to train future health care professionals to provide excellent health care for transgender and gender-diverse patients. The purpose of this resource, Advancing Inclusion of Transgender and Gender-Diverse Identities in Clinical Education: A Toolkit for Clinical Educators, is to facilitate critical inquiry among clinical educators regarding their approach to teaching about sex, gender, the historical and sociopolitical context of transgender health, and how to prepare their students to apply standards of care and clinical care guidelines set forth by national and international professional organizations. [ABSTRACT FROM AUTHOR]

Purpose: The study purpose was to describe the availability of sex, gender identity, and sexual orientation (SOGI) data in a large, Catholic health system. Methods: A retrospective chart review on the Sisters of St. Mary (SSM) Health database was conducted from January 1, 2012, to March 27, 2024. The availability of SOGI data and number of sexual and gender minority patients was reported. Results: Among the 5,759,869 records, data on sex was available for the majority of the population (99.9 percent); data on gender identity and sexual orientation were reported for smaller proportions (7.4 percent and 4.5 percent, respectively). Sex and gender were reported among 7.4 percent of the population. A total of 4,567 gender minority and 14,644 sexual minority patients were seen. Conclusion: Though SOGI data were largely unavailable in the SSM Health database, the system has the capacity to separately record sex, gender, and sexual orientation, with a range of response options to capture gender and sexual orientation diversity. [ABSTRACT FROM AUTHOR]

This article reviews and evaluates available research on multicultural training within the field of marriage and family therapy. Four top-tier journals in the field of marriage and family therapy (Journal of Marital and Family Therapy, American Journal of Family Therapy, Contemporary Family Therapy, and Family Process) were used to identify studies on multicultural training. A total of 15 studies met inclusion criteria for review. Following an account of existing trends within the marriage and family therapy multicultural training literature, we provide a critique of the research reviewed and make numerous recommendations for future research in this area. [ABSTRACT FROM AUTHOR]

Background: Transgender and nonbinary (TGNB) adolescents and young adults are underrepresented in the literature on eating disorders and body image-related problems, despite increased mental health disparities and emerging research showing high associations between gender dysphoria, body image, and eating disorders among TGNB youth. Aims: The scoping review was designed to critically examine the research on TGNB adolescents and young adults who experience eating and body image related problems as well as clinical studies on treatment approaches and effectiveness. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this scoping review. The electronic databases of MEDLINE and PsychInfo were used for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for transgender minor children, adolescents, or young adult samples (18 to 25 years old) and address differences in eating/body-related problems by age. The relevant data was extracted and narratively summarized. Results: 49 studies were identified, data extracted, and analyzed. Increased prevalence of eating disorders and body image problems were identified for TGNB youth. Body-gender congruence through gender affirming social and medical interventions (e.g., hormone therapy) were noted as significant for alleviating body image problems and facilitating eating disorder treatment. Family and social factors were not well understood in the literature and a need for increased study of TGNB youth from varied racial/ethnic, neurodiverse, and within specific identities (e.g., nonbinary) and families and cultural contexts is still needed. Conclusions: Future research should consider the use of developmental and family theories for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, more studies are needed with those from minoritized racial and ethnic groups, neurodiversity, and varied gender identities (e.g., nonbinary and gender queer) for identifying important differences. Plain English summary: Forty-nine published research studies with transgender and nonbinary (TGNB) adolescents and young adults on eating patterns and body image were identified, summarized, and critically examined. Eating disorders and body image problems are more prevalent with TGNB adolescents and young adults, as compared to their non-transgender peers. More research is needed TGNB minor children, adolescents, and young adults as separate groups and as part of family and social settings where they may experience rejection and delays in seeking and accessing treatment. [ABSTRACT FROM AUTHOR]

Background: Eating disorder treatment approaches and outcome studies have historically centered almost exclusively on cisgender populations. Transgender and nonbinary (TGNB) adults are underrepresented in general and intervention research despite being at increased risk for eating and body image-related problems. Aims: This scoping review was designed to gather and examine the research with TGNB adults who experience eating and body image related problems, as well as clinical studies on the effectiveness of treatment approaches. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used for reporting this review. MEDLINE and PsychInfo were used as electronic databases for searching subject terms. Inclusion criteria for studies required the quantitative measurement or qualitative exploration of body image or eating for TGNB adults. The relevant data were extracted and summarized based on quantitative findings and qualitative themes. Results: After review of over 1258 articles, 59 studies met criteria and data were extracted and summarized. Factors associated with eating disorders and body image problems across studies suggests gender-affirming medical interventions are effective and emphasized treatment for an eating disorder is warranted alongside gender affirming medical care. Body image was associated with eating patterns aimed at meeting gendered ideals of body shape and size. There was variation in guiding theories and absence of consensus in the definition of transgender in the review studies. This likely demonstrates the changing language, social acceptance of TGNB people and identities, diagnostic criteria, and clinical conceptualizations of eating and body image. Conclusions: Future research should consider the use of theory for guiding inclusion of salient social factors influencing eating patterns, body image, and treatment outcomes. In addition, future research is needed that centers on nonbinary and genderqueer populations, as well as those from minoritized racial and ethnic groups to inform culturally appropriate concerns, needs, and treatment modalities. Plain English Summary: Fifty-nine published research studies with transgender adults on eating patterns, body image, and associated risks and comorbidities were collected and summarized. Across studies, gender affirming medical interventions like hormone therapy and surgery were associated with decreases in eating disorder symptoms and improved body image. Studies from interviews with transgender adults found social causes for disordered eating and poor body image including rejection and discrimination. Future studies should use guiding theories for testing the causality and consider rejection and discrimination experienced by transgender adults. [ABSTRACT FROM AUTHOR]

Transgender and gender non-binary (TGNB) adults face structural and interpersonal stigma from their families and society at large when living openly and seeking gender affirming healthcare. To better understand the significance of family and social contexts for shaping the lived experiences of TGNB adults, this phenomenological qualitative study aimed to describe TGNB transgender identity development and coming out processes inclusive of significant past and present experiences. TGNB participants (N = 17) completed a one-time semi-structured interview and member checking of analysis findings. Results identified two themes: 1) TGNB identity development and socially "testing the waters" in gender expression; and 2) coming out when "the world just refuses to make space." Implications are made for advancing feminist systemic research and clinical practice with TGNB clients. [ABSTRACT FROM AUTHOR]

Family relationships are protective against poor behavioral health for youth. Couple and Family Therapy (CFT) graduate programs are critical for readying the behavioral workforce to work systemically with youth and their families. This study identified the elements of a CFT masters training process that readied students to work with youth. Qualitative description with focus group interviews of three cohorts of master's students (n = 14) was used. Thematic analysis identified five themes demonstrating the primacy of early experiences for fostering safety, reflective and active training approaches, multicultural and sexuality topics, and pragmatics of talking to physicians and children. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to explore the impact of an Interprofessional Transgender Health Education Day (ITHED) on student knowledge and attitudes towards the transgender population. METHODS: This mixed-methods study involved a pre-test and post-test survey administered to students (n=84 pre-test and n=66 post-test) in four health professional education programs (medicine, family therapy, speech, language, and hearing sciences, nutrition and dietetics.) surrounding participation in the ITHED. Differences in total and subscale scores of the Transgender Knowledge, Attitudes and Beliefs (T-KAB) before and after participation in the ITHED scale were analyzed using independent samples t-tests; qualitative responses were analyzed using a thematic, inductive process. RESULTS: Independent samples f-tests revealed no significant differences in pre- and post-ITHED total T-KAB scores, the three subscales, or for those who reported previous training, clinical experience, and regular contact with transgender individuals. Qualitative themes included: enthusiasm for learning about transgender health; need for healthcare providers to provide excellent care for transgender patients; and power of learning directly from the transgender community. CONCLUSIONS: Though participation in the ITHED did not result in significant changes in T-KAB scores, participants demonstrated high baseline T-KAB scores and expressed strong enthusiasm for learning about transgender health. Positioning transgender voices at the forefront of the education can foster a powerful student learning experience and honor ethical guidelines. [ABSTRACT FROM AUTHOR]

Not invited to the T party... Throughout this review, we intentionally used LGB with no T (i.e., transgender) due to the research within I Marriage and Health i only focusing on cisgender LGB people and their experience. The underlying assumptions of minority stress theory and the explanation for health disparities offer support for why the editors and various researchers in I Marriage and Health i are asking the novel questions addressed. I Marriage and Health: The Well-Being of Same-Sex Couples i , edited by Liu, Reczek, and Wilkinson (2020), is a compilation of research articles that highlight novel research about Lesbian, Gay, and Bisexual (LGB) partnerships using data mostly collected prior to Obergefell v. Hodges. I Marriage and Health i ask novel questions to highlight how oppression has negatively impacted the mental and physical health LGB partnerships. [Extracted from the article]

Gender identity change efforts (GICE) and sexual orientation change efforts (SOCE) continue to be practiced by mental health professionals and religious organizations. It is frequently sought out by families who are rejecting loved ones with marginalized sexual orientations and gender identities. This study explored the impact of religious and nonreligious GICE on the mental health of transgender and nonbinary adults through a secondary data analysis of the U.S. Transgender Survey. Results found that both nonreligious and religious GICE were associated with increased odds of suicidal ideation and attempts. Only nonreligious GICE was associated with severe psychological distress. Black individuals showed increased odds of binge alcohol consumption when exposed to nonreligious change efforts, while White individuals showed decreased odds with both nonreligious and religious GICE. This study supports ethical and legal bans on GICE. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, and queer (LGBQ) young people from religious families are at increased risk of family rejection, poor mental health outcomes, and are overrepresented in mental health services. This article describes a two-part qualitative study aimed at exploring the experiences of LGBQ young adults from religious families in psychotherapy, identifying positive and negative psychotherapy experiences, and understanding the influence of family and religion on the psychotherapy experience. Data were collected through a web-based survey (n = 77) and interviews (n = 7) with LGBQ young adults (ages 18-25) from religious families. The study followed an interpretative phenomenological approach. Integrated results found often invisible, relational therapy processes, and religious discourses as significant to LGBQ young people who seek psychotherapy. Implications for future research, effective systemic family therapy practices with LGBQ young people from religious families, and a critique on ethical and legal limits of confidentiality with policy implications are outlined. [ABSTRACT FROM AUTHOR]

Nephrology interdisciplinary guidelines, professional codes of ethics, principle-based ethical standards, and literature promote patient autonomy and self-determination through shared decision making as ethical practice. Healthcare professionals are accountable for practice that is mindful of the impact of cultural diversity and community on the values and beliefs of the patient, an important part of shared decision making (SDM). Despite previous research regarding dialysis decision making, relational autonomy in chronic kidney disease (CKD) and end-stage kidney disease SDM conversations is not well understood. This systematic literature review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework for identifying peer-reviewed literature on SDM for CKD. The findings were summarized into four broad themes: (1) promoting autonomy is a foundation of medical caring; (2) providers have a responsibility to respond to their asymmetrical social power; (3) autonomy is situated within the context of the patient; and (4) dialogue is a tool that negotiates clinical recommendations and patient goals. The caring practices of promoting autonomy with a dialogical resolution of a conflict acknowledging the interdependence of the parties and the patient's social–relational situatedness support a perspective of relational autonomy in dialysis decision-making practice and research. [ABSTRACT FROM AUTHOR]

Nephrology social workers are trained to assess and address the ecosystemic splits in nephrology care that threaten the resilience of dialysis patients and their families. Given this training and skills, nephrology social workers are ideally positioned to help center the patient and their decision partner in modality decisions that are increasingly influenced by provider incentives to promote home dialysis and transplant utilization. The Family Resilience Framework provides a paradigm for social work assessment and intervention during the iterative process of dyadic dialysis decision-making to develop an individualized care plan that promotes resilience through attunement to dyadic processes. [ABSTRACT FROM AUTHOR]

A majority of sexual minority (SM; lesbian, gay, bisexual, queer) adults identify as religious and use religious coping strategies for dealing with life's stressors. SM people report experiencing unique minority stressors of interpersonal rejection in family and religious settings as a product of religious doctrine that rejects same-sex relationships and attraction; however, the usefulness of religious coping strategies for handling minority stressors for improving the mental health of SM people is still unknown given mixed findings in previous studies. In addition, locating particular measures of religiously based minority stress may aid in identifying key factors affecting mental health. This study utilized quantitative data from a web-based survey to explore the relationships between religious coping, interpersonal religious discontent, minority stressors of family rejection and internalized stigma, and depressive symptoms of SM adults from religious families (n = 384). Moderation analysis demonstrated the significant interaction of religious coping and interpersonal religious discontent with minority stress factors for exacerbating the influence of greater minority stress on greater depressive symptoms when religious coping and interpersonal religious discontent were higher. In addition, those who left their religious affiliations experienced decreased minority stress and used less religious coping strategies. Implications for family psychotherapy and future research are addressed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the experiences of students enrolled in COAMFTE-accredited Couple and Family Therapy programs who transitioned to telehealth and telesupervision during the COVID-19 pandemic. Using Likert scales and free response prompts, 77 graduate students provided insight into how their academic programs and external internships prepared them for the transition. Results indicated webinars, articles, and additional supervision were the most frequently used training methods. Many participants reported feeling supported by their academic program and external internship supervisors, particularly through well-being check-ins, candid and open discussion, and increased availability of supervisors. A smaller proportion of participants experienced a lack of communication from leadership, leading to feelings of disorganization and isolation. These results highlight specific ways supervisors and instructors can support students in times of transition and crisis. Recommendations regarding communication with students and engagement of interns for academic programs and external internship sites are provided. [ABSTRACT FROM AUTHOR]

Couple and family therapists are increasingly using telehealth platforms to deliver services. Unfortunately, the literature on relational teletherapy is not well developed. This study sought to understand experiences of teletherapy with couples and families as it contrasts with individual clients and in‐person therapy. We utilized a hermeneutic phenomenological approach to qualitative inquiry from data collected through open‐ended questions on a web‐based survey of graduate student trainees (n = 66) in COAMFTE‐accredited couple and family therapy programs. Thematic analysis identified the body‐of‐the‐therapist and client as they exist (and are obstructed) due to technology for creating barriers and opportunities in translating CFT intervention to telehealth platforms. Relational teletherapy cultivated therapist creativity and exhaustion. It also made plain the need for systemic interventions with children and adolescents that engages their parents and home environments. Implications for CFT practice, training, and intervention research are outlined. [ABSTRACT FROM AUTHOR]

Sexual minority persons from religious families may experience low acceptance by parents, however, little is known about the relationship of religiosity and parent relationships on mental health into adulthood. This study sought to test a moderated mediation model predicting depression based on religious fundamentalism, parent acceptance, and parent-child relationship quality. Sexual minority adult participants (n = 384) from across the U.S. completed a web-based, anonymous survey. Results found a conditional indirect effect of religious fundamentalism on depression through parent acceptance with the parent-child relationship quality moderating the relationship between parent acceptance and depression. This was significant up to age 52. Clinical implications and future research with sexual minority adults and their families are explored. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lesbian, gay, bisexual, and questioning (LGBQ) adolescents are at increased risk of poor mental health due to minority stress, a chronic stress associated discrimination, social rejection, and victimization brought on by prejudicial attitudes towards LGBQ individuals. To improve understanding of the differential impact of various kinds of victimization on mental health outcomes for LGBQ adolescents, we analyzed data from the 2015 Youth Risk Behavior Survey (YRBS) for victimization and mental health symptom clusters and associations high school youth and compared by sexual orientation and gender. METHODS: Separate Latent Class Analysis (LCA) was conducted to identify profiles of both victimization and mental health symptoms for participants (N = 15,624). Subsequently, stratified weighted logistic regression models were used on an eligible analytic sample of 11,458 to assess differences in the association of victimization and mental health between LGBQ and heterosexual high school students. RESULTS: In each LCA, participants were assigned to one of 3 classes for victimization (minimal, 81.3%; bullying, 12.5%; or physical/sexual violence, 6.2%) and 1 of 2 classes for mental health symptoms (minimal, 81.2%; severe, 18.8%). LGBQ participants were overrepresented in physical/sexual violence and bullying victimization profiles. Both bullying and physical/sexual violence profiles were associated with almost 5 times the odds of endorsing severe mental health symptoms. Conclusions: This study expands our understanding of the relationship between types and effect of peer victimization for LGBQ and heterosexual youth with implications for school health and prevention efforts through increased positive school climate for LGBQ students. [ABSTRACT FROM AUTHOR]

The current study compared transracial adoption (TRA) parents who adopted internationally to those who adopted domestically (total n = 188; domestic n = 71; international n = 117) on multicultural experiences, perception of discrimination, and positive feelings toward racial minority groups, adoption support, and Parental Cultural Competence (PCC). Next a model for predicting PCC for both groups was tested. Results indicated significant differences between the groups based on multicultural experiences, perception of discrimination and positive feelings towards racial minority groups, and degree of available adoption support. Regression models predicting PCC tested with groups combined and separate suggest the significant role of multicultural experiences in predicting PCC for both groups; however, the largest effect of multicultural experiences on PCC was seen for domestic transracially adoptive parents. Discussion of results is considered with implications for future research. [ABSTRACT FROM AUTHOR]

A total of 208 therapists and therapists-in-training were surveyed to better understand if clinical assessments and recommendations regarding "sex addiction" changed based upon a client's gender, relationship status, or exclusivity status. Using clinical vignettes, this study examined the clinical assessment and recommendations of licensed mental health providers (n = 92) and mental health providers in-training (n = 116). Results indicated that professional ratings differed based on relationship exclusivity and gender; specifically, female nonmonogamous behavior was rated more negatively than male nonmonogamous behavior, while male monogamous behavior was rated more negatively than female monogamous behavior. Recommendations for treatment varied, with higher addiction ratings leading to greater odds of recommending individual, group, and community support over relational therapy. Clinical and training implications are discussed. Video abstract accessible by clicking here. [ABSTRACT FROM AUTHOR]

Clinical Issue: Lack of transgender health education for healthcare providers and students is consistently reported as a limitation to providing gender-affirming healthcare. Methods: The purpose of this study was to explore the impact of an Interprofessional Transgender Health Education Day (ITHED) in partnership with a community-based organization on student knowledge and attitudes towards the transgender population. We administered a mixed methods, pretest, post-test survey to students in clinical education programs at a private, Midwestern university. Differences in total and subscale scores of the Transgender Knowledge, Attitudes and Beliefs (T-KAB) were analyzed using independent samples t-tests; qualitative responses were analyzed using a thematic, inductive process. Outcomes: Independent samples t-tests revealed no significant differences in pre- and post-ITHED total and subscale T-KAB scores. Qualitative themes included: enthusiasm for learning about transgender health; need for healthcare providers to provide excellent care for transgender patients; and power of learning directly from the transgender community. Conclusions: Participants demonstrated high baseline T-KAB scores and expressed strong enthusiasm for learning about transgender health. Positioning transgender voices at the forefront of the education can foster a powerful student learning experience and honor ethical guidelines. [ABSTRACT FROM AUTHOR]

Modified grounded theory method was utilized to explore the process of how clinicians defined and chose to respond to challenging issues in systemic therapy. Defining an issue as challenging was determined by negotiating internal and external cues and “bringing it forward” and “slowing the pace” emerged as key themes in responding to challenging issues. Clinicians appeared to focus on in-session relational process over content, attending to internal aspects of themselves and their interaction with clients and then negotiating those aspects of awareness with their clients. Practice implications are focused on supervision and helping postgraduate clinicians move toward the developmental stage of experienced professionals. [ABSTRACT FROM PUBLISHER]

Introduction: Caregiver and family engagement in dialysis decisions varies over the end-stage kidney disease treatment trajectory, with family preferences as primary consideration factors for patients starting dialysis. This interpretive phenomenological study explores how dialysis patients and their partners experience dialysis decisions. Methods: Thirteen patient-decision partner dyads (26 participants) were interviewed together about their experience with dialysis decision-making. A 5-step iterative process of data analysis occurred concurrently with data collection. Results: The patients received in-center hemodialysis (n = 6) and home dialysis (peritoneal dialysis or home hemodialysis (n = 7). Decision partner relationships included romantic partners (n = 9) and either parent, sibling, or friend (n = 4). Fifty-7 percent of participants were White; 46% of patients were women, and 76% of decision partners were women. Three interrelated themes were identified: Their body, but not their life; Seeking semiliberation, and Decision-making is caring. Discussion: Dyads were attuned to patient autonomy while managing the collateral effects of dialysis. Shifting the paradigm of dialysis treatment decisions from promoting patient autonomy to dialogues exploring relational autonomy helps providers balance the competing demands of incentivized standards to promote home dialysis with patients and their decision partners realities. Public Significance Statement: This study centers the relational autonomy of patients in demonstrating that while dialysis patients and their decision partners prioritized the autonomy of the person on dialysis, the focus of treatment decisions shifted over time from managing symptoms and treatment side-effects to shared family goals. Health care providers who engage in shared decision-making with people on dialysis should recognize patients are part of relational systems and decisions are influenced by relational context. Attention to relational autonomy in shared decision-making can help health care providers and the patient system navigate complicated dialysis decisions. [ABSTRACT FROM AUTHOR]

Background: Having a mental health diagnosis is associated with contraceptive non-adherence and user-related contraceptive failures of short-acting methods. There is a lack of research on the relationship between mental health diagnoses and early discontinuation of highly effective long-acting reversible (LARC) methods such as the intrauterine device (IUD) and subdermal implant (SDI).Methods: Using a Primary Care and Obstetrics and Gynecology Patient Data Registry, we conducted a cross-sectional analysis of the relationship between any mental health diagnosis (any anxiety disorder or depression) and early LARC removal (<1 year post-insertion) among 385 reproductive-aged (14-50 years) women in 2008-16. Adjusted logistic regression was used to calculate odds ratios and 95% confidence intervals.Results: Almost 10% (n = 37) of the sample had an early LARC removal, of which 62.2% were hormonal IUD and 37.8% were SDI. Women with a mental health diagnosis had a higher prevalence of early LARC removal (13.6% vs. 8.0%, p = =.090). Although non-significant, there was a trend in adjusted analyses indicating twice the odds of early removal for women with a mental health diagnosis versus no diagnosis (OR = =2.04, 95% CI = =0.97-4.27).Limitations: This study is limited by a small sample size and availability of variables from a reportable medical record database. Pregnancy intentions and side effects of method use could not be accounted for which may have impacted timing of removal.Conclusions: Understanding why women choose early LARC removal can inform counseling to help women make informed choices about their contraceptive method that meets their reproductive needs. [ABSTRACT FROM AUTHOR]