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PurposeTo explore trends in sexual orientation group differences in suicidality among Indigenous adolescents and evaluate whether gaps between heterosexual and sexual minority/Two-Spirit adolescents have changed over time.MethodsLeveraging pooled school-based population data from five waves of the British Columbia Adolescent Health Survey (1998-2018), we used age-adjusted logistic regression models, separately for boys and girls, to examine 20-year trends and disparities in past year suicidal ideation and suicide attempts among heterosexual and sexual minority/Two-Spirit Indigenous adolescents (N = 13,788).ResultsSuicidal ideation increased among all sexual orientation groups in 2018 compared to previous survey waves. Suicide attempts spiked for heterosexual girls in 2003, remained stable for heterosexual boys, and decreased for sexual minority/Two-Spirit boys and girls over time. Compared to their heterosexual peers, sexual minority/Two-Spirit boys had higher odds of suicidal ideation since 1998, whereas sexual minority/Two-Spirit girls had higher odds of suicidal ideation since 2003. Sexual minority/Two-Spirit (vs. heterosexual) boys were approximately 4-7 times more likely to attempt suicide since 2008, whereas sexual-minority/Two-Spirit (vs. heterosexual) girls were approximately 3-4 times more likely to attempt suicide since 2003. These gaps in suicidality were persistent across time.DiscussionSexual minority/Two-Spirit Indigenous adolescents are at an elevated risk for suicidality compared to their heterosexual Indigenous peers. While trends of suicidal ideation worsened for all Indigenous adolescents, suicide attempts either lessened or remained stable over time. Greater efforts are needed to help reduce suicidality among Indigenous adolescents in Canada, especially among sexual minority/Two-Spirit young people.

Scholarly conversations regarding sexual violence and sexuality education typically emphasise cisgender and heterosexual experiences, leaving sexual and gender minority young people's voices unheard. This happens despite adolescence being a crucial period for the onset of sexual violence, with sexual and gender minority youth reporting elevated levels of victimisation. Moreover, the preponderance of research focusing on victimisation suggests notable gaps in our understanding of sexual violence perpetration. This study examined contextual factors shaping sexual violence victimisation and perpetration among sexual and gender minority youth, with school playing a key role. Based on qualitative data from semi-structured interviews with 50 young people aged 14-26 years who self-reported sexual violence perpetration in the Growing Up with Media survey, the analysis demonstrates how schooling's 'hidden curriculum' leaves sexual and gender minority youth ill-equipped to navigate the world of sexuality. Formal sexuality education remains heteronormative and gender-segregated, resulting in incomplete understandings of sexual violence. At the informal level, gendered double standards and peer norms reinforce the second-class sexual citizenship of sexual and gender minority youth. Our findings suggest that schools may be complicit in sexual violence victimisation and perpetration by sending limited and mixed messages regarding gender and sexuality. Research and policy implications are discussed.

Research on enacted stigma, or stigma- and bias-based victimization, including bullying and harassment, among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth often focuses on one context (e.g., school) or one form (e.g., bullying or microaggressions), which limits our understanding of these experiences. We conducted qualitative go-along interviews with 66 LGBTQ adolescents (14-19 years) in urban, suburban, town, and rural locations in the United States and Canada identified through purposive and snowball sampling. Forty-six participants (70%) described at least one instance of enacted stigma. Three primary themes emerged: (1) enacted stigma occurred in many contexts; (2) enacted stigma restricted movement; and (3) second-hand accounts of enacted stigma shaped perceptions of safety. Efforts to improve well-being among LGBTQ youth must address the diverse forms and contexts of enacted stigma that youth experience, which limit freedom of movement and potential access to opportunities that encourage positive youth development. School nurses can play a critical role in reducing enacted stigma in schools and in collaboration with community partners.

Go-along interviews, which are interviews conducted while being in and moving within participant selected spaces, were conducted with 66 lesbian, gay, bisexual, transgender, and queer adolescents (14-19 years old) in their self-identified communities to explore perceived community attributes, including safe spaces, resources, and supports; this article highlights methodological lessons learned. Successful recruitment in 2 countries and varied community settings required partnership with local lesbian, gay, bisexual, transgender, and queer supporting agencies, including school-based gay--straight alliances. Youth chose to walk, use public transportation, and drive to community locations, identifying numerous formal and informal resources in their communities. Participant reflections highlighted that go-along interviews can be conducted in safe ways that encourage lesbian, gay, bisexual, transgender, and queer youth to express themselves about communities in which they live, study, work, play, and relax.

Drawing on data from focus groups with 152 trans youth aged 14 to 18 years in the United States, this article explores the factors that the participants understood as contributing to adolescent pregnancy among trans youth. Youth posited that unintended pregnancies occur due to barriers to contraceptives; a lack of gender-affirming sexual health education; sexual assault and dating violence; and mental health–influenced sexual risk-taking. Participants suggested that intended pregnancies may be a self-development strategy; a self-directed effort to repress/change gender modality or identity; and due to the perceived incompatibility between pregnancy and transition, where pregnancy must occur prior to transitioning. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between substance use and sexual orientation among Asian adolescents in Canada. We analyzed an East- and Southeast-Asian subsample of a province-wide, school-based survey (weighted N = 51,349). Compared to heterosexual adolescents of the same gender, gay, lesbian, bisexual, and mostly heterosexual adolescents were more likely to use alcohol, marijuana, or other illicit drugs. Particularly, sexual minority girls were at increased risk for substance use. The findings suggest the need for substance use prevention interventions that are sensitive to gender, sexual orientation, and culture. (Contains 3 tables.)

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse. (Contains 4 tables.)

Adolescents forego mental health care in spite of self-perceived needs for services; this presents a significant public health problem. Using data from the 2001 Adolescent Health Care Access Survey of 16-year-olds in Saint Louis County, Minnesota, we assessed barriers to mental health care among the 878 respondents who reported ever needing psychological or emotional counseling. Demographic characteristics were compared among those who had always, had sometimes, or had never received needed mental health care. Overall, 57% of the youths reported foregoing mental health care at least once. Girls and adolescents living with both parents were significantly more likely to have foregone care. Youths identified two common barriers to accessing care: "Thought or hoped the problem would go away" (50%) and "Didn't want parents to know" (36%). School-based interventions should be sensitive to mental health needs, especially among girls and teens living in two-parent families. (Contains 4 tables.)

Some studies suggest lesbian, gay, and bisexual (LGB) teens are at higher risk than peers for violence at home, in school, and in the community. That can bring them into the child welfare system or services for runaway and homeless teens. This study compared self-reported experiences of sexual and physical abuse based on sexual orientation and gender in seven population-based surveys of youth. The authors used c[squared] and age-adjusted odds of abuse to compare bisexual to heterosexual, mostly heterosexual, and gay and lesbian students. They also provide case studies to illustrate the experiences of such youth. (Contains 3 tables.)

The purpose of this descriptive study was to pilot test an Asthma Assessment Interview (AAI) and to determine the approximate age a child with asthma is capable to self-carry an inhaler. A random sample of 34 students with asthma (Grades K through 10) from a midwestern school district were interviewed by the school nurse using the AAI, which assesses knowledge of asthma, symptoms, coping strategies, medication administration skills, triggers, and judgment about when to use an inhaler including the ability to tell time. Only 38% passed the AAI. No students ages 5 to 7 passed, fewer than 50% of students ages 8 to 10 passed, and half or more of students age 11 or older passed the AAI. Results suggest a school nurse should supervise elementary students when using an inhaler; most should not self-carry. The AAI can be a useful part of the school nurse's assessment. (Contains 4 figures.)

Sexual abuse is a profound stressor that complicates the development and health of adolescents, yet its prevalence has been difficult to estimate among adolescents in school populations. This study explored the prevalence of both incest and nonfamily abuse in 2 cohorts of adolescents in Minnesota in the 1990s (1992: N = 77,374; 1998: N = 81,247). Findings indicate that sexual abuse was reported by both boys and girls and among students of all ethnic groups. Approximately 10% of adolescents reported sexual abuse in each cohort, with girls 5 times more likely to report abuse than boys. Ethnic variation was minor, with African American, Native American, and Hispanic teens slightly more likely to report abuse than White or Asian American youth. School nurses should routinely assess for a history of sexual abuse in adolescents and should be prepared to provide support and referral for abused students and their families.). Findings indicate that sexual abuse was reported by both boys and girls and among students of all ethnic groups. Approximately 10% of adolescents reported sexual abuse in each cohort, with girls 5 times more likely to report abuse than boys. Ethnic variation was minor, with African American, Native American, and Hispanic teens slightly more likely to report abuse than White or Asian American youth. School nurses should routinely assess for a history of sexual abuse in adolescents and should be prepared to provide support and referral for abused students and their families. (Contains 4 tables.)