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Introduction: It is well-documented that sexual minority youth are at a higher risk of experiencing being thrown away and running away from their parental home, the two main pathways to youth homelessness. These challenges are often related to family rejection and strained child-parent relationships. However, little knowledge exists of how sexual minority status intersect with race/ethnicity in this context. Methods: The study utilized data from Wave III (2001–2002) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) (1994–2018) with a sample size of 14,181 survey participants to examine the effects of sexual minority status and race/ethnicity on the experience of youth being ordered to move out and running away from one's parental home. Results: A series of regression analyses revealed that sexual minority youth were more likely to experience being thrown away and running away from their parental home. Furthermore, the findings showed significant intersectional disparities from sexual minority status and Black race in experiences of being thrown away and running away even after controlling for various sociodemographic, family circumstances, and other risk factors. Black sexual minority youth faced heightened risks of parental home displacement, indicating increased vulnerability within sexual minority youth. Conclusions: The study provides the first large-scale, nationally representative population-based evidence for the unique risk that Black sexual minority youth are facing with respect to the two pathways to youth homelessness. Policy Implications: Families with sexual minority youth and youth experiencing homelessness may benefit from racially/ethnically specific and sexuality-specific interventions. [ABSTRACT FROM AUTHOR]

Although parents of sexual and gender minority (SGM) adolescents play a critical role in communicating about sexual health to their children, most parents have reported that they are unknowledgeable and uncomfortable talking about sexual health to their SGM adolescent. Because of the limited availability of sex education programs for parents of SGM adolescents, the study aimed to (1) describe the attitudes toward using and willingness to use a hypothetical online sex communication intervention for parents of SGM adolescents and (2) examine factors associated with willingness to use such an intervention. Parents of SGM adolescents from across the United States (N = 385) completed an online survey from March 10–16, 2023. Most participants were open to participating in a hypothetical online sex communication program and had positive attitudes toward it. Logistic regression results showed that participants who overall agreed a hypothetical online parent-based sex education intervention would be helpful and of interest had higher odds of being overall willing to participate in such a hypothetical intervention. Additionally, participants with higher income levels were also more likely to be willing to participate in a hypothetical program. Results from this exploratory study suggest that most parents of SGM adolescents have positive attitudes toward a hypothetical online parent-based sex education program and are willing to participate in it, highlighting a need to develop sex education programs tailored to the needs and preferences of parents of SGM adolescents. Additionally, equitable access to such programs is necessary especially regarding income level. [ABSTRACT FROM AUTHOR]

School nurses are uniquely positioned to support lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) students. One approach is involvement in Gender and Sexuality Alliances (GSAs). GSAs have been found to improve outcomes for LGBTQ students. The purposes of this quality improvement project were to build infrastructure for GSAs by implementing a GSA Support Plan including a digital resource binder, GSA advisor trainings, and establishment of an Advisor Leadership Committee and increase the number of schools with a GSA. The binder was distributed electronically to 95 advisors. Forty-nine participants attending virtual trainings. A statistically significant increase in all measures of participant confidence occurred between the pre- and post-training surveys. The Advisor Leadership Committee was established. This paper adds to the literature by showing that support for GSAs is important to aiding LGBTQ students. Further, authors suggest ways in which school nurses can harness their expertise to be involved with GSAs. [ABSTRACT FROM AUTHOR]

LBGTQ+ students often miss the support and information they need in the school nursing, but little is known about junior high school (JHS) nurses' work with LGBTQ+ students. 15 JHS nurses were interviewed in focus groups about their perceptions of supporting LGBTQ+ students. Four interconnected themes were identified with inductive thematic analysis: (1) JHS nurses' professional identity and practice; (2) Recognition of sexual and gender diversity in school; (3) Family acceptance process; and (4) LGBTQ+ students as school nursing clients. JHS nurses self-identified as accepting professionals, but having limited skills, knowledge, and education needed in supporting LGBTQ+ students. Supporting LGBTQ+ students is a complex phenomenon, and to enhance JHS nurses' competence in providing care for these students, sexual and gender diversity needs to be included in evidence-based nursing information sources, covered in nursing education, and the school needs to be secured as LGBTQ+ safe place. [ABSTRACT FROM AUTHOR]

This study assessed associations between state legislative activity, sexual minority adolescent minority stress, and suicide attempt. State-level sociopolitical climates are variably supportive and hostile toward sexual minority adolescents. This study, therefore, examined whether state sociopolitical climate is associated with sexual minority adolescent minority stress and, in turn, the risk of suicide attempt in this high-risk population. A nationwide sample of sexual minority adolescents (N = 2,558) responded to online surveys in 2018 and 2019 assessing minority stress and past-year suicide attempt. Legislative activity scores, that is, the number of anti- and pro-LGBTQ pieces of legislation proposed each year in each state, were accessed from the Human Rights Campaign State Equality Index, assigned to youth based on their state of residence, and used as an indicator of sociopolitical climate. We examined associations between legislative activity, minority stress, and suicide attempt using path analyses. Legislative activity is directly associated with sexual minority adolescent minority stress and indirectly associated with suicide attempt through minority stress among sexual minority adolescents. Amidst nationwide attacks on sexual minority adolescent health and well-being, study findings emphasize the associations between sociopolitical climate, minority stress exposure, and health. [ABSTRACT FROM AUTHOR]

Youth who identify as transgender or gender non-conforming (TGNC) are at greater risk than their peers for mental health concerns. School staff knowledge and training on supporting the mental health of these students may have a significant effect on this population. To better understand where school staff are provided such training, we conducted a scoping review to determine any differences in staff knowledge and training between urban, suburban, and rural high schools. We searched five electronic databases using keywords: transgender or gender variant or gender non-conforming, mental health, school, and student. Twelve articles met the criteria for review. We found no comparative studies that differentiate staff training and knowledge across high school settings. Most articles demonstrated the efficacy of training school staff in supporting TGNC students, and demand from school staff for access to such training. School nurses can lead and advocate for such training to support TGNC students. [ABSTRACT FROM AUTHOR]

Sexual assault and harassment (SAH) has become an increasing global concern that disproportionately impacts gender and sexual minority youth, yet research is scarce outside Western nations. In addition, sexual assault and sexual harassment are closely related experiences in both academic inquiries on sexual victimization and public discussion in the global #Metoo movement. Drawing from a large Chinese college student sample (N = 50,818), we investigated the prevalence of SAH victimization during childhood, adolescence, and emerging adulthood, as well as the SAH disparities between sexual minority and heterosexual youth. The population‐weighted prevalence of SAH victimization was estimated to be 20.23% during childhood, 42.87% during adolescence, and 21.87% during emerging adulthood, with more than half of the youth (55.41%) having ever experienced any SAH. Logistic regression results suggested girls and sexual minorities were disproportionally impacted across childhood, adolescence, and emerging adulthood. The discussion is framed in the context of Chinese culture and current Chinese legislation related to SAH. [ABSTRACT FROM AUTHOR]

This study investigated differences in depressive symptoms, loneliness, and self‐esteem for monosexual (lesbian, gay) and plurisexual (bisexual, pansexual, queer) sexual minority youth (SMY) by relationship status (single, partnered) and relationship configuration (same‐gender partner, different‐gender partner). Participants included 338 SMY (Mage = 19.10 years) who reported on their relationship status, partner's gender identity, well‐being, and ability to confide in partner about LGBTQ issues. Results indicated that for plurisexual youth, single status was associated with greater loneliness; plurisexual youth with same‐gender partners reported fewer depressive symptoms and marginally greater ability to confide in their partner about LGBTQ issues than those with different‐gender partners. Findings reveal similarities across SMY while also highlighting some unique challenges among plurisexual youth with different‐gender partners. [ABSTRACT FROM AUTHOR]

This research examined associations between dating and number of friends for rural adolescents with same‐sex and other‐sex dating partners using longitudinal sociometric data (N = 2826; 55% female, 87% White, mean age = 14 at baseline). In multilevel models assessing within‐person change, boys gained female friends when they were in same‐sex romantic relationships, compared to when they were single. In contrast, girls in same‐sex relationships lost female friends and gained male friends. Adolescents in other‐sex romantic relationships gained same‐sex friends compared to when they were single. Results advance understanding of adolescent social and sexual development, suggesting that sexual minority adolescents find allies when dating but may struggle to maintain same‐sex friendships. [ABSTRACT FROM AUTHOR]

Abstract Background Little comparative data on substance use (SU) between sexual minority youth (SMY) and heterosexual youth (HET) is available. This study compares the prevalence of SU in an urban cohort between SMY and HET and evaluates demographic and psychosocial predictors of SU. Methods Data came from a prospective-longitudinal cohort study in an urban setting (N = 1297). SU and psychosocial variables such as internalizing symptoms, self-control, sensation-seeking, bullying-victimization, subjective stress, leisure activities, and peer influences were assessed with self-reports at age 17 and 20. SU was stratified by sex and sexual attraction, and the groups were compared using regression models, with demographic and psychosocial variables included as covariates. Results SMY- and HET-youth displayed differences in a number of psychosocial variables. Overall, SMY- and HET-youth differed in their 12-months prevalence of SU: At age 17, SMY-females had significantly higher rates of SU than HET-females for cannabis (aOR = 2.14, p = 0.04), ecstasy/MDMA (aOR = 4.29, p = 0.01), and hallucinogens (aOR = 5.59, p = 0.02). At age 20, SMY-females had significantly higher rates of SU than HET-females for tobacco (aOR = 2.06, p = 0.03), cannabis (aOR = 2.24, p = 0.004), ecstasy/MDMA (aOR = 3.93, p

Introduction: Bystander intervention is a promising approach for prevention of sexual violence. Assessing factors that may promote or hinder bystander intervention among sexual minority adolescents (i.e., lesbian, gay, bisexual, queer) is essential, given high rates of violence among sexual minority youth. Prior research examining barriers and facilitators of bystander intervention intentions does not consider how factors may vary by sexual identity. As such, the current study aimed to (1) examine how barriers and facilitators of bystander intentions, bystander intentions, and bystander behavior vary between heterosexual and sexual minority high school adolescents and (2) explore mediators of the association between sexual identity and bystander intervention intentions. We proposed that students' level of school connectedness, gender equitable attitudes, and anticipated positive consequences of bystander intervention (e.g., having a moral desire to help) would promote bystander intervention intentions, whereas binge drinking, and students anticipated negative consequences of bystander intervention (e.g., fear for one's own safety) would tend to weaken bystander intervention intentions. Methods: Participants included 2,645 10th grade students (Mage = 15.37, SD = 0.61) recruited from high schools in the Northeast United States. Results: Sexual minority youth reported higher bystander intentions, bystander behavior, anticipated positive consequences of bystander intervention, gender equitable attitudes, and binge drinking relative to heterosexual youth. Sexual minority youth had lower school connectedness than heterosexual youth. Anticipated negative consequences of bystander intervention did not vary by group. Parallel linear regression analyses found that only anticipated positive consequences of bystander intervention and gender equitable attitudes fully mediated the relationships between sexual identity and bystander intentions. Conclusions: Bystander intervention programs may benefit from attending to specific facilitators of bystander intervention among sexual minority youth, such as gender equitable attitudes. [ABSTRACT FROM AUTHOR]

Positive family functioning is negatively associated with drug use, sexual risk behaviors, and depression; however, existing measures of family functioning were not specifically developed for Latina/o/x sexual minority youth (LSMY). This study examined the factor structure of family functioning and whether it is invariant across sexual orientation (i.e., LSMY and heterosexual Latina/o/x youth). Participants included 454 Latina/o/x youth (LSMY: n = 115, 25.3%). Results yielded a higher-order family functioning factor consisting of parental involvement, positive parenting, parent-adolescent communication, and parental monitoring. The model fit for the sample was acceptable (CFI/RMSEA =.91/.04) and configural invariance indicated that the model fit the data adequately in both groups (CFI/RMSEA =.87/.05). Fit of the metric invariance model (Δχ2 (42) = 54.83, p =.09, ΔCFI, ΔRMSEA, ΔTLI <.001) was not significantly worse than the configural model, however, the scalar invariance model (Δχ2 (42) = 80.18, p <.001, ΔCFI =.01, ΔRMSEA, ΔTLI <.001) was significantly worse than the less constrained models, suggesting that family functioning was noninvariant with regard to sexual orientation. Noninvariance may be related to the unique experiences of LSMY related to sexual orientation that are not captured in existing measures of family functioning. [ABSTRACT FROM AUTHOR]

Objective: The present study sought to explore how support from one's family of origin predicts the development of self‐esteem across the transition to adulthood for sexual minority individuals compared with their heterosexual peers. Background: Familial relationships have an influence on the development of self‐esteem. Additionally, lesbian, gay, and bisexual emerging adults may perceive less support from their families than heterosexual peers. Methods: The present study used secondary data from the National Longitudinal Study of Adolescent and Adult Health study. The study conducted a multiple group latent growth curve following the development of self‐esteem. Results: Results indicated that feeling as though one's family understood them in adolescence was significantly associated with self‐esteem during adolescence for both sexual minority and majority individuals. Additionally, this sense of feeling understood by one's family was also associated with the rate of change of the developmental trajectory of self‐esteem across four time points. Discussion: The study illustrates the lasting influence one's family of origin has during this important developmental moment. Results illustrated how familial understanding in adolescence was significantly associated with the development of self‐esteem for both sexual minority and sexual majority individuals. Implications: The relationship with the family of origin has a lasting impact into emerging adulthood, and practitioners working with families can help ensure support for sexual minority adolescents. This includes, but is not limited to, encouraging communication within the family to build a sense of understanding. [ABSTRACT FROM AUTHOR]

Background: Little comparative data on substance use (SU) between sexual minority youth (SMY) and heterosexual youth (HET) is available. This study compares the prevalence of SU in an urban cohort between SMY and HET and evaluates demographic and psychosocial predictors of SU. Methods: Data came from a prospective-longitudinal cohort study in an urban setting (N = 1297). SU and psychosocial variables such as internalizing symptoms, self-control, sensation-seeking, bullying-victimization, subjective stress, leisure activities, and peer influences were assessed with self-reports at age 17 and 20. SU was stratified by sex and sexual attraction, and the groups were compared using regression models, with demographic and psychosocial variables included as covariates. Results: SMY- and HET-youth displayed differences in a number of psychosocial variables. Overall, SMY- and HET-youth differed in their 12-months prevalence of SU: At age 17, SMY-females had significantly higher rates of SU than HET-females for cannabis (aOR = 2.14, p = 0.04), ecstasy/MDMA (aOR = 4.29, p = 0.01), and hallucinogens (aOR = 5.59, p = 0.02). At age 20, SMY-females had significantly higher rates of SU than HET-females for tobacco (aOR = 2.06, p = 0.03), cannabis (aOR = 2.24, p = 0.004), ecstasy/MDMA (aOR = 3.93, p < 0.001), stimulants (aOR = 3.45, p = 0.002), and hallucinogens (aOR = 6.65, p < 0.001). SMY-males reported significantly lower rates for tobacco and cannabis than HET-males at age 17. At age 20, they reported significantly higher rates for the use of ecstasy/MDMA (aOR = 2.30, p = 0.04) and hallucinogens (aOR = 2.43, p = 0.03). Conclusions: Given that psychosocial variables were significant covariates of SMY-status and SU, our results underline the importance of accounting for these when explaining differences in SU between adolescents. While differentiation by sex is established in most studies, such standardized comparisons are lacking with regards to sexual identities. But knowledge about SU of SMY is critical for designing effective interventions. This is especially true for SMY-females: Thus, SU in SMY-females early in life needs to be explored more thoroughly and addressed with adequate prevention measures. [ABSTRACT FROM AUTHOR]

Everyday forms of political engagement, such as civic participation and collective action, have been recognized as a crucial factor for positive youth development, but less is known about their resilience effects on youth from marginalized populations, especially in less democratic societies. The present study investigated experiences of everyday political engagement among sexual minority youth in China and examined their compensatory and protective effects against heterosexist victimization. A sample of 793 Chinese sexual minority youth was included in the study. The results showed that collective action operated as a protective factor in buffering the effect of heterosexist victimization, such that its association with academic engagement was not significant among those with higher levels of collective action. In contrast, civic participation served the compensatory function and was associated with greater academic engagement, a stronger sense of school belonging, and fewer depression symptoms, but it did not protect against the negative effects of heterosexist victimization. The findings highlight the importance of identity‐based action among sexual minority youth and provide insight into the differential resilience effects of everyday political engagement. The study has implications for fostering resilience among sexual minority youth with victimization experiences in school and counseling settings. Highlights: The study examines the resilience effects of everyday political engagement among sexual minority youthCollective action serves a protective function and civic engagement acts as a compensatory factorCollective action buffers the effect of heterosexist victimization on academic engagementThe adverse effects of victimization are not found among those with higher collective actionCivic engagement is associated with positive outcomes but does not protect against victimization [ABSTRACT FROM AUTHOR]

BackgroundDifferences in risk and protective factors (e.g., victimization, abuse, social support) have been used to explain elevated rates of suicidal ideation and suicide attempts in sexual minority youth (SMY) relative to heterosexual peers. However, little is known regarding how risk and protective factors may explain suicide risk differences among subgroups of SMY. The aims of this study were to 1) examine differences in prevalence and severity for suicide risk and protective factors among SMY, and 2) explore whether risk and protective factors are differentially associated with suicidal ideation and suicide attempts for SMY subgroups.MethodsParticipants were 6,423 adolescents (ages 12-17) recruited from 14 Emergency Departments across the United States who completed an assessment of suicide risk and protective factors. SMY were 20% of the sample (n = 1,275) and categorized as bisexual (8%), gay/lesbian (2%), mostly straight (5%), or other sexual minority (5%).ResultsBisexual youth had elevated rates of suicidal ideation and attempts, more risk factors (e.g., bullying victimization, depression), and fewer protective factors (e.g., parent-family connectedness, positive affect) relative to mostly straight and other sexual minority youth. Bisexual and gay/lesbian youth only differed in parent-family connectedness (lower among bisexual youth). Depression and parent-family connectedness had weaker associations with suicidal ideation for bisexual youth.LimitationsEmergency departments were not nationally representative. Study design was cross-sectional, preventing causal inferences.ConclusionsInterventions seeking to mitigate risk factors and promote protective factors are greatly needed for SMY and may benefit from tailoring to address unique stressors for sexual minority subgroups.

Sexual minority youth are at increased risk of intimate partner violence (IPV) victimization compared to their heterosexual peers. However, the sexual minority population is not a homogenous group and risk of IPV victimization varies by LGB+ subgroup (e.g., gay/lesbian, bisexual, and unsure). Using two waves of data (2017, 2019) from the National Youth Risk Behavior Survey (YRBS), this study analyzes (a) differences in physical and sexual IPV victimization between heterosexual and sexual minority youth, (b) within group differences among sexual minority youth, and (c) if the relationship between IPV victimization and sexual identity is attenuated after controlling for sociodemographic characteristics and theoretically relevant risk factors. Results indicate that sexual minority youth are at elevated risk of IPV victimization compared to their heterosexual peers. Within-LGB+ analyses show that bisexual youth are more likely than gay/lesbian youth to be victims of sexual IPV. The association between physical and sexual IPV victimization and sexual identity is partially attenuated by sociodemographic variables and observed risk factors. Findings indicate that intervention and prevention programming should be tailored to identify, and treat, the risks and needs of unique, at-risk populations. [ABSTRACT FROM AUTHOR]

Objective: This study examined how preparation for ethnic and sexual orientation bias uniquely and collectively contributes to ethnic identity and sexual orientation identity development among Latinx sexual minority youth (SMY). Background: Theories indicate that parental socialization strategies are associated with youth's development, yet no studies have examined how multiple forms of socialization are uniquely and collectively associated with youth's identity development. Method: Hypotheses were tested using self‐reported data from 385 Latinx SMY (M = 20.26, SD = 2.6). Results: Preparation for ethnic bias was negatively associated with ethnic identity affirmation but positively associated with ethnic identity exploration and resolution. Preparation for sexual orientation bias was negatively associated with ethnic identity exploration, resolution, and affirmation, as well as sexual orientation identity resolution and affirmation, but not exploration. Several interactions emerged between preparation for ethnic bias and sexual orientation bias predicting ethnic and sexual orientation identity. Conclusion: Findings suggest that preparation for bias related to ethnicity and sexual orientation are interconnected, rather than independently shaping ethnic and sexual orientation identities development among SMY. Implications: Additional studies are needed to understand the impacts of family socialization related to ethnicity and sexuality to optimize identity development among Latinx SMY. [ABSTRACT FROM AUTHOR]

We quantitatively examined whether Dutch sexual minority youth raised with conservative Protestantism reported more family- and self-stigmatization, suicidal ideation, and depression than those socialized by Catholicism or Mainline Protestantism. Subsequently, we qualitatively examined how youth raised with conservative Protestantism coped with sexuality identity and mental health challenges. Survey data came from sexual minority youth (N = 584, age 16–25) raised with conservative Protestantism (Evangelical/Pentecostal n = 44 and Dutch Orthodox Reformed n = 88, Mainline Protestantism n = 117, and Catholicism n = 335). Group differences in associations were studied through univariate analysis of variance. Next, thematic and interpretative analyses of six interviews of survey respondents raised with conservative Protestantism were performed. Sexual minority youth raised with Evangelicalism/Pentecostalism reported significant higher levels of family stigmatization and suicidal ideation than youth raised with other Christian religions. They addressed these challenges by religious coping, formulating critiques of stigma, and support from Christian self-help groups. [ABSTRACT FROM AUTHOR]

Sexual minority youth are at increased risk of substance use compared to their heterosexual peers, and bisexual youth appear to be at greatest risk. However, little is known about their motivations for and against using substances, how they make decisions, and what consequences they experience. We used qualitative data from a study of 54 cisgender and transgender male youth (ages 14–17 years) who reported attractions to more than one gender or regardless of gender (i.e., bisexual, pansexual, or queer; collectively referred to as bi+) to explore these aspects of substance use. Participants completed a survey and an interview, and interviews were thematically analyzed. Qualitative analyses revealed that participants described diverse motivations for using substances (e.g., to cope with stress, to experiment, to have fun) and for not using them (e.g., concern about consequences, not having access). The most common sources of stress were mental health problems, school, and family. They did not describe sexual orientation-related stress as a motivation for their use, but they acknowledged that it could influence others' use. Participants also described thinking about when, where, and with whom they were going to use prior to doing so (e.g., only using in safe places and with people who they trusted). Finally, they described a range of consequences they experienced (e.g., getting sick, getting in trouble), and a subset of transgender participants described experiencing dependence symptoms. These findings suggest that substance use prevention and harm reduction interventions for bi+ male youth should address diverse motivations for use, including general stressors, which are often overlooked compared to minority-specific stressors. Further, interventions should approach youth as capable of making decisions. Findings also highlight the particular need to address substance use among transgender youth. [ABSTRACT FROM AUTHOR]

Minority stress theory is a model for understanding health disparities among sexual minorities, defined as those who experience a level of same-sex attraction, identity, or behavior. Methods for assessing minority stress among youth included only adult measures until the development of the Sexual Minority Adolescent Stress Inventory (SMASI). The SMASI appears to be a robust scale in its ability to measure specific stressors and global minority stress among adolescents; however, it does not measure the domain-level constructs of proximal and distal stress, which are integral features of the underlying theory. This study tests the psychometric defensibility of including these domain-level factors within an updated SMASI measurement model. Results provide evidence for the structural validity of the proximal and distal domains within the SMASI measurement model and suggest this updated model has more informational value than the original model for capturing minority stress. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, queer, nonbinary, and other sexual and gender minority (LGBTQ+) youth are at substantially greater risk than cisgender heterosexual youth for experiencing teen dating violence (TDV) victimization, including emotional, physical, and sexual abuse within dating/romantic relationships. Despite these inequities, there are no evidence-based interventions designed specifically to address TDV among LGBTQ+ youth. To redress this dearth of interventions, we utilized a youth-centric approach, wherein 46 LGBTQ+ youth co-developed intervention concepts for reducing TDV. Participants engaged in a process of generating, prioritizing, and refining intervention concepts for reducing TDV inequities using human-centered design activities. LGBTQ+ youth generated eight intervention concepts, including the name, description, audience, problem focus, goals, and process for each. Their interventions focused on strategies for enhancing education, support systems, and advocacy. The intervention concepts had a wide variety of intended audiences, including LGBTQ+ and non-LGBTQ+ youth, teachers, school administrators, and policymakers. Overall, LGBTQ+ youth sought to improve education and skills pertaining to violence, sexual health, and healthy relationships; enhance support systems and resources for students' basic, mental health, and safety needs; and build advocacy channels related to "outing" and LGBTQ+ students' needs. These LGBTQ+ youth-generated programmatic and policy intervention concepts, in addition to our human-centered design approach, can be directly leveraged by health promotion practitioners and prevention experts into future intervention development, implementation, and evaluation efforts to improve LGBTQ+ youth health, well-being, resilience, and advocacy. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim was to assess the associations of antibullying U.S. state statutes that enumerate sexual orientation with exposure to bullying and other stressors and with suicidal ideation and suicide attempts in sexual minority and non sexual minority youth. METHODS: We analyzed data from the 2015 national school-based Youth Risk Behavior Survey, representative of 9th through 12th grade students attending public and private schools in the United States. We reviewed each states antibullying statutes and classified them on enumeration. RESULTS: Antibullying state laws that enumerate sexual orientation were associated with lower risk for suicide attempts and serious attempts requiring medical attention and lower risk for forced sexual intercourse. They were also associated with feeling safe at school or on the way to or from school. Results did not differ by sexual orientation. CONCLUSIONS: Enumeration of sexual orientation was associated with reduced stressors and suicide attempts, but it is insufficient to remove significant disparities based on sexual orientation. Additional policies and practices are required to address persistent sexual orientation disparities in exposure to bullying and suicidal behavior.

Positive views of adolescents' sexuality have only begun to garner interest in the last two decades. Despite great strides in this emerging area, progress is limited by the paucity of valid and reliable measures among this population. The goal of this study was to validate the widely used adult five-item Global Measure of Sexual Satisfaction (GMSEX) in a large sample of sexually active adolescents. A total of 1,036 adolescents (516 girls, 49.8%) aged between 14 and 17 years (Mage = 14.62; SD = 0.66) were recruited to investigate the reliability and validity of the GMSEX. The GMSEX yielded strong psychometric properties in adolescents, including factor structure, measurement invariance, and reliability. Results showed that the scale works similarly for boys and girls as well as for heterosexual, cisgender, and sexual minority adolescents. The GMSEX is a short, reliable, and valid measure of sexual satisfaction that can be used in future studies focusing on adolescents' sexuality and relationships. [ABSTRACT FROM AUTHOR]

This study examines the relationship between state legislation relevant to equality for sexual minorities and past-year suicide attempts among lesbian, gay, bisexual, and questioning (LGBQ) adolescents in the United States. Data were aggregated from 24 states that participated in the 2017 Youth Risk Behavior Surveillance System (N = 70,599). We utilized multilevel logistic regression to determine whether observed positive associations between sexual minority identity and past-year suicide attempts differ as a function of 2016 State Equality Index (SEI), an objective measure of state laws and policies affecting equality for sexual minorities. LGBQ adolescents were significantly more likely to report having made a suicide attempt in the past year than heterosexual youth (adjusted odds ratio [AOR]: 3.82; 95% confidence interval [CI]: 3.29–4.44). The 2016 SEI moderated the positive association between sexual minority identity and suicide attempts, with odds of past-year suicide attempts significantly reduced in states with more inclusive legislation (AOR: 0.91; CI: 0.85–0.97). Among sexual minority subgroups, significant effect modifications were found for bisexual (AOR: 0.88; CI: 0.77–0.99) and questioning (AOR: 0.87; CI: 0.78–0.96) – but not gay or lesbian (AOR: 1.10; CI: 0.97–1.24) – adolescents. The effect modification was strongest for bisexual males (AOR: 0.68; CI: 0.47–0.99). State legislation relevant to equality for sexual minorities differentially affected associations between sexual minority identity and suicide attempts, such that past-year suicide attempts were substantially lower in states with more inclusive legislation. Inclusive state legislation may exert a protective effect on risk for suicide attempts among sexual minority youth. [ABSTRACT FROM AUTHOR]

Sexual minorities face mental health disparities compared to heterosexual people. There is limited research on the possible connections between mental health and e-cigarette use among sexual minority youth. This study examines anxiety, depression, and e-cigarette use for sexual minority youth only and between sexual minorities versus straight youth. Study data were drawn from the 2021 National Youth Tobacco Survey (n = 16,065). Prevalence of self-reported anxiety and depression by sexual minority status was calculated, and the univariate analysis was assessed using Rao-Scott Chi-Square tests. Multivariable logistic regression models were used to evaluate the association of current e-cigarette use with self-reported anxiety and depression among sexual minority youth. The study also examined current e-cigarette use between sexual minorities versus straight students for those with or without anxiety and depression, and stratified analyses were performed by sex. Analysis showed a substantially higher prevalence of all self-reported mental health problems among sexual minorities than straight students. Sexual minority males with anxiety (aOR 1.91, 95 % CI, 1.22–3.00), depression (aOR 2.08, 95 % CI, 1.27–3.40), moderate depression and anxiety (aOR 1.85, 95 % CI, 1.16–2.97), and severe depression and anxiety (aOR 2.03, 95 % CI, 1.16–3.56) were more likely to be current e-cigarette users than their straight peers with similar mental health conditions. Self-reported measures and the analysis design precludes making causal inferences. Sexual minority males with mental health conditions may be particularly vulnerable to e-cigarette use and may require special efforts toward prevention and cessation. • This study examines youth mental illness, sexual minority status, and e-cigarette use. • Mental health problems are more prevalent in sexual minority versus straight students. • No e-cig use difference among sexual minority groups with and without mental conditions. • SM males use e-cigs more than straight youth with similar types of mental issues. [ABSTRACT FROM AUTHOR]

This research compares the relationship experiences, beliefs, and intentions related to love and romantic relationships of 75 individuals who indicated they were asexual (from a sample of 2,665 young adults) with subsamples of individuals who indicated they were either heterosexual, bisexual, or gay/lesbian. Identifying as asexual generally associated with having generally less-romantic beliefs and less interest in marriage and parenthood. The asexual group also tended to have more in common with other sexual minority groups than with the heterosexual group. Multivariate analyses revealed that asexuality was especially associated with being single and with seeing oneself living with one's parents after college. [ABSTRACT FROM AUTHOR]

Social media such as Instagram have provided sexual minority youth with safer contexts to express their sexual identity authentically and positively. However, as much of the existing literature draws upon small-scale, cross-sectional, and/or qualitative designs, it is currently unclear how authentic and positive self-presentation on social media informs sexual identity development over time. This study therefore explored the longitudinal relationship between authentic and positive self-presentation on Instagram, and the sexual identity clarity and self-acceptance of sexual minority youth. The moderating effect of micro- (i.e., peer feedback on Instagram) and macro-level (i.e., cultural context) social factors was also examined. Two-wave survey data were collected from 729 sexual minority youth from the United States, the Czech Republic, and Poland (M age = 18.54, SD = 1.63, Female = 76.82%), and data were analyzed using a multi-group cross-lagged panel model. A positive reciprocal relationship was found between positive self-presentation on Instagram and self-acceptance, whilst the associations between sexual identity clarity and self-presentation were moderated by peer feedback on Instagram. Cultural context had no moderating effect on the hypothesized model. Results suggest that whilst a dynamic relationship exists between sexual identity development and self-presentation on Instagram, peer feedback on Instagram may inform the frequency and effects of potentially adaptive self-presentation. This study therefore sheds new light on the developmental and social factors that inform the social media use of sexual minority youth, and findings extend our understanding of how social media contributes to sexual identity formation. • Sexual minority youth often turn to Instagram to present their sexual identity, which may inform identity development. • Positive self-presentation on Instagram positively predicts self-acceptance two months later. • Self-acceptance positively predicts positive self-presentation on Instagram two months later. • The interrelations between sexual identity clarity and self-presentation were moderated by peer feedback on Instagram. • Cultural context did not significantly moderate our hypothesized model. [ABSTRACT FROM AUTHOR]

This article reviews research on changes in self-reported sexual orientation labels and associated health outcomes among adolescents and young adults. Using seven electronic databases and supplementary methods, we identified 30 studies for inclusion in the review, published between 2000 and 2020. This review aimed to summarize the approaches to measuring sexual orientation change; the prevalence, patterns, and directionality of changes in sexual identity; and how changes in sexual orientation relate to health outcomes among adolescents and youth adults. The reviewed studies lacked agreement in operationalization and assessment of sexual orientation changes. Prevalence of change in self-reported sexual orientation differed by birth sex, whereby cisgender female participants were more likely to report a change than male participants. In addition, adolescents and youth identifying with a nonheterosexual orientation or sexual minority at baseline were more likely to report a change in sexual orientation. Few studies reported on the impact of changes in sexual orientation on behavioral health outcomes. Adolescents who reported either nonheterosexual orientation at baseline or a shift toward nonheterosexual orientation had a greater likelihood of reporting depressive symptomology, suicidality, and substance use compared to those who did not report a change or reported consistent heterosexuality. Recommendations for future research and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Lesbian, gay, and bisexual (LGB) adolescents are often at higher risk than their heterosexual peers for adverse sexual health, violence, mental health, and substance use outcomes. Schools are a vital resource for enhancing protective behaviors and reducing risk behaviors. Sixteen school districts selected schools to implement a sexual health program (exposed) or usual programming (unexposed). We analyzed LGB student health outcomes using 2015 and 2017 Youth Risk Behavior Surveys. Analyses compared LGB student health outcomes by exposure status across time points using a multilevel approach. Program exposure was associated with decreased odds of ever having sex, ever testing for HIV, and using effective hormonal birth control, and an increased odds of condom use. There were no significant findings among secondary violence, mental health, and substance use outcomes. This evaluation highlights the potential for schools to reduce sexual risk behaviors among LGB youth, and opportunities to improve access to health services. [ABSTRACT FROM AUTHOR]

Previous research indicates that teen dating violence (TDV) is more common among sexual minority than heterosexual adolescents, with approximately half of female sexual minority adolescents (SMA) endorsing TDV victimization in the last year. In samples of adolescents without regard to sexual orientation, exposure to violent pornography is associated with TDV, but this relationship has not been assessed in female SMA. The current study sample consisted of 10th-grade high school students aged 14-17 who identified as cisgender females (N = 1,276). Data were collected from a baseline survey prior to the delivery of a sexual assault prevention intervention. Female SMA had 2.54 times the odds (95%CI [1.75, 3.69]) of being exposed to violent pornography and 2.53 times the odds (95%CI [1.72, 3.70)]) of TDV exposure compared to heterosexual girls. Exposure to violent pornography was not associated with involvement in TDV among female SMA, controlling for episodic heavy drinking (aOR = 2.25, 95%CI [0.88,6.22]). Given the relatively higher rates of violent pornography and TDV exposure among female SMA compared to heterosexual girls, it is critical that sex education curricula address these experiences and meet the needs of adolescents of all sexual orientations. Future research can assess how these TDV interventions might be tailored for female SMA. Although we did not find that exposure to violent pornography was associated with TDV among female SMA, these investigations should be replicated with larger data sets, given that the association between exposure to violent pornography and engagement in TDV was in the expected direction. [ABSTRACT FROM AUTHOR]

Introduction: Sex education is important to support healthy sexual development/behaviors among heterosexual and sexual minority youth. Efforts to assess the efficacy of different sex education programs have been complicated by the lack of an established and detailed way to characterize overall sex education content. Methods: This study delineates seven different types of sex education and compares the impact of education types on the probability of sexual intercourse and contraceptive method use among a nationally representative sample of females aged 15–19 years. Data were obtained from four National Survey of Family Growth surveys (2011–2019). Multinomial logistic regression was used to examine associations and calculate predicted probability values. Results: Among youth in this analysis (N = 3952), 14.9% identified as a sexual minority and 72% reported sex education including refraining from sex, contraception, and STIs/HIV. Compared to their heterosexual peers, sexual minorities were more likely to report no sex education and less likely to report receipt of abstinence-only education. All types of education, except education solely focused on refraining from sex and contraception methods, had a statistically significant effect on sexual behavioral outcomes (intercourse in the past 12 months and type of contraceptive use) as compared to no sex education. Conclusions: Findings highlight the need for consideration of the specific/total content of sex education, benefits/drawbacks of sex education types, and the needs of sexual minority youth. Policy Implications: Research is needed to further explore outcomes associated with specific curricular content. Specific content of sex education should be considered prior to making curricular policies decisions. [ABSTRACT FROM AUTHOR]

Scholars posit that media texts are polysemic (i.e., open to multiple interpretations) with popular media representing a social institution within Western cultures that spreads dominant societal values, norms, and expectations. Due to their marginalized position within society, sexual minority individuals (i.e., LGBQ+) are frequently underrepresented by mainstream media messages. One way in which marginalized individuals can challenge the dominant, heteronormative discourse is through subversive in which individuals interpret messages against heteronormative ideals (i.e., queer readings). Across two studies, a reliable and valid measure of the uses and gratifications of queer readings was explicated; revealing a four-factor, 20-item scale. Results contribute to the entertainment media and fan studies literatures by providing an understanding of the utility of queer readings in the experiences and development of sexual minority individuals, as well as presents numerous future avenues for inquiry.

HIV incidence remains high among US youth, especially among sexual minority youth. However, only half of youth with HIV are aware of their status. One potential explanation for low HIV testing rates is that restrictive policies may prevent minors from access HIV testing due to parental consent requirements. Using pooled data from the local Youth Risk Behavior Survey, we assessed whether state HIV testing laws, including age restrictions and explicit inclusion of HIV in STI testing consent laws, were associated with differences in HIV testing rates; differences by sexual behavior were also examined. Among female youth, policies were not associated with HIV testing. However, among male youth, both the presence of age restrictions and explicit inclusion in STI services were significantly associated with increased odds of HIV testing. Results indicate that policy changes may be effective at increasing testing among male youth who have sex with other males. [ABSTRACT FROM AUTHOR]

Interpersonal violence is pervasive among youth in the United States. Sexual minority youth are disproportionately impacted. Utilizing data from the 2017 Youth Risk Behavior Surveillance System (YRBS, N = 12,868), this study describes the disparities in victimization among heterosexual and sexual minority youth. Sexual minority status was operationalized to include nonheterosexual identity (e.g., bisexual) and/or behavior (e.g., reporting same- and different-sex partners). Other predictors included sex (male/female), a sexuality*sex interaction term, age, and race/ethnicity. Outcomes included lifetime forced sexual intercourse and 12-month incidence of sexual violence, physical violence in relationships, sexual violence in relationships, in-school bullying, and cyberbullying. Approximately 15% (n = 1,974) of participants were classified as sexual minority youth and 48% (n = 6,213) self-identified as female. More than half (56%, n = 7,190) identified as racial and/or ethnic minorities. In bivariate logistic regression, sexual minority youth were significantly more likely to report all outcomes (p <.001). In multivariable logistic regression, sexual minority and female youth were significantly more likely to report all outcomes (p <.001). With the exception of physical violence in dating, sexuality*sex interaction terms were significant predictors for all outcomes (p <.001), indicating that the risks associated with sexual minority status are heightened for male youth. This study concludes with a call for more attention toward violence among and against sexual minority youth. Although some prevention and response efforts address the unique needs and experiences of these youth, particularly antibullying initiatives, efforts to address sexual and dating violence often emphasize heterosexual contexts and communities. [ABSTRACT FROM AUTHOR]

Prior research has revealed sexual minority youth are more likely to carry weapons both outside of and within school. However, to date, no study has examined the degree to which bullying and harassment is associated with weapon carrying among sexual minority youth. We utilized the Youth Risk Behavior Survey to examine the prevalence and likelihood of carrying weapons by sexual identity, adjusting for adverse experiences. From the Youth Risk Behavior Survey 2009-2015, we examined self-report of adverse experiences (e.g., being bullied, skipping school due to fear for personal safety) and performed Logistic regressions to estimate the odds of carrying a weapon and were adjusted to include demographics and adverse experiences. When surveyed by sexual identity, 14.0% of heterosexual, 21.8% of gay/lesbian, 18.5% of bisexual, and 17.4% of "not sure" students reported carrying a weapon in the past 30 days. Odds of carrying a weapon were significantly increased for youth who skipped school due to feeling unsafe at school, had ever been threatened with a weapon in the past year, and had ever been in a physical fight. Compared to heterosexual female peers, sexual minority women had increased odds of carrying a weapon. Pediatricians should recognize that experiencing bullying and feeling unsafe are associated with weapon carrying, particularly among sexual minorities. Pediatricians and professionals who work with youth should recognize that reported experiences of bullying may not be the most salient indicator of risk for weapon carrying among all youth, and that other fears of or experiences with bullying are crucial to screen for among sexual minorities in particular. [ABSTRACT FROM AUTHOR]

Introduction: Bisexual male youth are more likely to engage in certain behaviors that contribute to HIV/STI transmission (e.g., substance use) than are heterosexual and gay male youth. However, sexuality education rarely addresses the unique needs of sexual minority youth, especially bisexual, pansexual, and queer (bi+) youth, and little is known about their sexuality education experiences and preferences. As such, the goal of this study was to examine bi+ male youth's experiences learning about sex and their preferences for sexuality education. Methods: In 2019, 56 bi+ male youth ages 14–17 were surveyed and interviewed about their sexuality education experiences and preferences. Participants identified as bisexual (64%), pansexual (27%), and queer (9%), were racially/ethnically diverse (39% white, 32% Latinx, 20% Black, 9% other races), and included cisgender (79%) and transgender (21%) male youth. Results: Participants described varied experiences with school-based sexuality education (e.g., none, abstinence only, covered sexual health in some way), but it rarely addressed their unique needs. They typically learned about sex by searching for information online and from sexually explicit media. Participants identified several topics they wanted to learn more about (e.g., sex with same-gender partners, anal sex, consent), but they typically believed they were prepared to have sex. Finally, some participants described benefits of tailoring sexuality education to their unique needs, while others described benefits of more inclusive programs. Conclusions and Policy Implications: Findings suggest that bi+ male youth do not receive adequate sexuality education to make informed decisions about safer sex, highlighting the critical need for reform. [ABSTRACT FROM AUTHOR]

Youth experiencing homelessness (YEH) often engage in "couch-surfing," or frequently moving from one tenuous living arrangement to another. Understanding the characteristics and risk factors associated with couch-surfing is necessary to designing adequate responses to youth homelessness. The present study aims to investigate factors associated with youth at risk of couch-surfing or sleeping on the streets relative to staying in a shelter. The present study used Homeless Management Information System administrative data sourced from 16 communities across the U.S. between January 2015 and February 2017 (n = 9,417). Multinomial logistic regression models were used to explore correlates (e.g., demographics, homeless histories, risk and victimization, behavioral health, and self-sufficiency) of couch-surfing or sleeping on the streets relative to staying in an emergency shelter program. YEH identifying as female; Black or another non-Latinx youth of color; or as lesbian, gay, bisexual, questioning, or another sexual orientation (LGBQ+) were at greater risk of couch-surfing relative to staying in a shelter. YEH who threatened to harm themselves or others in the preceding 12 months or who attributed their homelessness to an abusive relationship were significantly more likely to either be couch-surfing or on the streets. Service providers must recognize and validate the vulnerabilities and risks experienced by couch-surfing YEH in order to help reduce barriers to accessing services faced by this population. Federal definitions of homelessness should be aligned to correct systemic biases and more accurately reflect the realities of how youth experience homelessness. [ABSTRACT FROM AUTHOR]

Background. Sexual and gender minority youth (SGMY) experience health inequities compared with cisgender heterosexuals, and these inequities are heightened in areas with high structural stigma. Quantitative research shows school assets (e.g., adult support) are associated with better health for SGMY. Though some qualitative studies elucidated how school staff support SGMY, none have triangulated such strategies in a geographically and sociodemographically diverse sample of school staff and SGMY. This paper describes a multi-perspective qualitative study design and offers lessons learned from conducting such a study. Methods. Using a novel stratified sampling frame, we interviewed 60 SGMY and 29 school staff who attended/worked at high schools in U.S. states with low, medium, and high structural stigma. To ensure sociodemographic diversity, we constructed sampling quotas, and recruited SGMY using social media and staff using a multi-pronged approach. Results. The stratified sampling strategy met our goal of enrolling diverse SGMY and staff participants. SGMY participants attended schools in low (n = 20), medium (n = 22), and high (n = 18) structural stigma states. We enrolled 18 cisgender girls, 18 cisgender boys, and 24 gender minority youth. Fifty-three percent of SGMY were youth of color, and 45% attended schools in rural areas. School staff participants worked at schools in low (n = 11), medium (n = 11), and high (n = 7) structural stigma states. School staff participants were 55% heterosexual, 91% cisgender, and had diverse roles (e.g., teacher, principal, librarian, and nurse). Conclusions. This paper describes new methods for collecting qualitative data from diverse SGMY and school staff. Some lessons learned from this study include the importance of using trauma-informed interviewing methods, having a suicidality safety protocol, establishing a priori sampling quotas, and creating tailored social media advertisements. With these data we will explore the heterogeneity of SGMY and school staff experiences across varying structural stigma levels, yielding foundational information for future school-based interventions. [ABSTRACT FROM AUTHOR]

Prior scholarship has documented health-relevant consequences of sexual minority youth (SMY) sexual identity disclosure (i.e., "outness"), yet most of the extant work focuses on one social context at a time and/or measures outness as dichotomous: out or not out. However, SMY are out in some contexts (e.g., family, friends) and not in others, and to varying degrees (e.g., to some friends, but not to all). Using a national sample of 8884 SMY ages 13–17 (45% cisgender female, 67% White, 38% gay/lesbian and 34% bisexual, and 36% from the U.S. South), this study used latent class analysis to identify complex patterns of outness among SMY, as well differences in class membership by demographics, depression, family rejection, and bullying. The results indicated six distinct classes: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ peers (n = 1707), out to LGBTQ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). The findings reveal significant differences in class membership by age, sexual identity, gender identity, race and ethnicity, geography, and well-being outcomes. Moreover, these findings underscore the complex role of outness across social contexts in shaping health and well-being. [ABSTRACT FROM AUTHOR]

Sexual violence victimization among adolescents, specifically sexual minority youth, is a significant public health concern. The purpose of this study was to compare sexual violence victimization rates among sexual minority and heterosexual youth using nationally representative data from the 2019 Youth Risk Behavioral Surveillance System. Results indicated that lesbian, gay, bisexual, and questioning youth were significantly more likely than heterosexual youth (p <.05) to experience sexual violence (22.3% vs. 9.1%), sexual dating violence (16.3% vs. 6.4%), and forced sexual intercourse (17.6% vs. 5.9%). Among sexual minority youth, female participants were more likely than male participants (p <.05) to experience sexual violence (23.5% vs. 18.0%), sexual dating violence (17.2% vs. 11.6%), and forced sexual intercourse (19.0% vs. 13.1%). This study identified varying rates of sexual violence victimization among a national sample of youth while examining the differences between heterosexual and sexual minority communities. The additional behavioral risks experienced by sexual minority youth should be further researched to determine impact on overall quality of life and to help guide health education intervention development. [ABSTRACT FROM AUTHOR]