Minority stress theory suggests that lesbian, gay, and bisexual (LGB) individuals are at a greater risk for health problems than non-LGB individuals because they face greater exposure to social stress such as prejudice, discrimination, and bullying. Consistent with the minority stress theory, LGB youth experience more bullying than their non-LGB peers. They also have higher rates of depression and suicidal ideation than their non-LGB peers. While controversial, an emerging body of research finds that there is an association of peer bullying with depressed mood and suicidal ideation, particularly for LGB adolescents. While risk factors are an important area of research, it is also important to study protective factors that can promote resilience in youth particularly for those individuals at risk for suicidality. Sexual minority youth who express feeling safe, connected, or attached at school have a reduced likelihood of depressed mood and suicidality. Despite this growing body of literature, few studies have examined the association between LGB health and protective factors among LGB populations in general, and adolescents specifically. Understanding the factors that act as sources of resiliency among LGB adolescents is then critical to reducing health disparities. Thus, the current study will explore whether bullying and feelings of mattering influence depressed mood and suicidality among a sample of sexual minority adolescents. Data from this study come from a larger sample of adolescents in a school district in the Western Plains. Moderation analyses will be conducted to explore whether mattering acts as a protective factor against depressed mood and suicidal ideation for sexual minority youth who are being bullied. We will discuss the need to tailor prevention efforts toward reducing bullying perpetrated against LGB youth and enhancing feelings of mattering at school for LGB youth.

In comparison to their heterosexual counterparts, sexual/gender minority (SGM) adolescents report higher levels of depression (Fergusson et al., 1999; Mustanski et al., 2010), which studies have found to be associated with victimization due to sexual orientation or gender identity (Birkett et al., 2015). Studies of heterosexual adolescents have found that perceived parental support buffered the manifestation of depressive symptoms in participants who reported being bullied (Tanigawa et al., 2011). While limited data exists on the association between perceived parental support and depression in SGM adolescents, a study of lesbian, gay, and bisexual adolescents found that adolescents who reported high levels of parental abuse were also more likely to attempt suicide (D’Augelli et al., 2005). Using a sample of adolescent men who have sex with men (AMSM), the authors predict that higher levels of perceived parental support will buffer the effects of victimization and microaggressions on depressive symptoms. Data were collected from a larger longitudinal study evaluating the efficacy of a tiered HIV-prevention eHealth intervention targeted toward adolescent AMSM in the U.S. Participants (N = 587) were between the ages of 13 and 18 at baseline with an average age of 16.49 (SD = 1.26) and were racially/ethnically diverse (40.89% White, 10.73% Black, 34.75% Latino/Hispanic, 13.63% Multiracial/Other). Microaggressions were measured using a two-item subset of The Sexual Orientation Microaggression Inventory (Nadal et al., 2010; Swann et al., 2016). The Sexual Orientation Disclosure Scale evaluated “outness” to parents and perceptions of parental acceptance of sexual orientation. The LGBT-related Victimization Scale (D’Augelli, 1992) assessed physical threats or violence resulting from LGBT identification. Finally, the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression – Short Form 8b instrument measured self-reported depressive symptoms over the past week. Linear regression controlling for age and race assessed the impact of victimization and microaggressions on depression. Outness by victimization and outness by microgression interactions were assessed for significance to determine outness’s role in moderating these relationships. Victimization was positively associated with depression in all models (beta coefficients range from .62 to 1.18, p-values < .001). Total support from parents moderated the relationship between victimization and depression, such that having zero support led to a stronger relationship between victimization and depression (beta coefficient = 1.17), when compared to having more than zero support (beta coefficients range from 0 to .76). Moreover, being out to zero parents led to a stronger relationship between victimization and depression (beta coefficient = 1.17), when compared to being out to one or two parents (beta coefficients = 0.28 and 0.49, respectively). Microaggressions were positively associated with depression in all models (beta coefficients range from .70 to .74, p-values < .001). However, there were no significant support/outness by microaggressions interactions in predicting depression. The authors conclude that having some support weakens the impact of victimization upon depression and has no effect on the impact of microaggressions on depression. In sum, parental support buffers the effects of victimization on depression, but SGM youth may benefit from additional sources of support.

Background: The first studies to assess ACEs in lesbian, gay, and bisexual (LGB) populations found that this group experienced a great number of ACEs, and were more likely to report abuse and household dysfunction, compared to heterosexuals. This past work has focused on child abuse and household problems but has not assessed the role of childhood neglect on the health of adult LGB and trangender and gender nonconfroming (TGN) people. In order to fully understand the effect of ACEs on poor health, an examination of the influence of neglect on adult LGB and TGN health is needed. We hypothesized that transgender adults with higher ACEs scores would report poorer physical and mental health compared to their LGB peers.
Methods: In the present study we analyzed the relationship between ACEs and adult mental and physical health among TGN (21%, n = 102) compared to their LGB (79%, n = 375) peers, from 477 LGBTQ+ individuals in San Antonio, Texas. These data were drawn from Colors of PRIDE SA, a Community-Based Participatory Research (CBPR) project aimed at better understanding the development and activation of resilience among LGBTQ+ individuals living in South Texas. We calculated the prevalence chi-square of demographic characteristics and ACE score by gender-identity and used bivariate analysis to identify significant group differences related to gender. Separate multivariable logistic regression models were constructed for mental and physical health outcomes with gender-identity as the primary predictor variable. Logit models adjusted for sexual orientation, age, race, Latino/Hispanic heritage, relationship status, educational attainment, and income. We constructed a second set of logit models adjusting for ACE score.
 
Results: Significant differences were found between TGN and cisgender respondents on 3 ACE items. TGN respondents were 52% more likely to report emotional abuse, 58.8% more likely to report emotional neglect, and 53.4% more likely to physical neglect compared to cisgender respondents [OR = 1.87; CI = 1.09 – 3.21]. In the unadjusted model, TGN participants were more than twice as likely to report poor mental health [OR = 2.17; 95% CI = 1.21 – 3.89). In the second model, adjusted for ACE Score, the relationship between TGN identity and poor mental health remained [OR = 2.12; 95% CI = 1.18 – 3.81]. As well, the model detected a significant relationship between ACE score and poor mental health, with those indicating higher ACEs score having greater odds of poor mental health [OR = 1.24; 95% CI = 1.04 – 1.22].
Discussion: We found that negative experiences in childhood, particularly abuse and neglect, are associated with poorer mental health in adulthood in a population that already experiences a number of risk factors for poor mental health. Also, findings demonstrate that neglect was a common childhood experience among our sample with TGN individuals reporting significantly more emotional and physical neglect compared to LGB respondents. This suggests that assessing childhood neglect is important when examining the relationship between assess and poor adult health, and future research should include these measures when conducting research with these populations. Finally, we found that ACEs were associated with mental health among our sample, but the ACEs-adjusted model suggests other factors, possibly trans-specific ACEs or adverse adult experiences, exist that contribute to these observed differences.

Be YOU: Young, Outspoken, Unbreakable is a school-based curriculum developed by a community-based organization in Austin, Texas to support the well-being of students who are vulnerable to minority stress. Attendees will learn how Be YOU improved student emotional regulation skills and decreased rumination based on data from the recent program pilot. We will discuss the challenges and benefits of providing psychoeducational support groups to LGBTQIA+ youth in school settings, and how collaboration is essential in providing support to youth who often need it most, queer and trans youth of color attending Title I Schools. This presentation will have four specific purposes: 1. Give attendees a sense of the Be YOU program by giving them access to curriculum activities; 2. Share data about the Be YOU program from the 2017/2018 pilot, including demographic information about participants, information about school performance, and pre-post assessment data about mental health and well-being as analyzed by researchers from the Sexual Orientation and Gender Identity (SOGI) Health and Rights Lab at the University of Texas at Austin; 3. Discuss the minority stress model and how stigma gets “under the skin” of LGBTQIA+ youth, and how the Be YOU program helped to mitigate this process by focusing on our “inside world” and our “outside world”; 4. Discuss the practical aspects of providing services in a school setting, and the reasons it is worth doing so despite the challenges.

Background: Youth in foster care may lack adequate sexual health knowledge and skills due to backgrounds of neglect, abuse, and trauma, emphasizing the need for sexual health education in this population. Compared to heterosexual-cisgender foster youth, LGBTQ+ foster youth may not receive adequate sexual health education, especially if staff or caretakers lack the skills necessary to address the specific sexual health needs of LGBTQ+ youth. This concern is amplified when considering that LGBTQ+ youth are overrepresented in the foster care system. Indeed, foster youth and LGBTQ+ youth are each independently at increased risk for HIV/STDs. LGBTQ+ foster youth may therefore evidence greater sexual risk. However, the sexual health needs of LGBTQ+ foster youth have not been examined in the past. To address this, we explored how lesbian/bisexual female foster youth perceive and interpret their sexual health needs. Methods: One focus group was conducted with six female foster youth aged 16-18 years. Youth identified as Hispanic/Latino (n=1), biracial (n=2), African American/Black (n=3), and most as lesbian/bisexual (n=5). Youth were asked to identify what they perceived to be the most salient sexual health needs from a comprehensive list, provide rationales for their selections, describe ways to address these needs, and specify what knowledge about these needs youth in care lack. Data were transcribed verbatim and analyzed using an Interpretative Phenomenological Analysis approach. Results: Four main themes emerged from the analysis: fear of being victimized, distrust within and beyond relationships, self-protection from harm, and opportunities for education and communication. Lesbian/bisexual female foster youths’ perceptions and conceptualizations around sexual health needs were guided by fear and distrust. Youth provided several examples of how they were distrustful of individuals’ intentions; they feared the possibility of intentional contraction of HIV/STDs from others, as well as the potential for sexual victimization by online and in-person predators. As a result, youth emphasized the importance of taking measures to protect themselves sexually, mentally, and physically. Youth also described how they did not trust or desire to engage with certain governmental justice institutions regarding their sexual health needs, specifically the police and court systems. Lastly, youth described what they prefer when learning and communicating about sexual health, and the characteristics of individuals whom they would confide in about these topics. These included individuals who work to gain their trust, protect their privacy and confidentiality, and are able to communicate honestly and sensitively. Discussion: Lesbian/bisexual female foster youths’ framing of their sexual health needs in terms of fear, distrust, and self-protection implies that they may not feel safe in their current environments or prepared to handle threats to their sexual health safety. Sub-themes emphasizing the need for trust and comfort in order to communicate with adults stress the importance of strong interpersonal relationships between lesbian/bisexual female foster youth and parents/staff. Lastly, more research is needed to explore the sexual health needs of lesbian/bisexual female foster youth specific to their sexual identities, as well as foster parent/staff skills in providing them sexual health education.

Sexual and gender minority (SGM) youth have elevated rates of mental health disorders and substance use. It is, therefore, important to identify factors that may protect SGM against these negative outcomes to inform both policy and interventions for this population. In this study, we examined whether involvement in a romantic relationship, a well-established protective factor for mental health and substance use among heterosexual adults, is also protective for young SGM. Using a sample of 222 SGM assigned female at birth (ages 18 to 21), we assessed whether relationship involvement was associated with depressive symptoms, anxious symptoms, and use of alcohol, marijuana, and other illicit drugs. One-way ANCOVAs controlling for gender and sexual identity demonstrated that, overall, relationship involvement was not associated with marijuana or illicit drug use, but participants in a relationship reported fewer depressive symptoms, fewer anxious symptoms, and less problematic alcohol use compared to participants who were single. However, moderation analyses revealed that these findings differed by participant gender, sexual identity, and partner gender. Relationship involvement was a protective factor against depressive symptoms, anxious symptoms, and problematic alcohol use for cisgender females, but not for gender minorities. In addition, relationship involvement was associated with fewer depressive and anxious symptoms for those who identified as gay/lesbian, but the association was not present for those who identified as bisexual/pansexual or those who had other sexual identities. Finally, participants in a relationship with a cisgender female partner had fewer depressive and anxious symptoms than participants with a cisgender male partner, participants with a gender minority partner, and participants who were single. Together, these findings suggest that being in a romantic relationship may promote mental health and protect against problematic alcohol use for many, but not all, young SGM assigned female at birth. Specifically, the benefits of relationship involvement may only be present for those who identify as cisgender female, gay/lesbian, and for those who have a cisgender female partner. The demographic differences observed highlight the importance of considering differences among subgroups of SGM in research, theory, and efforts to reduce mental health disparities and substance abuse.