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We evaluate the association of familial factors and suicidality among transgender adults in the U.S. by estimating the odds of lifetime suicide ideation and attempt using the 2015 U.S. Transgender Survey. Predictors include family support, family rejection, and specific experiences related to both. About 79% of sample respondents have experienced suicidal ideation and nearly 43% have made a suicide attempt. The predicted probability of suicide attempt is 0.35 for those with no family rejection experiences, 0.75 for those who have had all five experiences in our models. Rejection predicts both outcomes and experiences of rejection have a cumulative impact.

Introduction The inclusion of sexual orientation and gender identity measurements in national epidemiological surveys allows for the assessment of sleep disparities among sexual and gender minorities. Our objective is to establish the association of sexual orientation and gender identity with sleep duration. Methods We used 2020 Behavioral Risk Factor Surveillance System data from 33 states who included the sexual orientation and gender identity (SOGI) optional module in their questionnaires. The outcome variable is sleep duration (≤4 hours, 5, 6, 7, 8, 9, and ≥10 hours). Main predictors are sexual orientation (heterosexual, gay/lesbian, bisexual, and other) and gender identity (cisgender, trans woman, trans man, and trans gender non-conforming). We estimated multinomial logistic regression models due to the categorical nature of our outcome variable using Stata 17. We estimated models using sexual orientation alone as main predictor, gender identity alone, and then a combined model with both SOGI measures, and adjusted for sociodemographic characteristics and physical and mental health. Results Of the complete sample, 92% reported being heterosexual, 2% gay/lesbian, 3% bisexual, and 3% other sexual orientations. In addition, 99% reported being cisgender, and 0.2% reported being trans woman, trans man, and trans gender non-conforming, respectively. In the fully adjusted sexual orientation models, identifying as gay/lesbian was associated with a 27% increased likelihood of sleeping 8 hours and 71% increased likelihood of sleeping 10+ hours compared to heterosexuals. Self-identifying as bisexual and other orientations is associated with an 86% and 52% increased likelihood of sleeping 10+ hours, respectively. In the fully adjusted gender identity models, trans women were 115% more likely to report 8 hours of sleep, 122% more likely to report 9 hours of sleep, and 223% more likely to report 10+ hours of sleep. In the combined fully adjusted model, self-identifying as gay/lesbian, bisexual, or other orientations is associated with a 68%, 84%, and 63% increased likelihood of sleeping 10+ hours. Trans women are 149% more likely to report 10+ hours of sleep. Conclusion Based on our empirical analyses, being a sexual and/or gender minority is associated with a greater likelihood of reporting 10+ hours of sleep. Support (if any)

We interviewed 31 individuals about their online dating life and behaviors during the COVID-19 pandemic. We use literature on risk and health behaviors to generate four frames for dealing with risk associated with COVID-19 while dating: 1) Unconcerned about Risk, 2) Preliminary Risk Assessment, 3) Active Risk Negotiation, and 4) Risk Aversion. Further, we argue that risk perception causes daters to use implicit and explicit communication about health behaviors to determine COVID compatibility, a state of being in agreement with a partner about how to best minimize risk of contracting COVID-19. Daters want to know that their partner is behaving with similar regard for health guidance and that they are doing their best to keep those in their communities safe. Though daters may transition between frames throughout the course of the pandemic, we use these four frames to identify sets of beliefs, routines, and personal health practices across our sample that have relevance for social scientists, health communication scholars, and health care practitioners.

We assess the likelihood of moderate and severe psychological distress among Black immigrants. We test the region of context framework, which states that Black immigrants from majority-Black and racially mixed regions of origin have better health outcomes than Black immigrants from majority-white contexts. We utilize data from IPUMS Health Surveys, 2000–2018. We employed partial proportional odds models to assess the likelihood of moderate and severe psychological distress among Black immigrants and U.S.-born Black Americans. All immigrant groups, except for Black Europeans, are significantly less likely to be in moderate and severe distress vis-a-vis U.S.-born Black Americans (p

ImportanceTransgender, gender nonbinary, and genderqueer people are at increased risk for negative health outcomes, and medical school education is currently lacking on inclusion of these topics. However, there is little evidence of an association of clinician knowledge with the health of transgender people.ObjectiveTo evaluate the associations of patients’ perceptions of clinician knowledge with self-rated health and severe psychological distress among transgender people.Design, Setting, and ParticipantsIn this cross-sectional study, a secondary data analysis of the 2015 US Transgender Survey (a survey of transgender, gender nonbinary, and genderqueer adults conducted across 50 states) Washington, DC, US territories, and US military bases in 2015 was performed. Data were analyzed from February to November 2022.ExposuresPatients’ perception of their clinician’s knowledge about transgender health care.Main Outcomes and MeasuresSelf-rated health, dichotomized as poor or fair vs excellent, very good, or good, and severe psychological distress (scoring a validated threshold of ≥13 on the Kessler Psychological Distress Scale).ResultsThe sample included a total of 27 715 respondents (9238 transgender women [33.3%; 55.1% weighted; 95% CI, 53.4%-56.7%], 22 658 non-Hispanic White individuals [81.8%; 65.6% weighted; 95% CI, 63.7%-67.5%], and 4085 individuals aged 45-64 years [14.7%; 33.8% weighted; 95% CI, 32.0%-35.5%]). Of 23 318 individuals who answered questions regarding their perceptions of their clinicians’ level of knowledge, 5732 (24.6%) reported their clinician knows almost everything about transgender care, 4083 (17.5%) reported their clinician knows most things, 3446 (14.8%) reported their clinician knows some things, 2680 (11.5%) reported their clinician knows almost nothing, and 7337 (31.5%) reported they were unsure. Nearly 1 in 4 transgender adults (5612 of 23 557 individuals [23.8%]) reported having to teach their clinician about transgender people. In total, 3955 respondents (19.4%; 20.8% weighted; 95% CI, 19.2%-22.6%) reported fair or poor self-rated health and 7392 (36.9%; 28.4% weighted, 95% CI, 26.9%-30.1%) met the criteria for severe psychological distress. After adjusting for covariates, compared with individuals who reported their clinician knows almost everything about transgender care, exposure to clinicians with lower perceived levels of knowledge about transgender care was associated with significantly higher odds of fair or poor self-rated health (adjusted odds ratio [aOR] for knowing almost nothing, 2.63; 95% CI, 1.76-3.94; aOR for unsure, 1.81; 95% CI, 1.28-2.56) and severe psychological distress (aOR for knowing almost nothing, 2.33; 95% CI, 1.61-3.37; aOR for unsure, 1.37; 95% CI, 1.05-1.79). Respondents who had to teach a clinician about transgender people had higher odds of reporting fair or poor self-rated health (aOR, 1.67; 95% CI, 1.31-2.13) and severe psychological distress (aOR, 1.49; 95% CI, 1.21-1.83) compared with those who did not.Conclusion and RelevanceThe findings of this cross-sectional study suggest that there is an association between perceived clinician knowledge about transgender people and self-rated health and psychological distress among transgender people. These results highlight the importance of integration and enhancement of transgender health in medical education curriculum as a necessary intervention to improve the health of transgender people.

Purpose This study aims to examine how gender variation in trans identities shape exposure to bias and discrimination. The authors then examine how trans identities intersect with race/ethnicity, education and social class to shape exposure risk to bias, discrimination and harassment in the workplace. Design/methodology/approach The authors use data from the 2015 U.S. Transgender Survey with 24,391 trans-identified respondents. To account for the nested nature of trans people in state contexts, the authors use two-level logistic multilevel models. The authors are guided by Puwar’s bodies out of place as the theoretical grounding for this study. Findings The authors find significant differences in how trans women and men experience discrimination. The authors also find differences in race, education and social class. Finally, the presence of anti-discrimination policies presents mixed results. Originality/value The authors’ analysis reveals important differences in trans workers’ exposure to discrimination based on gender identity, social class, race/ethnicity and policy context, and draws upon a rich and large data set.

The authors investigate the association between self-reported experiences of discrimination and social media use among Black American adults. Experiences of discrimination were assessed using a 10-question scale of self-reported discrimination encounters. Data analysis was based on a sample of 220 Black American adult respondents residing in Texas. The results indicate that Black Americans reporting higher levels of discrimination use social media more frequently than those who report lower levels of discrimination. In addition, Black Americans who experience higher levels of discrimination are more likely to have accounts on Twitter or Facebook than those who experience lower levels of discrimination. Together, these findings suggest that social media sites such as Twitter serve as sites of expression for people of color to air their grievances, find community, and cope with online and offline forms of racism and discrimination.

The Census Bureau defines a family as a group of two or more people who reside together and are related by birth, marriage, or adoption (U.S. Census Bureau Current Population Survey Subject Definitions 2019). Since the 1950s marriage and family structure in the United States has undergone a significant transformation. This transformation includes a decline in marriage, a rise in new forms of family, and an expansion of what constitutes a “family” for the general population. The historical conception of family as being the “traditional” nuclear family consisting of a mother and father and their children continues to erode. Future trends in marriage and family suggest the continued decline in the rate of marriage and expansion of new forms of family. I review trends in marriage and family utilizing U.S. Census Bureau Decennial Census and Current Population Survey data from 1950 through 2018, discuss the expanding view of “family” using Pew Research Center Changing American Family data (2011), and close with a discussion of the future forms of families.