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Background: LGBTQ+ youth engage in organized physical activity to a lesser degree than their cisgender and heterosexual counterparts. Existing literature on this organized physical activity disparity is limited, particularly with LGBTQ+ youth samples. The current analysis examined individual and systemic barriers to organized physical activity for LGBTQ+ youth across sexual, gender, and racial identities. Methods: A subsample of LGBTQ+ students (N = 4566) from the 2021 Dane County Youth Assessment completed items that measured barriers to organized physical activity and systemic factors (ie, family money problems and bias-based bullying) associated with access to organized physical activity. Latent class analysis discerned patterns of individual and systemic barriers to organized physical activity. Latent class regression modeling tested gender, sexual, and racial identities as correlates of latent class membership. Results: More than half of the sample did not participate in organized physical activity. Four profiles of LGBTQ+ youth were discerned based on self-reported barriers: high barrier (8%), bullied (16%), low interest or perceived skills (28%), and low barrier (48%). The low-barrier class included a greater proportion of LGBTQ+ youth who identified as White, or cisgender, or heterosexual as well as youth self-reporting higher organized physical activity. The high-barrier and bullied classes comprised more marginalized gender and sexual identities. Conclusions: LGBTQ+ youth experience individual and systemic barriers to organized physical activity, including inequitable access and bullying, and barriers are uniquely experienced across sexual, gender, and racial identities. Physical activity promotion among LGBTQ+ youth would be strengthened by policies that address inequitable access to opportunities and bias-based bullying. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) youth of color--in particular Latinx SGM youth--experience higher incidents of bullying compared to heterosexual and cisgender White youth. These disparities oftentimes explain increased negative mental health outcomes, such as depression. Parental acceptance may be a particularly important buffer to the effects of bullying on negative mental health outcomes among Latinx SGM youth. In a sample of 1,005 Latinx SGM youth (ages 13-17), we assessed: (a) the prevalence of parental acceptance and bullying, (b) the influence of bullying on depression, and (c) whether the relationship between bullying and depression was moderated by parental acceptance. Results showed that, on average, Latinx SGM youth reported rarely experiencing parental acceptance, frequently experiencing symptoms of depression, and frequently being bullied. Findings revealed that parental acceptance and bullying were significantly related to depression. Furthermore, there was no interaction between parental acceptance and bullying on depression. Findings have implications for how different Latinx cultural values may be further considered to better understand Latinx SGM youth's perception of their parental figure's acceptance of their sexual and gender identity and its role on bullying and depression.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth report hostile school climates and sexuality-based harassment, but scholarship has not clearly documented how these climates might be associated with college aspirations among this population. Given college has become a common aspiration for many high school youths, we sought to explore subgroup differences in college aspirations among LGBTQ youth, and whether or not LGBTQ-specific community factors, such as Gender Sexuality Alliances (GSA) presence and teacher support, were related to college aspirations. To do this, we analysed a large sample (N = 11,327, M[subscript age] = 15.57) of LGBTQ youth from across the United States. We compared college aspirations across subgroups of youth via bivariate and multivariable logistic regression models to explore how school factors (i.e., presence of GSAs and LGBTQ-specific teacher supportiveness) were associated with college aspirations among LGBTQ youth. We found that transgender youth were less likely to aspire to go to college compared to cisgender counterparts. Additionally, more common sexual minority subgroups (e.g., gay/lesbian) were less likely to aspire to go to college compared to their counterparts with more emergent identity labels (e.g., asexual, queer). The presence of GSAs and higher reports of LGBTQ-supportive teachers were associated with increased odds of aspiring to go to college across all LGBTQ youth in our sample. These findings have implications for how schools and teachers prepare sexual and gender minorities for college. The findings imply that LGBTQ populations should not be treated as monolithic in their college readiness, preparation, and aspirations.

Background: Unhealthy weight control and disordered eating behaviors are prevalent among adolescents who identify as a gender and/or sexual minority (SGM). The current study examined how perceptions of school safety contribute to reduced negative weight control and eating behaviors across adolescents with diverse sexual and gender identities. Methods: Data on perceptions of school safety, as well as negative weight control and disordered eating behaviors (i.e., binge eating, eating to cope), were drawn from a large national sample of SGM secondary school students (i.e., grades 7-12; N = 17,112; "LGBTQ National Teen Survey"). Results: Differences in negative weight control and disordered eating behaviors emerged as a function of gender identity and sexual orientation. School safety was significantly associated with fewer negative weight control behaviors (B = -0.30, p < 0.001), reduced binge eating (B = -0.19, p < 0.001), and less eating to cope (B = -0.21, p < 0.001). Despite slight variation in the strength of these associations, the protective effects of school safety were significant across sexual and gender identities. Conclusions: Findings suggest that efforts to support feelings of school safety among SGM students are likely to have positive implications for eating and weight-related behaviors, and emphasize the need for interventions to promote climates of safety and inclusion within the school setting.

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.

Adolescents who identify as asexual (i.e., do not experience sexual attraction) remain understudied despite a recent increase in studies carried out among asexual adults. The present study provides data on the frequency of asexual identities among adolescents with attention to diversity across the asexuality spectrum, including a focus on demisexual adolescents. We utilized a national sample of 17,112 LGBQA + adolescents aged 13–17—of which 773 (4.5%) identified as asexual and 105 (0.6%) identified as demisexual. We compared those identifying as asexual and those identifying as demisexual on outness and social–emotional adjustment. In addition, we tested differences between asexual adolescents and allosexual sexual minority youth (SMY) on their sexual identity outness and social–emotional adjustment, and whether the associations differed by sexual identity. We found that asexual adolescents were out to significantly fewer people and experienced fewer depressive symptoms than demisexual adolescents. Asexual adolescents reported lower outness, greater depressive symptoms, and lower self-esteem compared to allosexual SMY. Greater outness was associated with higher self-esteem across asexual and allosexual SMY. These findings suggest increasing identification as asexual among youth compared to previous generations and point to greater social–emotional adjustment challenges for asexual compared with allosexual SMY. [ABSTRACT FROM AUTHOR]

There is a paucity of national data documenting chest binding practices among transgender and gender diverse (TGD) adolescents, despite the possibility that adolescents chest bind at high rates due to gender identity exploration and/or structural barriers to accessing other gender affirmation strategies. We used data from the 2022 LGBTQ National Teen Survey to estimate the prevalence and sociodemographic characteristics of chest binding among TGD adolescents assigned female at birth (AFAB; n = 6,080), and, in supplementary analyses, a broader sample of AFAB and intersex LGBTQ+ adolescents (n = 7,622). Nearly two-thirds (63.8%) of TGD AFAB adolescents in our sample reported chest binding. More than 80% of transgender boys reported chest binding. Chest binding varied by some sociodemographics but was prevalent across many characteristics. Chest binding is a common gender exploration and affirmation strategy among TGD AFAB adolescents. Adolescent health providers require data to inform evidence-based healthcare related to chest binding. [ABSTRACT FROM AUTHOR]

Objectives. To examine linear and nonlinear associations between psychosocial syndemic factors and HIV risk and engagement in HIV prevention care among sexual and gender minority (SGM) youths. Methods. Between February and October 2022, we recruited 17 578 SGM youths aged 13 to 18 years in the United States for an online survey. We examined the relationship of syndemics (i.e., binge drinking, drug use, sexual victimization, and anti–lesbian, gay, bisexual, and transgender discrimination) with sexual behaviors (i.e., sexual initiation, condomless anal or vaginal sex, and number of sexual partners) and HIV prevention care (i.e., HIV testing, preexposure prophylaxis awareness and utilization) using regression. Results. Psychosocial syndemic burden (number of syndemic factors reported) was linearly and cubically associated with engagement in sexual behaviors. Psychosocial syndemic burden was linearly associated with higher HIV testing and preexposure prophylaxis awareness and cubically associated with higher preexposure prophylaxis utilization. Conclusions. Our findings are evidence of synergism across psychosocial syndemic factors regarding HIV risk and engagement in HIV prevention care among SGM youths in the United States. Public Health Implications. Multicomponent interventions may help reduce HIV risk and promote access to HIV prevention services among SGM individuals aged 13 to 18 years. (Am J Public Health. 2024;114(9):892–902. https://doi.org/10.2105/AJPH.2024.307753) [ABSTRACT FROM AUTHOR]

Disparities in psychosocial adjustment have been identified for lesbian, gay, and bisexual (LGB) youth, yet research that explores multiple sources of social support among subgroups of LGB youth is sparse. Social support theory is used as a framework to analyze the ways that different sources of support might promote better psychosocial adjustment for LGB youth. Data from a diverse sample among LGB youth (N = 835) were used to understand how social support from a close friend, teachers, classmates, and parents might be differently associated with depression and self-esteem. We found that parent support and its importance to the participant were consistently related to higher self-esteem and lower depression for all youth, except for lesbians for whom no forms of social support were associated with self-esteem. Teacher and classmate support influenced some subgroups more than others. These results provide parents, clinicians, and schools a roadmap to assist youth navigate supports.

Although pre-exposure prophylaxis (PrEP) is a highly effective preventive treatment for HIV, anticipated PrEP stigma can hinder uptake. Perceptions of bias in HIV prevention and evaluations (e.g., happiness) tied to social support among Black and Latine/x sexual and gender diverse (SGD) individuals could be important correlates of anticipated PrEP stigma. To further this line of inquiry, a national sample of 872 Black and Latine/x SGD individuals who had and had never taken PrEP (Mage = 25.1, SD = 2.8) reported how they perceived HIV prevention and how happy they were with their social support. Multivariable linear regressions revealed that greater perceptions of bias in HIV prevention services were associated with higher anticipated PrEP stigma among Black and Latine/x SGD individuals who have never taken PrEP. Greater happiness with friend support was associated with lower PrEP stigma, whereas greater happiness with family support was associated with higher PrEP stigma among individuals who have taken PrEP. Findings highlight the need for PrEP and HIV interventions to address the intersectional stigma attached to prevention and for researchers to understand how evaluations of social support may contribute to stigma among Black and Latine/x SGD individuals. [ABSTRACT FROM AUTHOR]

Sexual and gender minority youth (SGMY) report greater alcohol use in comparison to their heterosexual counterparts. Prior research has found that elevated alcohol use among SGMY can be explained by minority stress experiences. Sexual identity outness may be another factor that drives alcohol use among SGMY, given that outness is associated with alcohol use among older sexual and gender minority samples. We examined how patterns of sexual identity outness were associated with lifetime alcohol use, past-30-day alcohol use, and past-30-day heavy episodic drinking. Data were drawn from the LGBTQ National Teen Survey (N = 8884). Participants were SGMY aged 13 to 17 (mean age = 15.59) years living in the US. Latent class analysis was used to identify sexual identity outness patterns. Multinomial regressions were used to examine the probability of class membership by alcohol use. Six outness classes were identified: 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). SGMY in classes characterized by greater outness to peers, friends, and family had greater odds of lifetime alcohol use compared with SGMY in classes characterized by lower outness. These findings suggest that SGMY with greater sexual identity outness may be a target for alcohol use prevention programming. Differences in sexual identity outness may be explained by minority stress factors. [ABSTRACT FROM AUTHOR]