A Social Ecology of Bias-Based Bullying of Sexual and Gender Minority Youth: Toward a Conceptualization of Conversion Bullying

Homophobic bullying is pervasive and deleterious, and a source of extensive health and mental health disparities affecting sexual and gender minority youth (SGMY). Investigations conducted over the past two decades across the social ecology of SGMY indicate individual (e.g., gender), microsystem (e.g., schools), and exosystem level (e.g., community norms) factors associated with homophobic bullying. Emerging evidence at the macrosystem level demonstrates the powerful influence of laws, policies, and ideologies on the population health of sexual minority adults. Based on social ecological theory and emerging evidence at the macrosystem level, we advance a conceptualization of the religious social ecology of homophobic bullying and articulate the construct of conversion bullying, a form of bias-based bullying that may be unique to SGMY. Conversion bullying is manifested in the invocation of religious rhetoric and rationalizations in repeated acts of peer aggression against SGMY that cause harm, based on the premise that same-sex attractions and behaviors are immoral or unnatural and with implicit or explicit communication that one should change one's sexuality to conform to heteronormative ideals. We describe implications of conversion bullying for social work practice, education, social policy, and research.     

Teen Dating Violence,Sexual Harassment,and Bullying Among Middle School Youth: Examining Measurement Invariance by Gender

This study investigated measurement invariance by gender among commonly used teen dating violence (TDV), sexual harassment, and bullying measures. Data were collected from one cohort of seventh‐grade middle school students (N = 754) from four schools. Using structural equation modeling, exploratory and confirmatory factor analyses assessed measurement models and tested measurement invariance by gender for aggression measures. Analyses invoked baseline data only. Physical and psychological TDV perpetration measures achieved strict measurement invariance, while bullying perpetration demonstrated partial strict invariance. Electronic TDV and sexual harassment perpetration achieved metric/scalar invariance. Study findings lend validation to prior and future studies using these measures with similar populations. Future research should increase attention to measurement development, refinement, and testing among study measures.     

Sexual Education,Gender Ideology,and Youth Sexual Empowerment

Sexual education plays an essential role in preventing unplanned pregnancy and the transmission of sexually transmitted infections (STIs). School-based sexual education programs, in particular, may be well positioned to address social factors that are empirically linked to negative sexual health outcomes, such as traditional social norms surrounding gender and sexuality. However, youth are seldom granted access to sexual education programs that explicitly address these issues. This study presents findings from a pretest–posttest survey of a sexual education program that did. It was designed for eighth graders (N=95) in the context of a school–community collaboration. The study assessed the links between several components of sexual empowerment, including gender ideology, sexual knowledge, and contraceptive beliefs. Findings link participation in the sexual education program to more progressive attitudes toward girls and women, less agreement with hegemonic masculinity ideology, and increases in sexual health and resource knowledge. Structural equation models suggest that traditional attitudes toward women were significantly related to hegemonic masculinity ideology among both boys and girls, which was in turn negatively related to safer contraceptive beliefs.     

Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity

Bullying and substance use represent serious public health issues facing adolescents in the United States. Few large-sample national studies have examined differences in these indicators by gender identity. The Teen Health and Technology Study (N = 5,542) sampled adolescents ages 13 to 18 years old online. Weighted multivariable logistic regression models investigated disparities in substance use and tested a gender minority social stress hypothesis, comparing gender minority youth (i.e., who are transgender/gender nonconforming and have a gender different from their sex assigned at birth) and cisgender (i.e., whose gender identity or expression matches theirs assigned at birth). Overall, 11.5% of youth self-identified as gender minority. Gender minority youth had increased odds of past-12-month alcohol use, marijuana use, and nonmarijuana illicit drug use. Gender minority youth disproportionately experienced bullying and harassment in the past 12 months, and this victimization was associated with increased odds of all substance use indicators. Bullying mediated the elevated odds of substance use for gender minority youth compared to cisgender adolescents. Findings support the use of gender minority stress perspectives in designing early interventions aimed at addressing the negative health sequelae of bullying and harassment.     

Sexual Minority Women's Gender Identity and Expression: Challenges and Supports

Sexual minority women were divided into four groups to study their gender identities (butch and femme), and gender expression (traditionally gendered and non-traditionally gendered women who do not identify as butch or femme). Experiences of heterosexist events (discrimination, harassment, threats of violence, victimization, negative emotions associated with these events), mental health (self esteem, stress, depression), and supports for a sexual minority identity (social support, outness, internalized homophobia) were examined across these groups. Findings suggested that butch-identified women experienced more heterosexist events than femme women or women with non-traditional gender expressions. There were no differences in mental health variables.     

Avenues for Future Minority Stress and Substance Use Research among Sexual and Gender Minority Populations

Sexual and gender minority individuals (lesbian, gay, bisexual, transgender, queer [LGBTQ]) experience elevated rates of minority stress and associated substance use relative to their heterosexual and cisgender counterparts. Although the minority stress–substance use relationship is well documented, less is currently known regarding day-to-day minority stress and substance use risk processes. Rather than criticize existing literature, this review highlights future directions and advocates for the use of experience sampling methodology as a valuable research tool regarding real-time data capture. Greater utilization of this methodology is encouraged and expected to improve understanding of daily minority stress processes, and provide insight into real-time risk monitoring and intervention strategies.     

Gay Affirmative Cognitive Behavioral Therapy for Sexual Minority Youth: A Clinical Adaptation

Sexual minority youth (SMY) are at high risk for negative mental health outcomes such as depression, anxiety, substance abuse, and suicidality. However, there has been a disconnect between clinical social work practice and research with SMY, resulting in a lack of rigorous research that demonstrates the use of effective interventions. While cognitive behavioral therapy (CBT) has long been established as a best practice option for the general adolescent population suffering from mental health problems, knowledge about the use of CBT with SMY lags far behind. Thus, the purpose of this article is to present a clearly defined adaptation of CBT for SMY that integrates gay affirmative practices for youth (e.g., coming out, stigma and discrimination, the role of social support and community). Specifically, the authors: (a) discuss the impact of minority stress on SMY; (b) highlight the specific components of CBT that represent a good fit for SMY and also address the criticisms of using such an approach; (c) consider the importance of using gay affirmative practices with SMY; and (d) offer recommendations for incorporating gay affirmative practices into traditional CBT models to better meet the needs of SMY.     

Strengths First: An Empowering Case Management Model for Multiethnic Sexual Minority Youth

This article (1) describes the development of a strengths-based case management (SBCM) model for multiethnic sexual minority youths; (2) provides a profile of participant risks and strengths; and (3) discusses critical considerations for implementation with this population. Participants (N = 162) reported complex risks such as family rejection as well as personal strengths. SBCM is a promising intervention that provides opportunities to bridge the unique gaps in service for this vulnerable population. Strategies to incorporate strengths into program assessments and address issues such as family engagement and service delivery challenges are offered.     

Integrated Behavioral Health and Counseling Gender and Sexual Minority Populations

abstract

Counselors are increasingly expected to operate within an integrated behavioral health framework across systems of care. This critical literature review provides an overview of the integrated behavioral health paradigm, including the practice of interprofessional collaboration, with specific application to lesbian, gay, bisexual, transgender, queer (LGBTQ), and other gender and sexual minority issues. Implications for practice and research are discussed, along with a focus on concrete recommendations for application practicing interprofessionally with and on behalf of LGBTQ clients.     

Disengaged or Bookworm: Academics,Mental Health,and Success for Sexual Minority Youth

Same‐sex attracted youth (SSAY) experience higher rates of negative mental health outcomes compared with their heterosexual peers; however, the association between sexual minority status and academic achievement is less clear. We used four waves of data from the National Longitudinal Study of Adolescent Health to compare 1,279 ethnically diverse SSAY (57% male) based on the degree to which they were “engaged” (65%) or “disengaged” (35%) in school, classified through cluster analysis techniques. The pattern of results indicated significantly better mental health among the engaged group one and 6 years later (e.g., fewer depressive symptoms, less alcohol use), and more occupational and educational achievement eleven years later. The implications of school connection and achievement across a decade of life are discussed.     

School-Based Groups to Support Multiethnic Sexual Minority Youth Resiliency: Preliminary Effectiveness

Sexual minority youth (SMY) face multiple challenges as a result of their marginalized sexual and/or gender identities, yet evidence informed programs for the population are absent from the literature. This study describes the pilot research efforts of affirmative supportive safe and empowering talk (ASSET), the first LGBTQ affirmative school-based group counseling intervention created specifically to promote resiliency. In a pilot uncontrolled trial, multiethnic SMY (n = 263) completed measures of self-esteem, social connectedness, and proactive coping at baseline and following completion of the ASSET intervention. Post-intervention analysis using general linear modeling suggests that self-esteem and proactive coping increased significantly across all subgroups, while social connectedness remained constant. ASSET holds promise to enhance the resiliency of SMY in school-based practice settings. Further research should address the effect of ASSET participation on measures of risk and resiliency, and compare outcomes across multiple group interventions.     

Bullying Victimization Trajectories for Sexual Minority Adolescents: Stable Victims,Desisters, and Late‐Onset Victims

Sexual minority adolescents are bullied more frequently than heterosexual peers. Research is lacking on their rates of general and sexual orientation bullying victimization. The present study identified (1) the rate, onset, and desistance of general and sexual orientation bullying victimization, (2) the rate of bullying victimization trajectories, and (3) risk and protective factors across trajectories. A life history calendar method and thematic analysis were employed with a sexual minority adolescent sample (N = 52, 14–20 y/o). General bullying began at age 5 and declined after age 12, with sexual orientation bullying increasing throughout adolescence. Late‐onset victim (34.6%) was the most common trajectory, followed by stable victim (28.9%), desister (23.1%), and nonvictim (13.5%). Differences in risk and protective factors were found across trajectories.     

Disparities in Persistent Victimization and Associated Internalizing Symptoms for Heterosexual Versus Sexual Minority Youth

This study investigated whether lesbian, gay, and bisexual (LGB) adolescents were at higher risk for persistent victimization of bullying compared to heterosexual adolescents, and how victimization trajectories were associated with internalizing symptom development across LGB and heterosexual adolescents. Data came from a five‐wave study (M_ageT1 = 11.1 to M_ageT5 = 22.3; n = 151 LGB; n = 1,275 heterosexual) and informants were adolescents and their parents. Adolescents were classified in three victimization trajectories: persistent (5.6%), decreasing (28.1%) or low (66.3%) victimization. LGB adolescents reported more persistent victimization, relative to no (OR = 6.79, 95% CI [3.52, 13.13]) or decreasing victimization (OR = 3.09, 95% CI [1.53, 6.24]), compared to heterosexual peers. Further, persistent victimization was more strongly associated with anxiety among LGB than among heterosexual adolescents.     

Gender and Sexual Orientation Bullying Victimization are Associated with Gun Carrying Among Adolescent Boys

Child and Adolescent Social Work Journal - Gun carrying and bullying victimization are associated among adolescent boys, however the type of the bullying remains relatively unknown. This study...     

Where Risks and Protective Factors Operate Differently: Homeless Sexual Minority Youth and Suicide Attempts

Using a sample of 628 homeless youth and young adults from eight US cities, this study examines whether the relationship between having been in custody of social services and suicide attempts, and the relationship between engaging in survival sex and suicide attempts differ based on sexual orientation. Findings suggest that being in custody of social services is associated with a significant increase in likelihood of suicide attempts for heterosexual youth, it does not, however, significantly change the already increased risk of suicide attempts for sexual minority youth. Engaging in survival sex appears to be associated with increased risks of suicide attempts for both heterosexual and sexual minority youth, but the increase in likelihood is much stronger for heterosexual youth than for sexual minority youth. Implications for practice and future research are discussed.

Acculturation,Gender Disparity,and the Sexual Behavior of Asian American Youth

Asian American youth are less likely to be sexually active than adolescents from other ethnic groups; however, with acculturation, they may adopt the more liberal sexual norms of American society. Moreover, owing to differing parental expectations for sons and daughters about sexuality, gender disparity might exist in the adoption of American sexual norms. This article used the proportional hazards model and the generalized estimating equations Poisson model to examine how acculturation influences the initiation of sexual intercourse and the number of sexual partners. The results show that acculturation leads to more liberal sexual mores among Asian American youth. However, despite what might be expected from the sexual double standard, the models show that more acculturated females, as indicated by their use of English at home, had an earlier onset of sexual intercourse and a higher number of sexual partners. This is the opposite of what would be predicted by the sexual double standard theory. This might be due to the fact that Asian females tend to be more socially accepted by the host society than Asian males. Information on partners shows that Asian American females have more diversified racial backgrounds than their male counterparts. They are also more likely to have older sexual partners.     

Differences in Sexual Orientation Diversity and Sexual Fluidity in Attractions Among Gender Minority Adults in Massachusetts

This study characterized sexual orientation identities and sexual fluidity in attractions in a community-based sample of self-identified transgender and gender-nonconforming adults in Massachusetts. Participants were recruited in 2013 using bimodel methods (online and in person) to complete a one-time, Web-based quantitative survey that included questions about sexual orientation identity and sexual fluidity. Multivariable logistic regression models estimated adjusted risk ratios (aRRs) and 95% confidence intervals (95% CIs) to examine the correlates of self-reported changes in attractions ever in lifetime among the whole sample (n = 452) and after transition among those who reported social gender transition (n = 205). The sample endorsed diverse sexual orientation identities: 42.7% queer, 19.0% other nonbinary, 15.7% bisexual, 12.2% straight, and 10.4% gay/lesbian. Overall, 58.2% reported having experienced changes in sexual attractions in their lifetime. In adjusted models, trans masculine individuals were more likely than trans feminine individuals to report sexual fluidity in their lifetime (aRR = 1.69; 95% CI = 1.34, 2.12). Among those who transitioned, 64.6% reported a change in attractions posttransition, and trans masculine individuals were less likely than trans feminine individuals to report sexual fluidity (aRR = 0.44; 95% CI = 0.28, 0.69). Heterogeneity of sexual orientation identities and sexual fluidity in attractions are the norm rather than the exception among gender minority people.     

Sexual Minority and Heterosexual Former Foster Youth: A Comparison of Abuse Experiences and Trauma-Related Beliefs

The current study compared the abuse experiences of 108 sexual minority and heterosexual former foster youth who received scholarships through the Orphan Foundation of America. Participants used an anonymous online survey to answer questions regarding their history of physical and sexual abuse. All participants who reported a history of sexual abuse also completed the Trauma Related Beliefs questionnaire (TRB; Hazzard, 1993). Differences across sexual orientation were observed in sexual, but not physical, abuse rates and in the Self-Blame/Stigmatization subscale of the TRB. Specifically, sexual minority participants reported more incidents of sexual abuse, as well as higher scores on the TRB subscale, than did heterosexual participants. These results suggest that sexual orientation is relevant to the experience of abuse among children in the child welfare system.