School-based Gender and Sexuality Alliance (GSA) clubs have well-documented benefits for sexual and gender minority (SGM) youth and their allies. However, little is known about what constitutes usual practice in these clubs, nor is much known about the adult advisors who serve as important safe adult relationships for SGM youth in schools. As such, the present study conducted a survey with 167 GSA advisors to gain a better understanding of usual practices within GSAs and advisor characteristics, training experiences, needs, and motivations in their role. Findings indicate that a majority of participating advisors are teachers in non-rural, public high schools. Only one third of participants indicated that they had received any training related to their role and all participants expressed needs for training across a variety of domains. In terms of their GSA meetings, participants indicated the frequency and duration of their meetings and the estimated amount of time spent focused on student emotional support, advocacy efforts, and social connection. We additionally conducted a thematic analysis surrounding advisor motivations to serve in their role. Themes included awareness of need, provision of a safe space, advocacy, and personal connections. Implications for provision of training and future supports for GSA advisors are discussed.

Background: In 2007, Cochran, Peavy, and Robohm conducted a study of treatment programs that indicated that they provided specialized services for gay and lesbian clients; however, phone calls to these agencies revealed that over 90% of these agencies actually did not provide services that were discernibly different from the agencies' general services. Objectives: Given the progress and development since 2007 regarding awareness of SGM (sexual and gender minority) rights and an increased understanding of the impact of health disparities on SGM individuals, the current study aimed to gain a renewed understanding of the state of SGM-specific substance treatment using a similar methodology. Results: agencies reporting that they provide SGMTitle specific services since 2007, fewer than 1 in 5 agencies who indicated offering SGM-specific treatment on the National Survey of Substance Abuse Treatment Services (N-SSAT S) survey actually provided such services (17.4%) in 2021. Conclusions/Importance: The current study reinforces the already observed need for specialized substance treatment services for the SGM population. Despite having hundreds more SGM-specific substance treatment services in existence today compared to 2007, our findings point to a strong need to address the discrepancies between self-reported and existing availabilities of SGM-specific services in substance treatment. Actions that can potentially close this gap might be two-fold: standardizing the definition of and criteria for SGM-specific services and increasing funding and resources that could expand the availability of such services, particularly in rural regions.

The presence of a Gender and Sexuality Alliance (GSA) reduces risk for sexual and gender minority (SGM) youth across a variety of domains, but little is known about the adult advisor-level variables contributing to these observed benefits. This study explored relationships between advisors' tenure, receipt of professional development, self-efficacy, and social emotional competencies (SECs). Participants (N = 167) completed an online survey measuring their own social-emotional competencies and their perceived self-efficacy as a GSA advisor. As hypothesized, results demonstrated relationships between advisor tenure and self-efficacy and between advisor receipt of professional development and self-efficacy. Further, advisor SEC significantly predicted self-efficacy, and both receipt of professional development and SEC positively predicted perceived self-efficacy, as well. Findings point to opportunities for providing training to GSA advisors, with a focus on SEC to increase their efficacy in working with SGM youth. Implications for school psychologists are discussed.

Despite the growing literature on barriers to mental health care experienced by gender-minority individuals, there are few studies that describe mental health providers' competencies for delivering care to transgender clients of mental health care. The current study was designed to explore the relationships between mental health care providers' (N = 107) transphobia, gender minority-specific knowledge, and hypothetical treatment decisions when working with gender-minority clients. Online surveys gauged providers' transphobia using the Genderism and Transphobia Scale (Hill & Willoughby, 2005) as well as their knowledge based on self-reported understanding of gender minority-related issues. Treatment decisions were based on three sets of vignettes that measured providers' responses to both transgender and not explicitly transgender clients in comparable situations. Transphobia negatively predicted knowledge, such that higher transphobia scores were correlated with lower knowledge scores, F(1, 85 = 24.16), p = .02, R-2 = .22. Similarly, transphobia was significantly predictive of treatment decisions in the sample, F(1, 76) = 33.66, p < .01, R-2 = .31, wherein higher transphobia scores were associated with a wider discrepancy in treatment decisions between transgender and not explicitly transgender clients. The significant relationships between these variables warrants a call for targeted bias-reduction efforts among mental health providers to improve services for and reduce discrimination against gender-minority individuals accessing mental health services.

Concealment of gender and sexual identity constitutes a key proximal stress process in the minority stress model, and disparate literature indicates the presence of cognitive, affective, and behavioral components of concealment. There may be utility in testing these components as predictors of health disparities for gender and sexual minority (GSM) individuals. We hypothesized that greater engagement in concealment across these 3 components would be associated with worse physical health, more severe depression and anxiety, and higher rates of substance use among GSM individuals. Also, we hypothesized that each concealment component would predict depression and anxiety symptoms, whereas behavioral concealment, but neither cognitive nor affective concealment, would be associated with substance use. GSM adults (N = 640, M-age = 24.36, SD = 7.51) were recruited nationally. A measure was developed to assess the 3 components of concealment, and participants completed this measure as well as queries of current physical health, current depression and anxiety symptoms, and recent alcohol and drug use via an online survey. Multivariate hierarchical regressions demonstrated no relationship between concealment and physical health; however, concealment positively predicted depression, anxiety, and substance use symptoms. Varied relationships between the components of concealment and the response variables were found, including relationships between internalizing-externalizing symptoms and behaviors. Concealment and its constitutive components relate to a broad range of mental health symptomatology and behaviors among GSM individuals. This study is particularly timely in the current political context, as individuals in this sample appear to be more likely to conceal because of the increasing tenuousness of GSM rights.

Background Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA). Methods Fifty SGM participants (Mage=21.82, SD=4.70; 84% White) completed baseline assessment (e.g., concealment and lifetime victimization) followed by EMA of daily discrimination and anxious and depressed mood for 14 days. Results As hypothesized, daily discrimination predicted momentary increases in anxious and depressed mood, b = .34, p < .001. Notably, these effects were more pronounced among individuals who reported higher levels of identity concealment, b = .25, p < .001, and previous SGM-based victimization experiences (marginally), b = .18, p = .05. Main effects of cumulative lifetime victimization and identity concealment, measured at baseline, were associated with higher ratings of anxious and depressed mood over the two-week study. Discussion While identity concealment may reduce exposure to discrimination and victimization, we found that concealment and prior victimization predict heightened reactivity to daily discrimination experiences. Additional research is needed to further explicate real-time effects of minority stress exposure, and to develop interventions that may mitigate risk among SGM individuals with prior victimization exposure and higher levels of identity concealment in particular.

This project utilized a Community-Based Participatory Research (CBPR) approach to conduct qualitative interviews with 30 transgender adults living in a rural state. Participants’ identities spanned from trans women and men to nonbinary and Two-Spirit. The aim of this study was to better understand the experiences, needs, and priorities of the participants as well as to examine possible determinants of mental health, well-being, and suicidality for transgender individuals in Montana. These factors were investigated at individual, interpersonal, community, and societal levels using an ecological framework. Qualitative results indicate that participants experienced discrimination at all levels. Participants noted that discrimination contributed to mental health challenges and limited access to adequate general and transgender-specific health care services, both of which impacted overall well-being. This is reflected most notably in the elevated rate of past suicidal ideation attempts among the sample. Participants reported that the ability to transition, as well as other protective factors, played a role in reducing suicidality and improving mental and physical health. Our findings highlight the need to address transgender mental health through implementing changes at multiple ecological levels.

The intricate, intimate, and definitively idiographic experiences of transgender individuals are eloquently documented by Matthew Heinz in his book Entering Transmasculinity: The Inevitability of Discourse. From the book’s subtitle, the use of the term “inevitability” to describe discourse regarding transmasculinity is a poignant indicator of the times in which we live, as just a few decades ago, “dearth” may have been a more apt descriptor. The academic literature on transgender issues has recently burgeoned, with a frequent focus on the disproportionate rates of health disparities (e.g., Hughto, Reisner, & Pachankis, 2015; Stotzer, 2009; Tebbe & Moradi, 2012), transition related barriers such as gatekeeping and diagnostic dilemmas (e.g., Belluardo-Crosby & Lillis, 2012; Coleman et al., 2012), and the fight to eliminate anti-transgender prejudice (e.g., Reed, Franks, & Scherr, 2015; Schilt, 2010; Walch et al., 2012). While these are certainly among the discourses detailed in his book, Heinz uniquely chronicles “current transmasculine discourse...where advocacy against systemic gender-based violence encounters tips for transguys’ father’s day presents” (p. 125). Heinz’s thoughtful inclusion and review of YouTube videos, Buzzfeed and Yahoo! discussion boards, blogs, spoken word performances, popular media, news articles, and many other sources of discourse provides an insightful lens into the identity development process, the transition navigation, and the gender socialization of numerous transmasculine individuals. A focus on the diverse experiences of these individuals is long overdue. Heinz also integrates groundbreaking research from empirical studies, such as Bennett’s dissertation on developing a psychoanalytic model of psychological development throughout transition, and Bockting, Knudson, and Goldberg’s (2006) research on mental health practices for transgender individuals and their loved ones, with these non-academic sources to create a profound reference piece for those interested in gaining insight into what it means to identify as a transmasculine individual. Although geared primarily toward an academic audience—researchers of LGBT issues and communication studies, in particular—this book provides a multitude of resources that would be of use for individuals navigating their own gender identity, for parents of transmasculine individuals, for practitioners seeking to enhance their competencies, and for community organizers and activists. Heinz notes that most commonly, transmen are depicted as white, middle-class, heterosexual, able-bodied individuals itching to uncover their bare chests to the world. He challenges this representation by asserting that entering transmasculine discourse means embarking on a journey of multifinality; sharing, in his book, “not just a story of emergence from a set of representations, but stories of emergence

This chapter argues that the likelihood of stigmatized experiences is increased by the health disparities. Mitigating biases against these experiences is important to enacting a welcoming clinic environment. The chapter provides an overview of the historical pathologization of transgender identities. Transgender individuals are likely to be correct that mental health professionals learned nothing about transgender identity, health disparities of transgender people, or the World Professional Association of Transgender Health Standards of Care (WPATH SOC) while in graduate school. Due to these training deficits, transgender individuals, aware that they may very well be the first transgender client a provider has seen, take on the role of educating providers on the history of discrimination and mistreatment of the transgender community. The chapter provides a welcoming clinic environment for transgender clients is not just commensurate with the WPATH SOC; it is in keeping with the principles and values of all mental health professions.

Objective: Sexual and gender minority (SGM) individuals experience elevated rates of minority stress, which has been linked to higher rates of nicotine and substance use. Research on this disparity to date is largely predicated on methodology that is insensitive to within day SGM-based discrimination experiences, or their relation to momentary nicotine and substance use risk. We address this knowledge gap in the current study using ecological momentary assessment (EMA). Method: Fifty SGM individuals, between 18 and 45 years of age, were recruited from an inland northwestern university, regardless of their nicotine or substance use history, and invited to participate in an EMA study. Each were prompted to provide data, six times daily (between 10:00 a.m. and 10:00 p.m.) for 14 days, regarding SGM-based discrimination, other forms of mistreatment, and nicotine, drug, and alcohol use since their last prompt. Results: Discrimination experiences that occurred since individuals' last measurement prompt were associated with greater odds of nicotine and substance use during the same measurement window. Substance use was also more likely to occur in relation to discrimination reported two measurements prior in lagged models. Relative to other forms of mistreatment, discrimination effects were consistently larger in magnitude and became stronger throughout the day/evening. Conclusion: This study adds to existing minority stress research by highlighting the both immediate and delayed correlates of daily SGM-based discrimination experiences. These results also contribute to our understanding of daily stress processes and provide insight into ways we might mitigate these effects using real-time monitoring and intervention technology.

The future for sexual and gender minority (SGM) youth is a promising one, given the requisite supports, in Growing Into Resilience: Sexual and Gender Minority Youth in Canada, written by Andre Grac...

The 2013 book Transgender Experience: Place, Ethnicity, and Visibility, edited by Chantal Zabus and David Coad, contributes a multinational perspective to the extant trans* scholarly literature. The editors have assembled a collection of personal narratives, scholarly essays, and a photographic narrative that introduce the reader to aspects of the trans* experience that are likely to be novel and enlightening.

In this study, we investigated the potential effects of statewide nondiscrimination laws on community stigma, as well as its relationship with psychosocial stressors and mental health outcomes. Gender minority individuals (N = 120) completed an online survey containing psychosocial and mental health outcome measures. The experiences of participants who resided in states with and without nondiscrimination laws were compared in regard to perceived community stigma. Hierarchical and logistic regression were used to test the hypothesized relationships between community stigma and lifetime discrimination and victimization; current depression, anxiety, and substance use; and lifetime suicide attempts. Approximately 60% of participants reported residing in a state without nondiscrimination laws (n = 74). These participants reported higher levels of perceived community stigma, and stigma was positively associated with reports of lifetime discrimination and victimization. The observed relationship between stigma and current anxiety symptoms was marginally significant. Logistic regression results indicate that stigma was positively related to the odds of reporting a lifetime suicide attempt. Analyses suggest that statewide nondiscrimination laws are associated with lower rates of perceived stigma at the community level, which, in turn, is associated with lower rates of discrimination, victimization, anxiety, and risk for attempted suicide.

Background: Sexual minority young adults experience elevated rates of distal stress (discrimination, victimization), and related psychological distress and alcohol misuse. However, few studies have examined the degree to which personality trait differences conferrisk/resilience among sexual minority young adults. We hypothesized that psychological distress would mediate the relationship between distal stress and alcohol misuse, but that these relationships would be moderated by personality trait differences.Method: Sexual minority young adults (N = 412) were recruited nationally. Survey measures included demographic questions, minority stressors, Five Factor personality traits, and current psychological distress and alcohol misuse symptoms. We used a data-driven two-stage cluster analytic technique to empirically derive personality trait profiles, and conducted mediation and moderated mediation analyses using a regression based approach.Results: Our results supported a two-group personality profile solution. Relative to at-risk individuals, those classified as adaptive scored lower on neuroticism, and higher on agreeableness, extraversion, conscientiousness, and openness to experience. As predicted, psychological distress mediated the relationship between distal stress and alcohol misuse. However, personality moderated these relationships to the degree that they did not exist among individuals classified as adaptive.Discussion: In the current study, we found that personality moderated the established relationships between distal stress, psychological distress, and alcohol misuse among sexual minority young adults. Future research is needed to further explicate these relationships, and in order to develop tailored interventions for sexual minority young adults at risk. (C) 2016 Elsevier Ltd. All rights reserved.