PURPOSE:Cannabis use is common in adolescence and has been associated with negative health effects, and higher prevalence has been seen among marginalized youth. Research has not examined regular use or attitudes promoting use, particularly taking an approach grounded in intersectionality and minority stressors. The present study examines how regular cannabis use, perceptions of risk, approval from parents and friends, and peer norms of use differ across multiple social positions. METHODS:82,933 8th, 9th, and 11th grade students provided data on the 2022 Minnesota Student Survey, including past 30-day cannabis use (3 + times vs. fewer) and related attitudes. Exhaustive Chi-square Automatic Interaction Detection models tested how youth with combinations of five social positions (i.e., racial and ethnic identity, sexual orientation, gender identity, access to resources, location type) varied on each cannabis-related dependent variable. RESULTS:3.8 % reported regular cannabis use, and attitudes were generally not supportive of use. Regular use was higher among older adolescents (7.8 % of 11th, 1.8 % of 8th grade), and the highest prevalence nodes were characterized by marginalized social positions. For example, 24.8 % of 8th grade students who identified as American Indian/Alaska Native or multiracial, gay/ lesbian/bisexual/queer, and high poverty reported regular use - almost fourteen times higher than the prevalence for 8th grade overall. CONCLUSIONS:Both typical adolescent development and marginalization may underlie the observed pattern of findings, and cannabis use may be a coping mechanism to deal with oppression. Prevention activities should account for marginalization and act on multiple levels to address this structural issue.

Youth with marginalized racial, ethnic, sexual, and gender identities experience bias and stigma in schools that relate to school absences, disengagement, and pushout and may impact learning and achievement over time. Using data from 9th-12th graders who participated in the 2019 Minnesota Student Survey (N=80,456) and the 2017-2019 California Healthy Kids Survey (N=512,067), we used Exhaustive Chi-Square Automatic Interaction Detection (ECHAID) to explore how experiences of bias-based bullying and teacher caring were related to general absences, safety-related absences, and grades among youth with diverse races, ethnicities, sexual and gender identities. Both datasets demonstrated important heterogeneity in the school experiences of youth with marginalized identities, particularly in the context of bias-based bullying victimization and low teacher caring. Structural change in schools should be guided by the experiences of youth with marginalized identities to improve school attendance, safety, and achievement.

Effective efforts to promote equity require survey measurement that accurately captures youth's experiences of gender. The present study aimed to identify multiple categorization options and examine differences in rates of gender-based bullying and past-year suicidal ideation by those options. Data come from the 2022 Minnesota Student Survey, specifically 8th, 9th, and 11th grade students (N = 98,682). Students (age range: 12-19 years, M = 14.8, SD = 1.3) had nine response options for gender, with 96.1% selecting one, 3.0% selecting two, 0.6% selecting three, and 0.9% selecting four or more. Responses were coded four ways (15-, 9-, or two 4-category options). Important between-group differences were lost when combining responses into larger groups. For example, the prevalence of gender-based bullying was 39.3% for genderfluid+ youth and 52.2% for nonbinary youth (p < .05) in the 15-category option. Using the 9-category variable that combines nonbinary, nonbinary+, genderfluid, and genderfluid+ into one group, the prevalence of gender-based bullying was 49.8%, which masks significant differences seen with the 15-category variable. The findings from this study support further research with expanded, select-all-that-apply gender identity response options in large adolescent epidemiologic surveys and inform survey creation and analytic approaches. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BACKGROUND:Asian American sexual and gender diverse youth experience bias-based stressors rooted in stereotypes and forms of oppression, which can contribute to coping behaviors like alcohol use. Few studies examine lifetime alcohol use with a focus on understanding heterogeneity within Asian American adolescents. METHODS:The analytic sample included Asian American youth in 9th through 12th grade (N = 86,799) who completed the 2017-2019 California Healthy Kids Survey, a statewide, school-based survey. Exhaustive Chi-square automatic interaction detection was conducted using SPSS. Variables included exposure to sexual orientation and gender identity-based (SOGI) and race-based bullying and different social identities (ethnic, sexual, and gender identities and sex assigned at birth). RESULTS:Past-year SOGI-based bullying was reported by 11.2% of students and race-based bullying was reported by 18.8% of students. 19.6% of students indicated lifetime alcohol use, with higher rates among those in older grades (13.1% 9th grade to 31.8% 12th grade). Lowest lifetime alcohol use prevalence were among monoracial Asian American youth who were not the targets of bias-based bullying, while highest lifetime alcohol use rates were among youth identifying as multiracial and/or with a minoritized sexual orientation and experiencing bias-based bullying. CONCLUSIONS:Findings suggest bias-based victimization may lead youth to cope or attempt to fit in through alcohol use. Bisexual and multiracial youth, who are often marginalized from monoracial and monosexual communities also had high lifetime alcohol use prevalence. Future research should identify intersectionality-informed strategies to address the nuanced bias-based bullying experiences of Asian American sexual and gender diverse youth, particularly in school settings.

Asian American sexual and gender diverse youth experience bias-based stressors rooted in stereotypes and forms of oppression, which can contribute to coping behaviors like alcohol use. Few studies examine lifetime alcohol use with a focus on understanding heterogeneity within Asian American adolescents. The analytic sample included Asian American youth in 9th through 12th grade (N = 86,799) who completed the 2017-2019 California Healthy Kids Survey, a statewide, school-based survey. Exhaustive Chi-square automatic interaction detection was conducted using SPSS. Variables included exposure to sexual orientation and gender identity-based (SOGI) and race-based bullying and different social identities (ethnic, sexual, and gender identities and sex assigned at birth). Past-year SOGI-based bullying was reported by 11.2% of students and race-based bullying was reported by 18.8% of students. 19.6% of students indicated lifetime alcohol use, with higher rates among those in older grades (13.1% 9th grade to 31.8% 12th grade). Lowest lifetime alcohol use prevalence were among monoracial Asian American youth who were not the targets of bias-based bullying, while highest lifetime alcohol use rates were among youth identifying as multiracial and/or with a minoritized sexual orientation and experiencing bias-based bullying. Findings suggest bias-based victimization may lead youth to cope or attempt to fit in through alcohol use. Bisexual and multiracial youth, who are often marginalized from monoracial and monosexual communities also had high lifetime alcohol use prevalence. Future research should identify intersectionality-informed strategies to address the nuanced bias-based bullying experiences of Asian American sexual and gender diverse youth, particularly in school settings.

Homophobia is a societal process that marginalizes non-heteronormative identities through attitudes, behaviors, and institutional norms. In digital spaces, these dynamics appear as online homophobia, including homophobic cyberbullying. While prior research has examined cultural aspects of homophobia, fewer studies have explored how adolescents perceive its presence online. This study presents findings from 17 focus groups involving 95 adolescents (Mage = 17.9, SD = 1.3; 77.8% girls, 21.1% boys) conducted in Northern Italy. Participants reflected on online homophobic behavior and the factors that sustain it. Thematic analysis revealed two overarching themes: (1) the influence of cultural and social norms, and (2) personal beliefs and attitudes. Subthemes included the role of family and religion, peer conformity, social validation, gendered expectations, and reliance on stereotypes. Adolescents described online homophobia not only as an extension of offline prejudice, but also as a way to signal belonging or avoid marginalization. Participants also discussed emotional motives such as fear, insecurity, and frustration as key drivers behind online homophobic behavior. These findings point to the need for educational and policy interventions that address the normalization of homophobic language, foster critical digital literacy, and promote online spaces that support gender and sexual diversity.

Studies show bias-based bullying and harassment compromise health for youth with minoritized identities, and heavy/regular use of cannabis has implications for adolescent brain development. We examined how regular cannabis use varied by experiences of bullying based on sexual orientation, gender identity, and expression (SOGIE) or race and ethnicity, and social positions. Data came from 8th, 9th, and 11th graders completing the 2022 Minnesota Student Survey (N = 82,933). Students reported past 30 day cannabis use (3-5 times or more versus fewer/none), social positions (i.e., sexual, gender, racial, and ethnic identities, grade, access to resources), and race- and SOGIE-based bullying in the past 30 days (any versus none). Exhaustive Chi-square automatic interaction detection identified combinations of five social positions and bias-based bullying associated with the highest prevalences of regular cannabis use for each grade. Results indicated that across grades, cannabis use was 50-68 % lower among youth in social positions with the highest prevalence of frequent cannabis use when they were not the targets of bias-based bullying compared to youth with the same social positions who were targets of bias. For example, 18 % of 8th graders who had low access to resources; identified as American Indian, Alaska Native, or multiracial; and who experienced SOGIE-based bullying engaged in regular cannabis use, compared to 6.8 % prevalence for youth with the same identities who did not report bias-based bullying. Future research that examines bias-based bullying as a potential mechanism in adolescent cannabis use is warranted, particularly among youth with multiple minoritized identities.

OBJECTIVES:Examine very short sleep among adolescents across multiple intersecting social positions and experiences of sexual orientation-based bullying and cyberbullying in two statewide samples. METHODS:A harmonization of two large statewide school-based datasets from grades 9-12 (2019 Minnesota Student Survey, and 2018-2019 California Healthy Kids Survey) was utilized for the analysis (N = 379,710). Exhaustive chi-square automatic interaction detection (an approach for quantitative intersectionality research) explored variability in very short sleep (≤5 hours/night) among adolescents from multiple intersecting social positions (race/ethnicity, gender identity, sexual orientation, and sex assigned at birth), grade, state, and two types of bullying experiences (sexual orientation-based bullying and cyberbullying). Intersectional groups reporting the highest prevalence of very short sleep were identified. We compared very short sleep rates among adolescents from the same social positions who experienced bullying with those who did not experience bullying. RESULTS:Very short sleep was common among this sample of adolescents (19.2%), especially among those holding multiple marginalized social positions (36.9%-51.4%). Adolescents who were transgender or gender diverse or questioning gender identity, and with minoritized sexual and racial/ethnic identities were overrepresented among high prevalence groups of very short sleep. Bullying experiences were reported by all highest prevalence groups. Adolescents who were bullied had 24.9%-51.3% higher rates of very short sleep than adolescents from the same intersecting social positions who were not bullied. CONCLUSIONS:Very short sleep is pervasive among marginalized adolescents. Findings suggest that victimization contributes to adolescents' very short sleep rates. Individual-level interventions may fall short of promoting better sleep among adolescents; systemic interventions addressing bullying are needed. CLINICAL TRIAL REGISTRATION:N/A.

Youth experiencing a suicidal crisis may interface with public services like police. The current analysis examined how intersecting social identities (gender, sexual, and racial/ethnic identities) and history of suicidality were associated with discomfort asking the police for help, using a decision tree approach. The sample included 8th grade students (N=36,513) who participated in the 2022 Minnesota Student Survey. 32.4% of students reported discomfort with asking the police for help. Youth with multiple marginalized identities who have experienced suicidal ideation and suicide attempt had the greatest discomfort with asking the police for help. Non-police models for crisis response teams are indicated.

Microaggressions are subtle expressions of stigma that convey structural power and marginalization; they are commonly experienced by Black, Indigenous, and People of Color (BIPOC) and LGBTQ+ individuals. Research has begun to consider intersectional microaggressions (e.g., racism within the LGBTQ+ community) and has found associations with emotional distress among BIPOC LGBTQ+ youth. Little is known about relations with other health behaviors, so the present study examines experiences of intersectional microaggressions and emotional distress (depressive symptoms and anxiety symptoms), disordered eating (unhealthy weight control, extreme weight control, and binge eating), sexual behaviors (multiple partners and inconsistent condom use), and human immunodeficiency virus (HIV) testing in a large national sample. Participants were 4,097 U.S. BIPOC LGBTQ+ youth aged 13–18 years in 2022. Logistic regression models estimated the odds of each dependent variable by intersectional microaggression scale score, adjusting for gender, sexual, and racial and ethnic identities. Interaction terms were used to detect effect modification by these identities. Bivariate analyses showed that the experience of intersectional microaggressions varied significantly across social identities. In logistic regression models, the odds of emotional distress, disordered eating behaviors, and having multiple sexual partners were significantly elevated for each point on the intersectional microaggression scale. The association between intersectional microaggressions and HIV testing was modified by gender identity, such that among sexually active cisgender boys, intersectional microaggressions were significantly associated with greater odds of HIV testing, but this relationship was nonsignificant for other gender identity groups. Bullying prevention recommendations should take an explicitly intersectional lens and focus on intersectional microaggressions as a form of stigma.

Purpose: We investigated associations between sport participation and depressive and anxiety symptoms among transgender and gender diverse (TGD) adolescents, considering social positions and experiences of bias-based bullying specific to sexual orientation, gender identity, and/or gender expression (SOGIE-BB). Method: TGD adolescents (n = 10,454) completed a school survey. Adolescents in eighth, ninth, or 11th grade self-reported sports team participation, elevated depressive and anxiety symptoms, experiencing past-month SOGIE-BB, specific gender identity, race/ethnicity, and access to resources. We identified groups with highest prevalences of elevated depressive and anxiety symptoms by sports team participation (any/none), experiences of SOGIE-BB (any/none), and social positions using Exhaustive Chi-square Automatic Interaction Detections. Via post-hoc tests, we determined whether prevalences differed between adolescents with the same social positions 1) without SOGIE-BB, 2) with sports participation, and 3) without SOGIE-BB and with sports participation. Results: Experiencing SOGIE-BB comprised each of the highest prevalence elevated depressive and anxiety groups. Four of 7 groups with elevated depressive symptoms and 3 of 4 groups with elevated anxiety symptoms reported no sports participation. Among adolescents sharing social positions, experiencing no SOGIE-BB was significantly associated with lower prevalences of elevated depressive and anxiety symptoms. Sports participation was also significantly associated with lower prevalences of elevated depressive and anxiety symptoms, including when experiencing SOGIE-BB. This was true for all but two high prevalence groups. Conclusion: Sports team participation is associated with better mental health among TGD adolescents. Experiencing SOGIE-BB is associated with higher mental health risks. Promoting sports participation and preventing SOGIE-BB could each enhance TGD adolescents' well-being.

Objectives/Goals: Inclusive physical activity (PA) interventions could improve trans and gender diverse (TGD) adolescents’ PA levels, perceived social support from peers and adults, and mental health, but no stakeholder-informed interventions exist. We describe parents’ impressions of TGD adolescent children’s PA experiences and advice for a PA intervention. Methods/Study Population: We conducted individual Zoom interviews with parents of 13- to 20-year-old TGD adolescents (n = 15). All parents were recruited from a gender healthcare clinic. All children self-identified as TGD, an umbrella term including people who have a gender identity different from social expectations for their assigned sex. We asked questions regarding children’s current and historical participation in PA, parents’ perceptions of barriers to PA for their TGD children, and parents’ desired intervention components. After each interview, parent participants were compensated $100 for their time. We analyzed interview transcripts, focusing on insights to incorporate in an intervention. This study was approved by the University’s Institutional Review Board. Results/Anticipated Results: Parents shared rich histories of their children’s PA participation, compounding barriers to PA, numerous benefits of PA, and a range of preferences for program activities and inclusive practices (e.g., safety protocols, training for adult leaders). They also emphasized the need for TGD youth to build social connectedness through PA. Discussion/Significance of Impact: We gathered concrete advice from parents on creating a PA intervention, which we will use to build a social PA program that meets TGD adolescents’ needs. Addressing health disparities and improving PA, social support, and mental health among TGD adolescents will require such stakeholder input to improve upon existing PA and sports opportunities.

The objective of the present paper is to apply an intersectional lens to HIV prevention behavior disparities among LGBTQ+ adolescents across multiple social positions (racial, ethnic, gender, and sexual identities) and access to LGBTQ+-inclusive school resources (sex education and gender-sexuality alliances). Data are from the 2022 LGBTQ National Teen Survey (N = 10,871). Descriptive analyses and chi-square tests were conducted for social position, LGBTQ+-inclusive school resources, and HIV prevention variables. Social positions and two LGBTQ+-inclusive school resources were then entered into exhaustive chi-square automatic interaction detection models of HIV prevention behaviors (heard of/taken pre-exposure prophylaxis, HIV-testing, and consistent condom use). Groups with the highest and lowest prevalence of HIV prevention behaviors are described. LGBTQ+-inclusive school resources, especially sex education, were promotive of HIV prevention behaviors and mitigated some disparities across social positions. However, some disparities by social positions persisted. Gay or queer cisgender boys were consistently in the highest prevalence HIV prevention behavior groups, whereas youth who self-reported they were bisexual/pansexual, asexual, sexual identity questioning, straight or a sexual identity not listed, especially those who lacked LGBTQ+-inclusive school resources, were overrepresented in the low prevalence groups. LGBTQ+-inclusive school resources are important sources of HIV prevention information and may mitigate some HIV-related disparities.

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