Ryan J. Watson

Trends and disparities in disordered eating among heterosexual and sexual minority adolescents

OBJECTIVE Disordered eating has decreased for all youth over time, but studies have not focused specifically on lesbian, gay, and bisexual (LGB) youth. Research has found that LGB youth report disordered eating behaviors more often compared to their heterosexual counterparts, but no studies have documented trends over time for LGB youth and considered whether these disparities are narrowing or widening across sexual orientation groups. METHOD We use pooled data from the 1999 to 2013 Massachusetts Youth Risk Behavior Surveys (N = 26,002) to investigate trends in purging, fasting, and using diet pills to lose or control weight for heterosexual and sexual minority youth. We used crosstabs, logistic regression, and interactions in regression models, stratified by sex. RESULTS The prevalence of disordered eating has decreased on all three measures across nearly all groups of heterosexual and sexual minority youth. However, we found disparities in reported disordered eating behaviors for LGB youth persisted across all survey years, with LGB students reporting significantly higher prevalence of disordered eating than heterosexuals. The disparities in fasting to control weight widened between the first and last survey waves between lesbian adolescents and heterosexual females. DISCUSSION The significant reductions over time in prevalence of disordered eating among some youth are encouraging, but the disparities remain. Indeed, the increasing prevalence of fasting, diet pill use, and purging to control weight among lesbians may warrant targeted prevention and intervention programs.

Sexual orientation trends and disparities in school bullying and violence-related experiences, 1999–2013.

Numerous recent studies have demonstrated that schools are often unsafe for lesbian, gay, and bisexual (LGB) adolescents, who are more likely than heterosexual peers to be bullied, harassed, or victimized in school contexts. Virtually all of these studies call for change, yet none investigate whether or not it has occurred. Using repeated waves of a population-based high school survey, we examine (1) the extent to which sexual orientation differences in school bullying and violence-related experiences are reported by lesbian/gay, bisexual, and heterosexual male and female adolescents; (2) trends in school bullying and violence-related experiences for each gender/orientation group, and (3) whether disparities have changed over time. Data were drawn from eight Massachusetts biennial Youth Risk Behavior Surveys from 1999 to 2013, grouped into 4 waves totaling 24,845 self-identified heterosexual, 270 lesbian/gay, and 857 bisexual youth. Disparities between LGB and heterosexual peers were found in all indicators. Heterosexual youth and gay males saw significant reductions in every outcome between the first and last waves. Among bisexual males, skipping school due to feeling unsafe, carrying weapons in school, and being bullied all decreased, but among lesbians and bisexual females only fighting in school declined significantly. Improvement trends in school safety were more consistent for heterosexual youth and gay males than for bisexual or lesbian females. Notably, despite these improvements, almost no reduction was seen in sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities.

Prevalence of pregnancy involvement among Canadian transgender youth and its relation to mental health, sexual health, and gender identity

ABSTRACT While little research has been conducted into the reproductive experiences of transgender people, available evidence suggests that like cisgender people, most transgender people endorse a desire for these experiences. This study explores the pregnancy experiences and related health factors among transgender and gender diverse 14 to 25 year olds using a national Canadian sample (N = 923). Results indicated that 26 (5%) transgender youth reported a pregnancy experience in the past and the prevalence among 14- to 18-year-olds was comparable to population-based estimates using the same question in the British Columbia Adolescent Health Survey. Transgender youth with a history of pregnancy involvement reported a diverse range of gender identities, and this group did not differ from the remainder of the sample on general mental health, social supports, and living in felt gender. This group did report over six times greater likelihood of having been diagnosed with a sexually transmitted infection by a doctor (19%), but they did not differ in reported contraception use during last sexual intercourse. These findings suggest that pregnancy involvement is an issue that should not be overlooked by health professionals working with transgender youth and that this group has particular sexual health needs.

Disordered eating behaviors among transgender youth: Probability profiles from risk and protective factors

PURPOSE Research has documented high rates of disordered eating for lesbian, gay, and bisexual youth, but prevalence and patterns of disordered eating among transgender youth remain unexplored. This is despite unique challenges faced by this group, including gender-related body image and the use of hormones. We explore the relationship between disordered eating and risk and protective factors for transgender youth. METHODS An online survey of 923 transgender youth (aged 14-25) across Canada was conducted, primarily using measures from existing youth health surveys. Analyses were stratified by gender identity and included logistic regressions with probability profiles to illustrate combinations of risk and protective factors for eating disordered behaviors. RESULTS Enacted stigma (the higher rates of harassment and discrimination sexual minority youth experience) was linked to higher odds of reported past year binge eating and fasting or vomiting to lose weight, while protective factors, including family connectedness, school connectedness, caring friends, and social support, were linked to lower odds of past year disordered eating. Youth with the highest levels of enacted stigma and no protective factors had high probabilities of past year eating disordered behaviors. DISCUSSION Our study found high prevalence of disorders. Risk for these behaviors was linked to stigma and violence exposure, but offset by social supports. Health professionals should assess transgender youth for disordered eating behaviors and supportive resources.

Sources of Social Support and Mental Health Among LGB Youth

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.

LGBT cyberspaces: a need for a holistic investigation

Cyberspaces provide many opportunities for lesbian, gay, bisexual, and transgender (LGBT) youth to build social networks, share information, and become more informed about their sexuality without the risk of being ‘outed’. Concurrently, however, there are a myriad of risks that problematize this positive narrative associated with these cyberspaces. There is a scarcity of scholarship in geographical literature about the risks related to youths’ interactions with LGBT cyberspaces. To date, most of the available scholarship pertains to the beneficial outcomes related to cyberspaces. However, we propose that researchers need to critically investigate the unhealthy behaviors produced by cyberspaces. There are a variety of online communities and websites that provide inaccurate health information, and this could inform poor health decision-making by LGBT youth.

Parent Support Matters for the Educational Success of Sexual Minorities

Abstract Recent research has documented disparities in academic experiences and achievement for sexual minorities. Two important correlates of well-being for all youths are their relationships with family members and experiences at schools. We used nationally representative data to investigate whether the association between perceived maternal and parental support (defined as warm, firm, and accepting parental bonds) and educational outcomes differs for sexual minority compared to heterosexual youths. The sample consisted of 12,064 participants. Results indicated that parent support was significantly associated with grade point average (GPA), school belonging, and school troubles for both sexual minority and heterosexual participants, but the magnitudes differed. In addition, we found a two-way interaction between sexual minority status and parental support in association with school belonging, indicating that for sexual minority youths, low parental support was associated with particularly low levels of school belonging compared to heterosexual youths. This project highlights the importance of family support as a contributor for healthy development.

Are we leveling the playing field? Trends and disparities in sports participation among sexual minority youth in Canada

Purpose Sports participation and physical fitness are widely beneficial for young people, yet activity levels among young people are declining. Despite growing popular media attention on the participation of sexual minority (e.g., lesbian, gay, and bisexual) youth in sports and various campaigns to improve the often homophobic climate of sports, there is limited evidence that sexual minority youth participate in sports. Our aim was to provide a current portrait of sports participation among 3 groups of sexual minority youth (e.g., lesbian, gay, and bisexual) in British Columbia, Canada, as well as to document population trends. Methods Pooled population-level data from British Columbia, Canada (n = 99,373) were used to examine trends and disparities in sports participation among sexual minority and heterosexual youth. Age-adjusted logistic regression models were used to examine changes in participation over time and disparities in participation over time (1998–2013). Results We found an overall decline in sports participation and physical activity (PA) for all youth. Sexual minority students were less likely to participate in formal sports (with a coach) and informal sports (without a coach) compared with their heterosexual peers. The disparity in participating in informal sports between heterosexual and sexual minority youth has narrowed over time for some sexual orientation groups, whereas the disparity in participating in formal sports has widened over time in some cases. Conclusion This study provides a comprehensive examination of sports participation among sexual minority youth over the past 15 years. Despite changing societal attitudes and laudable efforts to reduce homophobia in sports, results suggest that there are continued barriers to participation for sexual minority youth. Further research is needed to understand the factors that limit sports participation for these youth and to inform program development. PA is critical to lifelong health and well-being, and thus continued efforts are needed to increase the sports participation of sexual minority youth in particular.

Sexual minority youth continue to smoke cigarettes earlier and more often than heterosexuals: Findings from population-based data

BACKGROUND An established body of research documents that sexual minority (i.e., lesbian, gay, and bisexual) populations are at higher risk for several adverse health behaviors and outcomes compared to their heterosexual counterparts. Smoking is one behavior where the gap is especially large, particularly among youth. Researchers have increasingly drawn attention to contextual determinants of health behaviors affecting sexual minority youth. PURPOSE Although these factors have evolved over time, few scholars have examined time as a contextual factor that affects sexual minority health behaviors or the level of inequality with heterosexual populations. We aimed to fill this gap. PROCEDURES We used eight years of data from the Massachusetts Youth Risk Behavior Survey (MYRBS), pooled into four waves, to determine whether gaps between sexual minority and heterosexual youth have widened or narrowed for three different indicators of smoking: having ever smoked, early onset smoking, and daily cigarette smoking in the past 30 days. RESULTS We find that, though rates of smoking for all youth in Massachusetts have declined since the late 1990s, significant disparities remain between sexual minority and heterosexual youth. CONCLUSIONS Findings may suggest that targeted tobacco control programs in Massachusetts are needed; perhaps shifts in social attitudes toward smoking have affected smoking behaviors in diverse segments of society.

Trends in suicidality among sexual minority and heterosexual students in a canadian population-based cohort study.

Despite evidence from numerous studies that document disparities in suicidality for sexual minorities, few have investigated whether or not these trends have improved over time, which is the objective of the current study. Using school-based population data over a 15-year period (1998 to 2013), multivariate logistic regressions were used to calculate age-adjusted odds ratios (ORs) separately by gender. Interactions were included to test widening or narrowing disparities within orientation groups, which makes this one of the first studies to test whether gaps in disparities between heterosexual and sexual minorities have widened or narrowed over time. Results show that sexual minority youth are persistently at a greater risk for suicidal behavior, a trend that has continued particularly for bisexual youth of both sexes. Results also suggest that the gap in suicidal behavior is widening among some female sexual orientation groups, yet narrowing for other male sexual orientation groups. These findings have important public health implications, especially since we see decreases in suicidal behavior for heterosexual adolescents, but not in the same way for many sexual minority youth, despite advances in social acceptance of gay, lesbian, and bisexual issues in North America.