IMPORTANCETransgender and nonbinary (TNB) youths are disproportionately burdened by poor mental health outcomes owing to decreased social support and increased stigma and discrimination.Although gender-affirming care is associated with decreased long-term adverse mental health outcomes among these youths, less is known about its association with mental health immediately after initiation of care. OBJECTIVE To investigate changes in mental health over the first year of receiving gender-affirming care and whether initiation of puberty blockers (PBs) and gender-affirming hormones (GAHs) was associated with changes in depression, anxiety, and suicidality. DESIGN, SETTING, AND PARTICIPANTSThis prospective observational cohort study was conducted at an urban multidisciplinary gender clinic among TNB adolescents and young adults seeking gender-affirming care from August 2017 to June 2018. Data were analyzed from August 2020 through November 2021. EXPOSURES Time since enrollment and receipt of PBs or GAHs. MAIN OUTCOMES AND MEASURES Mental health outcomes of interest were assessed via thePatient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales, which were dichotomized into measures of moderate or severe depression and anxiety (ie, scores Ն10), respectively. Any self-report of self-harm or suicidal thoughts over the previous 2 weeks was assessed using PHQ-9 question 9. Generalized estimating equations were used to assess change from baseline in each outcome at 3, 6, and 12 months of follow-up. Bivariate and multivariable logistic models were estimated to examine temporal trends and investigate associations between receipt of PBs or GAHs and each outcome. RESULTS Among 104 youths aged 13 to 20 years (mean [SD] age, 15.8 [1.6] years) who participated in the study, there were 63 transmasculine individuals (60.6%), 27 transfeminine individuals (26.0%), 10 nonbinary or gender fluid individuals (9.6%), and 4 youths who responded "I don't know" or did not respond to the gender identity question (3.8%). At baseline, 59 individuals (56.7%) had moderate to severe depression, 52 individuals (50.0%) had moderate to severe anxiety, and 45 individuals (43.3%) reported self-harm or suicidal thoughts. By the end of the study, 69 youths (66.3%) had received PBs, GAHs, or both interventions, while 35 youths had not received either intervention (33.7%). After adjustment for temporal trends and potential confounders, we observed 60% lower odds of depression (adjusted odds ratio [aOR], 0.40; 95% CI, 0.17-0.95) and 73% lower odds of suicidality (aOR, 0.27; 95% CI, 0.11-0.65) among youths who had initiated PBs or GAHs compared with youths who had not. There was no association between PBs or GAHs and anxiety (aOR, 1.01; 95% CI, 0.41, 2.51).

Introduction Youth as young as 11 are given responsibility to manage their asthma. Yet, little is known regarding early adolescents’ asthma self-management behaviors. This study characterizes urban early adolescents’ asthma self-management behaviors and perceived responsibility to manage asthma, exploring demographic differences and examining the relationship between asthma responsibility and disease management. Methods 317 Hispanic and Black early adolescents (mean age=12.7) with persistent, uncontrolled asthma reported prevention and symptom management steps, and responsibility for asthma care. We used Poisson, cumulative logistic, logistic, and linear mixed-effects regression models to assess relationships between demographic predictors, prevention and management behaviors, and responsibility for asthma care. Results 50% took 7–9 prevention steps; few saw physicians when asymptomatic or took daily medication. When symptomatic, 92% used medication to treat symptoms, 56% sought medical attention. Controlling for asthma responsibility, fewer older youth reported observing how they feel when asthma is likely to start, observing symptom changes, or asking for help. More boys reported taking medication daily or upon trigger exposure. Controlling for age, gender, and race/ethnicity, those reporting more asthma responsibility were less likely to report taking management steps, seeking preventive care, asking for help, or going to a doctor/hospital for their asthma. Conclusions Early adolescents’ asthma self-management is suboptimal. With increasing age, they are less observant regarding their asthma and less likely to seek help. Although they perceive themselves to have greater responsibility for managing their asthma, early adolescents do less to care for their asthma, suggesting they are being given responsibility for asthma care prematurely.

The present study examined the relationship of perceived parental closeness and parental ethnic identity on personal ethnic identity and colorblindness beliefs in 275 part-White biracial Americans (M age = 23.88). Respondents completed online measures of their personal ethnic identity (minority, White, and multiracial), perceived parental ethnic identity, parental closeness, and attitudes about the state of race relations and the need for social action in the United States. Using path modeling, results show that part-White biracial individuals perceive their ethnic identity to be strongly linked to their parental racial identities, especially when they had closer parental relationships. Moreover, stronger minority identity was linked to less colorblind attitudes, and greater White identity was linked to greater colorblind attitudes suggesting that patterns of identity may influence how biracial individuals view race-relations and the need for social action. Implications for biracial well-being and their understanding of prejudice and discrimination are discussed.

Many Latino students miss opportunities to develop their full potential in U.S. schools. Increasing attention is being paid to the malleable, nonacademic, factors that can affect student learning. The current study sought to evaluate the impact of school climate on Language Arts grade for Latino students in a large, low-income, urban middle school. In addition, the novel construct of Social-Normative Expectations, student perceptions of school-wide norms about achievement expectations for their peers, was explored in relation to school climate and academic achievement. The study sample reflected 513 Latino students, Grades 7 and 8. A mediation model found that approximately 30% of the variance in final Language Arts grades was accounted for by the predictors, including control variables ( R2 = .299). A distinctive mediation effect was also found, whereby the impact of school climate was associated with an approximately .6 points lower final grade mediated through the indirect pathway of Social-Normative Expectations ( b = −0.064, SE = 0.019, 95% confidence interval [CI] = [−0.104, −0.028]). Implications of these findings are discussed.

For students and schools, the current policy is to measure success via standardized testing. Yet the immutable factors of socioeconomic status (SES) and race have, consistently, been implicated in fostering an achievement gap. The current study explores, at the school-level, the impact of these factors on test scores. Percentage of students proficient for Language and Math was analyzed from 452 schools across the state of New Jersey. By high school, 52% of the variance in Language and 59% in Math test scores can be accounted for by SES and racial factors. At this level, a 1% increase in school minority population corresponds to a 0.19 decrease in percent Language proficient and 0.33 decrease for Math. These results have significant implications as they suggest that school-level interventions to improve academic achievement scores will be stymied by socioeconomic and racial factors and efforts to improve the achievement gap via testing have largely measured it.