There are several unique factors that may predict mental illness among TGNC youth. Understanding these factors may offer opportunities for targeted clinical and structural interventions.

Objective: Minority stress contributes to several physical and psychological problems in sexual and gender minorities but is largely understudied in transgender/gendernonconforming (TGNC) individuals, particularly TGNC adolescents. The availability of psychometrically sound measures of adolescent minority stress can help improve assessment and treatment planning in this area. This original research study examined whether an existing measure of TGNC-related minority stress and resilience among adults could retain construct and psychometric validity when administered to TGNC adolescents. Method: Respondents were 258 TGNC adolescents, aged 12 to 17.99 years (M ϭ 15.1, SD ϭ 1.4), majority White/European American (70.2%) and assigned female at birth (71.7%) seeking care in an interdisciplinary gender-health clinic within a pediatric academic medical center in the Midwestern United States. Respondents completed a battery of clinical measures as standard of care, including the Gender Minority Stress and Resilience (GMSR) measure, measures of anxiety and depressive symptoms, and parental support. Results: Findings indicated that minor adaptation of the existing adult measure resulted in high internal consistency and construct validity across 9 subscales assessing domains of minority stress and resilience in this sample of TGNC adolescents. Conclusions: This study provides evidence of the factor structure, reliability, and validity of an adolescent extension of the GMSR (i.e., GMSR-A). These findings demonstrate the clinical utility of the GMSR-A, a tool that can help increase understanding of minority stress and resilience phenomena experienced by TGNC adolescents.

Identification of subgroups of the homeless populations, or typologies, has been an important research priority to guide homelessness services and policies. This study builds on previous typological research conducted in the general homeless population by focusing on individuals with mental illness to further delineate typologies within a more homogenous subset of the homeless population. A time-patterned typology based on episodes of street and shelter homelessness over a four-year period was applied to a sample of 246 individuals identified through mental health administrative records. Four groups were created based upon patterns of homelessness: 26.8% experienced homelessness for 4 years, 13.4% had one episode of homelessness but were no longer homeless at the end of the follow-up, 48.4% had at least two episodes of homelessness, and 11.4% had a single episode of homelessness lasting 3 months or less. Findings from a multinomial logistic regression indicated that gender, presence of a psychotic disorder, substance abuse, and year of study enrollment significantly predicted group membership. Residential trajectories upon exit from homelessness and at the end of the four-year follow-up were examined. Implications for current policy and future research are discussed.

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Sexual and gender minority (SGM) adults have rates of depressive disorders that are higher than those of cisgender or heterosexual adults. These differences are likely due to the ways that SGMs are treated both on an individual and population basis. This chapter begins by discussing evolving conceptualizations of depressive disorders among SGMs with a focus on the dimensionality in symptomatology. Insights are provided into the ways that differences in risk for depressive disorders occur in SGMs by subpopulations with a focus on gender, developmental stages, and geographic context. The authors discuss social risks, examining the ways in which stigma, discrimination, and early life adversity can contribute to depressive disorders in SGMs. This provides a basis for researchers and clinicians to explore and include structural and societal change in addressing mental health disorders in SGMs. The authors also discuss the comorbidity of depressive disorders with several chronic health conditions with particular regard to the health inequities that some subpopulations of SGMs face. Adopting an intersectional approach is useful in studying depressive disorders among SGMs, and the authors suggest pairing this approach with the National Institute of Health’s Research Domain Criteria (RDoC) framework. Future directions are suggested to researchers and clinicians to reduce risks of depressive distress in SGM subpopulations.

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