Analysis of Reported Health Care Use by Sexual Orientation Among Youth

Reisner, Sari L.; Mateo, Camila M.; Elliott, Marc N.; Tortolero, Susan R.; Davies, Susan L.; Lewis, Terri; Li, Dennis; Schuster, Mark A.

doi:10.1001/jamanetworkopen.2021.24647

Cited by 13 publications

(11 citation statements)

References 46 publications

(74 reference statements)

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“…This greatly exceeds the prevalence of non-heterosexual individuals in other studies carried out on youths e.g. Reisner et al (2021) reported a 15% prevalence of LGB in a sample of young people (N = 4,256) aged 15; Watson and colleagues (2019) found that 24% of youths aged 13-17 identified with non-traditional labels such as pansexual or nonbinary. A prevalence of 47.2 % in our sample can hardly be explained only within the context of self-harm.…”

Section: Discussionmentioning

confidence: 69%

Differences in the Extent and Function of Self-Harm With Regard To the Sexual Orientation of Youths

Démuthová¹,

Démuth²

2022

Proceedings of the 6th International Conference on Research in Social Sciences

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During adolescence, the formation of an individual's identity and other developmental tasks are a challenge and frequently put a great deal of mental pressure on a young person. The processes and strategies they select to cope with these burdens may not always be adaptive; during their youth, a young person often reacts with various forms of inappropriate behaviour. One very common maladaptive coping strategy, whose prevalence in the youth population continues to grow, is self-harm. The process of going through their youthful years may be made even more challenging if the individual encounters difficulties in the exploration of their own identity or in how they present it to others. In this context, the nonheterosexually oriented population of youths are particularly at risk. The study focuses on the issue of self-harm in the context of the sexual orientation of a youthbased on a sample of 265 participants aged between 15 and 25 (AM = 19.371). It examines the extent and function of self-harming behaviour and links it to sexual orientation (heterosexual or nonheterosexual). The results showed a statistically significantly higher rate of self-harm (sig. < 0.001) in those youths who are non-heterosexually oriented. Certain specific functions of self-harm (the prevention of dissociation and suicide) were found to dominate within this group which indicates a possible link to other clinical symptoms within self-harm.

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Section: Discussionmentioning

confidence: 69%

Differences in the Extent and Function of Self-Harm With Regard To the Sexual Orientation of Youths

Démuthová¹,

Démuth²

2022

Proceedings of the 6th International Conference on Research in Social Sciences

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“…Stigma, exclusion, and minority stress are thought to be the reasons for these disparities and affect sexuality- and gender-diverse young people and their families from early life . Sexuality- and gender-diverse young people also experience barriers to health care access, including discrimination and noninclusive practices . A better understanding of developmental trajectories, based on longitudinal studies using nuanced questions, will help to inform health services and support clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…Generation 2 (Gen2) self-report of race/ethnicity has not been ascertained. There were 2868 live births (Gen2), followed up at the ages of 1, 2, 3,5,8,10,14,17,20,22, and 27 years. Follow-up of Gen1 and Gen2 participants is ongoing.…”

Section: Design and Participantsmentioning

confidence: 99%

“…Sexuality- and gender-diverse young people experience disproportionate health and social adversity and barriers to health care access . Approximately 5% to 15% of adolescents are sexuality diverse, and 0.5% to 2% are transgender or gender diverse, with wide variance due to measurement differences and age, with most estimates in older adolescents (aged ≥15 years).…”

Section: Introductionmentioning

confidence: 99%

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Childhood and Adolescence Gender Role Nonconformity and Gender and Sexuality Diversity in Young Adulthood

Marino,

Lin,

Davies

et al. 2023

JAMA Pediatr

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ImportanceSexuality- and gender-diverse youth experience disproportionate health and social adversity. Accurate early-life indicators are important for development of supportive approaches.ObjectiveTo examine whether commonly used items measuring childhood conformity to gender roles are associated with sexual orientation in young adulthood.Design, Setting, and ParticipantsThis single-center, prospective cohort study (the Raine Study) assessed 2868 children of 2900 women who were recruited during pregnancy from August 1, 1989, to April 30, 1992, with follow-up ongoing. The Achenbach System of Empirically Based Assessment (ASEBA) Child Behavior Checklist, Teacher Report Form, and Youth Self-Report tools were used to survey parents, teachers, and youths to examine gender diversity among the participating youths. Parents were followed up at years 5, 8, 10, 14, and 17, adolescents at years 14, 17, and 27, and teachers at years 10 and 14. Data were analyzed from August 1, 2020, to July 31, 2023.ExposuresParent and teacher report that a child “behaves like the opposite sex” (gender role behavior), and parent and self-report that a child “wishes to be the opposite sex” (gender role wish), in response to assessment items.Main Outcome MeasuresYear 27 self-reported sexual identity, attraction, and behavior.ResultsOf the 2868 children in the original birth cohort, 1154 (40.2%) participated in the year 27 follow-up, of whom 608 (52.7%) were recorded female at birth and 546 (47.3%) were recorded male at birth. Of these, 582 who were recorded female at birth continued to identify as female (cisgender) (95.7%), and 515 recorded male at birth continued to identify as male (cisgender) (94.3%); 47 (4.1%) did not complete the questionnaire. Of cisgender participants, 76 of 605 women (12.6%) and 52 of 540 men (9.6%) had a diverse sexual identity, 204 of 605 women (33.8%) and 77 of 540 men (14.3%) were same-gender attracted, and 100 of 605 women (18.6%) and 39 of 540 men (7.2%) had ever engaged in same-gender sexual behavior. Across all follow-ups, after adjusting for gender, nonconforming gender role behavior was consistently associated with diverse sexual identity and behavior (adjusted odds ratio [aOR] for identity, 2.8; 95% CI, 1.9-4.2; behavior aOR, 2.4; 95% CI, 1.6-3.5). Self-reported gender role wish was consistently associated with diverse sexual orientation (identity aOR, 2.3; 95% CI, 1.4-3.8; attraction aOR, 1.7; 95% CI, 1.1-2.5; behavior aOR, 1.9; 95% CI, 1.2-2.9).Conclusions and RelevanceIn this cohort study, ASEBA gender role nonconformity was associated with diverse sexual orientation, beginning in early childhood. Findings suggest that the ASEBA measures should not be used to infer sexual orientation or gender diversity in clinical or research settings; asking direct questions may provide more accurate data.

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“…Such gaps include the awareness of ongoing discrimination and bias impacting the healthcare of LGBTQ youth, as well as the lower rates of insurance among transgender youth. Filling these knowledge gaps is important to providing compassionate care to LGBTQ patients by understanding, for instance, the reasons that LGBTQ youth, as with adults, may delay seeking orthopaedic care or be less likely to attend follow-up visits [34]. Among oncologists, Schabath et al [40] determined that clinicians with a stronger foundation of basic LGBTQ health knowledge were more likely to understand the importance of integrating this knowledge into their practices.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, Attitudes, and Practices in the Orthopaedic Care of Sexual and Gender Minority Youth: A Survey of Two Pediatric Academic Hospitals

Feroe

Hutchinson

Miller

et al. 2022

Clin Orthop Relat Res

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Background Lesbian, gay, bisexual, transgender, and queer (LGBTQ) children and adolescents continue to experience unmet healthcare needs, partly because of clinician biases, discrimination, and inadequate education. Although clinician attitudes and knowledge related to sexual and gender minority health have been well studied in other medical specialties, these have been scarcely studied in orthopaedics.Questions/purposes (1) What are pediatric orthopaedic healthcare professionals' attitudes (perceived importance, openness, comfort, and confidence) toward caring for sexual and gender minority youth? (2) What do pediatric orthopaedic healthcare professionals know about caring for this patient population? (3) What factors are associated with clinician attitude and/or knowledge? (4) What existing initiatives to improve orthopaedic care for this population are clinicians aware of at their home institutions? Methods All 123 orthopaedic healthcare professionals at two pediatric academic hospitals in the Midwestern and Northeastern United States were sent a 34-question, internetbased, anonymous survey. The survey queried respondent demographics, attitudes, knowledge, and practice behaviors at their home institutions related to the care of sexual and gender minority youth. Respondent attitudes were queried using the Attitudes Summary Measure, which is a survey instrument that was previously validated to assess clinicians' attitudes regarding sexual and gender minority patients. Items used to assess knowledge and practice behaviors were developed by content experts in LGBTQ health and/or survey design, as well as orthopaedic surgeons to improve face validity and to mitigate push-polling. Attitude and knowledge items used a 5-point Likert scale. Sixty-six percent (81 of 123) of clinicians completed the survey. Of those, 47% (38 of 81) were physicians, 73% (59 of 81) were licensed for fewer than 20 years, 63% (51 of 81) were women, and 53% (43 of 81) described themselves as liberal-leaning. The response proportions were 73% (38 of 52) among eligible physicians specifically and 61% (43 of 71) among other clinicians (nurse practitioners, physician assistants, and registered nurses). To assess potential nonresponse bias, we compared early responders (within 2 weeks) with late responders (after Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request.

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Analysis of Reported Health Care Use by Sexual Orientation Among Youth

Cited by 13 publications

References 46 publications

Differences in the Extent and Function of Self-Harm With Regard To the Sexual Orientation of Youths

Differences in the Extent and Function of Self-Harm With Regard To the Sexual Orientation of Youths

Childhood and Adolescence Gender Role Nonconformity and Gender and Sexuality Diversity in Young Adulthood

Knowledge, Attitudes, and Practices in the Orthopaedic Care of Sexual and Gender Minority Youth: A Survey of Two Pediatric Academic Hospitals

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