Trans and Gender-Diverse Latinx Individuals in the Southern United States: Experiences With Violence and Service Utilization.

Using secondary data from the 2015 U.S. Transgender Survey, we explored transgender and gender-diverse Latinx individuals in the Southern U.S. experiences with transprejudice and antitrans violence at the individual, interpersonal, and structural levels. Findings include high rates of any form of antitrans violence in the past year and intimate partner violence in a lifetime. Most respondents accessed healthcare services in the past year. However, many reported transprejudice and antitrans violence accessing these services. Findings highlight the need for comprehensive changes at all levels to improve the well-being of transgender and gender-diverse Latinx Southerners experiencing gender-based violence.

"You Aren't Alone": An Analysis of Trans Latinas' Use of Instagram.

Social media platforms, such as Instagram, provide space for marginalized groups to connect, learn about and express themselves, and cultivate community. Trans Latinas, a group target of violence and discrimination, resist by expressing themselves and building community through social media. As cisgender researchers, we explored how trans Latinas use #translatina on Instagram as a shared space to present themselves and their identities, to leverage this knowledge in our fields. We analyzed 134 posts in February and March of 2020 employing basic and interpretive content analyses while considering Goffman's theory of presentation of self. Results showed that trans Latinas mostly presented individually through posed selfies taken near the camera, using a straight camera angle, standing, not smiling, and making eye contact. Most users wore makeup, styled hair, and accessories. Analyzing written captions and photos, four themes were constructed to understand how trans Latinas presented their identities and connected with others: (1) expressions of beauty and femininity, (2) fostering community, (3) commercial or work, and (4) feeling good and confident. These results have implications for mental health and health promotion practices, as social media could serve as affirming spaces for trans Latinas to reinforce their self-determination, maintain a sense of self, and build community.

Trends in Suicide Among Lesbian, Gay, and Bisexual Hispanic Individuals: National Violent Death Reporting System Data from 2012-2016.

Due to multiple minority stressors, persons who are Hispanic and lesbian, gay or bisexual (LGB) can experience an increased risk of injury and death, including suicide. We examined trends and correlates of deaths by suicide among LGB Hispanic individuals using data from the National Violent Death Reporting System from 2012 to 2016 (N = 1,132). A multilevel mixed-effects logistic regression model examined time-series trends associated with suicide between LGB and heterosexual individuals, controlling for sociodemographic and clinical characteristics. Over time, increases in suicide were larger among LGB Hispanic individuals. Increased odds associated with suicide were also attributed to women, individuals with a higher education level, those who experienced mental health problems, those with alcohol-related problems, and individuals with a history of mental illness. LGB Hispanic individuals continue to see an increased risk for suicidality. Health intervention and policy efforts should focus on the multiple minority stressors experienced by this population.

How perception relates to student utilization of college campus counseling services.

Objective: Examine how student demographics and perception of on-campus counseling service availability, accessibility, acceptability, and quality is related to utilization. Participants: A total of 262 students from 49 Georgia (U.S.) higher education institutions. Methods: A logistic regression examined student perception of on-campus counseling services and associations with service utilization, controlling for covariates. Results: (1) Non-heterosexual students were more likely to use on-campus counseling services than heterosexual students, (2) students in rural areas were more likely to utilize services than students in urban areas, (3) insured students had higher odds of utilizing services than uninsured students, and (4) higher ratings of perceived accessibility were associated with likelier service use. Conclusions: The perception of accessibility was significantly associated with higher odds of on-campus service use. Thus, a better understanding of student perception of on-campus counseling center accessibility is warranted.

COVID-19 Pandemic and Intimate Partner Violence: an Analysis of Help-Seeking Messages in the Spanish-Speaking Media.

The role of the Spanish-speaking media is crucial for how Latinx communities learn about seeking help when experiencing intimate partner violence (IPV). This study investigated the IPV help-seeking messages disseminated by the Spanish-speaking media in the U.S. during the COVID-19 pandemic. We engaged in an exploratory content analysis of videos from Univision's main website, the most-watched Spanish-speaking media network in the U.S. We searched for videos related to IPV help-seeking posted from March 19-April 21, 2020-including the weeks after the World Health Organization declared COVID-19 a global pandemic and the U.S. mandated a shelter-in-place. After assessing inclusion criteria, 29 videos were analyzed. Data were analyzed using basic content analysis to determine frequencies and inductive interpretive content analysis to code for help-seeking messages. We identified eight manifest messages related to seeking help when experiencing IPV in times of a crisis: (1) contact a professional resource; (2) contact law enforcement; (3) contact family, friends, and members of your community; (4) create a safety plan; (5) don't be afraid, be strong; (6) leave the situation; (7) protect yourself at home; and (8) services are available despite the pandemic. We found that the manifest messages alluded to three latent messages: (1) it is your responsibility to change your circumstances; (2) you are in danger and in need of protection; and (3) you are not alone. IPV and media professionals should ensure a structural understanding of IPV in their help-seeking messages and avoid perpetrating stigmatizing and reductionist messages.

Predictors of healthcare mistreatment among transgender and gender diverse individuals: Are there different patterns by patient race and ethnicity?

Using data from the 2015 United States Transgender Survey, this study investigates which patient sociodemographic characteristics and psychosocial risks are associated with likelihood of transgender mistreatment in healthcare and how patterns vary for patients of color. Numerous predictors, including alignment of identity documents, were associated with healthcare mistreatment. Among subgroups of transgender patients of color, psychosocial risks were more consistently significant than sociodemographic characteristics in predicting mistreatment. National and international health organizations are called to enact clear policies that affirm transgender patients and patients of color and establish a commitment to effectively serving these populations within their ethical codes.

Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers.

Promotoras de salud (Spanish for female community health workers) are integral to efforts to enhance the health and well-being of Latinx individuals, families, and communities. The purpose of this study was to describe the challenges that promotoras face and the proposed solutions from the perspective of the promotoras themselves. Five promotoras who worked for a year as volunteers in a community-based participatory research study, Lazos Hispanos, participated in two group interviews. Eight challenges emerged-balancing their new work with their family commitments, handling their perceived imbalance of power with men, managing the emotional impact of hearing participants' problems, facing and handling the barriers imposed by having limited English language skills, feeling discouraged by the perception of ethnocentric beliefs and discrimination from some providers, feeling disheartened by the cultural beliefs of some Latinx participants, handling the lack of transportation for themselves and for the participants, and managing the burden of data collection for the research aspect of the program. The explanation of these challenges and the practical solutions they proposed are embedded in their intersecting identities. The solutions are a valuable addition to the practice of health promotion and community-based participatory research, particularly within Latinx communities.

A multistakeholder evaluation of Lazos Hispanos: An application of a community-based participatory research conceptual model.

The goal of Lazos Hispanos is to enhance the health and well-being of the Latinx community through promotoras, who connect community members with service providers for multiple health and social needs. A community-based participatory research conceptual model framed the multimethod evaluation of promotoras, service providers, and community participants at baseline and at the 1-year follow up. The promotoras increased their self-efficacy and knowledge, felt a strong sense of commitment to the community, viewed themselves as a bridge between participants and providers, and felt empowered by their new role. Service providers valued the promotoras as their ambassadors in the community and Lazos Hispanos as central to connecting service providers, promotoras, and community members; they noted that this collaboration increased their accountability with the Latinx community. This multistakeholder evaluation highlights the depth of positive changes achieved during the first year and the challenges of a community-embedded project and the benefits and possibilities of calling upon theoretically informed evaluation models.

Suicide ideation, planning, and attempts: the case of the Latinx LGB youth.

Background: Guided by an ecological systems theory (EST) framework, the purpose of the present study was to investigate how multiple micro, mezzo, and macro factors influence the suicidality continuum from suicidal ideation to suicide attempt among Latinx LGB (lesbian, gay, and bisexual) youth living in the United States. Methods: Data for this cross sectional-study included 451 participants who self-identified as Latinx LGB on the 2017-National Youth Risk Behavioral Survey. The analysis explored micro, mezzo, and macro-level factors' association with three suicidality outcomes (ideation, planning, and attempt) at the bivariate and multivariate level. Since the outcome variables were dichotomized, univariate logistic regressions and backward elimination logistic regressions were used. Results: The most commonly reported suicidal behavior was ideation (n = 173; 40%), followed by planning (n = 150; 34%), and then attempt (n = 64; 21%). Findings from the backward elimination logistic regression on suicidal ideation suggest the best set of independent variables are being bullied at school (odds ratio [OR] = 2.81; CI: 1.61-4.89), experiencing sexual assault(OR = 2.32; CI: 1.32-4.07), experiencing depressive symptoms (OR = 1.99; CI: 1.07- 3.69),being cannabis use (OR = 1.76; CI: 1.08-2.89), and being female (OR = 1.72; CI: 1.01-2.93).For suicide planning the model suggested, experiencing depressive symptoms (OR = 3.21; CI:1.74-5.91), cannabis use (OR = 2.46; CI: 1.49-4.07), being bullied at school (OR = 2.04; CI:1.17-3.58), and experiencing sexual assault (OR = 1.88; CI: 1.07-3.31) exhibited the strongest relationships. Suicide attempt was significantly associated with cannabis use (OR = 3.12; CI:1.60-6.08), experiencing depression (OR= 2.89; CI: 1.30-6.43), experiencing sexual assault (OR = 2.77; CI: 1.34-5.71), and being bullied at school (OR = 2.34; CI: 1.12-4.91). Conclusion: Given the findings of this study, it is essential that tailored suicide prevention efforts be established that uniquely address the intersections of race/ethnicity and sexual orientation and how this intersection influences micro, mezzo, and macro factors associated with suicide ideation, planning, and attempt among Latinx LGB adolescents.

A Comparison of Health Disparities among Transgender Adults in Colorado (USA) by Race and Income.

Transgender individuals face heightened risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health. However, few studies have thoroughly examined the general physical and mental health of transgender adults or within-group health differences by race/ethnicity and income. To that end, after controlling for health insurance status, age, and engagement in exercise, this study asks: (a) are transgender people of color more likely than White transgender individuals to experience poor health outcomes?, and (b) is lower annual household income among transgender adults associated with poorer health outcomes? The current study analyzes secondary data from a survey of transgender adults (N = 417) in one state in the Western United States using multiple linear regression and logistic regression models. Transgender people of color had significantly greater odds than their White counterparts of having arthritis/rheumatoid arthritis/gout/lupus/fibromyalgia, or having asthma, but lower odds of being told by a provider that they had depression. Having a lower income was significantly associated with worse general health as well as multiple indicators of poor physical and mental health, including depression, anxiety, and suicidal ideation. We discuss implications for health care delivery for transgender people and for future research.