Transgender and nonbinary young adults' depression and suicidality is associated with sibling and parental acceptance-rejection.

INTRODUCTION: Transgender and nonbinary young adults (TNB YA) report high rates of depression and more suicidality than their cisgender counterparts. Parental rejection is a known predictor of worse mental health among TNB YA; however, less is known about TNB YA experiences of sibling acceptance-rejection. The purpose of this study was to determine how TNB YA perception of sibling and parental acceptance-rejection are related to TNB YA depression and suicidality. DESIGN: Cross-sectional. METHODS: TNB YA (ages 18-25) who had disclosed their gender identity to an adult sibling were recruited to take part in an online study and completed measures of sibling and parent acceptance-rejection, depression, as well as lifetime and past year suicidality. Stepwise regressions were conducted to evaluate associations between acceptance-rejection and TNB YA depression and suicidality. RESULTS: The sample consisted of 286 TNB YA (Mage = 21.5, SD = 2.2) who were predominantly White (80.6%) and assigned female sex at birth (92.7%). Each family member's acceptance-rejection was associated with increased TNB YA depression scores when considered independently and combined. Independently, high rejection from each family member was associated with greater odds of reporting most suicidality outcomes. When all family members were considered together, only high rejection from a male parent was associated with four times greater odds of reporting lifetime suicidality. High rejection from both parents was associated with greater odds of reporting past year suicide attempt (OR: 3.26 female parent; 2.75 male parent). CONCLUSION: Rejection from family members is associated with worse depression and suicidality, and rejection from male parents may be particularly damaging. Sibling acceptance uniquely contributes to TNB YA's depression symptoms alone and in the context of parental support.

Transgender and nonbinary young adults' perception of sibling and parental support for gender identity.

Transgender and nonbinary young adults report frequent parental rejection was linked to poor mental health. There are limited data about transgender and nonbinary young adult sibling relationships following disclosure or discovery of gender identity. The purpose of this analysis is to compare transgender and nonbinary young adults' perception of parental and sibling support specifically for gender identity immediately after disclosure and in the present day. Eligible respondents were recruited via paid social media advertisements. Respondents provided data on demographics, family relationships, and perceived support for gender identity. The sample consisted of 348 transgender and nonbinary young adults (Mean age: 21.5 years) who lived in the United States, identified as White and were assigned female at birth. The majority reported on a nuclear family. Nearly three-quarters (71.3%) had disclosed their identity to at least one parent and had done so within the past 3 years. Overall, respondents perceived a significant increase in family members' support from the time of disclosure to the time of the survey. Most respondents reported improved family relationships since disclosing their gender identity. Siblings were perceived as significantly more supportive than either parent at both time points. Siblings could be an essential source of support for transgender/nonbinary young people, particularly if parents are not accepting or do not yet know their child's gender identity. Nurses and other professionals working with transgender and nonbinary young people in school, community, and clinical settings should assess perceived support across familial relationships.

Improving Outcomes of Opioid Overdose: Preparing Nursing Students to Intervene.

PROBLEM: Death by overdose has been steadily increasing since 1992 and has become a public health epidemic. With the rise of prescription pain medications for nonmedical use and the highest use of illicit substances by those ages 18-25, the need for action is imperative. PURPOSE: The aim of the study was to determine whether an educational intervention had an effect on nursing students' knowledge and skills regarding administration of intranasal naloxone for opioid overdose. METHOD: A convenience sample of baccalaureate nursing students was recruited for the study. A pretest/posttest design was used to evaluate the educational intervention. A paired t test was used to compare differences in pre- and posttest scores. RESULTS: A total of 49 students completed the study. The majority were women ages 25 and below, 31 (63.2%) had some or no background knowledge of opioid overdose, and 42 (85.7%) had not received previous training on intranasal naloxone. Student knowledge increased significantly (p < .001) following the educational intervention. Twenty-four students requested hands-on training for implementation of the intranasal naloxone and scored 100% accuracy in return demonstration. CONCLUSIONS: Implementation of this brief training was effective for increasing the knowledge of opioid overdose for an at-risk population. The nursing student is in a unique position to educate, train, and intervene for peers, friends, and family members who are at high risk for an opiate overdose. Nursing students have a pronounced advantage to assess for respiratory depression and initiate CPR, thereby interrupting a fatal overdose.