Understanding the social and community support experiences of sexual and gender minority individuals in 12-Step programs.

Sexual and gender minority individuals (e.g., gay, bisexual, non-binary, transgender; SGMI) are 2-6 times as likely as cisgender heterosexual individuals to experience alcohol or other substance use disorders. SGMI participate in 12-Step groups, such as Alcoholics Anonymous (AA), at high rates. Though social support is an established mechanism through which 12-Step programs support reductions in substance use, little is known about SGMI's experiences of the social support in 12-Step programs. This qualitative study aims to understand the experiences of social and community support among SGMI involved in 12-Step programs. This study employed thematic analysis to interpret open-ended responses from 302 SGMI who had participated in 12-Step programs. Data was from The PRIDE Study, a large, national, online. longitudinal, cohort study of SGMI. Two themes emerged about how SGMI experienced social and community support in 12-Step programs: beneficial connections and harmful environments. Beneficial connections included a sense of community, shared experiences, and skills provision. Harmful environments included marginalization, oppression, violence, and bullying. This study highlights the variability of experiences of SGMI participating in 12-Step programs. These findings suggest that many SGMI may benefit from 12-Step programs but may need support in coping with potential harms that can emerge through participation.

Rates and predictors of Alcoholics Anonymous attendance across sexual orientations.

Sexual minority (e.g., gay, lesbian, bisexual) individuals experience alcohol dependence at 2-6 times the rates of heterosexual individuals. Among the general population, Alcoholics Anonymous (AA) serves as the most common source of support for alcohol-related problems in the United States. Yet, relatively little is known about sexual minority involvement in AA, including rates and predictors of AA attendance among sexual minorities. This paper aims to: 1) Compare rates of AA attendance across sexual orientations; 2) Compare relationships between AA attendance and common predictors of AA attendance across sexual orientations. Using five waves of the National Alcohol Survey (N = 7862 respondents with at least one lifetime AUD symptom), this study found lesbian and bisexual women, but not gay and bisexual men, had greater odds of attending AA, even while controlling for lifetime AUD severity, gender, race/ethnicity, age, religiosity, and current income. Interaction models for women showed there was a stronger association between older age and AA attendance, a stronger association between greater religiosity and AA attendance, and a weaker association between lifetime AUD severity and AA attendance for sexual minority women relative to heterosexual women. This study did not find significant interactions between sexual orientation and these covariates for men. These results suggest AA may serve as a promising resource for sexual minority individuals experiencing alcohol-related problems, particularly for sexual minority women who are older, more religious, and have less severe AUD.

Racial/Ethnic Disparities in Mutual Help Group Participation for Substance Use Problems.

Mutual help groups are a ubiquitous component of the substance abuse treatment system in the United States, showing demonstrated effectiveness as a treatment adjunct; so, it is paramount to understand whether they are as appealing to, and as effective for, racial or ethnic minority groups as they are for Whites. Nonetheless, no known comprehensive reviews have examined whether there are racial/ethnic disparities in mutual help group participation. Accordingly, this study comprehensively reviewed the U.S. literature on racial/ethnic disparities in mutual help participation among adults and adolescents with substance use disorder treatment need. The study identified 19 articles comparing mutual help participation across specific racial/ethnic minority groups and Whites, including eight national epidemiological studies and 11 treatment/community studies. Most compared Latinx and/or Black adults to White adults, and all but two analyzed 12-step participation, with others examining "self-help" attendance. Across studies, racial/ethnic comparisons yielded mostly null (N = 17) and mixed (N = 9) effects, though some findings were consistent with a racial/ethnic disparity (N = 6) or minority advantage (N = 3). Findings were weakly suggestive of disparities for Latinx populations (especially immigrants, women, and adolescents) as well as for Black women and adolescents. Overall, data were sparse, inconsistent, and dated, highlighting the need for additional studies in this area.

A Systematic Review of Family Victimization Experiences Among Sexual Minority Youth.

Sexual minority youth experience substantially higher rates of family victimization than their heterosexual peers. No systematic review has yet identified the predictors and consequences in this vulnerable population of childhood abuse, exposure to sibling abuse and domestic violence, and sibling aggression. This systematic review aims to (a) describe differences in these family victimization rates by sexual orientation, gender, and race/ethnicity; (b) identify potential sexual minority and non-sexual minority-specific risk factors; and (c) identify physical, mental, and behavioral health and extrafamilial victimization correlates. The systematic review, which followed PRISMA guidelines, yielded 32 articles that met study inclusion criteria. Rates of childhood physical, sexual, and emotional abuse were consistently higher for sexual minority youth than for their heterosexual peers. Bisexual youth appear to be at greater risk for physical abuse than their gay and lesbian peers. Younger age at sexual minority milestones (first awareness, disclosure, and same-sex sexual contact) and higher levels of sexual minority-specific (sexuality disclosure, gender non-conformity) and non-sexual minority-specific (delinquent behaviors, parental drinking) risk factors were associated with higher rates of family victimization. Sexual minorities who experienced some form of childhood abuse reported more frequent physical (higher rates of HIV, higher BMIs, lower levels of perceived health), mental (higher rates of depression, PTSD symptoms, experiential avoidance, internalized homophobia), and behavioral (higher rates of suicidality, substance misuse, earlier sexual debut, unprotected anal sex) health problems relative to heterosexual or non-abused sexual minority peers. Sexual minority females who experienced childhood physical or sexual abuse were at greater risk than abused sexual minority males for sexual assault later in life. We conclude this systematic review with recommendations for future research, including the necessity for longitudinal research that utilizes a poly-victimization conceptual framework to identify the developmental pathways connecting risk factors, different types of family victimization, and health and extrafamilial victimization consequences.

Conducting Anonymous, Incentivized, Online Surveys With Sexual and Gender Minority Adolescents: Lessons Learned From a National Polyvictimization Study.

Sexual and gender minority adolescents represent an understudied and hard-to-reach population who experience higher rates of mental and behavioral health problems in comparison to their cisgender, heterosexual peers. Online surveys and the proliferation of Internet-connected devices among adolescents offer an exciting opportunity for researchers to begin addressing research gaps and past methodological limitations with these hard-to-reach populations. The purpose of this article is to provide guidance to researchers who are designing and implementing anonymous, incentivized, online surveys by examining the following critical domains-(a) recruitment and engagement: means of leveraging social media and videos to recruit and engage a more nationally representative sample; (b) safety and protection: strategies for administering informed consent and protecting participant anonymity and well-being; and (c) data integrity: mechanisms to detect dishonest and repeat responders. To facilitate discussion of these aims, concrete examples are used from SpeakOut-a 3-year, national study funded by the National Institute of Justice that utilized an anonymous, incentivized, online survey with a large sample of sexual and gender minority adolescents ( N = 1,177) to identify the prevalence, incidence, and correlates of polyvictimization. The article concludes with lessons learned from this national study and recommendations for technological innovations and future research that will strengthen the utility of anonymous, incentivized, online surveys to study sexual and gender minority adolescents and other hard-to-reach populations.

Social Ecological Correlates of Polyvictimization among a National Sample of Transgender, Genderqueer, and Cisgender Sexual Minority Adolescents.

Polyvictimization is a common experience for youth in the United States, with 20% nationally experiencing five or more different forms of victimization in the last year. Utilizing a large, national convenience sample of sexual and gender minority adolescents (N = 1177, 14-19 years old), the current study aimed to (a) generate the first estimates of last year polyvictimization (including nine victimization subtypes) for transgender, genderqueer, and cisgender (i.e., assigned birth sex aligns with gender identity) sexual minority adolescents and (b) identify social ecological correlates of last year polyvictimization. The study utilized an online survey advertised through Facebook and community organizations across the United States. Approximately, 40% of participants experienced ten or more different forms of victimization in the last year and were classified as polyvictims. A significantly higher percentage of transgender female (63.4%), transgender male (48.9%), genderqueer assigned male at birth (71.5%) and genderqueer assigned female at birth (49.5%) were polyvictimized in comparison to cisgender sexual minority males (33.0%). Polyvictimization rates for cisgender sexual minority females (35.1%) were not significantly different from male counterparts (33.0%). Several significant risk factors for polyvictimization were identified: genderqueer identity for participants assigned male at birth and higher-levels of posttraumatic stress, family-level microaggressions, and peer rejection. The manuscript concludes with recommendations for future research including the exploration of factors (e.g., lack of community support, gender-role policing) associated with higher polyvictimization rates for genderqueer adolescents. Additionally, professionals (e.g., foster care, homeless shelters, schools) require new tools to assess for polyvictimization among sexual and gender minority adolescents.