Barriers to Participation in Organized Physical Activity Among LGBTQ+ Youth: Differences by Sexual, Gender, and Racial Identities.

BACKGROUND: LGBTQ+ youth engage in organized physical activity to a lesser degree than their cisgender and heterosexual counterparts. Existing literature on this organized physical activity disparity is limited, particularly with LGBTQ+ youth samples. The current analysis examined individual and systemic barriers to organized physical activity for LGBTQ+ youth across sexual, gender, and racial identities. METHODS: A subsample of LGBTQ+ students (N = 4566) from the 2021 Dane County Youth Assessment completed items that measured barriers to organized physical activity and systemic factors (ie, family money problems and bias-based bullying) associated with access to organized physical activity. Latent class analysis discerned patterns of individual and systemic barriers to organized physical activity. Latent class regression modeling tested gender, sexual, and racial identities as correlates of latent class membership. RESULTS: More than half of the sample did not participate in organized physical activity. Four profiles of LGBTQ+ youth were discerned based on self-reported barriers: high barrier (8%), bullied (16%), low interest or perceived skills (28%), and low barrier (48%). The low-barrier class included a greater proportion of LGBTQ+ youth who identified as White, or cisgender, or heterosexual as well as youth self-reporting higher organized physical activity. The high-barrier and bullied classes comprised more marginalized gender and sexual identities. CONCLUSIONS: LGBTQ+ youth experience individual and systemic barriers to organized physical activity, including inequitable access and bullying, and barriers are uniquely experienced across sexual, gender, and racial identities. Physical activity promotion among LGBTQ+ youth would be strengthened by policies that address inequitable access to opportunities and bias-based bullying.

"Bridging the Gap": School Nurse Experiences Providing Care for Transgender and Gender Diverse Students and Their Parents/Guardians.

School systems are often not set up to support transgender and gender diverse (TGD) students, which results in unsafe and unsupportive environments and other institutional barriers to helping TGD students thrive. An important factor to students' feeling safe and supported in schools may be their relationship with school nurses. The purpose of this study was to describe school nurses' experiences working with TGD students and their parents/guardians, their role in working with this community, and the challenges nurses face when trying to serve TGD students. Semistructured interviews were conducted with 23 school nurses across a Midwestern state. Thematic analysis was used to identify themes: gender-affirming education and interpersonal collaboration, bridging the gap between TGD youth and parents/guardians, gender-affirming care and confidentiality, and navigating parental acceptance and gender-affirmation. School nurses expressed a strong desire to support TGD students but lack the structure and training within schools.

Mental Health and Protective Factors for Transgender and Gender-Diverse Youths Who Trade Sex: A Minnesota Statewide School-Based Study, 2019.

Objectives. To describe the prevalence of sex trading by gender and by associations with mental health concerns and protective factors. Methods. We used data from 9th and 11th graders who completed the 2019 Minnesota Student Survey. The analytic sample (n = 67 806) included transgender and gender-diverse (TGD) youths and cisgender youths who reported trading sex. Data on 7 mental health measures and 4 school-related and health care-related protective factors were collected. Results. The prevalence of sex trading (5.9%) was 5 times higher among TGD students than cisgender students (1.2%). In addition, the prevalence of all mental health concerns was high among TGD students who traded sex (e.g., 75.9% reported a lifetime suicide attempt, as compared with 45.9% of cisgender students who traded sex). Fewer statistical differences were found across protective factors. When TGD students who traded sex were compared according to sex assigned at birth, no statistically significant differences were found. Conclusions. Our findings support strong calls for increased competence regarding gender and sex trading or exploitation in clinical and school-based settings to decrease health disparities among TGD youths. Public Health Implications. In this study, we have presented unique prevalence estimates of mental health disparities among TGD students in the United States who trade sex. Our results indicate that TGD students who trade sex are at risk for mental health symptoms and that sensitivity to both gender and sex trading or exploitation will be critical to meeting the needs of this group in clinical as well as school-based settings.

Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS): Construct validity among transgender, nonbinary, and LGBQ samples.

Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity. Aim: This study examined the construct validity of the newly revised, UGDS-GS. Method: Tests of measurement invariance were conducted in stages to assess measurement invariance of the UGDS-GS across three groups: cisgender, binary transgender, and nonbinary/genderqueer. Results: Findings indicate that the UGDS-GS functions acceptably in all three gender groups (configural and metric invariance). Also, across binary transgender and nonbinary/genderqueer groups, the measure functions very similarly with all four types of invariance. Item level findings highlight the specificity of the measure to distinguish experiences of binary transgender and nonbinary/genderqueer persons differently from cisgender LGBQ individuals. Conclusions: The UGDS-GS demonstrates a large degree of invariance across binary transgender, nonbinary/genderqueer, and cisgender LGBQ subgroups; and therefore, findings indicate this revision to be a substantial improvement. This 18-item self-report, Likert-type scale measure is a) inclusive of all gender identities and expressions (e.g., transfeminine spectrum, transmasculine spectrum, genderqueer, nonbinary, cisgender); b) appropriate for use longitudinally from adolescence to adulthood; and c) administered at any point in the social or medical transition process, if applicable, or in community-based research focused on gender dysphoria that examines cisgender and transgender persons.

At the Intersection of Sexual Orientation and Gender Identity: Variations in Emotional Distress and Bullying Experience in a Large Population-based Sample of U.S. Adolescents.

This study examines the intersection of sexual and gender identities among adolescents, including the prevalence of these groups and rates of emotional distress and bullying victimization. Data come from a large population-based sample; two measures of sexual orientation and gender identity create eight identity groups. Youth who report identifying both as lesbian, gay, bisexual, or queer/questioning (LGBQ) and as transgender/gender diverse (TGD) had significantly higher levels of two measures of emotional distress and four measures of bullying victimization than those who report only identifying as LGBQ non-TGD or straight TGD. Implications for research and practice are discussed.

Predictive validity of the genderqueer identity scale (GQI): differences between genderqueer, transgender and cisgender sexual minority individuals.

Introduction: The Genderqueer Identity Scale (GQI; McGuire et al., this issue) - a newly developed and validated measure - assesses genderqueer identity via four subscales: challenging the gender binary, the extent to which participants actively work to dismantle gender binaries in identity and expression); social construction of gender, or the degree to which participants interpret their gender identity as something that develops versus an innate essentialist phenomenon; theoretical awareness of gender, the degree of social and political intention attached to gender identity; and gender fluidity, or repeated shifting of gender expression across periods of time. Aim: This descriptive study examined the predictive validity of the GQI and group differences in genderqueer identity with a sample of transgender, genderqueer and nonbinary spectrum, and cisgender sexual minority adults (N = 510). Methods: We hypothesized that Genderqueer Non-binary (GQNB) participants would score higher on GQI subscale scores compared to transgender participants who identify within the gender binary. Results: Results from ANOVA models indicated a statistically significant difference in intrapersonal subscales across sexual minority and transgender binary or genderqueer groups. For the interpersonal subscales there were differences across all three groups. Cisgender sexual minority participants reported the lowest levels on all scales, while genderqueer participants reported the highest, and transgender binary were in-between. Discussion: The GQI demonstrates strong predictive validity in distinguishing binary transpersons from GQNB and cisgender sexual minority persons. Findings reveal that these three subgroups who might otherwise be similarly categorized (i.e., LGBTQ) show significant differences on challenging the binary, social construction, theoretical awareness, and gender fluidity constructs.