NINR funding dedicated to sexual and gender minority health: 1987-2018.
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ABSTRACT: Background
Despite multiple federal initiatives and calls to action, nursing literature on the health of sexual and gender minority (SGM) populations remains sparse. Low levels of funding for SGM-focused research may be a factor.Purpose
To examine the proportion and focus of National Institute of Nursing Research (NINR)-funded projects that address SGM health, the number and type of publications arising from that funding, and the reach of those publications over time.Methods
NINR-funded grants focused on SGM research and bibliometrics of resultant publications were identified using multiple search strategies in NIH RePORTER and PubMed and Scopus, respectively.Findings
Since 1987, NINR has funded 25 projects addressing the health of SGM populations. Pre-doctoral fellowship funding resulted in more publications in nursing journals than research grant funding.Discussion
There are clear differences in patterns of funding for fellowships and research grants with corresponding differences in publications and impact on the nursing literature.
SUBMITTER: Bosse JD
PROVIDER: S-EPMC7269852 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeSexual and gender minorities (SGMs) are underrepresented and information about SGMs is difficult to locate in national health surveillance data, and this limits identification and resolution of SGM health disparities. It is also not known how measures of sexual orientation and transgender-inclusive gender identity in health surveillance compare with best practice recommendations. This article reviews and summarizes the publicly available, English language, large-scale, rigorously sampled, national, international, and regional data sources that include sexual orientation or transgender-inclusive gender identity and compares measures with best practice guidelines.MethodsA systematic review was undertaken of national, international, state, and regional health surveillance data sources. Data sources that measured sexual orientation or transgender-inclusive gender identity and met seven inclusion criteria were included.ResultsForty-three publicly accessible national, international, and regional data sources included measures of sexual orientation and transgender-inclusive gender identity and health. For each data source, sampling design, sample characteristics, study years, survey questions, contact persons, and data access links are provided. Few data sources met best practice recommendations for SGM measurement: 14% measured all three dimensions of sexual orientation (identity, behavior, attraction) as recommended by the Sexual Minority Assessment Research Team. No data sources measured transgender-inclusive gender identity according to the Gender Identity in U.S. Surveillance-recommended two-step method of measuring sex assigned at birth and current gender identity.ConclusionsThis article provides a much needed detailed summary of extant health surveillance data sources that can be used to inform research about health risks and disparities among SGM populations. Future recommendations are for more rigorous measurement and oversampling to advance what is known about SGM health disparities and guide development of interventions to reduce disparities.
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Project description:Sexual/gender minority (Sexual/gender minority people are also referred to as Lesbian, Gay, Bisexual, Transgender, Queer) youth are more likely than cisgender heterosexual youth to exhibit depressive symptoms and be victimized. School climate research indicates that the presence of a Gay-Straight Alliance (a Gay-Straight Alliance or Gender-Sexuality Alliance is also referred to as a GSA and is a youth group to support sexual/gender minority youth), a supportive school climate, and seeking help from teachers are associated with more positive mental health outcomes; however, they are not typically measured together. This study uses a survey that measures all four measures of school environment with a national sample of 240 sexual/gender minority high school students ages 14-18 (mean age 15.77) where 53% of participants had a Gay-Straight Alliance in their school. The sample is 53% cisgender, 100% sexual minority and 62% white. Adjusting for demographics and presence of a Gay-Straight Alliance, fewer depressive symptoms were associated with lower help-seeking intentions for suicidal thoughts. The presence of Gay-Straight Alliance was not statistically associated with past-month help-seeking intentions or behaviors. Additionally, a more supportive school climate was associated with lower anxiety and depressive symptoms. However, the presence of a Gay-Straight Alliance was not statistically associated with anxiety or depressive symptoms. These findings suggest that a supportive school climate and supportive school personnel may be important for supporting the mental health of sexual/gender minority students.
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Project description:ImportanceLittle is known about the neurologic health needs of sexual and gender minority (SGM) individuals, and existing research indicates health care disparities for this group.ObjectiveTo describe the current state of science in SGM neurology and highlight areas of knowledge and gaps to guide future research.Evidence reviewAll articles published before April 12, 2020, in PubMed, Embase, Web of Science, PsycInfo, CINAHL, and BIOSIS Previews were searched using a search string encompassing SGM descriptors and neurologic disorders. A total of 8359 items were found and entered into EndNote, and 2921 duplicates were removed. A blind title and abstract review was performed followed by full-text review in duplicate, with conflicts settled through consensus, to identify 348 articles eligible for data abstraction. Articles presenting primary data about an identified adult SGM population addressing a clinical neurology topic were included. Descriptive statistics were used for abstracted variables.FindingsOf 348 studies, 205 (58.9%) were case reports or series, 252 (72.4%) included sexual minority cisgender men, and 247 (70.9%) focused on HIV. An association was found between autism spectrum disorder and gender dysphoria in 9 of 16 studies (56.3%), and a higher risk of ischemic stroke in transgender women was shown in other studies. Literature in neuroinfectious disease, the most common topic, largely focused on HIV (173 of 200 studies [86.5%]). Findings in other neurologic topics were limited by lack of data.Conclusions and relevanceIn this rigorous compendium of SGM neurology literature, several deficiencies were found: most studies focused on a limited breadth of neurologic pathology, included only a portion of the overall SGM community, and did not assess other aspects of sociodemographic diversity that may contribute to disparities in health care access and outcomes among SGM individuals. Expanding neurologic research to include broader representation of SGM individuals and incorporating sociodemographic factors, like race/ethnicity and socioeconomic status, are essential steps toward providing equitable neurologic care for this community.
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Project description:IntroductionAlthough population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities.MethodsUsing ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (n=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care.ResultsConditional on sociodemographic factors, all sexual, gender, and racial minority groups, except straight white women, gay white men, and bisexual non-white men, reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual, gender, and racial minority groups.ConclusionsSexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities.
| S-EPMC4875806 | biostudies-literature
Project description:Sexual minority individuals (e.g., lesbian, gay, bisexual people) face sexual health inequalities related to their experiences with providers in sexual health care settings, yet few prior studies have focused on these experiences. In the current study, we analyzed qualitative interviews with a diverse sample of 58 sexual minority individuals from three age cohorts in the United States to explore sexual minority people's perspectives of sexual health care. Thematic content analysis revealed four key themes: erasure, enacted stigma, felt stigma, and affirmative care. Subgroup differences in themes across gender, sexual identity, race/ethnicity, and age cohort were also assessed. Women and genderqueer participants reported erasure in the context of identity dismissal in family planning conversations, and men reported felt stigma in the context of hyperawareness of sexual minority identity. Some sexual minority people of color also reported intersectional felt stigma as a result of multiple marginalized identities. Additionally, fewer men reported erasure compared to women or genderqueer people and fewer gay and lesbian participants reported erasure than bisexual or queer people. Implications of these findings include the need for more sexual minority health care initiatives and training and the development of affirmative care practices for sexual minority populations, including those with multiple marginalized identities.
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Project description:BackgroundLesbian, gay, bisexual, transgender, queer, and intersex people-inclusively termed "sexual and gender minorities"-have unique health and health care needs that are not being met by most healthcare providers due to lack of training in health care professional schools. The purpose of this qualitative study was to examine implementation factors for advancing sexual and gender minority health professional student curricula in academic settings.MethodsSemi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) were conducted with sixteen curricular champions to identify factors relevant to curricular adoption, integration, and sustainment. Themes were coded using a hybrid of deductive and inductive approaches and reported using major CFIR domains.ResultsFacilitators supporting implementation of sexual and gender minority health curricula included collaboration among multiple stakeholders, alignment of formal and hidden curricula, fostering an organizational culture that valued inclusion and diversity, engagement with external subject matter experts or faculty with content expertise, and thoughtful and inclusive planning.ConclusionThis study contributes to health care professional education research as well as to implementation science. Facilitators that were identified in this study can be used to increase the adoption, integration, and sustainment of sexual and gender minority health curricula in diverse academic settings.
| S-EPMC7201690 | biostudies-literature
Project description:ObjectiveSexual and gender minority (SGM) adolescents report elevated risk for psychopathology. Identifying as a racial/ethnic minority and sexual minority (SM) or gender minority (GM) may lead to greater stress/discrimination and psychopathology. We examined nonsuicidal self-injury, suicide ideation, and suicide attempts (i.e., self-injurious thoughts and behaviors [SITBs]) and depressive symptoms across intersections of sexual orientation, gender, and race/ethnicity.MethodStudy participants consisted of a large (n = 2,948; 59% GM) sample of adolescents aged 14-18 who were recruited online to complete a cross-sectional survey. SGM status, race/ethnicity, and their interactions were used to predict depressive symptoms and SITBs. Associations among race/ethnicity and GM-specific psychosocial factors were assessed.ResultsSM (B = 3.75) and GM (B = 8.81) participants reported higher depressive symptoms and SITB histories (odds ratios [ORs] from 1.92 to 2.43 and 2.87 to 5.44, respectively). Asian participants were less likely to report nonsuicidal self-injury (OR = 0.45), and Latinx participants were more likely to report suicide attempts (OR = 1.50). Although omnibus tests of interactions were largely insignificant, exploratory analyses revealed fewer depressive symptoms (B = -8.40) and SITBs (ORs from -0.95 to -2.05) among Black SM participants and, at times, Black GM participants. This protective effect may relate to lower self-reported expectations of rejection due to gender.ConclusionsGM participants reported the highest risk for depressive symptoms and SITBs. Contrary to hypotheses, multiple minority identification was not associated with greater psychopathology. Future research, assessing specific sexual and gender identities across diverse samples, is needed to highlight how race affects psychopathology risk across these identities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Project description:INTRODUCTION:Sexual and gender minority (SGM) young adults have higher smoking prevalence than their non-SGM peers. Less is known about differences in smoking characteristics within the SGM community. METHODS:Participants were SGM young adult smokers age 18-25 (N?=?165, M age?=?21.8) enrolled in a clinical trial of the Put It Out Project, a Facebook smoking cessation intervention for SGM young adults. Analyses tested differences between 1) sexual orientation groups, and 2) gender identity groups, on the following smoking characteristics: cigarettes/day, daily smoker (yes/no), social smoker (yes/no), years of smoking, number of close friends who smoke (out of 5), age of initiation, age began smoking regularly, time to first cigarette (30?min or less/>30?min), lifetime quit attempts, past-year quit attempts, and stage of change for quitting smoking (precontemplation, contemplation, preparation). RESULTS:Participants were 56% bi/pansexual, 18% gay, 18% lesbian, 8% other (e.g., asexual, queer). The gender identity of the sample was 52% cisgender, 18% transgender, 30% gender non-binary. Lesbian women began smoking at an older age (M?=?18.0, SD?=?2.0) than "other" sexual orientation participants (M?=?15.7, SD?=?2.2), p?<?.05. Transgender participants smoked the most cigarettes per day (M?=?11.3, SD?=?6.7), followed by cisgender (M?=?8.1, SD?=?5.6), then non-binary (M?=?5.7, SD?=?3.5) participants (p?<?.001; pairwise comparisons p's?<?0.05). No other constructs differed by sexual orientation or gender. CONCLUSIONS:Smoking characteristics were mostly similar across subgroups of young adult SGM smokers; however, transgender individuals were heavier smokers.
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Project description: Not available
| S-EPMC10493785 | biostudies-literature
Project description:OBJECTIVE:Weight-based victimization (WBV) involves being the target of intentional physical, verbal, or psychological harm because of one's body weight. Youth experience harmful health consequences from WBV, but this literature has neglected sexual and gender minority (SGM) youth, despite their high rates of overweight and obesity, and mental health problems. The present study assessed health behaviors (substance use), self-rated health, perceived control over stressors, depressive symptoms and self-esteem as a function of WBV in a large, national sample of LGBTQ (lesbian, gay, bisexual, transgender, and queer) adolescents. METHOD:Participants (N = 9,838, Mage = 15.6 years, SD = 1.26) completed a web-based battery of questionnaires examining victimization, health, family, and school experiences of LGBTQ adolescents in the United States. RESULTS:WBV was associated with increased odds of alcohol use, binge drinking, marijuana use, and cigarette use, independent of adolescents' age, race, body mass index (BMI), sexual identity, gender identity, caregiver education, and U.S. region. Frequency of WBV at school and weight teasing from family members were both consistently associated with lower self-rated health, lower perceived control over stressors, lower self-esteem, and higher depressive symptom scores. CONCLUSIONS:These findings present the first large-scale evidence of the relationship between WBV and adverse health behaviors in SGM youth. Sexual minority youth who experience WBV, especially from family members, may be vulnerable to adverse health behaviors and low perceived health, regardless of their BMI. These findings highlight the importance of considering WBV when examining health behaviors in LGBTQ youth, and increased awareness of these issues among health care professionals. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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