Supporting Occupational Justice for Transgender and Gender-Nonconforming People Through Narrative-Informed Theater: A Mixed-Methods Feasibility Study
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ABSTRACT:
SUBMITTER: Wasmuth S
PROVIDER: S-EPMC8369667 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Understanding the magnitude of mental health problems, particularly life-threatening ones, experienced by transgender and/or gender nonconforming (TGNC) youth can lead to improved management of these conditions. METHODS:Electronic medical records were used to identify a cohort of 588 transfeminine and 745 transmasculine children (3-9 years old) and adolescents (10-17 years old) enrolled in integrated health care systems in California and Georgia. Ten male and 10 female referent cisgender enrollees were matched to each TGNC individual on year of birth, race and/or ethnicity, study site, and membership year of the index date (first evidence of gender nonconforming status). Prevalence ratios were calculated by dividing the proportion of TGNC individuals with a specific mental health diagnosis or diagnostic category by the corresponding proportion in each reference group by transfeminine and/or transmasculine status, age group, and time period before the index date. RESULTS:Common diagnoses for children and adolescents were attention deficit disorders (transfeminine 15%; transmasculine 16%) and depressive disorders (transfeminine 49%; transmasculine 62%), respectively. For all diagnostic categories, prevalence was severalfold higher among TGNC youth than in matched reference groups. Prevalence ratios (95% confidence intervals [CIs]) for history of self-inflicted injury in adolescents 6 months before the index date ranged from 18 (95% CI 4.4-82) to 144 (95% CI 36-1248). The corresponding range for suicidal ideation was 25 (95% CI 14-45) to 54 (95% CI 18-218). CONCLUSIONS:TGNC youth may present with mental health conditions requiring immediate evaluation and implementation of clinical, social, and educational gender identity support measures.
| S-EPMC5914494 | biostudies-literature
Project description:Despite calls for improved data-collection efforts tracking transgender and gender nonconforming (TGNC) people in science, technology, engineering, and mathematics (STEM) education, there have been no reports of TGNC continuation in STEM majors at the university level. Using national, longitudinal data from the Higher Education Research Institute at the University of California, Los Angeles, we analyzed the experiences of 20,910 students who indicated an initial intent to major in a STEM field and found that TGNC students (n = 117) continue in STEM majors at a rate ∼10% lower than their cisgender peers. This gap persists despite TGNC students' high levels of academic ability and academic self-confidence. Through multilevel regression modeling, we found this difference is not explained by experiences that have predicted the likelihood of cisgender students leaving STEM. The only significant predictor of STEM attrition for TGNC students in our model was whether they sought personal counseling; TGNC students who more frequently sought personal counseling were 21% less likely to remain in STEM majors. Overall, TGNC students leave STEM at rates similar to or higher than other minoritized groups, building the case for a multifaced, intersectional approach to addressing diversity and equity in the preparation of the future STEM workforce.
| S-EPMC9250371 | biostudies-literature
Project description:INTRODUCTION:Important mental and physical health disparities exist for transgender and gender diverse youth compared with cisgender youth (i.e., those whose birth-assigned sex and gender identity align), yet little is known about factors that protect transgender and gender diverse youth from health problems. The objective of this paper is to identify modifiable protective factors in the lives of transgender and gender diverse adolescents, with the goal of informing efforts to eliminate disparities in depression, suicidality, and substance use in this population. METHODS:Secondary data analysis of the 2016 Minnesota Student Survey examined associations between eight protective factors (connectedness to parents, adult relatives, friends, adults in the community, and teachers; youth development opportunities; and feeling safe in the community and at school) and depression, suicidality, and substance use (alcohol, binge drinking, marijuana, nicotine) among 2,168 adolescents who identified as transgender, genderqueer, genderfluid, or questioning their gender. Logistic regressions assessed the role of each protective factor separately and simultaneously. RESULTS:Each protective factor was associated with lower odds of emotional distress and substance use. When protective factors were examined simultaneously, parent connectedness was protective for all measures. Feeling safe at school and connected to adults in one's community protected against depression and suicidality; teacher connectedness buffered risk of substance use. CONCLUSIONS:Given that transgender and gender diverse youth report lower levels of connectedness and safety, bolstering an explicitly transgender and gender diverse-friendly network of caring parents, safe and supportive schools, and connections to adults in the community may support efforts to eliminate disparities in depression, suicidality, and substance use.
| S-EPMC6501838 | biostudies-literature
Project description:IntroductionExposure to violence victimization may help explain disparities of substance use among gender-nonconforming youth (i.e., those whose gender expression differs from societal expectations).MethodsIn 2015, three large urban school districts (2 in California and 1 in Florida) conducted a Youth Risk Behavior Survey that included the assessment of gender expression among a racially/ethnically diverse population-based sample of 6,082 high school students. Five categories of violence victimization were assessed (felt unsafe at school, threatened or injured with a weapon at school, bullied at school, electronically bullied, and forced sexual intercourse). In 2019, the effect of violence victimization on substance use disparities was examined by calculating sex-stratified prevalence ratios by gender nonconformity, adjusted for sexual identity, race/ethnicity, and grade (adjusted prevalence ratio 1 [APR1]), and comparing these with prevalence ratios adjusted for those variables plus violence victimization (adjusted prevalence ratio 2 [APR2]).ResultsAmong female students, only being threatened or injured with a weapon was significantly (p<0.05) associated with gender nonconformity and there were no substance use disparities by gender nonconformity. Among male students, every category of violence victimization was more prevalent among gender-nonconforming than among gender-conforming students and most substance use categories demonstrated significant gender nonconformity disparities. After controlling for violence victimization, these disparities decreased but remained statistically significant for the use of cocaine (APR1=2.84 vs APR2=1.99), methamphetamine (APR1=4.47 vs APR2=2.86), heroin (APR1=4.55 vs APR2=2.96), and injection drug use (APR1=7.90 vs APR2=4.72).ConclusionsSchool-based substance use prevention programs may benefit from strategies that support gender diversity and reduce violence victimizations experienced by gender-nonconforming students, by providing a safe and supportive school environment.
| S-EPMC7885263 | biostudies-literature
Project description:The purpose of this study was to better understand parents' perceptions of how, if at all, their transgender and gender-nonconforming (TGNC) children exhibited common childhood emotional and behavioral concerns in relation to gender nonconformity/gender dysphoria (GD), and to identify ways in which evidence-based interventions (EBI) targeting emotional and behavioral concerns could be adapted to best serve TGNC children. Qualitative data were gathered from a targeted focus group activity with 40 parents (25 mothers, 15 fathers) of 24 TGNC children ages 4-11 years old. Parents of TGNC children described how 4 prespecified domains of emotional and behavioral problems (i.e., oppositional behavior, anger, sadness, and fears/worries) are characterized in the context of gender-nonconformity/GD. Parents also identified precipitants of these problems. Overall study findings indicate there is a role for EBI adaptation as parents identified many different examples of emotional and behavioral challenges emerging in unique and nuanced ways in TGNC children.
| S-EPMC6223326 | biostudies-literature
Project description:Purpose: Parent support is considered crucial for the health of transgender and gender-nonconforming (trans/GNC) children, yet little research has focused on how to support parents and caregivers. This study considered the experience of participation in a support group for parents of transgender children on families. Methods: Online surveys were conducted with parents whose children were receiving clinical care at a gender specialty clinic and who participated at least once in a monthly support group. Close-ended questions addressed the importance of participation and open-ended questions addressed the specific ways it was helpful, how it impacted them and their trans/GNC child, and if they faced barriers to participating. Results: The majority of the 48 participants (77.1%) identified as female. The mean age of their trans/GNC child was 13.9 years (standard deviation 5.1, range 5-22 years); just over half (n=25) of their trans/GNC children identified as male. Participants overwhelmingly reported positive experiences with the support group, with 72.9% reporting that the group was either important or critically important to them and 66.7% reporting that it was important or critically important to their trans/GNC child. Perceived benefits included the opportunity to learn about legal, medical, and school issues and receive emotional support. Conclusion: Support groups provide an important complement to specialized clinical care for families with trans/GNC children. Logistical challenges, lack of age peers, and lack of people of color all served as limitations of the group. Further research is needed to understand the experiences of fathers and to determine if the support group model would be effective with racially/ethnically and economically diverse populations.
| S-EPMC6689185 | biostudies-literature
Project description:ImportanceThe cultural roles and expectations attributed to individuals based on their sex often shape health behaviors and outcomes. Gender nonconformity (GNC) (ie, gender expression that differs from societal expectations for feminine or masculine appearance and behavior) is an underresearched area of adolescent health that is often linked to negative health outcomes.ObjectiveTo examine the associations of GNC with mental distress and substance use among high school students.Design, setting, and participantsCross-sectional study based on data from the Youth Risk Behavior Survey (YRBS) conducted in 2015. The setting was 3 large urban US school districts (2 in California and 1 in Florida). Participants were a racially/ethnically diverse population-based sample of 6082 high school students representative of all public school students in grades 9 through 12 attending these 3 school districts.Main outcomes and measuresSex-stratified adjusted prevalence ratios (APRs) (adjusted for race/ethnicity, grade, and sexual identity) for high gender-nonconforming students (very/mostly/somewhat feminine male students or very/mostly/somewhat masculine female students) and moderate gender-nonconforming students (equally feminine and masculine students) relative to a referent group of low gender-nonconforming students (very/mostly/somewhat masculine male students or very/mostly/somewhat feminine female students).ResultsAmong 6082 high school students, 881 (15.9%) were white, 891 (19.1%) black, 3163 (55.1%) Hispanic, and 1008 (9.9%) other race/ethnicity. Among female students (2919 [50.0% of the study population]), moderate GNC was significantly associated with feeling sad and hopeless (APR, 1.22; 95% CI, 1.05-1.41), seriously considering attempting suicide (APR, 1.41; 95% CI, 1.14-1.74), and making a suicide plan (APR, 1.52; 95% CI, 1.22-1.89); however, substance use was not associated with GNC. Among male students (3139 [50.0% of the study population]), moderate GNC was associated with feeling sad and hopeless (APR, 1.55; 95% CI, 1.25-1.92); high GNC was associated with seriously considering attempting suicide (APR, 1.72; 95% CI, 1.16-2.56), making a suicide plan (APR, 1.79; 95% CI, 1.17-2.73), and attempting suicide (APR, 2.78; 95% CI, 1.75-4.40), as well as nonmedical use of prescription drugs (APR, 1.81; 95% CI, 1.23-2.67), cocaine use (APR, 2.84; 95% CI, 1.80-4.47), methamphetamine use (APR, 4.52; 95% CI, 2.68-7.61), heroin use (APR, 4.59; 95% CI, 2.48-8.47), and injection drug use (APR, 8.05; 95% CI, 4.41-14.70).Conclusions and relevanceThis study suggests mental distress is associated with GNC among female and male students. Substance use also appeared to be strongly associated with GNC among male students. These findings underscore and suggest the importance of implementing school-based programs to prevent substance use and promote student mental health that are inclusive of gender diversity in students.
| S-EPMC6248138 | biostudies-literature
Project description:Gender is one of the central categories organizing children's social world. Clear patterns of gender development have been well-documented among cisgender children (i.e., children who identify as a gender that is typically associated with their sex assigned at birth). We present a comprehensive study of gender development (e.g., gender identity and gender expression) in a cohort of 3- to 12-y-old transgender children (n = 317) who, in early childhood, are identifying and living as a gender different from their assigned sex. Four primary findings emerged. First, transgender children strongly identify as members of their current gender group and show gender-typed preferences and behaviors that are strongly associated with their current gender, not the gender typically associated with their sex assigned at birth. Second, transgender children's gender identity (i.e., the gender they feel they are) and gender-typed preferences generally did not differ from 2 comparison groups: cisgender siblings (n = 189) and cisgender controls (n = 316). Third, transgender and cisgender children's patterns of gender development showed coherence across measures. Finally, we observed minimal or no differences in gender identity or preferences as a function of how long transgender children had lived as their current gender. Our findings suggest that early sex assignment and parental rearing based on that sex assignment do not always define how a child identifies or expresses gender later.
| S-EPMC6900519 | biostudies-literature
Project description:This article examines six cases of publicly funded Applied Behavior Analysis (ABA) therapy for Latino children with autism spectrum disorder (ASD) to contribute to thinking about occupational justice. In this ethnographic study of six Latino families of children with ASD in Los Angeles County, all families were offered ABA for their children, but five families experienced occupational challenges leading them to insist on modifications of ABA or to opt out of the service. We consider in each case (a) how the families' experiences can be understood occupationally, (b) how ABA affected the functionings and capabilities of the children and their families, and (c) how the parents' accounts relate to occupational justice. Applying the capabilities approach can help operationalize the concept of occupational justice as a tool to evaluate social policy across cases.
| S-EPMC5332377 | biostudies-literature
Project description:ObjectiveTo determine the activities and circumstances proximal to a welding related occupational eye injury, a hybrid narrative coding approach derived from two well developed classification systems was developed to categorize and describe the activity, initiating process, mechanism of injury, object and/or substance, and the use of protective eyewear from the narrative text data reported for each injury.MethodsRoutinely collected workers' compensation claims over a one year period (2000) were analyzed from a large US insurance provider. An index term search algorithm of occupation, incident, and injury description fields identified 2209 potential welding related eye injury claims. After detailed review of these claims, 1353 welders and 822 non-welders were analyzed.ResultsDuring 2000, eye(s) as the primary injured body part accounted for 5% (n = 26 413) of all compensation claims. Eye injuries accounted for 25% of all claims for welders. Subjects were mainly male (97.1%) and from manufacturing (70.4%), service (11.8%), or construction (8.4%) related industries. Most injuries were foreign body (71.7%) or burn (22.2%) and 17.6% were bilateral. Common activities include welding (31.9%) and/or grinding (22.5%). Being struck by an airborne object occurred in 56.3% of cases. Non-welders showed similar patterns except that burns (43.8%) were more frequent and more often initiated by another worker (13.9%).ConclusionsNarrative injury text provides valuable data to supplement traditional epidemiologic analyses. Workers performing welding tasks or working nearby welders should be trained to recognize potential hazards and the effective use of proper safety equipment to prevent ocular injury.
| S-EPMC1730216 | biostudies-literature