Widening mental health and substance use inequities among sexual and gender minority populations: Findings from a repeated cross-sectional monitoring survey during the COVID-19 pandemic in Canada

Youth homelessness has been demonstrated to disproportionately affect sexual and gender minority (SGM) youth compared to heterosexual cisgender peers. In this context, we aimed to compare health risks between service-seeking SGM and heterosexual cisgender youth experiencing homelessness, including harmful risks stemming from substance use and severity of symptoms of mental health disorders. We recruited 100 racially diverse, unstably housed participants aged 18–24 who access services at an urban non-profit organization in San Francisco, CA. Data analysis included 56 SGM participants who identified as gay, lesbian, bisexual, pansexual, unsure, transgender, and nongender, and 44 heterosexual cisgender participants. In contrast to previous studies reporting significantly higher frequency of substance use and more severe symptoms of depression, generalized anxiety, and post-traumatic stress disorder among SGM youth compared to heterosexual cisgender peers, many of these health disparities were not observed in our diverse study population of service-seeking youth. Furthermore, with the exception of methamphetamine, SGM participants did not exhibit greater harmful risks resulting from substance use, such as health, social, financial, and legal complications. We discuss the reduced burden of health disparities between SGM and heterosexual cisgender youth in our service-seeking study population within the context of gender- and sexuality-affirming programming offered at the partnering community organization. We conclude that longitudinal data on these tailored community-level interventions are needed to further explore the reduced burden of health disparities observed among service-seeking SGM youth experiencing homelessness in San Francisco in order to continue supporting pathways out of homelessness for youth of all sexual and gender identities nationwide.

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Substance Use and Related Disorders in Sexual and Gender Minority Populations

The American Psychiatric Association Publishing Textbook of Substance Use Disorder Treatment ◽

10.1176/appi.books.9781615373970.kb39 ◽

2021 ◽

Author(s):

Jeremy Kidd

Keyword(s):

Substance Use ◽

Minority Populations ◽

Gender Minority ◽

Sexual And Gender Minority ◽

And Gender

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Sexual and gender minority populations and suicidal behaviours

Oxford Textbook of Suicidology and Suicide Prevention ◽

10.1093/med/9780198834441.003.0042 ◽

2021 ◽

pp. 353-360

Author(s):

Helen Keeley ◽

Fiachra Ó Súilleabháin ◽

Máire Leane

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Well Being ◽

Minority Populations ◽

Sexual Diversity ◽

Gender Minority ◽

Increased Risk ◽

Gender Status ◽

Sexual And Gender Minority ◽

And Gender

Despite the sociolegal changes that have signalled greater acceptance of sexual diversity and gender expansive identities in the twenty-first century, worldwide studies highlight the increased risk of mental health problems and suicidality for those with a sexual and/or gender minority status. This chapter discusses this increased risk of suicidality among sexual and gender minority populations across the life course. A recurring theme is that those who are less sure of their status, are most at risk. Therefore, the capacity of an individual to overcome internalized minority stress, stigma, guilt, and shame, and to reconcile, even take pride, in their sexual/gender status, is a significant issue. While sociolegal, cultural, and familial norms may seem beyond the remit of mental health professionals, affirmative and inclusive actions can be taken to support questioning youth, unsure adults, and distrustful older people, and to help improve the resilience and well-being of their LGBTQ+ service-users.

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The Intersections of Physical and Mental Health among Sexual and Gender Minority Populations

The Oxford Handbook of Sexual and Gender Minority Mental Health ◽

10.1093/oxfordhb/9780190067991.013.34 ◽

2020 ◽

pp. 379-393

Author(s):

Michele J. Eliason

Keyword(s):

Mental Health ◽

Minority Stress ◽

Minority Populations ◽

Physical And Mental Health ◽

Future Directions ◽

Gender Minority ◽

Adverse Childhood Events ◽

Adverse Childhood ◽

Sexual And Gender Minority ◽

And Gender

There is considerable evidence of health disparities among sexual and gender minority (SGM) populations in the areas of physical health and disability, mental health and suicidality, substance use and abuse, and access to care. However, little research has considered the possibility that disorders might concentrate in subgroups of SGMs with the greatest levels of minority stress over time or those who have experienced the greatest number of adverse childhood events. This chapter examines the scant evidence that physical and mental health disorders coexist in some SGM individuals and offers some critique of the existing research. Future directions for research are proposed.

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Sexual and Gender Minority Mental Health among Children and Youth

The Oxford Handbook of Sexual and Gender Minority Mental Health ◽

10.1093/oxfordhb/9780190067991.013.21 ◽

2020 ◽

pp. 228-243

Author(s):

Jessica N. Fish ◽

Laura Baams ◽

Jenifer K. McGuire

Keyword(s):

Mental Health ◽

Young People ◽

Mental Health Treatment ◽

Treatment Strategies ◽

Youth Mental Health ◽

Children And Youth ◽

Gender Minority ◽

The World ◽

Sexual And Gender Minority ◽

And Gender

Sexual and gender minority (SGM) young people are coming of age at a time of dynamic social and political changes with regard to LGBTQ rights and visibility around the world. And yet, contemporary cohorts of SGM youth continue to evidence the same degree of compromised mental health demonstrated by SGM youth of past decades. The authors review the current research on SGM youth mental health, with careful attention to the developmental and contextual characteristics that complicate, support, and thwart mental health for SGM young people. Given a large and rapidly growing body of science in this area, the authors strategically review research that reflects the prevalence of these issues in countries around the world but also concentrate on how mental health concerns among SGM children and youth are shaped by experiences with schools, families, and communities. Promising mental health treatment strategies for this population are reviewed. The chapter ends with a focus on understudied areas in the SGM youth mental health literature, which may offer promising solutions to combat SGM population health disparities and promote mental health among SGM young people during adolescence and as they age across the life course.

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Sexual Disorders among Sexual and Gender Minority Populations

The Oxford Handbook of Sexual and Gender Minority Mental Health ◽

10.1093/oxfordhb/9780190067991.013.13 ◽

2020 ◽

pp. 134-145

Author(s):

Heather L. Armstrong

Keyword(s):

Sexual Health ◽

Sexual Disorders ◽

Minority Populations ◽

Gender Nonconforming ◽

Complex Disorders ◽

Gender Minority ◽

Research Perspectives ◽

Sexual Orientations ◽

Sexual And Gender Minority ◽

And Gender

Sexual disorders and dysfunction are common among people of all sexual orientations and gender identities. And while definitions and conceptions of sexual health are typically broad, the clinical and research perspectives on sexual function and dysfunction have traditionally relied on the four-phase model of sexual response and disorders are generally classified as “male” or “female.” This chapter reviews the diagnostic criteria for specific sexual dysfunctions and presents a summary of existing research among sexual and gender minority populations. Overall, research on sexual dysfunction among sexual and gender minority people is limited, and this is especially true for transgender and gender nonconforming individuals. Understanding these often complex disorders requires that individuals, clinicians, and researchers consider a range of biopsychosocial factors that can affect and be affected by one’s sexual health and sexuality.

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Introduction

The Oxford Handbook of Sexual and Gender Minority Mental Health ◽

10.1093/oxfordhb/9780190067991.013.1 ◽

2020 ◽

pp. xvi-8

Author(s):

Esther D. Rothblum

Keyword(s):

Mental Health ◽

Clinical Social Work ◽

Psychiatric Nursing ◽

Health Programs ◽

Evidence Based ◽

Gender Minority ◽

Minority Mental Health ◽

Sexual And Gender Minority ◽

And Gender ◽

Mental Health Programs

The Oxford Handbook of Sexual and Gender Minority Mental Health provides an overview of the current research on the mental health of sexual and gender minority (SGM) populations. It is aimed at researchers conducting studies on the mental health of SGM populations, clinicians and researchers interested in psychiatric disorders that affect SGM populations, clinicians using evidence-based practice in the treatment of SGM patients/clients, students in mental health programs (clinical psychology, psychiatry, clinical social work, and psychiatric nursing), and policymakers. This chapter defines some terms and provides an overview of current and past SGM research methods.

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