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Awareness of and access to LGBTQ-friendly services among racialized sexual and gender minorities: Insights from the OutLook Study
Abstract
A study using data from the OutLook Study (a needs assessment in Waterloo Region) exploring the level of awareness and access to LGBTQ-friendly services among racialized (people of colour) and relationships to social support and other LGBTQ subgroups.
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This study explored the relationships between the existence of and length of time since implementation of school-based Gay-Straight Alliances (GSAs) and explicit anti-homophobic bullying policies in secondary schools across British Columbia, Canada, with experiences of anti-gay discrimination, suicidal ideation and attempts among lesbian, gay, bisexual (LGB), mostly heterosexual, and exclusively heterosexual students. Analyses of the province-wide random cluster-stratified 2008 B.C. Adolescent Health Survey (n =21,70 8) compared students in schools with GSAs or policies implemented at least 3 years, and less than 3 years, with those in schools without GSAs or anti-homophobia policies, using multinomial logistic regression, separately by gender. LGB students had lower odds of past year discrimination, suicidal thoughts and attempts, mostly when policies and GSAs had been in place for 3+ years; policies had a less consistent effect than GSAs. Heterosexual boys, but not girls, also had lower odds of suicidal ideation and attempts in schools with longer-established anti-homophobic bullying policies and GSAs. Given consistently higher documented risk for suicidal ideation and attempts among LGB and mostly heterosexual adolescents, prevention efforts should be a priority, and school-level interventions, such as GSAs, may be an effective approach to reducing this risk, while also offering prevention benefits for heterosexual boys.
The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university undergraduates. Three subscales, each addressing a different source of support, were identified and found to have strong factorial validity: (a) Family, (b) Friends, and (c) Significant Other. In addition, the research demonstrated that the MSPSS has good internal and test-retest reliability as well as moderate construct validity. As predicted, high levels of perceived social support were associated with low levels of depression and anxiety symptomatology as measured by the Hopkins Symptom Checklist. Gender differences with respect to the MSPSS are also presented. The value of the MSPSS as a research instrument is discussed, along with implications for future research.
Lesbian, gay, bisexual, and transgender (LGBT) youth are at risk for engaging in negative health behaviors and for experiencing at-school victimization. Specific benefits of attending a high school with a gay-straight alliance (GSA), including lower levels of suicidality, have been published; however, it is unclear whether GSAs are related to lower levels of problematic substance use, depressive symptoms, and psychological distress. Using a sample of 145 LGBT youth recruited from college and university organizations for LGBT students, we examined whether attending a high school with a GSA was related to more positive school experiences and mental health outcomes for LGBT youth. The results indicate that youth who attended a high school with a GSA report significantly more favorable outcomes related to school experiences, alcohol use, and psychological distress. The implications of the findings are discussed as they relate to school psychologists. Important limitations of this study are reviewed.
Lesbian, gay, and bisexual individuals who are also racial/ethnic minorities (LGBT-POC) are a multiply marginalized population subject to microaggressions associated with both racism and heterosexism. To date, research on this population has been hampered by the lack of a measurement tool to assess the unique experiences associated with the intersection of these oppressions. To address this gap in the literature, we conducted a three-phase, mixed method empirical study to assess microaggressions among LGBT-POC. The LGBT People of Color Microaggressions Scale is an 18-item self-report scale assessing the unique types of microaggressions experienced by ethnic minority LGBT adults. The measure includes three subscales: (a) Racism in LGBT communities, (b) Heterosexism in Racial/Ethnic Minority Communities, and (c) Racism in Dating and Close Relationships, that are theoretically consistent with prior literature on racial/ethnic minority LGBTs and have strong psychometric properties including internal consistency and construct validity in terms of correlations with measures of psychological distress and LGBT-identity variables. Men scored higher on the LGBT-PCMS than women, lesbians and gay men scored higher than bisexual women and men, and Asian Americans scored higher than African Americans and Latina/os.
Positive and negative life events and social support were correlated with illness among Navy Submarine School students. Negative, but not positive, life events in the recent past were related to reports of illness. Although social support by itself was not related to illness reports, the relationship between negative life events and illness was stronger among subjects with low rather than high levels of social support. The results suggest the importance of assessing both stressful life events and moderators of response to stress, such as social support, in investigating the role played by personality in illness.
Patients' trust in their physicians has recently become a focus of concern, largely owing to the rise of managed care, yet the subject remains largely unstudied. We undertook a qualitative research study of patients' self-reported experiences with trust in a physician to gain further understanding of the components of trust in the context of the patient-physician relationship.
Twenty-nine patients participants, aged 26 to 72, were recruited from three diverse practice sites. Four focus groups, each lasting 1.5 to 2 hours, were conducted to explore patients' experiences with trust. Focus groups were audio-recorded, transcribed, and coded by four readers, using principles of grounded theory.
The resulting consensus codes were grouped into seven categories of physician behavior, two of which related primarily to technical competence (thoroughness in evaluation and providing appropriate and effective treatment) and five of which were interpersonal (understanding patient's individual experience, expressing caring, communicating clearly and completely, building partnership/sharing power and honesty/respect for patient). Two additional categories were predisposing factors and structural/staffing factors. Each major category had multiple subcategories. Specific examples from each major category are provided.
These nine categories of physician behavior encompassed the trust experiences related by the 29 patients. These categories and the specific examples provided by patients provide insights into the process of trust formation and suggest ways in which physicians could be more effective in building and maintaining trust.
Two-hundred and twenty participants recruited through multiple sampling strategies completed a self-report questionnaire examining: (a) whether internalized homophobia predicts depressive and anxious symptoms, suicide, and substance abuse; and (b) the periods of gay-identity development which were particularly risky for suicide. Results indicate that internalized homophobia, particularly negative feelings towards one's own homosexuality (as measured by the Self subscale of the Nungesser Homosexual Attitudes Inventory), accounts for 18% of the variance in depressive scores and 13% of anxiety scores (using the Beck inventories). Internalized homophobia did not predict suicide independently from depression. The period of greatest risk for both suicidal ideation and suicide attempts was the period of disclosure of one's homosexuality to one's immediate family.
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