Adolescent health at the intersections of sexual, gender, racial/ethnic, immigrant identities and native language

项目摘要 性少数和性别少数(SGM)青少年的不良健康行为风险不成比例， 与他们的异性恋、顺性同龄人相比，他们的经历和结果。然而，SGM的年轻人并不是 人口同质性；每个人都有多种社会身份，这影响了他们所经历的风险和保护。 交叉性指的是权力和特权基于相互关联的社会结构的方式 职位(例如，由于种族/族裔、移民身份、母语)以及个人经历如何反映 授予特权和劣势的进程。相互构成的社会压迫形式(例如，耻辱 同时基于种族/民族、性别和性取向)可能会不同地影响 具有多个边缘化社会地位的SGM人。生活在这些交叉的社会职位中可能 产生独特的挑战和力量，促进青年的健康发展。 具有里程碑意义的2011年美国国家医学科学院(NAM)关于SGM人群和 最近的其他报告强调了使用交叉性框架进行卫生研究的必要性， 明确包括风险和复原力，以便为支持特别报告员青年的干预措施提供信息。建立在 新出现的文献表明，拉丁裔和黑人/非裔美国SGM青年可能面临更高的风险， 拟议的研究回应了NOT-MD-19-001，并提出了以下研究问题 SGM青少年(12-19岁)：1)在欺凌、危险行为、情绪困扰和 不同社会地位青年的保护因素(即种族/族裔群体、移民经历、 2)保护因素和其他特征上的差异如何解释差异 在不同社会地位的年轻人中的这些结果？3)什么是积极和消极的经历 特别与特别报告员身份重叠、同时产生的不平等有关， 种族/民族、移民经历和母语？我们将通过两项研究来回答这些问题 目标：首先，对现有的三个青少年健康数据集进行广泛分析：明尼苏达州 学生调查(N~122,000)、加州健康儿童调查(N~1,042,000)和LGBTQ国家青少年 调查(N~17,000)，具有不同的样本、人口统计特征和衡量标准。我们将测试多个 使用协调分析和平行分析的假设。第二，对-80进行定性访谈 来自不同社会地位的SGM青年更深入地理解量化结果并生成 对干预措施提出具体、相关的建议。我们将关注最多四个交叉的社会职位 如目标A所确定的，SGM青年面临最大差距的地方，以及确定的具体保护因素 在目标A中，采访的重点将是在简短的调查措施之外“深入挖掘”。定性的调查结果将 为最脆弱的SGM青年提供关于人际和社区资产的重要信息，以及如何 他们可以为其他年轻人提供支持。

Project Abstract Sexual and gender minority (SGM) adolescents are at disproportionate risk of poor health behaviors, experiences and outcomes compared to their straight, cisgender peers. SGM youth, however, are not a homogenous population; each has multiple social identities that affect the risk and protection they experience. Intersectionality refers to ways in which power and privilege are structured based on interrelated social positions (e.g. due to race/ethnicity, immigrant status, native language) and how individual experiences reflect processes that confer privilege and disadvantage. Mutually constitutive forms of social oppression (e.g., stigma simultaneously based on race/ethnicity, gender, and sexual orientation) may differentially affect the health of SGM people with multiple marginalized social positions. Living within these intersecting social positions may give rise to unique challenges as well as strengths that promote healthy development among youth. The landmark 2011 National Academy of Medicine (NAM) report on the health of SGM populations and additional recent reports have highlighted the need for health research using an intersectionality framework, explicitly including both risk and resilience, to inform interventions supporting SGM youth. Building on the nascent literature suggesting that Latino and Black/African American SGM youth might be at heightened risk, the proposed study responds to NOT-MD-19-001 and addresses the following research question regarding SGM adolescents (12-19 years old): 1) What are differences in bullying, risk behaviors, emotional distress, and protective factors among youth with different social positions (i.e. racial/ethnic groups, immigrant experiences, and native language)? 2) How do differences in protective factors and other characteristics explain differences in these outcomes among youth with different social positions? and 3) What positive and negative experiences are particularly relevant to the overlapping, simultaneous production of inequalities by SGM identity, race/ethnicity, immigration experiences, and native language? We will answer these questions with two study aims: First, conduct extensive analysis of three existing adolescent health datasets: the Minnesota Student Survey (N~122,000), California Healthy Kids Survey (N~1,042,000), and the LGBTQ National Teen Survey (N~17,000), which have different samples, demographic profiles, and measures. We will test multiple hypotheses using both harmonized and parallel analyses. Second, conduct qualitative interviews with 64-80 SGM youth from different social positions to more deeply understand quantitative findings and generate concrete, relevant recommendations for interventions. We will focus on up to four intersecting social positions where SGM youth face the greatest disparities, as identified in Aim A, and specific protective factors identified in Aim A will be the focus of interviews to “dig deep” beyond brief survey measures. Qualitative findings will provide critical information on interpersonal and community assets for the most vulnerable SGM youth and how they can be bolstered for other young people.