Peer Victimization and Risky Alcohol Use among Sexual Minority Youth: Understanding Mechanisms and Contexts

摘要 变性人和性别多元化(TGD)青年报告称，与顺性青年相比，健康差距很大， 包括基于性别的受害、更严重的心理健康症状(例如焦虑、抑郁、内在化 耻辱、自杀)和不成比例的更高的健康风险行为(例如，危险饮酒， 使用香烟、非法药物使用)。使用准确和相关的术语，区分不同的个人 具有不同的性和性别身份对于识别TGD青年谁是此类疾病的高危人群至关重要 健康差距。针对NOT-OD-23-046号文件，拟议的行政补充研究力求： (A)作为两个步骤进程的一部分，测试衡量当前性别认同的术语，并建议及时 以及(B)探讨TGD和顺性青年对性别的理解的变化 随着时间的推移，术语和性别识别。补充研究将基于Hequemburg的Co-Pis 和利文斯顿正在进行的R01(AA028810-01a)对同龄人的急性每日和纵向影响的研究 性少数化青少年(即女同性恋者、男同性恋者、双性恋者、同性恋者、同性恋者或LGBQ+者)的受害(PV)风险 酒精使用和保护因素的识别。拟议的补编将支持和加快 纳入有性行为的TGD青年(n=75)，与有性行为的顺式性别青年进行比较 (n=75)。性别认同将在管理的调查中使用两步程序进行评估 在两个时间点(基线和6个月)与这些参与者(N=150)。此外，还有两个定性的 认知访谈(基线，6个月)将对顺性青年(n=25)和 从调查参与者中随机挑选TGD青年(n=25)，以实现以下目标：目标1 检查TGD和顺性别青年(n=50，每组25人)对两步答案选项的看法，并 使用认知面谈的方法提出修改建议。两者中混淆或含糊的来源- 相关修改的步骤答案选项和建议(即“双性”、“非二进制”)将为 探索过了。青少年的性别认同在其自我概念中的中心地位及其在其知觉中的作用 还将审查分两步进行的性别评估选项。目标2是描述这两个因素的影响： 对处于发育过渡期的TGD性弱化青少年的研究进展 以不稳定的性别(和性)身份为特征的时期。衡量的性别认同的描述性模式 使用两步法的两个时间点将通过纵向调查(基线，6- TGD和顺性青年(每组n=75)。认知面试(为期6个月)将探索 青少年(n=25)对两步问题捕捉变化的有效性的看法 随着时间的推移，以及TGD和顺性青年中的性别认同模式。的修订版 性别认同评估分两步进行，第一步将根据参与者的反馈进行 面谈；将在面谈2中探讨修改TGD LGBQ+青年的适宜性。

Abstract Transgender and gender diverse (TGD) youth report significant health disparities compared to cisgender youth, including gender-based victimization, greater mental health symptoms (e.g., anxiety, depression, internalized stigma, suicide), and disproportionately higher rates of health risk taking behaviors (e.g., hazardous alcohol use, cigarette use, illicit drug use). Use of accurate and relevant terminology that distinguishes among individuals with diverse sexual and gender identities is critical to identifying TGD youth who are at heightened risk for such health disparities. In response to NOT-OD-23-046, the proposed administrative supplemental study seeks to: (a) test terminology for measuring current gender identity as part of the two-step process and suggest timely and relevant modifications, and (b) explore changes in TGD and cisgender youths’ interpretations of gender terminology and gender identification over time. The supplemental study will build on Co-PIs Hequembourg’s and Livingston’s ongoing R01 (AA028810-01A) study of the acute daily and longitudinal effects of peer victimization (PV) on sexual minoritized adolescents’ (i.e., lesbian, gay, bisexual, queer, + or LGBQ+) risky alcohol use and identification of protective factors. The proposed supplement will bolster and expedite the inclusion of sexual minoritized TGD youth (n = 75) for comparison with sexual minoritized cisgender youth (n=75) in the parent study. Gender identity will be assessed using the two-step process in surveys administered in two timepoints (baseline and 6-months) with these participants (N = 150). Additionally, two qualitative cognitive interviews (baseline, 6-months) will be conducted with a subsample of cisgender youth (n = 25) and TGD youth (n = 25) randomly selected from the survey participants to achieve the following aims: Aim 1 is to examine TGD and cisgender youths’ (n = 50, 25 each group) perceptions of the 2-step answer options and suggest modifications using a cognitive interviewing approach. Sources of confusion or ambiguity in the two- step answer options and suggestions for relevant modifications (i.e., “intersex,” “non-binary”) will be explored. The centrality of youths’ gender identity in their self-concept and its role in their perceptions of the two-step gender assessment options also will be examined. Aim 2 is to describe the implications of the two- step process in research with TGD sexual minoritized adolescents who are at a transitional developmental period featuring fluid gender (and sexual) identities. Descriptive patterns of gender identification measured over two time points using the two-step method will be captured via longitudinal surveys (baseline, 6- months) of TGD and cisgender youth (n = 75 each group). Cognitive interview (at 6-months) will explore youths’ perceptions (n = 25 each cis and TGD) of the effectiveness of two-step questions for capturing changes over time as well as patterns of gender identification among TGD and cisgender youth. A revised version of the two-step gender identity assessment will be developed based on participant feedback in the first interview; modifications will be explored for appropriateness with TGD LGBQ+ youth in interview 2.