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Jessica Fish Talk on "The Paradox of Social Progress for LGBTQ+ Youth and the Untapped Potential of Family"
The Sociology Department presents: The Paradox of Social Progress for LGBTQ+ Youth and the Untapped Potential of Family
Located in Coming Up
Fish editorial published in AJPH
So-called “conversion therapy” efforts create serious harm for youth that are LGBTQ
Located in News
Article Reference Troff document (with manpage macros)Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility
Supportive housing later in life tends to be a key concern for lesbian, gay, bisexual, and transgender (LGBT) elders. Most senior care providers are un(der)prepared to meet the needs of older LGBT adults. This study evaluated the efficacy of a 4 h, face-to-face, research-based, LGBT-diversity training designed to improve senior housing facility staff’s cultural competency regarding the needs of LGBT elders. Findings from this study found a significant increase in LGBT content knowledge between pre- and post-intervention assessments and a significant decrease in perceived preparedness when working with LGBT elders. These effects remained significant after controlling for staff designation, religion, educational attainment, and training session. Findings suggest that staff’s cultural competence affected their perceived readiness to address LGBT elders’ needs. Implications are related to the concept of cultural humility or the lifelong process of understanding others’ experiences based on the recognition of lack of un(der)preparedness to create a culturally supportive residential environment.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article ReferenceComparing National Probability and Community‑Based Samples of Sexual Minority Adults: Implications and Recommendations for Sampling and Measurement
Scientific evidence regarding sexual minority populations has generally come from studies based on two types of samples: community-derived samples and probability samples. Probability samples are lauded as the gold standard of population research for their ability to represent the population of interest. However, while studies using community samples lack generalizability, they are often better able to assess population-specific concerns (e.g., minority stress) and are collected more rapidly, allowing them to be more responsive to changing population dynamics. Given these advantages, many sexual minority population studies rely on community samples. To identify how probability and community samples of sexual minorities are similar and different, we compared participant characteristics from two companion samples from the  Generations Study , each designed with the same demographic profile of U.S. sexual minority adults in mind. The first sample was recruited for a national probability survey, whereas the second was recruited for a multicommunity sample from four U.S. cities. We examined sociodemographic differences between the samples. Although there were several statistical differences between samples, the effect sizes were small for sociodemographic characteristics that defined the sample inclusion criteria: sex assigned at birth, race/ethnicity, and age cohort. The samples differed across other characteristics: bisexual respondents, respondents with less education, and those living in non-urban areas were underrepresented in the community sample. Our findings offer insights for recruiting community samples of sexual minority populations and for measuring sexual identity on probability surveys. They also bolster confidence in well-designed community samples as sources for data on sexual minority populations.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation
Purpose:  We propose a new theoretically grounded approach for estimating sexual orientation-related health risk that accounts for the unique and shared variance of sexual identity across other measures of sexual orientation (i.e., attraction and behavior). We argue and illustrate that this approach provides specificity not demonstrated by approaches that independently estimate and compare health risk based on sexual identity, attraction, and behavior. Methods:  Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III, collected in 2012–2013 (N = 36,309, ages 18 and older). The Karlson-Holm-Breen method tested the degree to which attraction- and behavior-based disparities in mental health and substance use disorders change after adjusting for sexual identity. Results:  Sexual attraction- and behavior-based disparities in mental health and substance use disorders statistically varied when comparing models that did and did not adjust for sexual identity. Adjusting for sexual identity appeared to have a larger influence on attraction- and behavior-based health associations among men; sexual minority and majority differences were attenuated on nearly every outcome after adjusting for sexual identity. This attenuation was less common among women. Among women, some behavior-based disparities were wider in sexual identity-adjusted models relative to unadjusted models. Conclusion:  We demonstrate more accurate approaches to capturing and comparing sexual orientation-related health disparities across multiple measures of sexual orientation, which account for the shared variance between sexual identity and measures of attraction and behavior. Adjusted estimates provide more specificity regarding relative health risk across specific subgroups of sexual minority people, and the intervention and prevention strategies needed to address them.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Associations Between Community-Level LGBTQ-Supportive Factors and Substance Use Among Sexual Minority Adolescents
Purpose:  Using representative school-based data and community-level primary data, we investigated how environmental factors (e.g., school and community climate) might be protective against substance use behaviors among a vulnerable population of adolescents. Methods:  We analyzed a sample of 2678 sexual minority adolescents using a combination of student-level data (British Columbia Adolescent Health Survey) and primary community-level data (assessing lesbian, gay, bisexual, transgender, and queer [LGBTQ]-specific community and school environments). Using multilevel logistic regression models, we examined associations between lifetime substance use (alcohol, illegal drugs, marijuana, nonmedical use of prescription drugs, and smoking) and community-level predictors (community and school LGBTQ supportiveness). Results:  Above and beyond student characteristics (e.g., age and years living in Canada), sexual minority adolescents residing in communities with more LGBTQ supports (i.e., more supportive climates) had lower odds of lifetime illegal drug use (for boys and girls), marijuana use (for girls), and smoking (for girls). Specifically, in communities with more frequent LGBTQ events (such as Pride events), the odds of substance use among sexual minority adolescents living in those communities was lower compared with their counterparts living in communities with fewer LGBTQ supports. Conclusions:  The availability of LGBTQ community-level organizations, events, and programs may serve as protective factors for substance use among sexual minority adolescents. In particular, LGBTQ-supportive community factors were negatively associated with substance use, which has important implications for our investment in community programs, laws, and organizations that advance the visibility and rights of LGBTQ people.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Substance Use Among a National Sample of Sexual and Gender Minority Adolescents: Intersections of Sex Assigned at Birth and Gender Identity
Purpose:  We examined how substance use differed as a function of sex assigned at birth and gender identity (cisgender, transgender, or nonbinary/genderqueer) by type of substance. We sought to test whether current gender identity and sex assigned at birth were key factors in substance use among a large contemporary sample that included transgender and nonbinary/genderqueer adolescents. Methods:  We analyzed data from a large national U.S. sample of sexual and gender minority (SGM) adolescents (n = 11,129) collected between April and December 2017. Chi-square tests of independence were used to test whether substance use behaviors varied by sex assigned at birth and gender identity. A series of multivariate logistic regression models tested the odds of substance use by sex assigned at birth and gender identity, as well as the interaction between sex assigned at birth and gender identity. Results:  More than half of our sample reported lifetime alcohol use, and one-fourth of the sample reported lifetime marijuana use. Adolescents assigned male at birth had higher prevalence of substance use compared with adolescents assigned female at birth (AFAB). Multivariate models elucidated greater risk for most substance use outcomes for transgender adolescents compared with cisgender adolescents. We found significant interaction effects between gender identity and sex assigned at birth for recent alcohol use and lifetime and recent cigarette use among adolescents AFAB. Conclusions:  These findings have implications for stakeholders who develop nationally representative surveys, researchers who examine substance use disparities among SGM adolescents, and mental health professionals who treat underage substance use among vulnerable populations.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Sexual Orientation Disparities in Substance Use: Investigating Social Stress Mechanisms in a National Sample
Introduction: Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders, but relatively little is known about differences in substance use disorders across diverse sexual minority subgroups. There is also limited understanding of how different social stressors account for sexual orientation disparities in substance use disorders. Methods: Using nationally representative data collected in 2012−2013 (n=34,597), differences in past-year DSM-5 alcohol, cannabis, and tobacco use disorders were assessed across 4 sexual orientation groups (heterosexuals and 3 sexual minority subgroups, lesbian/gay-, bisexual-, and heterosexual-identified sexual minorities). This study assessed whether stressful life events mediated substance use disorder disparities between heterosexuals and each sexual minority subgroup, and whether stressful life events and lesbian, gay, and bisexual discrimination events mediated these substance use disorder differences. Analyses were conducted in 2019. Results: For both men and women, substance use disorders and stress experiences varied by sexual identity. For example, compared with heterosexual men, larger proportions of gay and bisexual men had a past-year alcohol use disorder. Among women, all sexual minority subgroups had higher rates of each substance use disorder than heterosexuals. For each substance use disorder, stressful life events mediated disparities between heterosexuals and sexual minority subgroups, except for heterosexual-identified sexual minority men. Both stressful life events and lesbian, gay, and bisexual discrimination mediated substance use disorder differences between sexual minority subgroups, with stronger indirect effects through lesbian, gay, and bisexual discrimination for lesbians/gay men and stronger indirect effects through stressful life events for bisexual adults, generally. Conclusions: Sexual minority subgroups have a greater prevalence of substance use disorders, mediated through both stressful life events and lesbian, gay, and bisexual discrimination. More research is needed to comprehensively assess the processes underlying sexual orientation substance use disparities.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article ReferenceThe Rejection Sensitivity Model: Sexual Minority Adolescents in Context
Theoretical and empirical integration of the rejection sensitivity (RS) model to sexual minority people is one of the few attempts to extend existing theoretical frameworks that explain mental health disparities for this population, namely the minority stress framework (Meyer,  2003 ) and its extensions (Hatzenbuehler,  2009 ; Testa, Habarth, Peta, Balsam, & Bockting,  2015 ). Theoretical origins of RS are rooted in the desire to understand how rejection from significant others affects subsequent other close relationships (Downey & Feldman,  1996 ). This was later extended to conceptualize rejection based on membership of a stigmatized group and modified to understand sexual orientation-related RS among sexual minorities (Dyar, Feinstein, Eaton, & London,  2016 ; Pachankis, Goldfried, & Ramrattan,  2008 ). Feinstein ( 2019 ) brings new life to this adapted application by grounding and integrating the basic tenets of sexual orientation-related RS alongside a critical health compromising process of minority stress: vigilance. Meyer theorized vigilance as a core form of proximal minority stressors and explains that “LGB people learn to anticipate—indeed, expect—negative regard from members of the dominant culture. To ward off potential negative regard, discrimination, and violence, they must be vigilant” and this vigilance is “related to feared possible (even if imagined) negative events” (Meyer,  2003 , p. 680–681). Feinstein explains that existing theoretical frameworks (Hatzenbuehler,  2009 ; Meyer,  2003 ) mention vigilance and RS as important processes, but lack a comprehensive integration of these concepts. Given that schemas for RS are formed early in the life course, we focus on the applicability to sexual minority adolescents, and other marginalized groups.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Jessica Fish and Bradley Boekeloo win Data Contract to Study LGBTQ Health Disparities
They are one of the four research groups chosen for the data contract
Located in News