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. 2019 Mar;35(2):270-281.
doi: 10.1111/jrh.12311. Epub 2018 Jun 25.

Emotional Distress, Bullying Victimization, and Protective Factors Among Transgender and Gender Diverse Adolescents in City, Suburban, Town, and Rural Locations

Marla E Eisenberg  1 , Amy L Gower  1 , Barbara J McMorris  2 , G Nicole Rider  3 , Eli Coleman  3
Affiliations

Emotional Distress, Bullying Victimization, and Protective Factors Among Transgender and Gender Diverse Adolescents in City, Suburban, Town, and Rural Locations

Marla E Eisenberg et al. J Rural Health. 2019 Mar.

Abstract

Purpose: Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protective factors among TGD high school students in city, suburban, town, and rural locations.

Methods: Data come from a statewide school-based survey conducted in Minnesota in 2016 (n = 2,168 TGD youth). Analysis of covariance models were used to predict the prevalence of multiple indicators of emotional distress, bullying victimization, and protective factors across the 4 location categories, with multiple adjustments.

Findings: Significant linear trends were observed for 2 emotional distress outcomes and 2 bullying victimization outcomes, with urban TGD students having the lowest rates and rural having the highest prevalences. Additional significant differences in emotional distress were noted, with unexpectedly high rates of depressive symptoms and suicidal ideation among suburban students.

Conclusions: Helping TGD adolescents in all types of locations identify resources and supportive professionals is critical to supporting this population.

Keywords: adolescence; bullying; mental health; social environment; transgender.

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Conflict of interest statement

Disclosures: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Predicted Probabilities of Bullying Victimization Among TGD Students, by Location
Notes: *P < .05 ab: Within sections, predicted probabilities that share a letter are statistically equivalent (P > .05). Models adjust for assigned sex, grade in school, race/ethnicity and free/reduced-price lunch status among TGD students. Overall prevalence of bullying victimization for cisgender students is shown for reference only. TGD = transgender and gender diverse
Figure 2
Figure 2. Protective Factors Among TGD Students, by Location
Notes: *P < .05 ab: Within sections, predicted probabilities that share a letter are statistically equivalent (P > .05). Models adjust for biological sex, grade in school, race/ethnicity and free/reduced-price lunch status among TGD students. Overall mean levels of protective factors for cisgender students are shown for reference only. TGD = transgender and gender diverse
Figure 3
Figure 3. Predicted Probabilities of Emotional Distress Among TGD Students, by Location
Notes: *P < .05; **P < .01 abc: Within sections, predicted probabilities that share a letter are statistically equivalent (P > .05). Models adjust for assigned sex, grade in school, race/ethnicity, free/reduced-price lunch status, any bullying victimization (past 30 days), and protective factors summary score, among TGD students only. Overall prevalence levels of emotional distress for cisgender students are shown for reference only. TGD = transgender and gender diverse
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References

    1. Institute of Medicine. The Health of Lesbian Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: National Academy of Sciences; 2011. - PubMed
    1. Veale JF, Watson RJ, Peter T, Saewyc EM. Mental Health Disparities Among Canadian Transgender Youth. J Adolesc Heal. 2017;60(1):44–49. doi: 10.1016/j.jadohealth.2016.09.014. - DOI - PMC - PubMed
    1. Eisenberg ME, Gower AL, McMorris BJ, Rider GN, Shea G, Coleman E. Risk and Protective Factors in the Lives of Transgender/Gender Non-Conforming Adolescents. J Adolesc Heal. 2017;61:521–526. doi: 10.1016/j.jadohealth.2017.04.014. - DOI - PMC - PubMed
    1. Connolly MD, Zervos MJ, Barone CJ, Johnson CC, Joseph CLM. The Mental Health of Transgender Youth : Advances in Understanding. J Adolesc Heal. 2016;59:489–495. doi: 10.1016/j.jadohealth.2016.06.012. - DOI - PubMed
    1. Clark TC, Lucassen MFG, Bullen P, et al. The health and well-being of transgender high school students: results from the New Zealand adolescent health survey (Youth’12) J Adolesc Heal. 2014;55(1):93–99. doi: 10.1016/j.jadohealth.2013.11.008. - DOI - PubMed

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