Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Division of General Pediatrics and Adolescent Health, Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN, USA.
Prev Med. 2020 Oct;139:106191. doi: 10.1016/j.ypmed.2020.106191. Epub 2020 Jul 9.
Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. Student reports of past-year suicidal ideation, suicidal attempts, and self-harm behaviors were merged with community-level data assessing diverse aspects of LGBTQ-supportive resources and progressive political climates in communities surrounding the schools. Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation (aOR = 0.94, 95% CI [0.88, 1.01]) and suicidal attempts (aOR = 0.91, 95% CI [0.83, 1.00]) and significantly lower self-harm behaviors (aOR = 0.91, 95% CI [0.85, 0.98]). Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.
尽管加拿大在减少对女同性恋、男同性恋、双性恋、跨性别、酷儿和疑问 (LGBTQ) 群体的污名化方面做出了支持性的结构性改变，但性少数群体青年与异性恋同龄人相比仍面临差距。我们旨在描述 LGBTQ 支持环境和政治氛围，并研究它们与加拿大西部性少数青少年自杀行为之间的联系。数据来自 2013 年不列颠哥伦比亚省青少年健康调查，这是一项对加拿大不列颠哥伦比亚省公立学校学生进行的聚类分层随机横断面调查；我们从 274 所学校中抽取了 2678 名自我认同为 LGB 且主要为异性恋的学生（69%为女孩），在加权模型中代表了全省 24624 名性少数学生的估计人数。学生报告的过去一年自杀意念、自杀企图和自残行为与社区层面的数据合并，该数据评估了学校周围社区中 LGBTQ 支持资源和进步政治氛围的各个方面。调整后的多水平模型显示，对于性少数青少年女孩，更高的社区 LGBTQ 支持度预示着自杀意念（aOR=0.94，95%CI[0.88,1.01]）和自杀企图（aOR=0.91，95%CI[0.83,1.00]）略有显著降低，自残行为（aOR=0.91，95%CI[0.85,0.98]）显著降低。此外，进步的政治氛围预示着自杀意念（aOR=0.89，95%CI[0.78,1.02]）和自残行为（aOR=0.87，95%CI[0.77,0.99]）略有显著降低。对于性少数青少年男孩，调整后的模型中没有社区层面的变量与自杀行为相关。因此，LGBTQ 支持社区和进步的政治氛围似乎对性少数青少年女孩的自杀行为具有保护作用，但对性少数青少年男孩没有。
