Harvard Medical School, Boston, Massachusetts
Massachusetts General Hospital, Boston, Massachusetts.
Pediatrics. 2021 Oct;148(4). doi: 10.1542/peds.2021-050255. Epub 2021 Sep 14.
Evidence suggests that sexual minority (SM) and gender minority (GM) youth are more likely to experience self-injurious thoughts and behaviors (SITBs) than heterosexual and cisgender youth. A major barrier to identifying and treating SITBs is nondisclosure. In this study, we explored differences in SITB disclosure patterns between SM and GM youth and their heterosexual and cisgender peers. In this study, we further examined the association between discrimination experiences and SITB disclosure.
Adolescents ( = 931) completed questionnaires assessing demographics, SITBs, disclosure history, disclosure barriers, future intentions to disclose SITBs, and discrimination history.
Few differences in SITB disclosure patterns emerged between SM and GM youth and heterosexual and cisgender youth ( > .05). SM and GM youth endorsed greater rates of fear of disclosure to and worrying parents, two parent-related barriers ([Formula: see text] = 8.11, = .017; [Formula: see text] = 7.25, = .027). GM youth reported greater discrimination experiences than SM youth (F = 6.17, .002); discrimination experiences impacted their willingness to disclose future SITBs more so than their SM and heterosexual and cisgender peers (F = 11.58, .001). Among the full sample, more discrimination experiences were associated with lower previous disclosure honesty to therapists and pediatricians ( = -0.09 to -0.10, < .05). Among SM and GM youth, discrimination experiences were associated with lesser odds of disclosing suicide attempts in the future ( = -0.12, < .05).
Minority stress experiences may interfere with SITB disclosure, particularly among GM youth. Targeted interventions should be considered to reduce minority stress and support disclosure.
有证据表明,性少数群体(SM)和性别少数群体(GM)青年比异性恋和顺性别青年更有可能出现自伤念头和行为(SITBs)。识别和治疗 SITBs 的主要障碍是不披露。在这项研究中,我们探讨了 SM 和 GM 青年与他们的异性恋和顺性别同龄人之间 SITB 披露模式的差异。在这项研究中,我们进一步研究了歧视经历与 SITB 披露之间的关联。
青少年(n=931)完成了问卷,评估了人口统计学、SITBs、披露史、披露障碍、未来披露 SITBs 的意向以及歧视史。
SM 和 GM 青年与异性恋和顺性别青年之间的 SITB 披露模式差异很小(>0.05)。SM 和 GM 青年更担心向父母和父母相关的披露障碍([公式:见文本] = 8.11,[公式:见文本] =.017;[公式:见文本] = 7.25,[公式:见文本] =.027)。GM 青年比 SM 青年报告了更多的歧视经历(F=6.17,[公式:见文本] =.002);歧视经历对他们未来披露 SITBs 的意愿的影响大于对他们的 SM 和异性恋和顺性别同龄人(F=11.58,[公式:见文本] =.001)。在全样本中,更多的歧视经历与之前向治疗师和儿科医生披露的诚实程度较低有关([公式:见文本] = -0.09 至-0.10,[公式:见文本] <.05)。在 SM 和 GM 青年中,歧视经历与未来披露自杀企图的可能性较小有关([公式:见文本] = -0.12,[公式:见文本] <.05)。
少数群体应激经历可能会干扰 SITB 披露,特别是在 GM 青年中。应考虑采取有针对性的干预措施,以减少少数群体应激并支持披露。