Specialty of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.
Centre for Population Health, Western Sydney Public Health Unit, North Parramatta, Australia.
J Med Internet Res. 2022 Sep 21;24(9):e38449. doi: 10.2196/38449.
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at higher risk of poor mental health and well-being. Social media platforms can provide LGBTQ youths with a space that counters heteronormative environments and potentially supports mental health and well-being. Mental health includes an individual's state of psychological and emotional well-being and not merely the absence of mental disorders.
We sought to identify how LGBTQ youths and adolescents use social media for connection with other LGBTQ peers and groups, identity development, and social support and how these affect mental health and well-being.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) procedures were used to guide this review. Searches were conducted in ACM Digital Library, CINAHL, Ovid Embase, Ovid MEDLINE, and Web of Science in March 2021. This review focused on LGBTQ youths aged 10 to 24 years. Included peer-reviewed studies must comprise social media; explore peer connection, identity development, or social support; and be published from 2012 onward. In total, 2 researchers extracted data and performed quality assessments independently using the Newcastle-Ottawa Scale for quantitative articles and the Critical Appraisal Skills Programme for qualitative articles. Qualitative synthesis was performed on articles that satisfied the eligibility criteria.
A total of 26 studies (n=15, 58% qualitative; n=8, 31% quantitative; n=3, 12% mixed methods) met the inclusion criteria. Of the 8 quantitative studies, 6 (75%) were cross-sectional, and 2 (25%) were cohort studies. All studies ranged from moderate to high quality. Social media was a popular tool used by LGBTQ youths to connect with LGBTQ communities. In qualitative data, we found that LGBTQ youths negotiated and explored identity and obtained support from peers on social media. Instagram, Tumblr, and Twitter were commonly used to access LGBTQ content owing to ease of anonymity. Identity management was the most studied social media affordance, important to LGBTQ youths for strategic disclosure. Key strategies for managing identities included being anonymous, censoring locations or content, restricting audiences, and using multiple accounts. Quantitative studies (3/8, 38%) showed that social media was associated with reduced mental health concerns and increased well-being among LGBTQ youths. Mental health concerns arising from social media use were attributed to discrimination, victimization, and policies that did not accommodate changed identities.
We found that social media may support the mental health and well-being of LGBTQ youths through peer connection, identity management, and social support, but findings were limited by weaknesses in the evidence. More robust and longitudinal studies are needed to determine the relationship between social media use and LGBTQ mental health, particularly among adolescents. The findings may inform interventions to promote social media health literacy and the mental health and well-being of this vulnerable group.
PROSPERO CRD42020222535; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=222535.
女同性恋、男同性恋、双性恋、跨性别和酷儿（LGBTQ）群体面临更高的心理健康和福祉风险。社交媒体平台可以为 LGBTQ 青年提供一个反对异性恋规范环境的空间，并可能支持心理健康和福祉。心理健康包括个人的心理和情感健康状况，而不仅仅是没有精神障碍。
我们旨在确定 LGBTQ 青年和青少年如何使用社交媒体与其他 LGBTQ 同龄人建立联系、发展身份认同以及获得社会支持，以及这些如何影响心理健康和福祉。
采用 PRISMA（系统评价和荟萃分析的首选报告项目）程序指导本综述。2021 年 3 月在 ACM 数字图书馆、CINAHL、Ovid Embase、Ovid MEDLINE 和 Web of Science 中进行了搜索。本综述重点关注 10 至 24 岁的 LGBTQ 青年。纳入的同行评议研究必须包含社交媒体；探索同伴联系、身份发展或社会支持；并于 2012 年以后发表。共有 2 名研究人员独立使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对定量文章和批判性评估技能计划（Critical Appraisal Skills Programme）对定性文章进行数据提取和质量评估。对符合入选标准的文章进行定性综合分析。
共有 26 项研究（n=15，定性研究占 58%；n=8，定量研究占 31%；n=3，混合方法研究占 12%）符合纳入标准。8 项定量研究中，有 6 项（75%）为横断面研究，2 项（25%）为队列研究。所有研究的质量均为中等到高度。社交媒体是 LGBTQ 青年与 LGBTQ 社区建立联系的流行工具。在定性数据中，我们发现 LGBTQ 青年在社交媒体上协商和探索身份，并从同龄人那里获得支持。由于匿名性，Instagram、Tumblr 和 Twitter 是常用来获取 LGBTQ 内容的平台。身份管理是研究最多的社交媒体功能，对 LGBTQ 青年来说，这是战略披露的重要途径。管理身份的关键策略包括匿名、屏蔽位置或内容、限制受众和使用多个账户。3 项定量研究（38%）表明，社交媒体与 LGBTQ 青年的心理健康问题减少和幸福感增加有关。社交媒体使用带来的心理健康问题归因于歧视、受害和不适应身份变化的政策。
我们发现，社交媒体通过同伴联系、身份管理和社会支持可能支持 LGBTQ 青年的心理健康和福祉，但研究结果受到证据薄弱的限制。需要更强大和更长期的研究来确定社交媒体使用与 LGBTQ 心理健康之间的关系，特别是在青少年中。研究结果可能为促进社交媒体健康素养以及促进这一弱势群体的心理健康提供信息。
PROSPERO CRD42020222535; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=222535.
