Lesbian, gay, and bisexual (LGB) youth are a vulnerable population. Research has shown that LGB youth are at risk for discriminatory interpersonal victimization and social exclusion based on sexual orientation (D’Augelli et al., 2002). Heterosexual youth can have a range of attitudes toward LGB people, which may exacerbate or improve LGB youths’ social environments. It is important to understand how youths’ sexual orientation attitudes form, as this ultimately has an impact on LGB youths’ experiences. This study explored the relationship between parent messages about sexual orientation and the development of youths’ attitudes toward LGB people.

Participants in this study included 23 mother-child dyads. Participants completed video-recorded prompted conversations, during which they discussed topics related to sexual orientation. Parents’ messages related to sexual orientation were coded using qualitative content analysis (Morgan, 1993) in order to identify parents’ positive, neutral, heteronormative, and negative messages about LGB people. In addition, parents and youth both completed measures of explicit attitudes about LGB people (Modern Homonegativity Scale; Morrison & Morrison, 2002) and implicit attitudes about sexual orientation (Implicit Attitude Test; Nosek et al., 2007). Youth also completed a measure of behavioral attitudes (LGBT Ally Identity Development measure; Ji & Fujimoto, 2013).

The results of the study showed that the ratio of positive to negative messages parents provided during the prompted conversations were associated with youths’ explicit and behavioral attitudes toward LGB people with medium to large effect sizes, but did not relate to youths’ implicit attitudes. Parents’ implicit attitudes did not reach significance as a moderator to the relationship between parent messages and youth explicit attitudes, however the pattern of the moderation model was in the expected direction. Youths’ explicit and behavioral attitudes significantly correlated with one another and their implicit and behavioral attitudes approached significance with a medium effect size, whereas youths’ explicit and implicit attitudes did not correlate significantly. Mothers’ explicit attitudes significantly correlated with their explicit attitudes, suggesting that their verbal messages reflected their explicit attitudes.

This study empirically demonstrated that parent messages about sexual orientation relate to youths’ attitudes and behaviors toward LGB people. This provides a rationale for developing psychoeducational interventions aimed at supporting parents’ LGB-affirming parenting skills, regardless of their children’s current sexual orientation identity. Supporting parents in providing positive messages about LGB people could promote the development of LGB allies and a more positive social environment for LGB youth.

Sexual minority youth face mental health disparities compared to their heterosexual peers, including higher rates of depression, anxiety, suicide, and substance use. Parent support serves as a top predictive factor of mental health outcomes for sexual minority youth, but there are few psychological resources available to increase support. The first phase of this study involved the development of the Parent Resource for Increasing Sexual Minority Support (PRISMS), a brief online intervention for parents of sexual minority youth ages 13-18. Development of the PRISMS intervention was informed by psychological research about increasing parental self-efficacy and behavioral intentions for supportive parenting practices—two predictors of supportive behaviors—as well as interviews with parents of sexual minority individuals, usability testing, and feedback from researchers and practitioners with expertise in relevant areas. The second phase of this study involved testing the efficacy of the PRISMS intervention for increasing parental self-efficacy and behavioral intentions for sexual minority-supportive parenting practices, and assessing the acceptability of the intervention. Two-hundred-nineteen participants completed the study, and two analyses of covariance were performed. Results indicated that PRISMS significantly increased parental self-efficacy for sexual minority-supportive parenting practices compared to a control, F(1, 215) = 5.15, p = .024, but did not increase behavioral intentions F (1, 216) = .88, p = .350. An exploratory analysis using an independent samples t-test suggested that parents who were the most distressed about their child’s sexual orientation experienced gains in behavioral intentions (t = -2.17, p = .030), but further research is needed to assess this effect. Results also suggested that the PRISMS intervention was acceptable in terms of credibility, participant affect at post-test, and overall satisfaction at a level comparable to treatment as usual. Implications for research and practice are discussed. In total, the PRISMS intervention serves as a promising tool for increasing a key predictor of parent support for sexual minority youth.

Parental support plays a vital role in protecting trans youth from mental health risks including depression, anxiety, substance use, and suicide (Olson, Durwood, DeMeules, & McLaughlin, 2016; Simons, Schrager, Clark, Belzer, & Olson, 2013). Additionally, parents of trans youth experience distress themselves when learning their child is transgender and may experience worry, anxiety, guilt, and grief (Dierckx, Motmans, Mortelmans, & T’sjoen, 2016). This study examined the acceptability and feasibility of the Parent Support Program, an online intervention aimed at 1. decreasing parental distress and feelings of isolation, 2. increasing knowledge about gender diversity and empathy towards transgender youth, and 3. increasing intentions and self-efficacy to engage in transgender affirming behaviors. The intervention was developed based on previous research on the experiences and needs of parents of trans youth, theories of behavior change, and feedback from two focus groups with parents of transgender youth and experts in transgender mental health. The Parent Support Program includes three modules with psychoeducational text, affirming images, educational videos, videos of parents and trans youth, writing activities, and interactive quizzes. The pilot study found that the intervention was highly acceptable and provided helpful information on how to improve the feasibility of the intervention and conducting a larger efficacy study. Improvements include making the intervention more tailored and changing the online platform to decrease technical issues. Additionally, recruitment strategies will be adjusted to increase the credibility of the program and reach parents with less pre-existing support. Implications for future research andpractice with this population are discussed.

Objectives: This dissertation includes two studies. Study one aims to uncover sexual identity development and examine the differences in psychosocial health outcomes across various age, gender, and regional groups. Additionally, study two explores distinctive internalized stigma profiles that impact bisexual people’s psychosocial health outcomes and inspect the moderating effect of the latent classes of internalized stigma on the relationship between demographic characteristics of Chinese bisexuals (e.g., region, gender, age) and their health outcomes.Methods: An internet-based survey was administered to 685 respondents, from June to August 2021, reached primarily via lesbian, gay, bisexual, and transgender community organizations and professional networks. Participants reported their a battery of measures such as demographics, identity milestones, internalized stigma, and psychiatric symptoms. Results: Study one found that significant gender, and regional differences were observed regarding bisexual identity milestones. Individuals who were older, transgender and nonbinary identifying, and based in Taiwan disclosed their sexual identity more. Alarmingly, all respondents reported clinically elevated depression and anxiety symptoms, with a majority experiencing moderately severe depression (60%) and moderate or severe anxiety (80%). Approximately half of respondents contemplated suicide in the past year. Transgender and nonbinary bisexual individuals faced a higher risk of psychiatric symptoms and reduced subjective well-being compared to cisgender respondents, but having enhanced self-esteem served as a significant protective factor. In study two, latent profile analysis identified three bisexual subgroups: Self-appreciating (85.83%), Self-doubting (7.56%), and Self-dissonant (6.61%). Cisgender men, transgender and non-binary persons were significantly more likely than cisgender women to be in Self-doubting relative to Self-appreciating. Religious respondents were significantly more likely to be in Self-doubting relative to Self-appreciating. Respondents based in Taiwan were less likely to be in Self-doubting relative to Self-appreciating, compared to those based in mainland China. Self-appreciating individuals reported the lowest levels of depression, and the greatest levels of subjective well-being, and outness. The Self-doubting group reported significantly higher levels of outness than Self-dissonant. There were no significant group differences for LGBTQ community connectedness. Additionally, greater levels of IB, but not IH, was correlated with reduced well-being and more anxiety, depression, and suicidal ideation (r = -.22 to .08). Finally, internalized stigma latent classes influenced the relation between depression and region. Residing in Hong Kong was beneficial to Self-doubting and Self-dissonant participants since their depression levels did not increase compared to the Self-appreciating group, as those who lived in mainland China did. There were no significant moderating effects of community connectedness. Implications for future research, clinical interventions, and public health policies were discussed.

Transgender individuals seek mental health counseling for a variety of reasons (Bockting, Knudson, & Goldberg, 2006). However, their experiences in therapy are not always positive, and some experiences are quite negative (Rachlin, 2002). The present study utilizes an analogue research design and video vignettes to investigate how a therapist’s response to transgender identity exploration affects participants' perceptions of the therapist and the therapeutic relationship. The study utilized a series of mock therapy video vignettes that vary the way that a therapist responds to the client including transition affirming, non-binary affirming, and non-affirming responses. Transgender participants were asked about their plan to transition or not transition and were then randomly assigned to watch one of three mock therapy clips. Participants then completed a series of questions about their perception of the therapist’s expertness, likability, trustworthiness, the session smoothness and depth, and their own feelings of positivity, and arousal. Results indicate that the non-affirming video condition had a significant negative effect on the participant’s perceptions of the therapist and the quality of the therapeutic relationship. No significant differences were found between the transition affirming and non-binary affirming conditions. However, there was a trend for those who were not interested in transitioning to rate the non-binary affirming video more positively than the transition affirming video and those who were interested in transitioning to rate the non-binary affirming video slightly less positively than the transition affirming video. This study provides a more nuanced understanding of the ways in which transgender individuals experience various affirming and non-affirming therapeutic approaches and how these perceptions may be different based on the participants plan to transition or not transition.

Bisexuals experience a range of mental and behavioral health disparities compared to monosexuals, yet they are understudied and underserved. Bisexual health disparities may be characterized by a syndemic—interconnected and co-occurring risks in the context of stigma that jointly exacerbate the burden of disease—that emerges with a developmental onset in adolescence. In this project, I used a nationally-derived sample of bisexual youth and latent class modeling to investigate patterns of syndemic processes in this population. I examined the heterogeneity in the patterns of co-occurrence among three domains of high priority risk behaviors: sexual risk behavior, substance use, and victimization experiences. Findings indicated that within-group variation in the syndemic construct is categorical, systematic, and is comprised of Low Risk, Alcohol Use, Peer-victimization, Sexually Active, Syndemic, and Risk-taking classes. The proportions of bisexual identification, sex, and race varied across classes. Class membership was differentially associated with suicidality where the Syndemic and Peer-victimization classes were particularly elevated. These results reveal that there are multiple and distinctive forms of behavioral risk that confer differential health implications among bisexual youth; illustrate the utility of LCA for classifying typologies of risky and normative health behavior patterns; and encourage researchers and practitioners to carefully consider the jointly operating nature of behavioral risks in this population. Future directions include conducting replication and multiple-group invariance studies, examining additional antecedents and consequences of class membership, and investigating the plausibility of other mixture techniques to model complex syndemic processes among bisexuals and sexual minorities more broadly.

The present study explored parental support of transgender Latinx youth. Transgender Latinx youth experience multiple, intersecting forms of oppression. Given the important role that parents play in youth’s lives, parental support can act as a buffer against minority stressors (Meyer, 2003). Parental support is, in fact, associated with positive mental health outcomes, such as lower levels of depression, anxiety, and increased self-esteem (Olson et al., 2016; Przeworski & Piedra, 2020; Ryan et al., 2010; Simons et al., 2013). However, transgender Latinxs have reported lower levels of acceptance compared to other ethnic groups (Harrison-Quintana et al., 2008). Research is lacking regarding factors that may play a part in parental support of transgender Latinx youth, including cultural values, such as familismo, machismo/marianismo, and respeto. Additionally, youth themselves can contribute valuable information about types of parental support they desire or would find most helpful. An understanding of parental support for transgender Latinx youth grounded in the voices of youth could provide valuable insight to inform parents, clinicians, and researchers. Thus, the present study seeks to draw on youths’ perspectives to elucidate parental support for transgender Latinx youth. Nine nonbinary and trans men/transmasculine Latinxs aged 18-23 were interviewed regarding their experiences with parental support. A research team analyzed the data utilizing a constructivist grounded theory approach (Charmaz, 2006). Analyses yielded six themes and thirty-two sub-themes that created a model of parental support of transgender Latinx youth. Themes included in the model were as follows: Cultural Factors, External Factors, Existing Relationship with Parents, Youth Strategies, Supportive Behaviors, and Unsupportive Behaviors. The resulting model, Dynamic Model of Parental Support for Transgender Latinx Youth, illustrates the impact of cultural factors, external factors, and the existing parent-child relationship on youth’s strategies, parental behaviors, and felt sense of support. In this model, parental support is a dynamic process, as well as a snapshot in time, with fluctuations in parent and youth behaviors modifying youth’s feelings of support at a given point in time. This study advances research in parental support with unique contributions in terms of Latinx cultural factors, nuanced understanding of parental support, and dynamic interactions between parent and youth, as all of which is captured in the Dynamic Model of Parental Support for Transgender Latinx Youth. Limitations are addressed in terms of trustworthiness and transferability of results. Implications for practice, research, and parenting are discussed.

The COVID-19 pandemic magnified long-standing disparities among multiply minoritized communities and marked a historic rise in widespread awareness of systemic injustice, especially in the context of the Black Lives Matter social movement. The current dissertation explored the role of this awareness, via critical consciousness, among Latinx Sexual and Gender Minority (SGM) individuals during the COVID-19 pandemic. Data were analyzed using Latent Profile Analysis (LPA) to identify “profiles” or groups of participants with similar endorsement of critical consciousness variables. Further, covariates regarding economic distress during the pandemic and everyday discrimination further specified the nature of each profile. To gain additional insight into the mental health consequences of group membership, profiles were then compared to identify differences in depression, anxiety, alcohol use, and drug use. Results indicated support for a three-profile model, consisting of Blissfully Ignorant, Aware Inactivist, and Engaged Activist. Further, significant differences in mental health outcomes were observed among the profiles. Participants in the Aware Inactivist and Engaged Activist profiles endorsed higher rates of depression and anxiety compared to the Blissfully Ignorant profile. Additionally, the Engaged Activists self-reported significantly higher alcohol and drug use compared to the other two profiles. This study differentiated awareness of injustice from participation in activism, highlighting the complexities of critical consciousness and activism for multiply marginalized communities. Further reflections on main findings and implications for future research are discussed.

The purpose of the current study was to evaluate the feasibility and acceptability (F&A) of an online Mindfulness-Based Cognitive Therapy (MBCT) intervention for same-sex attracted men with a range of bullying experiences. The intervention was closely modeled after the original 8-week MBCT protocol developed by Segal, Williams, and Teasdale (2013). The sample consisted of men who identified as gay or same-sex attracted, between the ages of 19 and 61, who resided in the United States. Due to high dropout rates, we were unable to complete the original goal of assessing the efficacy of the intervention. The F&A study utilized a follow-up survey designed to evaluate factors leading to high attrition in the efficacy study. Out of the 80 participants who completed at least the pretests in the efficacy study, 41 participants completed the F&A survey. The F&A study utilized descriptive, multinomial logistic regression, and chi-square test of independence quantitative analyses. Qualitative content analysis (Crowe, Inder, & Porter, 2015) was also used to evaluate positive and negative experiences of the training. Analyses were conducted to determine the relationship between various demographic characteristics and retention rates. Age, socioeconomic status, bullying status, and internalized homonegativity status did not appear to be related to retention rates. While ethnicity did not appear to be statistically associated with retention rates, a large effect size suggested that participants of color may have been more likely to drop out of the study compared to White participants. Findings from the F&A study showed that monetary compensation and session length might have served as barriers to completing the 8-week training. That is, there is evidence that increased pay and decreased session length and overall number of sessions may have led to higher retention rates. Data revealed that the most unfavorable aspects of the efficacy study were related to training content (e.g., training was perceived as boring or lacking value). There was also evidence to show that some participants had difficulty with training logistics (e.g., not being able to view videos or the efficacy sessions not being optimized for mobile technology). Overall, this study shows promising support for engaging in F&A research to inform the effective design and implementation of mindfulness and other wellness-based trainings, particularly for same-sex attracted men. Future research efforts should aim to inform the development and evaluation of efficacy studies, which can yield adequate retention rates.