Heteronormativity, school climates, and perceived safety for gender nonconforming peers

Students' perceptions of their school climates are associated with psychosocial and academic adjustment. The present study examined the role of school strategies to promote safety in predicting students' perceptions of safety for gender nonconforming peers among 1415 students in 28 high schools. Using multilevel modeling techniques, we examined student- and school-level effects on students' perceptions of safety for gender nonconforming peers. We found that older students, bisexual youth, Latino youth, and youth who experienced school violence perceived their gender nonconforming male peers to be less safe. Similarly, we found that older students and students who experienced school violence and harassment due to gender nonconformity perceived their gender nonconforming female peers to be less safe. At the school-level, we found that when schools included lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues in the curriculum and had a Gay-Straight Alliance, students perceived their schools as safer for gender nonconforming male peers.     

Disordered Eating and Gender Identity Disorder: A Qualitative Study

The association between disordered eating and gender identity was examined in a sample of 20 (11 female-to-male, 9 male-to-female) transgender Finnish adults, aged 21–62 years. Using semi-structured interviews, participants' own understanding of the underlying causes of their disordered eating was analyzed, as well as the effect of gender reassignment on eating behaviors and cognitions. A majority of the participants reported current or past disordered eating. Participants most frequently described strive for thinness as an attempt to suppress features of one's biological gender, or accentuate features of one's desired gender. Gender reassignment was primarily perceived as alleviating symptoms of disordered eating.     

Disordered eating and gender identity disorder: a qualitative study

The association between disordered eating and gender identity was examined in a sample of 20 (11 female-to-male, 9 male-to-female) transgender Finnish adults, aged 21-62 years. Using semi-structured interviews, participants' own understanding of the underlying causes of their disordered eating was analyzed, as well as the effect of gender reassignment on eating behaviors and cognitions. A majority of the participants reported current or past disordered eating. Participants most frequently described strive for thinness as an attempt to suppress features of one's biological gender, or accentuate features of one's desired gender. Gender reassignment was primarily perceived as alleviating symptoms of disordered eating.     

Gender differences in delayed-type hypersensitivity response: Effects of stress and coping in first-year law students

Law students show significant deficits in emotional and physical well-being compared with groups of students in other areas of higher education. Furthermore, evidence suggests that these effects may be worse for women than for men. The use of active coping can positively affect immunity under stress, but this may be most true for men in the context of law school. The current study examined the delayed-type hypersensitivity (DTH) skin responses of first-year law students (n = 121) and a comparison group (n = 30). Students’ health behaviors, self-evaluative emotions, and coping strategies were also reported. Male law students had larger DTH responses than females, but this gender effect was not present in the comparison group. Endorsement of perseverance under stress (n = 19), an active coping strategy, moderated the gender effect on immunity. Perseverance associated with larger DTH responses and more positive self-evaluative emotion, but only among men. These results indicate that active coping may be less efficacious for women than for men in law school, which in turn may limit women’s opportunities to attenuate negative effects of law school.     

Impact of a modest delay in school start time in Hong Kong school adolescents

ObjectiveTo examine the effects of a modest delay (15 min) in school start time (SST) on adolescent sleep patterns, mood, and behaviors.MethodsTwo secondary schools in Hong Kong with a total of 1173 students (intervention: n = 617; comparison school n = 556) completed both baseline and follow-up questionnaires. School start time was delayed by 15 min, from 7:45 a.m. to 8:00 a.m., in the intervention school. The comparison school maintained their regular SST at 7:55 a.m. Students' sleep-wake patterns, daytime sleepiness, and mental and behavioral aspects were assessed by validated questionnaires before and after the intervention.ResultsStudents in the intervention school significantly delayed their weekday wake-up time (p < 0.001) and increased their total time in bed (p < 0.001) when compared to students in the comparison school. Both groups experienced a delay in their weekday bedtime. The students in the intervention school showed improved mental health [General Health Questionnaire (GHQ) score, p = 0.015], better prosocial behaviors (p = 0.009), better peer relationships (p < 0.001), greater attentiveness (p < 0.001), less emotional problems (p = 0.002), and less behavioral difficulties (p < 0.001) as measured by Strengths and Difficulties Questionnaire (SDQ).ConclusionsA modest delay (15 min) in school start time can increase adolescent sleep with corresponding improvement in mood and behaviors. Current findings have significant implications for education policy, suggesting that school administrators and policy makers should systematically consider delaying school start time to promote sleep and health among school-aged adolescents.Clinical trial registrationChiCTR-TRC-12002798. The trial protocol can be accessed at: http://www.chictr.org/en/proj/show.aspx?proj=3955.     

Effect of Screen Time on Physical and Mental Health and Eating Habits During COVID-19 Lockdown in Lebanon

Objective This study aimed to explore whether screen time and the screen type impacted various health aspects of children, including physical activity (PA), sleep quality, and eating habits. Additionally, we investigated whether children’s eating behavior while using electronic devices affects their physical and mental health. Methods We conducted an online survey asking for screen use (duration, type, and purpose), PA, eating habits, sleep problems, and level of depression. The participants were children between the ages of 3 and 7 years, and the survey was answered by the participants’ parents from March 3 to March 20, 2021. Results A screen time of ≥2 h in children was associated with various clinical characteristics, such as body mass index (BMI), sleep problems, depression, decreased PA, and unusual eating habits. Children’s food eating behavior while using electronic devices was predicted by a total screen time ≥2 h, smartphone screen time ≥2 h, sleep problems, owning electronic devices, and eating unhealthy food. Conclusion There was an interplay among children’s PAs, eating behaviors, depression, sleep problems, and screen time in this pandemic era. Therefore, guiding children on the correct use of electronic devices and helping them eat healthy are paramount during this COVID-19 pandemic.     

Into the pressure cooker: Student stress in college preparatory high schools

PurposeThe goals of this study were to (1) measure psychological, physiological, and behavioral indicators of stress, (2) assess the relationship between stress and student attitudes, and (3) explore coping behaviors in response to stress, among a sample of students in two academically high-achieving environments.MethodThree hundred thirty-three students in grades 9 through 12 from two college-preparatory high schools completed a cross-sectional online survey that included the Students' Life Satisfaction Scale, School Attitude Assessment Questionnaire-Revised, and assessments for stress-related indicators, including eating, sleeping and exercise, and strategies they utilized for coping with stress.ResultsStudents reported a high prevalence of physical and psychological correlates of stress, and related unhealthy behaviors such as widespread and chronic sleep deprivation and rushed meals.ConclusionsThe results suggest areas to focus attention for identifying and addressing maladaptive responses to stress among high-achieving student populations.     

Adolescents and sexual risk-taking: The interplay of constraining relationship beliefs,healthy sex attitudes,and romantic attachment insecurity

IntroductionAlthough sexual exploration during adolescence may be perceived as normative, many adolescents who are sexually active are likely to engage in risky sexual behaviors detrimental to their well-being. The present study examined the influence of insecure attachment (anxious and avoidant dimensions), healthy sex attitudes, and constraining relationship beliefs on the following sexual risk indicators: age at first sex, number of sexual partners, condom use, length of time knowing sexual partners, seriousness of relationship, and frequency of sex.MethodsCross-sectional data from two cohorts recruited one year apart for a five-year project were analyzed. Adolescents were public high school students from a Southern state in the USA (cohort 1: N = 878, 51.1% females, M = 16.50 years old; cohort 2: N = 759, 46.9% females, M = 15.78 years old).ResultsAcross both cohorts, healthy sex attitudes were related to having sex for the first time at an older age, having less sexual partners in a lifetime, and knowing one's sexual partner longer. High scores on the avoidant attachment dimension were related to less commitment to the relationship. This dimension also was related to holding lower scores on healthy sex attitudes, which in turn was related to having more sexual partners and knowing one's sexual partner for a shorter time. Although not replicated, higher endorsement of constraining relationship beliefs was associated with inconsistent condom use and greater sex frequency.ConclusionFindings suggests that attachment insecurity, healthy sex attitudes, and constraining relationship beliefs work together to influence adolescent sexual risks.     

Les comorbidités psychiatriques dans le transsexualisme : étude sur une population de transgenres libanais

IntroductionThe question of whether gender dysphoria is associated with psychiatric comorbidity has been addressed in several studies. Several cohort studies have shown that psychiatric comorbidity is one of the main features of poor prognosis following sex change therapy. Gender dysphoria is rare, with an estimated prevalence of 0.001% to 0.002% globally. The literature shows a high prevalence of psychiatric comorbidities in people with gender dysphoria, and that they are more common in male to female transsexuals. Data on long-term mortality show that transsexuals present a 51 % increase in mortality compared to the general population. This is mainly attributed to a six-fold increase in the number of suicides and a higher rate of psychiatric disorders and risky behaviors leading to HIV infection and substance abuse.PurposeAssess psychiatric comorbidity in a population of Lebanese transgender individuals and compare it to the general population. The hypothesis of our study is that the Lebanese transgenders suffer from more psychiatric comorbidities than the general population. Our second objective was to determine the specific mental health needs of this population in order to adapt our services to their medical needs and their specific concerns.MethodsOur objective was to acquire 20 transgender participants and 20 control subjects. We chose a snowball sampling method. The evaluation consisted of three questionnaires including a general demographic questionnaire, the MINI 5.0.0 Arabic version for axis I disorders and the SCID-II for axis II disorders.ResultsThe mean age of both groups was 23.55 years. Fifty-five percent (n = 11) transgender participants had active suicidal thoughts against 0 % in controls. Within the group of transgender, 45 % (n = 9) had a major depressive episode, 5 % (n = 1) had a generalized anxiety disorder, 5 % (n = 1) had a posttraumatic stress disorder and 10 % (n = 2) had a major depressive episode with comorbid posttraumatic stress disorder. We noted a significant difference between the two groups regarding the presence of suicidal ideation (P = 0.000) and the presence of axis I disorders (P = 0.039).DiscussionIn our study, we noted demographic and economic characteristics specific to the population of transgender individuals. We found a significant difference in the level of education, economic status and household composition. Transgender individuals suffer from more psychiatric pathologies compared to the general population. This may be due to social and familial discrimination and ostracism. These results demonstrate the vulnerability of this population. An awareness program for mental health professionals is essential in order to adapt care to the specific needs of this population. A list of non “transphobic” mental health professionals should be established.     

Orthorexia Nervosa in Turkish dietitians and dietetic students

ObjectivesOrthorexia Nervosa (ON) is characterized by a pathological obsession with healthy eating, and dietetic majors may have a potential risk of developing ON due to their occupation that necessitates consideration of optimal food choices. This study aimed to determine the prevalence of ON among a large sample of dietitians and dietetic students in Turkey and to investigate the association of ON with socio-demographic features and eating attitudes within the whole sample.MethodsParticipants (n = 1429) completed a self-administered online survey that featured socio-demographic characteristics, the Orthorexia Nervosa Questionnaire (ORTO-11), and the Eating Attitudes Test-26 (EAT-26). Scores on the ORTO-11 and EAT-26 determined the prevalence of ON and disordered eating behaviors, respectively.ResultsThe prevalence of ON among Turkish dietetic majors was 59.8% with a higher ratio in dietetic students (63.8%) than dietitians (52.9%) (P < 0.001). While graduation was associated with 33.1% lower odds of ON (P = 0.006), eating disorders could increase the ON risk approximately five times (P < 0.001). Furthermore, the greater total and subscale (dieting, bulimia, and oral control) scores of EAT-26 were associated with higher ON tendency (P < 0.001), even after adjustment for potential confounders.ConclusionsOur findings may shed light on the relevance of developing strategies to reduce the prevalence of ON in the dietetic population but need to be supported by further longitudinal and prospective studies.     

Eating Disorders and Disordered Weight and Shape Control Behaviors in Sexual Minority Populations

Purpose of Review

This review summarized trends and key findings from empirical studies conducted between 2011 and 2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations.

Recent Findings

Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males.

Summary

Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There is still a lack of eating disorder treatment and prevention studies for sexual minorities.

     

Breast and Chest Size Satisfaction: Relation to Overall Body Image and Self-Esteem

Abstract

Multiple ratings of breast and chest size preferences were assessed in 68 male and 120 female undergraduates and related to overall levels of appearance satisfaction, body image anxiety, and general self-esteem. Discrepancies between personal ideals, perceived ideals of the opposite sex, and current size ratings were differentially related, by gender, to other disturbance measures. For all analyses, the direction of associations was clear, indicating that among men chest discrepancies (indicative of dissatisfaction) were positively associated with body image disturbance and low self-esteem: among women, breast discrepancies were not related to these measures. The findings strongly support emerging research suggesting that the chest area is a site of dissatisfaction for men. The results are discussed in relation to possible cultural reasons for the gender differences found in this investigation as well as potential links between dissatisfaction with upper torso and unhealthy eating behaviors.     

Prospective relationships between stigma,mental health,and resilience in a multi-city cohort of transgender and nonbinary individuals in the United States, 2016–2019

Purpose

Gender-based stigma is a fundamental cause of mental health disparities among transgender and non-binary (TGNB) individuals, while resilience factors may be protective. We examined prospective relationships between gender-based enacted stigma, psychological distress, and resilience factors among TGNB individuals.

Methods

Between 2016 and 2017, we enrolled 330 TGNB individuals in three metropolitan areas in the U.S. in a prospective cohort study focused on gender identity development, risk, and resilience across the lifespan. Using multilevel regression, we examined prospective associations between enacted gender-based stigma and psychological distress (measured by the Global Severity Index/BSI-18), and examined transgender pride and social support as moderators, adjusting for age, sex assigned at birth, race/ethnicity, education, and income.

Results

Our sample was diverse in age (M = 34.4, range 16–87) and race/ethnicity (56.4% non-White). Over 2 years of follow-up, there was a decrease in reported gender-based stigma (b = − 0.61, p < 0.001) and transgender pride (b = − 0.14, p = 0.003), increase in social support (b = 0.21, p < 0.001), and no change in psychological distress. In adjusted analyses, gender-based stigma was positively associated with psychological distress (b = 1.10, p < 0.001) and social support was negatively associated with psychological distress (b = − 2.60, p < 0.001). Transgender pride moderated the relationship between stigma and psychological distress (p < 0.01), such that the association was stronger for lower levels of transgender pride.

Conclusions

Our study provides longitudinal evidence for the deleterious role of gender-based stigma among TGNB individuals. Future interventions should consider fostering transgender pride and social support to promote mental health and mitigate negative effects of gender-based stigma.

     

Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment

We studied current (GIDYQ-A) and recalled (RCGI) childhood gender identity among 719 upper secondary school students 401 girls, mean age 17.0 (SD = 0.88) years old and 318 boys, mean age 17.2 (SD = 0.86 years old in Finland. We also compared these dimensions of identity in community youth to same dimensions among adolescent sex reassignment (SR) applicants. Most community youth scored high on the normative, cis-gender end of gender experience (median score 4.9 for boys and 4.9 for girls) and recalled fairly gender typical childhood behaviours and experiences. The girls displayed more gender non-conformity in childhood. Among the boys 2.2% and among the girls 0.5% displayed potentially clinically significant gender dysphoria on the GIDYQ-A. The community youth differed clearly from adolescent SR applicants on current and recalled childhood gender identity (SR applicants were 47, 6 natal boys and 41 natal girls, average ages were 16.4 years old (SD = 0.93) and girls were on average 16.8 years old (SD = 1.0).     

The importance of teacher support: Differential impacts by gender and sexuality

Teachers play an important role in shaping the experiences of high school students with regard to patterns of heteronormativity and binary gender norms, particularly for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students. A climate survey of high school students (n = 953) in the United States examined the association between students' well-being and their relationships with teachers. The sample was majority white (65.8%) and multiracial (14.1%). Cisgender (cis)-girls (49.6%), cis-boys (41.2%), and trans students (9.2%), as well as heterosexual (78.4%) and LGBQ students (21.6%) were represented. Regression models indicate teachers' use of oppressive language and their intervention in situations of bias and students' trust and comfort with teachers were significantly associated with students' self-esteem. Teachers' use of biased language was directly associated with student self-reported grades. Moderation tests indicate teacher relationships are strongly associated with heterosexual and cisgender students' wellbeing. Recommendations for teacher education and future research are discussed.     

Gender differences in food choice: The contribution of health beliefs and dieting

Background: Gender differences in health behaviors have been reported in many studies but causal mechanisms have been neglected.Purpose and Methods: This study examines 4 food choice behaviors in a large sample of young adults from 23 countries and tests 2 possible explanatory mechanisms for the gender differences—women’s greater likelihood of dieting and women’s greater beliefs in the importance of healthy diets.Results: Women were more likely than men to report avoiding high-fat foods, eating fruit and fiber, and limiting salt (to a lesser extent) in almost all of the 23 countries. They were also more likely to be dieting and attached greater importance to healthy eating. Dieting status explained around 22% of the gender difference in fat choices, 23% of fiber choices, and 7% of fruit, but none of the gender difference in salt. Health beliefs explained around 40% of the differences in each of the dietary behaviors and together they explained almost 50%. Gender differences in food choices therefore appear to be partly attributable to women’s greater weight control involvement and partly to their stronger belifs in healthy eating.Conclusions: Further research is needed to understand the additional factors that could promote men’s participation in simple healthy eating practices. This research was supported by Cancer Research UK.     

Autism spectrum disorder among first-visit depressed adult patients: diagnostic clues from backgrounds and past history

ObjectiveThe present study aimed to extract discriminating indicators for diagnosis of autism spectrum disorder (ASD) from personal backgrounds and past history among depressed adult outpatients.MethodsSubjects were 430 depressed adults, consisting of patients with ASD (n= 70) and those without ASD (n= 360). Group comparison and discriminant analysis was conducted with regard to backgrounds (age, gender, education, marriage, living alone, physical diseases and family history of mood disorders) and past history (school non-attendance, bullied experience, psychotic-like experiences, conduct problems, suicide-related behaviors and interpersonal friction).ResultsSix discriminating indicators (interpersonal friction, bullied experience, psychotic-like experiences, age under 32 years, school non-attendance and university educational level) were identified by stepwise discriminant analysis (P< .001). Absence of the first 4 indicators almost excluded ASD diagnosis with the highest negative predictive value (98%) and the least negative likelihood ratio (0.11) whereas one or more out of these 4 indicators showed low positive predictive value (32%) despite high sensitivity (93%).ConclusionsThe abovementioned 4 indicators may be useful clues to cover possible ASD subjects among depressed adults although further detailed ASD focused diagnostic procedure is absolutely necessary to specify true ASD subjects. Meanwhile, absence of these 4 indicators is probably helpful to rule out ASD diagnosis.     

Physical activity during the segmented school day in adolescents with and without autism spectrum disorders

The purpose of this study was to assess the intensity of physical activity (PA) that secondary school-aged students with autism spectrum disorders (ASD) and typically developing (TD) students exert during a school day, and to compare the percentages of students achieving the recommended guidelines between groups. The PA of 60 male students (ASD, n = 30; TD, n = 30) was recorded every 10 s for up to 5 school days by performing uniaxial accelerometry. The main results are listed as follows: (a) daily PA was significantly lower among the students with ASD than among the TD students; (b) students with ASD spent significantly lower proportion of their time in moderate PA than TD students did during physical education (PE), recess, and lunchtime; and (c) fewer students with ASD than TD students achieved the PA guidelines during the school day and PE time. Schools should increase PA opportunities across the school day.     

La théorie interpersonnelle du suicide. Présentation et application dans la compréhension des idées suicidaires chez l’étudiant en médecine : étude dans un groupe de 178 étudiants

ObjectivesThe current paper presents firstly the Interpersonal Psychological Theory of Suicide (IPTS) and its interest in the risk of suicide in physicians and/or medical students and secondly an original study on 178 medical students.MethodsIn total, 178 medical students of the Université Libre de Bruxelles filled out an ad hoc questionnaire rating suicidal ideations (life-time), recent suicidal plans and recent suicidal ideations rated by the 9th item of the Beck Depression Inventory-II (BDI). The subjects completed the French version of the Interpersonal Needs Questionnaire (INQ) rating Perceived burdensomeness and Thwarted belongingness and the Acquired Capability for Suicide Scale (ACSS) as well as the Beck Depression Inventory-II (BDI-II). Among the 178 medical students, 95 had no suicide risk, 24 had life-time suicidal ideation, 28 had recent suicidal ideations and 26 had recent suicidal plans. The four groups were compared for gender and age as well as for the different rating scales using Chi² tests or analyses of variance (ANOVA).ResultsThe four groups had no significant differences for age, gender and scores on the ACSS. ANOVA revealed significant differences for perceived burdensomeness, thwarted belongingness and depression. To control the potential effect of depression, analyses of covariance (ANCOVA) were done taking as covariate a subscale of the BDI-II rating the cognitive component of depression. The two ANCOVA were significant. Post hoc tests comparing two by two the different groups reported that students with recent suicidal ideations or suicidal plans have significantly higher thwarted belongingness than students without suicide risk or students with life time suicidal ideations. Moreover, higher level of perceived burdensomeness was found only in students with suicidal plans comparatively with the three other groups.ConclusionHigh levels of thwarted belongingness and perceived burdensomeness characterize medical students with recent suicidal ideations or suicidal plans independently of the level of depression.