The purpose of this review was to examine socioecological risk factors for substance use among sexually and gender diverse (SGD) Latine youth and young adults (YYA). We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided search in PubMed, PsycInfo, Web of Science, and MEDLINE on July 16, 2025. Inclusion criteria were the following: (1) peer-reviewed journal article published on or after January 2014; (2) sample aged between 10 and 29 years old; (3) intersectional analysis of Latine and SGD subsample; (4) analysis for associative or predictive properties of individual-level, interpersonal-level, and/or structural-level risk factors with substance use. Studies that failed to meet all criteria were excluded. The quality of articles was assessed using the Appraisal tool for Cross-Sectional Studies and the Quality of Reporting of Observational Longitudinal Research tool. Twelve studies were included in the final synthesis, the majority being cross-sectional studies (9, 75%) with youth/adolescent samples (8, 67%). Outcomes from reviewed studies indicated that depression and psychological distress were associated with substance use among SGD Latine YYA. In addition, victimization, discrimination, and absence of social support contributed to substance use among SGD Latine YYA. Outcomes from reviewed studies prompt targeted consideration of individual-level mental health and interpersonal-level discrimination and support as it relates to substance use prevention and intervention among SGD Latine YYA. Future research should explore the intersecting cultural influences of being Latine and SGD on substance use and access to mental health and social support resources among SGD Latine YYA.

Purpose: This study examined receipt of a well-woman visit (WWV) and cervical cancer screening (CCS) at the intersection of sexual orientation and race/ethnicity among Illinois women aged 21-65. Methods: This study used 2016, 2018, and 2020 Illinois Behavioral Risk Factor Surveillance System (BRFSS) data for women aged 21-65 to examine rates of CCS (n = 2848) and 2016-2018, 2020, and 2021 Illinois BRFSS data to examine WWV receipt (n = 5863) by sexual orientation (heterosexual vs. lesbian, gay, and bisexual [LGB]). Self-reported race/ethnicity was tested as an effect modifier to assess intersectionality. Using binomial regression, adjusted prevalence differences (aPD) and 95% confidence intervals (CIs) were estimated. Covariates included age, education, marital status, employment, and health insurance coverage. Results: Overall, 4.6% of Illinois women aged 21-65 self-identified as LGB. Heterosexual and LGB women had a similar prevalence of receipt of both a WWV (77.1% and 71.7%, respectively; aPD = 3.22, 95% CI: -3.62 to 10.06) and CCS (85.3% and 83.4%, respectively; aPD = 2.13, 95% CI: -4.77 to 9.04). Among non-Hispanic (NH) Black women, heterosexual compared with LGB women had a higher prevalence of receiving both types of care; however, adjusted associations included the null. Hispanic women had similar prevalence estimates by sexual orientation for both outcomes, and NH White heterosexual compared with LGB women had a higher prevalence of CCS, but not WWV. Conclusion: In Illinois overall, heterosexual and LGB women received preventive care at similar rates. However, when stratified by race/ethnicity, WWV and CCS receipt rates may be higher for heterosexual compared with LGB women, indicating potential missed opportunities for preventive care.

The purpose was to investigate differences in polycystic ovary syndrome (PCOS) prevalence by sexual orientation among young adults in the United States. We used data from the Growing Up Today Study, a longitudinal cohort of young adults (age 23-35 in 2019). Participants assigned female at birth (N = 11,148) reported PCOS diagnoses on questionnaires between 2010 and 2019. We used modified-Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for PCOS diagnoses, comparing completely heterosexual participants (referent) to sexual minority participants (i.e., heterosexual with same-sex partnership, mostly heterosexual, bisexual, and lesbian). We also assessed whether health care utilization modified the association between sexual orientation and PCOS diagnosis. Models were adjusted for age and race/ethnicity. The overall prevalence of PCOS in the sample was 8.1%. Compared to completely heterosexual participants, sexual minority participants had a higher adjusted prevalence of PCOS diagnosis (PR: 1.28, 95% CI: 1.12-1.46). Within sexual minority subgroups, mostly heterosexual (PR: 1.24, 95% CI: 1.06-1.45), bisexual (PR: 1.69, 95% CI: 1.29-2.22), and lesbian (PR: 1.50, 95% CI: 1.04-2.16) participants had an elevated prevalence of PCOS compared to completely heterosexual participants. Differences in PCOS diagnosis persisted within strata of time since the last routine physical exam. These findings provide some of the first estimates of PCOS among sexual minority people, emphasizing the need to address differences in reproductive health among sexual minority young adults. They also reveal that health care utilization increases the likelihood of receiving a diagnosis and highlight the importance of health care access.

Purpose: Recognizing the necessity of supportive health care systems, we used strengths-based approaches to explore the potential protective nature of social support against health care barriers among sexually and gender diverse (SGD) young adults. Methods: Using data spanning May 2018 to July 2022 from the National Institutes of Health's All of Us Research Program, we created a sample of and produced descriptive estimates for 2417 SGD young adults between 20 and 35 years of age. Using logistic regressions, we calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to measure the association between two outcomes-delaying health care and reported discrimination in medical settings-and instrumental/emotional social support. We adjusted for age, gender identity, race and ethnicity, housing stability, and income. Results: Of our sample, 70.8% endorsed at least one reason for delaying care, and 45.0% reported discrimination in medical settings "rarely" or more frequently, with significant differences by gender identity, sexual orientation, race and ethnicity, housing stability, income, and education for both outcomes. More social support was associated with fewer reasons for delaying health care (instrumental: aOR = 0.78, 95% CI 0.71-0.86; emotional: aOR = 0.71, 95% CI 0.63-0.79) and fewer reports of discrimination in medical settings (instrumental: aOR = 0.72, 95% CI 0.66-0.78; emotional: aOR = 0.64, 95% CI 0.58-0.70). Conclusion: Our results suggest that social support might serve as a protective factor against health care barriers for SGD young adults. More strengths-based research is needed to understand intersectionality in SGD health care.

Purpose: This study explored the relation between intersectional cyberbullying (racism and cis heterosexism) and alcohol use as a coping strategy among sexual and gender minority (SGM) Latinx youth and assessed the psychological impact of these experiences and protective factors such as online safety and parental acceptance. Methods: Focusing on SGM Latinx youth (N = 1145) from the 2022 LGBTQ National Teen Survey collected within the United States, we explored the effects of intersectional cyberbullying (predictor; adapted version of the Bullying and Victimization Scale) on coping strategies involving alcohol use (outcome; Drinking Motive Questionnaire Revised Short Form) and psychological distress (mediator; Patient Health Questionnaire) and its interaction with online safety and parental acceptance (moderators; LGBTQ Parents Support Scale) using a mediation and a moderated mediation analyses (Hayes Models 4 and 21). Results: Intersectional cyberbullying was associated with alcohol use to cope, and psychological distress mediated this relation. Furthermore, both online safety and parental acceptance were significant moderators in this mediated relation, where higher levels of either moderator were associated with lower psychological distress or use of alcohol as a coping strategy. Conclusions: Our findings present key clinical and public health implications for SGM Latinx youth experiencing virtual forms of oppression.

Purpose: The Social Media and Sexual Health (SMASH) campaign, a multi-component study, aimed to address disparities in pre-exposure prophylaxis (PrEP) use among young Black and Latino men, ages 18-29, who have sex with men (YBLMSM) by using social media influencers and short videos to promote awareness and uptake. To inform the campaign's content and strategy, we conducted focus groups to explore YBLMSM's social media behaviors and perceptions of social influencers as PrEP messengers, including preferences for content, messaging, length, selection of appropriate influencers, and delivery methods that resonated with the target audience, and aligned with the SMASH campaign's goals. Methods: Between January and March 2021, we conducted five virtual focus groups with 22 YBLMSM to identify their preferred social media platforms, how they engage with social media, and their views on the potential of influencers to be effective PrEP messengers. Focus groups were audio-recorded, transcribed, and analyzed using template analysis. Results: Instagram was the most frequently used platform, considered a "jack-of-all-trades," while Facebook was viewed as outdated, and TikTok as catering to a younger audience. Participants emphasized several key factors for effective messaging: (1) authenticity, (2) lived experience, (3) targeted marketing versus broad reach, (4) sex positivity, and (5) balance of humor with seriousness. Conclusions: These findings shaped the casting and content creation for the SMASH campaign, providing valuable guidance for health promotion initiatives aimed at engaging YBLMSM with PrEP through social media.

Purpose: The current study examined relations among racial discrimination (RD), depression/suicidality, substance use, and school connectedness among Black youth who identified as lesbian, gay, bisexual, some other way, or not sure (LGBQ) and heterosexual youth. Methods: Data were obtained from the Adolescent Behaviors and Experiences Survey (ABES) conducted by the Centers for Disease Control and Prevention during January-June 2021. ABES was a one-time, online survey given to a nationally representative sample of U.S. high school students. Data for the current study included 1189 Black 9th-12th graders (50.0% female and 18.8% LGBQ). Measures included self-reports of depression/suicidality during the past year, substance use in the past 30 days, current feelings of school connectedness, RD in school across the lifespan, and sexual identity. Structural equation modeling was utilized to examine study aims. Results: Black LGBQ youth reported higher levels of RD, depression/suicidality, and substance use but lower school connectedness compared with heterosexual Black youth. RD was positively associated with depression/suicidality (b = 0.876, standard error = 0.197, p < 0.001) but not with substance use (p = 0.366). Sexual identity and school connectedness did not moderate the relationships between RD and depression/suicidality or RD and substance use. Conclusion: RD's positive association with depression/suicidality and lack of association with substance use was similar for Black heterosexual and LGBQ youth. Future research should expand on the role of intersectionality with other identity groups and protective factors for school-based RD experiences. Educators should explore interventions beyond only school connectedness for reducing school-based RD for Black youth.

Purpose: The purpose of this study was to examine differences in mental health outcomes of two groups within youth experiencing homelessness (YEH) and who have a substance use disorder (SUD): sexual minority (SM) and heterosexual females. Methods: This study used baseline data from four randomized clinical trials of substance use interventions for YEH with a SUD to examine differences in depression and suicidality between SM and heterosexual female youth. Participants were between 12 and 24 years of age. Meta-analytic methods were used to aggregate data across studies to estimate differences in mental health. Results: Results indicated that female SM-YEH had higher depression symptoms (Hedge's g [g]=0.20; 95% confidence interval [CI] 0.01-0.39), higher risk of a history of suicide behavior (risk ratio = 1.63; 95% CI: 1.17-2.27), and a greater number of suicide behaviors (g = 0.31; 95% CI: 0.09-0.54) compared to their heterosexual peers. These effect sizes were not moderated by age. Conclusion: Female SM-YEH had elevated levels of depression and suicidality compared to their heterosexual peers. The findings of this study align with research on mental health disparities between SM and heterosexual youth generally, which underscores the unique struggles and risks associated with identifying as a female SM-YEH with a SUD.

Purpose: Toward the goal of developing standardized sex, sexual orientation, and gender identity (SSOGI) measures that can be used across demographics and regions, this review aimed to synthesize and summarize how SSOGI have been assessed within health research, including the quality and validity of these measures. Methods: We conducted a systematic review of peer-reviewed research developing or evaluating SSOGI measures in PubMed, PsycInfo, CINAHL, and Health and Psychosocial Instruments bibliographic databases. Eligible studies reported original peer-reviewed research focused on SSOGI measurement in adult populations in the United States from 2012 through June 7, 2022. In consultation with librarians, search results were screened for inclusion using an innovative multiple-phase method of stratification, supervised clustering, and supervised machine learning. We conducted manual screening and data extraction in Covidence. Results: In total, 17,814 citations were returned from all databases, with 30 studies eligible for final inclusion in the review. Gender identity measurement was the focus of half of the included studies (51%), followed by sexual orientation (40%), with little asexuality-specific measurement research (n = 1 study), and beyond sexual orientation, research on sex or variations in sexual characteristics (n = 1 study, each). Conclusions: Although the field of sexual and gender minority health research has grown exponentially over the past decade, there remains a dearth of literature focused on the development and evaluation of SSOGI measures. We found heterogeneity across the SSOGI measurement literature including by study design, sampling strategy, and study population. Important identified gaps include the need for attention to the measurement of sex, variations in sex characteristics, and asexuality-inclusive sexual orientation measures.

Purpose: Sexually and racially minoritized people often have mistrust toward the healthcare system due to both perceived and actual experiences of discrimination. This may result in increased privacy concerns and a reluctance to share health-related information with health care providers. Drawing upon minority stress and an intersectionality framework, this study examines how rates of concealing health information differ between non-Hispanic White heterosexual people, non-Hispanic White lesbian, gay, and bisexual (LGB) people, racially minoritized heterosexual people, and those who are both sexually and racially minoritized. Methods: Using nationally representative cross-sectional data from the Health Information National Trends Survey from 2017 and 2018 (n = 4575), we fit logistic regression models to examine (1) whether sexually and racially minoritized people conceal health information from their providers more than their counterparts and (2) whether this tendency increases for those with multiple marginalized identities. Furthermore, we fit linear regression models to examine whether and how concealing health information from providers are linked to health outcomes. Results: Sexually and racially minoritized people had higher odds of concealing health information from providers than their counterparts. Those with multiple marginalized identities had even higher odds of withholding health information than other groups. Finally, we found a significant negative association between concealing health information and mental health. Conclusion: Our findings underscore the need to consider how the intersection of multiple marginalized identities shape health experiences and concerns over privacy in health care matters. We call for further research to better understand the complex dynamics of patient-provider relationships for marginalized populations.