Classroom to Clinic: An investigation of experiences of social support in high school and health risk behavior among transgender young adults living in the Southern U.S. Open Access

Abstract

Transgender young adults engage in more risky health behaviors compared to their cisgender peers. The Minority Stress Model posits that minoritized populations, such as trans young adults, endure excess stress, which translates to poor health behaviors and outcomes. The current study applies this model to investigate if experiences of social support in high school impact health risk behavior among trans young adults living in the Southern United States. Approximately 40% of trans adults live in the South and face a great amount of anti-trans policies. Trans participants ages 18-25 were sampled from the LGBTQ+ 2021 Southern Survey. IBM SPSS Statistics was used to run crosstabs and binary logistic regressions to examine associations between social support experiences in high school and health risk behavior in young adulthood, adjusting for racial identity and type of high school attended. Trans young adults were found to be more likely to have had an HIV test in the last year if there was a Gay-Straight Alliance (GSA) at their high school (aOR=5.33), if they felt that their teachers and faculty supported LGBTQ+ students (aOR=2.90), and if they felt that their teachers and faculty were supportive of GSAs (aOR=3.46). Trans young adults were found to be more likely to use marijuana if they were denied access to appropriate bathrooms in high school (aOR=2.25) and less likely to use marijuana if they were the target of rumors in high school (aOR=0.48). Strengths of this study include the use of recently collected data, age stratification, and its individuality of potentially being the only study on these variables. Limitations include the limited sample size, lack of a diverse sample, and lack of specificity in the measures. The results of this study prompt public health action through the support of high school GSAs and training of teachers and faculty to support trans students. Future research on social support and health risk behavior among the trans population may benefit from expanding the scope of risk behaviors and by continuing to explore the Southern United States context.

Table of Contents

INTRODUCTION………………………………………………………………………….…….1

Problem Statement……………………………………………………………………….…...2

Significance of the Study………………………………………………………….………….3

Overview of Southern Context & Theoretical Framework…………………….……...4

LITERATURE REVIEW……………………………………………………………….………..5

Risky Health Behaviors in Trans Young Adults…………………………….……………5

Teacher, Faculty and Peer Support of Trans High School Students…….………..…7

Gender-Sexuality Alliances in High School………………………………….………..…8

Discrimination in High School…………………………………………………….……..…9

Southern United States Context…………………………………………..…………...…10

Theoretical Framework: Minority Stress Model………………….………………….…11

METHODOLOGY………………………………………………………………………......…13

Data Collection, Sampling, and Participants…………………………………...………13

Demographic Variables……………………………………………………..………….……15

Social Support Variables…………………………………………………………..….……..15

Risky Health Behavior Variables…………………………………………….………..……16

Control Variables…………………………………………………………………….….…….18

Data Analysis…………………………………………………………………………..……....19

Positionality Statement………………………………………………..………………….…19

RESULTS………………………………………………………………………....…………..…20

Participant Characteristics……………………………………………….……………..….21

Bivariate Analyses………………………………………………………………………….…21

Multivariable Analyses……………………………………………………………..……….22

DISCUSSION……………………………………………………………………………….…..23

Strengths and Limitations……………………………………………………….………….25

Implications and Future Research……………………………………………………...…26

Conclusions…………………………………………………………………………….....……27

REFERENCES……………………………………………………………………………...…..29

TABLES………………………………………………………………………..…………………41

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Aging
Keyword	Substance Use Minority Stress Model HIV Test Uptake Transgender Social Support in High School COVID-19 Vaccine Uptake LGBTQ+ Health High School Student and Peer Support Transgender Health Promotion Southern United States LGBTQ Institute 2021 Southern Survey High School Teacher and Faculty Support Transgender Young Adult Health Risk Behavior LGBTQ+ Quantitative Methods Gender-Sexuality Alliance
Committee Chair / Thesis Advisor	Don Operario, Emory University
Committee Members	Robin McGee, Emory University

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