BACKGROUND Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (β = 0.15, p < .001), stress (β = 0.15, p = .001), eating as a coping strategy (β = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.

INTRODUCTION Nurses and physicians receive minimal training about providing competent care to transgender and gender-diverse (TGD) patients, and training specific to TGD youth is particularly lacking. This qualitative study examined health care providers’ experiences and attitudes about working with TGD youth to identify specific training needs. METHOD Semistructured interviews were conducted with 14 nurses and physicians who work with adolescents. Thematic analysis was used to characterize participants’ responses. RESULTS Five themes summarized participants’ responses to interview questions: Training Regarding Gender Diversity, Discomfort With Gender-Related Topics, Reasons for Not Asking About Gender, Talking About Gender With Patients, and Need for Resources. DISCUSSION Findings highlight multiple opportunities to improve provider education and care experiences of TGD youth. Specific training is needed to help providers manage discomfort with gender-related topics and simultaneously develop their knowledge of and skills for discussing gender issues.

Young peoples’ acceptance and use of nontraditional, descriptive identity labels (e.g., pansexual, genderqueer) require nurses to consider moving beyond use of traditional terms (e.g., gay, transgender). This mixed methods study explores (a) labels used by sexual orientation and gender identity (SOGI) minority youth, (b) their expressed importance and meaning of these labels, and (c) differences in label usage. Sixty-six SOGI minority adolescents in British Columbia, Minnesota, and Massachusetts (mean age = 16.6) participated in “go-along” interviews; during interviews, 42 (63.6%) commented on labels. Chi-square and t tests were used to compare traditional versus nontraditional labels across participant demographic categories. Inductive thematic analysis was used to identify representative themes. Approximately, 1/3 of participants used nontraditional sexual orientation identity labels; this finding was associated with a trans identity and nontraditional gender labels. Using terminology that is meaningful...

RATIONALE Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences. OBJECTIVE The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma. METHODS Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma. RESULTS Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p = .08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p = .005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.

Previous research has identified significant sexual orientation disparities in obesity. Contextual factors, like lack of anti-discrimination policies and gay-straight alliances, have been shown to be associated with health outcomes like poor mental health and substance use for lesbian, gay, and bisexual (LGB) individuals moreso than their heterosexual counterparts; however, little work to date has explored the role of contextual factors on sexual orientation disparities in obesity. Individual-level, serial cross-sectional data from the 2009-2013 College Student Health Survey, which includes 2- and 4-year college students (n = 29,118) attending 46 Minnesota colleges, were used. College-level data on LGB context were primarily collected through college websites. Multinomial logistic regression models were fit to examine associations between LGB college climate scores (including non-discrimination policies, presence of LGB or diversity-related student groups, LGB courses offered, LGB housing accommodations, and prevalence of LGB students) and students' weight status (underweight, healthy weight, overweight, and obese), based on self-reported height and weight. Higher LGB climate scores (i.e., more supportive environments) were associated with lower risk of overweight and obesity among all students. Sexual orientation-stratified findings among female students suggested that the association between LGB climate scores and weight status was similar to the overall female sample. Sexual orientation-stratified findings among male students showed a more complex relationship between LGB climate scores and weight status. More work is needed to disentangle the observed associations, and to investigate other contextual factors, like state- and city-level policies, social networks and norms, and individual resiliency within these contexts to better understand the contextual influences on sexual orientation disparities in obesity.

<p>Research on enacted stigma, or stigma- and bias-based victimization, including bullying and harassment, among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth often focuses on one context (e.g., school) or one form (e.g., bullying or microaggressions), which limits our understanding of these experiences. We conducted qualitative go-along interviews with 66 LGBTQ adolescents (14–19 years) in urban, suburban, town, and rural locations in the United States and Canada identified through purposive and snowball sampling. Forty-six participants (70%) described at least one instance of enacted stigma. Three primary themes emerged: (1) enacted stigma occurred in many contexts; (2) enacted stigma restricted movement; and (3) second-hand accounts of enacted stigma shaped perceptions of safety. Efforts to improve well-being among LGBTQ youth must address the diverse forms and contexts of enacted stigma that youth experience, which limit freedom of movement and potential access to opportunities that encourage positive youth development. School nurses can play a critical role in reducing enacted stigma in schools and in collaboration with community partners.</p>

<p>Body dissatisfaction is common in adolescence and associated with negative outcomes (e.g., eating disorders). We identified common individual trajectories of body dissatisfaction from midadolescence to adulthood and predictors of divergent patterns. Participants were 1,455 individuals from four waves of Project EAT (Eating and Activity in Teens and Young Adults), a population-based, 15-year longitudinal study. Aggregate body dissatisfaction increased over 15 years, which was largely attributable to increases in weight. Growth mixture modeling identified four common patterns of body dissatisfaction, revealing nearly 95% of individuals experienced relatively stable body dissatisfaction from adolescence through adulthood. Baseline depression, self-esteem, parental communication/caring, peer dieting, and weight-based teasing predicted differing trajectories. Body dissatisfaction appears largely stable from midadolescence onward. There may be a critical period for body image development during childhood/early adolescence. Clinicians should intervene with clients experiencing body dissatisfaction before it becomes chronic and target depression, self-esteem, parent/child connectedness, and responses to teasing and peer dieting.</p>

This paper examines the prevalence of homelessness among transgender/gender diverse (TGD) youth in a population-based sample of adolescents. We used data from a statewide sample of 9th and 11th grade adolescents in Minnesota who responded to a school-based survey during 2016 (N = 80,929). Survey questions assessed adolescents' gender identity and experiences of homelessness (either with adult family members or unaccompanied) in the past 12 months. We used chi-square analyses to compare the prevalence of homelessness between gender identity groups. Overall, 2.7% of the sample reported identifying as TGD. Significantly more TGD (vs. cisgender) youth reported experiencing homelessness either with adult family members (6.7% vs. 3.5%) or unaccompanied (3.6% vs. 1.1%; p < .0001). Findings from this population-based survey suggest that TGD youth are more likely to experience homelessness, either with a family member or unaccompanied, than cisgender peers. Ensuring housing stability among this population is critical, given health risks associated with homelessness during adolescence. Data on homelessness experiences of TGD youth are needed to inform practice and policies for this distinct population.

Background: Even before the onset of age-related diseases, obesity might be a contributing factor to the cumulative burden of oxidative stress and chronic inflammation throughout the life course. Obesity may therefore contribute to accelerated shortening of telomeres. Consequently, obese persons are more likely to have shorter telomeres, but the association between body mass index (BMI) and leukocyte telomere length (TL) might differ across the life span and between ethnicities and sexes. Objective: A collaborative cross-sectionalmeta-analysis of observational studies was conducted to investigate the associations between BMI and TL across the life span. Design: Eighty-seven distinct study samples were included in the meta-analysis capturing data from 146,114 individuals. Studyspecific age- and sex-adjusted regression coefficients were combined by using a random-effects model in which absolute [base pairs (bp)] and relative telomere to single-copy gene ratio (T/S ratio) TLs were regressed against BMI. Stratified analysis was performed by 3 age categories ("young": 18-60 y; "middle": 61-75 y; and "old": >75 y), sex, and ethnicity. Results: Each unit increase in BMI corresponded to a-3.99 bp (95% CI: -5.17, -2.81 bp) difference in TL in the total pooled sample; among young adults, each unit increase in BMI corresponded to a -7.67 bp (95% CI:-10.03,-5.31 bp) difference. Each unit increase in BMI corresponded to a -1.58 × 10-3 unit T/S ratio (0.16% decrease; 95% CI: -2.14 × 10-3, -1.01 × 10-3) difference in ageand sex-adjusted relative TL in the total pooled sample; among young adults, each unit increase in BMI corresponded to a -2.58 × 10-3 unit T/S ratio (0.26% decrease; 95% CI: -3.92 × 10-3, -1.25 × 10-3). The associations were predominantly for the white pooled population. No sex differences were observed. Conclusions: A higher BMI is associated with shorter telomeres, especially in younger individuals. The presently observed difference is not negligible. Meta-analyses of longitudinal studies evaluating change in body weight alongside change in TL arewarranted.

In this study, we examine how lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, who tend to experience greater feelings of isolation and discrimination than heterosexual youth, find and become integrated into supportive activities and resources. As part of a larger study on supportive lesbian, gay, bisexual, transgender, and queer youth environments, 66 go-along interviews with LGBTQ youth, from Massachusetts, Minnesota, and British Columbia were conducted. Analysis of these interviews identified important cues that prompt self-agency and integration into supportive environments and affirmative identities. In particular, we argue indirect links or cues such as media and print advertisements increase awareness of supports and resources, while personal links, such as referrals from trusted friends, adults, and regularly attended programs, can help youth form denser networks of support.

Abstract Purpose: As measures of birth-assigned sex, gender identity, and perceived gender presentation are increasingly included in large-scale research studies, data analysis approaches incorporating such measures are needed. Large samples capable of demonstrating variation within the transgender and gender diverse (TGD) community can inform intervention efforts to improve health equity. A population-based sample of TGD youth was used to examine associations between perceived gender presentation, bullying victimization, and emotional distress using two data analysis approaches. Methods: Secondary data analysis of the Minnesota Student Survey included 2168 9th and 11th graders who identified as “transgender, genderqueer, genderfluid, or unsure about their gender identity.” Youth reported their biological sex, how others perceived their gender presentation, experiences of four forms of bullying victimization, and four measures of emotional distress. Logistic regression and multifactor analysis of variance...