Homophobia is a societal process that marginalizes non-heteronormative identities through attitudes, behaviors, and institutional norms. In digital spaces, these dynamics appear as online homophobia, including homophobic cyberbullying. While prior research has examined cultural aspects of homophobia, fewer studies have explored how adolescents perceive its presence online. This study presents findings from 17 focus groups involving 95 adolescents (Mage = 17.9, SD = 1.3; 77.8% girls, 21.1% boys) conducted in Northern Italy. Participants reflected on online homophobic behavior and the factors that sustain it. Thematic analysis revealed two overarching themes: (1) the influence of cultural and social norms, and (2) personal beliefs and attitudes. Subthemes included the role of family and religion, peer conformity, social validation, gendered expectations, and reliance on stereotypes. Adolescents described online homophobia not only as an extension of offline prejudice, but also as a way to signal belonging or avoid marginalization. Participants also discussed emotional motives such as fear, insecurity, and frustration as key drivers behind online homophobic behavior. These findings point to the need for educational and policy interventions that address the normalization of homophobic language, foster critical digital literacy, and promote online spaces that support gender and sexual diversity.

Studies show bias-based bullying and harassment compromise health for youth with minoritized identities, and heavy/regular use of cannabis has implications for adolescent brain development. We examined how regular cannabis use varied by experiences of bullying based on sexual orientation, gender identity, and expression (SOGIE) or race and ethnicity, and social positions. Data came from 8th, 9th, and 11th graders completing the 2022 Minnesota Student Survey (N = 82,933). Students reported past 30 day cannabis use (3–5 times or more versus fewer/none), social positions (i.e., sexual, gender, racial, and ethnic identities, grade, access to resources), and race- and SOGIE-based bullying in the past 30 days (any versus none). Exhaustive Chi-square automatic interaction detection identified combinations of five social positions and bias-based bullying associated with the highest prevalences of regular cannabis use for each grade. Results indicated that across grades, cannabis use was 50–68 % lower among youth in social positions with the highest prevalence of frequent cannabis use when they were not the targets of bias-based bullying compared to youth with the same social positions who were targets of bias. For example, 18 % of 8th graders who had low access to resources; identified as American Indian, Alaska Native, or multiracial; and who experienced SOGIE-based bullying engaged in regular cannabis use, compared to 6.8 % prevalence for youth with the same identities who did not report bias-based bullying. Future research that examines bias-based bullying as a potential mechanism in adolescent cannabis use is warranted, particularly among youth with multiple minoritized identities.

Background: Asian American sexual and gender diverse youth experience bias-based stressors rooted in stereotypes and forms of oppression, which can contribute to coping behaviors like alcohol use. Few studies examine lifetime alcohol use with a focus on understanding heterogeneity within Asian American adolescents. Methods: The analytic sample included Asian American youth in 9th through 12th grade (N = 86,799) who completed the 2017-2019 California Healthy Kids Survey, a statewide, school-based survey. Exhaustive Chi-square automatic interaction detection was conducted using SPSS. Variables included exposure to sexual orientation and gender identity-based (SOGI) and race-based bullying and different social identities (ethnic, sexual, and gender identities and sex assigned at birth). Results: Past-year SOGI-based bullying was reported by 11.2% of students and race-based bullying was reported by 18.8% of students. 19.6% of students indicated lifetime alcohol use, with higher rates among those in older grades (13.1% 9th grade to 31.8% 12th grade). Lowest lifetime alcohol use prevalence were among monoracial Asian American youth who were not the targets of bias-based bullying, while highest lifetime alcohol use rates were among youth identifying as multiracial and/or with a minoritized sexual orientation and experiencing bias-based bullying. Conclusions: Findings suggest bias-based victimization may lead youth to cope or attempt to fit in through alcohol use. Bisexual and multiracial youth, who are often marginalized from monoracial and monosexual communities also had high lifetime alcohol use prevalence. Future research should identify intersectionality-informed strategies to address the nuanced bias-based bullying experiences of Asian American sexual and gender diverse youth, particularly in school settings.

Background: Teen dating violence (TDV) and exposure to intimate partner violence (eIPV) are associated with poorer mental health; however, few studies investigate verbal TDV or the independent contributions that TDV and eIPV have on mental health. Objective: Examine the prevalence of TDV (verbal, physical, sexual, multiple forms) among youth, associations between TDV and mental health, and how eIPV affects these associations. Participants and setting: A school-based sample of 71,635 9th and 11th grade students (51.5% assigned female, 71.9% White) completed the anonymous 2019 Minnesota Student Survey, providing data on mental/emotional/behavioral (MEB) problems and treatment, depression and anxiety symptoms, non-suicidal self-injury, suicidal ideation/attempts, TDV, and eIPV. Methods: Chi-square tests were used to compare the prevalence of mental health concerns by TDV form; logistic regression models controlled for demographic characteristics and eIPV. Interaction tests identified the multiplicative effects of eIPV and TDV on mental health. Results: TDV was reported by 36.4% of those with vs 13.6% of those without eIPV. Each type of TDV was significantly associated with adverse mental health (p's<0.001), even after adjusting for demographic variables and eIPV. The prevalence of each mental health outcome was significantly increased by eIPV for youth with no TDV (p's<0.001), verbal only (p's<0.001), sexual only (p's<0.05), and multiple forms of TDV (p's<0.001); findings for physical TDV varied. Conclusions: Education on healthy, consensual dating relationships is critical, alongside regular screening for eIPV and TDV, referring affected youth for treatment. Further research on factors that attenuate the association between TDV and mental health is warranted.

OBJECTIVES: To apply an intersectional lens to disparities in emotional distress among youth, including multiple social positions and experiences with bias-based bullying. METHODS: Data are from the 2019 Minnesota Student Survey (n 5 80 456). Social positions (race and ethnicity, sexual orientation, gender) and 2 forms of bias-based bullying (racist, ho-mophobic or transphobic) were entered into decision tree models for depression, anxiety, self-injury, suicidal ideation, and suicide attempts. Groups with the highest prevalence are described. Rates of emotional distress among youth with matching social positions but no bias-based bullying are described for comparison. RESULTS: LGBQ identities (90%) and transgender, gender diverse, and questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently ; racial and ethnic identities rarely emerged. Bias-based bullying characterized 82% of the highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20% to 60% lower (average 38.8%). CONCLUSIONS: Findings highlight bias-based bullying as an important point for the intervention and mitigation of mental health disparities, particularly among lesbian, gay, bisexual, transgen-der, gender-diverse, queer, and questioning adolescents. Results point to the importance of addressing bias-based bullying in schools and supporting lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning students at the systemic level as a way of preventing emotional distress. WHAT'S KNOWN ON THIS SUBJECT: Several studies have identified disparities in emotional distress among youth across social positions, but are limited by inclusion of only 2 social positions (eg, sexual orientation and race), use of regression models, and sample sizes that necessitated combining groups. WHAT THIS STUDY ADDS: LGBQ identities (90%) and transgender/gender-diverse/questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently; bias-based bullying characterized 82% of highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20%-60% lower.

In Reply In response to our article, 1 Apana et al emphasized the importance of data analysis that disaggregates Asian Ameri-can and Native Hawaiian and Pacific Islander populations. Our study used public health data sets from Minnesota and Cali-fornia and included racial and ethnic identities, along with other social identities and experiences, which are often collapsed , disguising differences between and among subgroups. Apana et al rightly noted that our approach still resulted in invisibilizing Native Hawaiian and Pacific Islander adolescents, who were effectively combined with Asian Ameri-can youth in prevalence estimates. We have therefore reexamined variables from our study comparing Native Hawaiian and Pacific Islander vs non-Native Hawaiian and Pacific Islander Asian American students. In Minnesota, 540 of 6954 students (7.8%) self-identified as Native Hawaiian and Pacific Islander, and the additional 92.2% selected Asian (potentially in combination with other racial or ethnic groups except for Native Hawaiian and Pacific Islander). In California, 8111 of 67 338 (12.0%) self-identified as Native Hawaiian and Pacific Islander. In Minne-sota, 2.5% of Native Hawaiian and Pacific Islander students identified as transgender, genderqueer, or genderfluid vs 1.5% of non-Native Hawaiian and Pacific Islander Asian American students. Native Hawaiian and Pacific Islander students self-reported a bisexual identity (9.9%) or a sexual orientation not listed (4.2%) at higher rates than non-Native Hawaiian and Pacific Islander Asian American students (6.7% and 2.3%, respectively). In California, Native Hawaiian and Pacific Islander students reported identifying as gay or lesbian (2.1%) and bisexual (6.3%) at higher rates than non-Native Hawai-ian and Pacific Islander Asian American peers (1.7% and 5.2%, respectively). Native Hawaiian and Pacific Islander adolescents also reported approximately 1.5 to 2 times the rates of gender-(11.5% vs 6.3% in Minnesota and 8.1% vs 5.7% in Cali-fornia) and sexual orientation-based bullying (11% vs 5.9% in Minnesota and 8.8% vs 5.8% in California) than non-Native Hawaiian and Pacific Islander Asian American adolescents and had higher rates of elevated depressive symptoms (31.0% vs 24.7% in Minnesota and 38.4% vs 31.8% in California). We concur with Apana et al's place-based research advo-cacy. History and context are important. Native Hawaiian and Pacific Islander individuals do not share the same cultural heritage as Asian American individuals, 2 and Native Hawaiian and Pacific Islander communities have histories with militariza-tion of the land and violent attempts of colonization and assimilation affecting long-term health outcomes. 3 As Apana et al noted, Indigenous Native Hawaiian and Pacific Islander cultures also uphold expansive conceptualizations of gender and sexuality, which may account for the higher self-reported sexual and gender identities above. 4 Further, this long-standing cultural stance likely contributed to Hawaii's legislative protections. For example, Hawaii has policies prohibiting bullying due to gender identity and expression and sexual orientation in educational settings. 5 The importance of this context and assessing how such policies are associated with health outcomes cannot be understated. We also think valuable information can come from assessing health outcomes of Native Hawaiian and Pacific Islander adolescents with multiple marginalized social identities in additional locations where such protections may or may not be in place, and with the reality that migration has increased for various reasons. Future research may benefit from examining results from Hawaii, the US Affiliated Pacific Islands, and other locations, which could support expansion and scaffolding of policies such as those in Hawaii. We appreciate and value Apana et al's advocacy and agree with the importance of inclusion with regard to data equity and research partnerships. Our team has secured funding to extend this work, include more Native Hawaiian and Pacific Islander people on our research team and youth advisory board, and strengthen and expand community partnerships with transparency and intention.

Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-eco...

Objective: Limited research incorporates an intersectional approach when evaluating disordered eating behaviors among those holding minoritized social positions, such as lesbian, gay, bisexual, queer, questioning, and/or transgender/gender diverse (LGBTQ) adolescents. The current study assessed stigma experiences from peers at school, self-esteem, LGBTQ pride, and overlapping social positions as they relate to disordered eating behaviors among LGBTQ adolescents. Method: Participants included 11,083 adolescents (Mage = 15.6, SD = 1.3; 34.8% transgender/gender diverse) from a large national survey study of LGBTQ adolescents from 2017. Exhaustive Chi-square Automatic Interaction Detection analysis was used to identify bias-based bullying experiences (i.e., weight-based, identity-based), self-esteem, LGBTQ pride, and overlapping social positions (i.e., gender identity, sexual identity, race/ethnicity, body mass index (BMI) percentile) associated with the highest prevalence of unhealthy weight control behaviors, extreme unhealthy weight control behaviors, and past year binge eating. Results: Adolescents in the 28 identified groups with a high prevalence of disordered eating behavior held at least one structurally marginalized social position (e.g., high BMI), bias-based bullying experience, low self-esteem, or low LGBTQ pride in addition to being LGBTQ. Weight-based bullying was a salient risk-factor for disordered eating across social positions. Among adolescents with the same social positions, levels of self-esteem, LGBTQ pride, but no bias-based bullying experience, prevalence estimates of disordered eating were, on average, 23% lower. Discussion: LGBTQ adolescents with multiple marginalized social positions and related factors engage in disproportionately high prevalence disordered eating. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents. Public significance: Multiply marginalized LGBTQ adolescents, most of whom also reported experiencing bias-based bullying from peers at school, reported disproportionately high prevalence disordered eating. In comparison groups of adolescents with no bias-based bullying experience, prevalence of disordered eating was, on average, 24% lower. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents.

<p> Via a school-based survey, we used a developmental assets framework to investigate associations of internal and social characteristics and weight-based bullying with sport and physical activity (PA) among female adolescents with high weight status ( <italic>n</italic>  = 4,468; <italic>M</italic> _age  = 14.9 years, <italic>SD</italic> _age  = 1.3; body mass index ≥ 95th percentile). Participants reported ≥60 min of PA on approximately 3.0 days ( <italic>SD</italic>  = 2.1) in the previous week. Over one-third played organized team sports, averaging 3.5 days ( <italic>SD</italic>  = 1.5) per week. Weight-based bullying was common (46%) and unassociated with lower sport and PA. Results from <italic>t</italic> -tests and chi-squared tests demonstrated that adolescents who played sport (vs. those who did not) had higher internal developmental assets, better perceived health, and stronger perceptions of caring from parents, friends, and other community adults. Similarly, adolescents engaging in more PA reported higher developmental assets. In regression models adjusted for all variables and demographic characteristics, higher internal developmental assets, better perceived health, and stronger perceptions of caring from adults in the community were positively and significantly associated with increased odds of sport participation and higher PA. Findings suggest female adolescents with high weight status have internal and social assets related to their participation in PA and sport, despite experiencing weight-based bullying. Adults (e.g., coaches, parents, and healthcare professionals) should help female adolescents with high weight status participate in sport and PA and build developmental assets. Adults should also recognize the frequent weight-based bullying youth encounter and strive to mitigate it in sport and PA contexts. </p>

Purpose: Latine transgender/gender diverse (TGD) adolescents may be at increased risk of emotional distress due to structural oppression affecting their intersecting nondominant identities. Multipl...