(Withdrawn) Psychological, Family Support, and Minority Stressors Among Sexual and Gender Minority Emerging Adults Who Use Tobacco Products in California

Background and purpose

Evidence in the literature suggests that Asian American adolescent and young adults experience a higher prevalence of psychological distress than that of any other racial/ethnic populations in the United States. Meanwhile, those who identify as a sexual and gender minority further share a higher burden of mental illness, due to the experiences of violence victimization and discrimination, lack of social and family support, and other minority identities. Yet, the associations between mental distress, minority stressors, and social support are not well established. Therefore, this study aims to describe the prevalence of psychological distress among a sample of Asian American sexual and gender minority adolescent and young adults (SGMAYA) and explore its relationship with family support and experiences of victimization and discrimination.

Methods

We analyzed data from a larger study understanding the disparities in tobacco product use among SGM emerging adults in California. Recruitment occurred between 2020 and 2021 through both online and in-person strategies. Psychological distress was assessed using the K-6 scale and family support was assessed by the Multi-Dimensional Support Scale. We also measured felt stigma, experiences of everyday discrimination. Pearson’s correlations were calculated to examine the bivariate relationships between scores of K-6, family support, and experiences of discrimination and other study variables. multivariable linear regression was conducted to determine the predictors of K-6 score. For this analysis, we only included individuals who identified as Asian American and reported as cig-gender sexual minority men/women or transgender and gender nonconforming (TGNC).

Results

Of all (n=155) participants identified as Asian American SGMAYA, the average age of was 22.1 (SD=2.7), 40.6% were cis-gender sexual minority women and 36.1% were TGNC. The K-6 score suggested that 54.9% were screened positive for severe mental illness (K-6 >13). Asian American TGNC and cig-gender sexual minority women were significantly more likely to be screened for severe mental illness than cig-gender sexual minority men (62.5% and 58.7% vs. 33.3%). In bivariable analyses, higher K-6 score was associated with higher levels of felt stigma and experienced discrimination (b=0.46 and b=0.22, p<0.01 for both) and lower levels of family support (b=-0.38, p<0.001). In the multivariable model adjusting for sociodemographic characteristics, a higher level of family support was a protective factor for psychological distress (adjusted b=-0.34, p<0.001) and experiences of discrimination was a significant risk factor (adjusted b=0.21, p<0.001).

Conclusions and implications

High percentage of Asian American SGMAYA in California screened for psychological distress. Our results illustrated the negative impact of experiencing stigma and discrimination on mental health well-being among a minoritized population. These findings highlight the importance of providing trauma-informed approached with standard mental health services. Programs and interventions to promote the mental health outcomes among this population could potentially aim to improve sources of family support. Future research should also focus on elucidating the extent of unmet needs for mental health care among Asian American SGMAYA, especially among sexual and gender minority women and transgender and gender nonconforming individuals. Innovative approaches and interventions are needed to provide psychological support to this population.