Exploring Health Inequities among Marginalized Youth Populations Using Innovative Visual Qualitative Methods

Significant health inequities have been documented among marginalized youth populations, particularly among gender minority (e.g. trans, genderqueer, non-binary) and homeless youth. Stressors related to social exclusion, stigma, and discrimination have been shown to contribute to higher risk factors for adverse health outcomes among both populations; however, these populations may not benefit from research and innovative public health interventions to the same extent as other youth populations. There is a critical need for research that explores the risk and protective factors for health disparities among marginalized youth populations in order to inform the development of interventions to promote their health and well-being. This dissertation uses innovative qualitative visual methods to explore stressors related to social exclusion among both marginalized youth populations – gender minority adolescents and formerly homeless transitional aged youth – as well as the psychosocial resources that they use to manage those stressors./nThe dissertation is composed of three separate papers: The data presented in the first two papers are drawn from the author’s independent research study of minority stress and psychosocial resources among trans, genderqueer and non-binary adolescents in New York City and the SF Bay Area. This study used a combination of “lifeline” interviews and “photo elicitation” interviews. The first paper focuses on the non-binary participants in the sample – or those who do not identify as solely male or female. The paper explores participants’ experiences of “identity invalidation,” defined as having one’s identity dismissed by others as not real or valid. The study data demonstrate that identity invalidation is a unique from of minority stress for non-binary individuals, with significant implications for their social and emotional well-being. Protective factors and internal resilience strategies were identified, and implications for interventions to reduce identity invalidation and promote better mental health among non-binary adolescents are discussed./nThe second paper examines parental support among trans, genderqueer, and non-binary adolescents. This paper explores participants’ perceptions, meanings, and experiences of their parents’ behaviors across three categories: supportive, rejecting, and mixed behaviors. Overall, participants reported that rejecting behaviors exacerbated their mental health problems and led to adverse psychological and social consequences, while supportive behaviors were related to positive psychological and social consequences. Intervention implications for improving family functioning, reducing rejecting parental behaviors, and supporting trans adolescent mental health and well-being are discussed./nThe data presented in the third paper are drawn from a community based participatory research study conducted in the first permanent supportive housing building designed for formerly homeless transitional aged youth in San Francisco. This study used “PhotoVoice” to explore the interconnections between structural violence and food insecurity in participants' lives. Participants reported several forms of structural violence that constrain their ability to access adequate and healthy food. Participant adaptations and coping responses to food insecurity are explored, as well as participant- and policy-driven solutions for reducing food insecurity within their community.

Advisor: Deardorff, Julianna