Understanding Sleep Health among Supra-binary Adolescents: Findings from a Nationally Representative Sample

• In Event: Understanding the Developmental Context of Sleep Health among Sexual and Gender Minority Youth

Abstract

Suprabinary youth, or youth whose gender identities are outside of existing binaries (e.g., non-binary, gender fluid, gender queer or agender identities), reflect a growing subsection of gender minority youth (Chew et al., 2020). Research has begun to establish that suprabinary youth differ from binary transgender populations in terms of their health outcomes in ways that necessitate a focus on this population (Scandurra et al., 2019). More broadly, a much larger literature suggests poorer health outcomes in general (Chew et al., 2020), and sleep health in particular, among gender minority youth, compared to their cisgender peers (Gavidia et al., 2022; Herschner et al., 2021). A gap remains in the literature, however, in terms of understanding if sleep health disparities are observed among suprabinary youth compared to their binary peers. In understanding health disparities between gender minority and cisgender youth more broadly, previous research documents several developmentally-informed factors that vary between gender minority and cisgender youth. Focusing on peer victimization, parent support, teacher support, friend support, and patterns of technology use may help us understand variation in sleep health (Alanko & Lund, 2020; Hatchel et al., 2018; Martin-Storey et al., 2020; Martin-Storey et al., 2022).
Objectives: The goals of the current study were to examine if (1) suprabinary youth were significantly different than their peers who identified as boys or girls in terms of difficulty falling asleep, average number of hours of sleep on a weekday and feelings of restedness after sleep, and (2) these associations remained significant accounting for peer victimization, family support, teacher support, friend support, and pre-bed cell-phone and computer/tablet use.
Method: Data from the Canadian version of the Health Behavior in School-Aged Children was used to assess sleep health across gender identity. Focusing on adolescents ages 13-17 (N = 14,542, 1.7% suprabinary youth, 47.6% boys, 50.7% girls), a nationally representative sample of youth reported on their sleep health, as well as on peer victimization, family, friend and parent support, pre-bedtime cell-phone and computer/tablet use, as well as control variables (age, family affluence, depressive symptoms, race/ethnicity).
Results: Accounting for age, family affluence, depressive symptoms and race/ethnicity, suprabinary youth reported fewer weekday hours of sleep, more difficulties falling asleep, and were less likely to report waking up feeling fresh and rested compared to their binary peers, as assessed using path analyses in Mplus (see Table 1). Except for weekday sleep hours, these associations were all significantly accounted for when the risk and protective factors were included in the path analyses. In particular, significant indirect effects between suprabinary identities and sleep outcomes for all three models were observed for peer victimization, family support and teacher support, and were observed via computer/tablet use before bed for difficulty falling asleep.
Discussion: These findings from a large, nationally-representative sample suggest that suprabinary youth may be experiencing poorer sleep health than their binary peers. These cross-sectional analyses suggest that many of the developmental factors associated with variation in functioning among gender minority youth more broadly (i.e., social support and peer victimization) are linked to sleep health among suprabinary youth in particular.

Authors

• Alexa Martin-Storey, Universite de Sherbrooke
  Presenting Author

• Kyla Mayne, Queen's University

• Melanie A Dirks, McGill University

• Wendy Craig, Queen’s University