Minority Stress and Sleep Quality among Gender Minority Adolescents

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

Abstract

Introduction
Poor sleep quality is related to a wide variety of biological, psychological, and physical health issues. Gender minority adolescents have been shown to have especially prominent sleep issues (Levenson et al., 2021). This could be one reason for health disparities seen in this population. Some research has suggested that minority stress (stressors due to societal stigma and discrimination of minoritized identities) could be one factor in explaining these sleep disparities (Butler et al., 2020; Kolp et al., 2020). However, little is known about the particular stressors most related to sleep issues and whether there are differences between gender minority adolescents of diverse gender identities. We hypothesized that greater levels of minority stress would be associated with greater levels of sleep issues among gender minority adolescents.

Methods
These analyses come from a larger study of LGBTQ+ adolescents’ health in the US (N = 17,112; ages 13-17). For this presentation, we focus on the gender minorities in the sample (n = 5,637, Mage = 15.4 years). We conducted an ANOVA to test differences between four gender identity groups: binary trans boys, binary trans girls, nonbinary youth assigned female at birth (AFAB), and nonbinary youth assigned male at birth (AMAB). To understand the association between minority stress and sleep, we conducted a regression predicting sleep problems with the following independent variables: LGBTQ-related victimization; LGBTQ-related family rejection; bullying based on gender, sexuality, and gender expression; misgendering; freedom of gender expression; freedom to use correct restrooms; and family connectedness. We controlled for age, race/ethnicity, gender identity, and whether they slept at home with their parents or somewhere else.

Results
We found significant differences among the gender identity groups, F(3, 425.3) = 15.62, p < .001. Post hoc tests revealed that trans boys and nonbinary AFAB people had the worst sleep issues compared to trans girls and nonbinary AMAB people, p’s < .001. The regression model significantly predicted sleep issues, R squared = .183, F(21, 3412) = 36.37, p < .001. Significant associations included LGBTQ-related victimization, LGBTQ-related family rejection, bullying based on sexuality, bullying based on gender expression, freedom to use correct restrooms (negative association), and family connectedness (negative association). Of these, family connectedness and LGBTQ-related victimization were the most strongly associated.

Discussion
We confirmed our hypothesis that minority stress would be related to worse sleep issues, and specifically we found that family connectedness and LGBTQ-related victimization were the most strongly related to sleep. We also found differences amongst gender minorities, with trans boys and nonbinary AFAB youth having the worst sleep issues. These results suggest that policy and clinical interventions that target families and victimization may be particularly beneficial for the health of gender minority youth. They also provide paths for future research on both biological and social influences on sleep quality amongst minoritized individuals.

Authors

• Will Beischel, Université de Sherbrooke
  Presenting Author

• Ryan J Watson, University of Connecticut

• Jean-Pascal Lemelin, Université de Sherbrooke