Research shows that although lesbian, gay, and bisexual (LGB) youth have poorer mental and physical health outcomes compared to their heterosexual peers, school-connectedness and supportive and caring relationships with their families have a positive impact on their health. However, little is known about how health outcomes differ for LGB youth of various ethnocultural backgrounds, or how sexual orientation might affect relationships between parents and children from different ethnocultural groups. To address this gap, we will be analyzing data from the BC Adolescent Health Survey to: (1) identify differences in health outcomes and trends between heterosexual and LGB youth from Indigenous, East Asian, and South Asian ethnocultural backgrounds; and (2) document the roles of families and schools in health outcomes within these groups.

Advisory committees (composed of youth, family members, health professionals, teachers, counselors and other community members) are being recruited for each of the ethnocultural groups. These committees will inform our study’s analyses, as well as the resulting knowledge translation materials and activities (e.g., pamphlets, presentations, infographics). Findings will be shared in academic journal articles and community reports, and will inform future culturally-respectful health promotion activities for LGB youth from diverse ethnocultural backgrounds.

This project is the Core of our 7 year Canadian Institutes of Health Foundation Grant, “Improving health equity for LGBTQ youth in Canada and globally: Addressing the role of families and culture”.

Principal Investigator: Dr. Elizabeth Saewyc

Co-Investigators: Dr. Terryann Clark, Dr. Hélène Frohard-Dourlent, Emmanuelle Godeau, Lorraine Grieves, Dr. András Költő, Dr. Jennifer Kryworuchko, Dr. Sheila Marshall, Dan Metzger, Dr. Colleen Poon, Dr. Stephen Russell, Dr. Hilary Rose, Annie Smith, Dr. Jaimie Veale, Dr. Jennifer Wolowic, Dr. Michele Ybarra

Funded by CIHR (Foundation Scheme) under the grant, “Improving health equity for LGBTQ youth in Canada and globally: Addressing the role of families and culture”, 2017-2024

SARAVYC is participating in Project RESPEQT (Research and Education on Supportive and Protective Environments for Queer Teens), an NIH (RO1) funded project to explore Multilevel Protective Factors for LGB youth in North America led by the University of Minnesota. In British Columbia, research members from SARAVYC under the direction of Dr. Elizabeth Saewyc interviewed a total of 20 youth from urban, rural and suburban communities. As part of the interviews, we had youth take us to the places they hang out, services they use, and the places they feel safe. We gathered in-depth information on LGB adolescents’ perceptions of supportive elements in their schools and communities; this information was used in conjunction with published literature and expert review to create an LGBTQ Environment Inventory that characterizes policies, programs, resources and other supports for LGBTQ youth that exist in these settings. The Inventory is now being used to measure indicators of support in 120 communities in British Columbia, Minnesota, and Massachusetts.

A SARAVYC researcher conducting a go-along interview

Findings thus far have been disseminated in academic papers such as “Chasing the rainbow: lesbian, gay, bisexual, transgender and queer youth and pride semiotics“, “Helping Young People Stay Afloat: A Qualitative Study of Community Resources and Supports for LGBTQ Adolescents in the United States and Canada“, and “‘Kicked out’: LGBTQ youths’ bathroom experiences and preferences“.

Principal Investigators: Dr. Marla Eisenberg and Dr. Elizabeth Saewyc (for BC portions)

Co-Investigators: Dr. Elizabeth Saewyc (for US portions), Dr. Heather Corliss, Dr. Richard Sullivan, and Dr. Yuko Homma

Funded under the grant “Multilevel protective factors in the lives of LGB youth in North America” by the U.S. National Institutes of Health, National Institutes for Child and Human Development, 2014-2018

In November 2018 we launched our second Canadian Trans and Non-Binary Youth Health Survey. The first survey, completed in 2013-14 included over 900 responses to our online survey from all provinces and territories except Nunavut and the Yukon. Results from the first found that while Canada’s transgender youth face significant physical and mental health issues, strong connections to family, school and community are helping many of them navigate these challenges. The 2018 survey will allow us to measure changes that have occurred over the last 5 years, as well as identify continuing challenges and changes that need to be made to support trans and non-binary youth.

Take the survey.

Read the report from the first survey here.

Read in French: ÊTRE EN SÉCURITÉ, ÊTRE SOI-MÊME :Résultats de l’enquête canadienne sur la santé des jeunes trans

Principal Investigator: Dr. Elizabeth Saewyc

Co-Investigators: Dr. Terryann Clark, Dr. Hélène Frohard-Dourlent, Emmanuelle Godeau, Lorraine Grieves, Dr. András Költő, Dr. Jennifer Kryworuchko, Dr. Sheila Marshall, Dan Metzger, Dr. Colleen Poon, Dr. Stephen Russell, Dr. Hilary Rose, Annie Smith, Dr. Jaimie Veale, Dr. Jennifer Wolowic, Dr. Michele Ybarra

Funding by CIHR (Foundation Scheme) under the grant “Improving health equity for LGBTQ youth in Canada and globally: Addressing the role of families and culture”, 2017-2024

Growing up with Media is the only national US longitudinal survey of youth designed to study the emergence of sexual violence (SV) perpetration in adolescence. It began in 2006 to examine the long-term linkages between exposure to violent media and the subsequent expression of violent behaviors among 1,600 youth. In 2010, when the youth cohort was 14-17 years of age, the study was re-funded to examine the emergence of sexual violence behavior in adolescence. Preliminary findings suggest that, compared to 9% of heterosexual youth, 33% of sexual minority youth have perpetrated sexual assault, attempted or completed rape, or coercive sex in their lifetime. Similarly, high rates of perpetration are noted for gender minority (49%) versus cisgender youth (11%). This project explores if and how the contextual factors that predict the emergence of SV perpetration are similar and different for sexual and gender minority (SGM) and non-sexual and gender minority youth.

The research objectives of this project are to illuminate how contextual factors that predict the emergence of SV perpetration are similar and different for SGM and non-SGM youth. The research team sought to examine how contextual factors (operationalized as: Sexual and/or gender minority status, general and distal minority stressors, environmental circumstances, and coping and social support) are similar and different predictors of SV for SGM and non-SGM youth. This study will hopefully result in closing the gaps in our understanding of how and why SV perpetration emerges in adolescence for SGM youth – and importantly, what can be done to prevent it.

Principal Investigators: Dr. Michele Ybarra

Co-Investigators: Dr. Kimberly Mitchell, Dr. Hanno Petras, and Dr. Elizabeth Saewyc

Funded by the National Institute of Health under the grant “Course and Prediction of Sexual Perpetration in Adolescence through Young Adulthood”, 2017-2020

Most of the sexual orientation research done on adolescents originates from the US and only a small number of publications come from other countries. For instance, there have been some recent publications from Turkey and Northern Ireland, but very little research published from African countries or the Middle East. The existence of LGBTQ2S communities has sometimes been phrased as a cultural specific phenomenon of the western world- this project aims to determine if that is the case.

The main research objective of this project is to find evidence of global estimates of adolescent sexual minorities. This will be achieved by conducting a systematic review of the available evidence of the estimates of the LGBTQ adolescent population around the world.

Principal Investigator: Dr. Elizabeth Saewyc

Co-Investigators: Dr. Terryann Clark, Dr. Hélène Frohard-Dourlent, Emmanuelle Godeau, Lorraine Grieves, Dr. András Költő, Dr. Jennifer Kryworuchko, Dr. Sheila Marshall, Dan Metzger, Dr. Colleen Poon, Dr. Stephen Russell, Dr. Hilary Rose, Annie Smith, Dr. Jaimie Veale, Dr. Jennifer Wolowic, Dr. Michele Ybarra

Funded by the Canadian Institutes of Health Research (Foundation Scheme) under the grant “Improving health equity for LGBTQ youth in Canada and globally: Addressing the role of families and culture”, 2017-2024

Despite compelling data that lesbian and bisexual women are at risk for sexually transmitted infections (STIs), programs tailored to the unique needs of adolescent lesbian, gay, and bisexual (LGB) women continue to be nonexistent. Perhaps not surprisingly, LGB women’s perceptions of HIV/STI and pregnancy risk is low, even though they report higher rates of sexual behaviors that increase their risk for STIs as compared to non-LGB women. For example, data from Dr. Michelle Ybarra’s national Teen Health and Technology study suggest that 14% of bisexual and 2% of lesbian women 12-18 years of age have had penile-anal sex; 33% of bisexual and 13% of lesbian adolescent women have also had penile-vaginal sex. Compared to 53% of gay male adolescents who use condoms “most of the time,” only 26% of lesbian female adolescents who have had vaginal or anal sex do similarly.

In addition to unprotected vaginal sex, multiple sexual partners and high-risk sexual partners have been noted at greater frequency among lesbian and bisexual adolescents compared to their heterosexual peers. As a result, rates of pregnancy and diagnoses of STIs are higher for LGB adolescent women than heterosexual women. Although this compelling evidence that lesbian and bisexual adolescent women are at risk for teen pregnancy, programs tailored to the unique needs of adolescent LGB women are nonexistent.

To fill this gap, the Center for Innovative Public  Health Research (CiPHR) has asked SARAVYC researchers and others to join them in developing and evaluating Girl2Girl, a novel text messaging-based teen pregnancy prevention program designed specifically for LGB women ages 14-18 years. The 10-week text messaging intervention included: 5 weeks of risk-reduction content (e.g., how to access and use different forms of contraception), followed by a booster module delivered 4 weeks later. To capitalize on technology’s reach, participants are recruited online. If Girl2Girl is effective at promoting teen pregnancy prevention behavior, it will begin filling the void of healthy sexuality programs aimed at reducing pregnancy for LGB adolescent women.

Learn more about CiPHR’s similar HIV prevention  intervention called Guy2Guy.

Principal Investigator: Dr. Michele Ybarra

Co-Investigators: Dr. Elizabeth Saewyc, Dr. Margaret Rosario, and Dr. Carol Goodenow

Funded by the U.S. Office of Adolescent Health under the grant “Girl2Girl: Harnessing text messaging to reduce teen pregnancy among LGB girls”, 2015-2020

FamilySmart Practice Readiness is an innovative program developed by the Institute of Families (IoF) that seeks to improve child and youth mental health by promoting collaborations between doctors, parents, and patients. Two concepts are central to the FamilySmart program: 1) “Together-Centeredness” or the ability of all stakeholders to make decisions collectively, and 2) “FamilySmart skills” or emotion-based skills that can be applied to make decisions more empathetically and taking into account other stakeholders’ points of view. This research project was a developmental evaluation of an innovative program in the field of child and youth mental health.

The FamilySmart Evaluation is a partnership developed between SARAVYC, the McCreary Centre Society, and the Institute of Families. This mixed-methods evaluation partnership aims to assess the pertinence and efficacy of the pilot phase of FamilySmart for this program to be scaled up across the province of British Columbia and eventually across Canada.

The objectives of the FamilySmart Evaluation are:

1. to observe four pilot training sessions
2. to interview training participants prior and after their participation in the training sessions
3. to analyze the observational (quantitative and qualitative) and interview (qualitative) data and produce a community-friendly report outlining the evaluation results
4. to provide recommendations for the improvement of the FamilySmart training program before scale-up.

Principal Investigators: Keli Anderson

Co-Investigators: Dr. Elizabeth Saewyc and Annie Smith

Funded by the Vancouver Foundation under the grant “FamilySmart Networks Evaluation”, 2016-2019

In 2015, SARAVYC joined a team of researchers seeking to increase health knowledge about and improve services for male youth who have experienced sexual violence. The CIHR funded grant, led by Principal Investigator Dr. Christine Wekerle of McMaster University, focuses on Aboriginal youth health (particularly mental health resilience) as well as the engagement of youths in violence prevention. The research targets health risk behaviors, mediators of impairment, and resilience for health promotion.

Lead by Dr. Elizabeth Saewyc, SARAVYC’s role will be to answer the following questions:

1. What are the contexts, exploitation experiences, and related health challenges of sexually exploited homeless and street-involved boys, and do they differ from those of sexually exploited homeless and street-involved girls?
2. What resilience factors are linked to lower odds of health problems among sexually exploited runaway and street-involved boys? What resilience factors are linked to lower odds of health problems among boys who are in school?
3. How might we need to adapt an existing effective intervention among sexually exploited girls for it to be feasible and effective for sexually exploited boys to promote resilience and health risks?

In partnership with the McCreary Centre Society, Dr. Saewyc and SARAVYC conducted a 12-city survey of street-involved and homeless youth age 12-19, using the same participatory methods from 2006 and 2000. We are using multivariate modelling, primarily logistic regression and probability profiling, to identify how combinations of risk and protective factors influence the probability of health problems, such as suicide or self-harm, problem substance use and risky sexual behaviours. We are examining health and risks for sub-groups of boys, such as gay and bisexual boys, who are at higher risk for sexual abuse than heterosexual peers. These patterns will be used to identify promising avenues for interventions.

Principal Investigator: Dr. Christine Wekerle

Co-Investigators: Dr. Christine Wekerle, Dr. Elizabeth Saewyc, Dr. Michael Boyle, Dr. Martine Hébert, Harriet L. MacMillan, Dr. Christopher John Mushquash, Dr. Sherry H. Stewart, and Dr. Michael Ungar

Funded by the Canadian Institutes of Health Research Team Grant on Boys and Men’s Health (Full Proposal), “Understanding health risks and promoting resilience in male youth with sexual violence experience”, 2014-2019

SARAVYC has developed an innovative, award-winning method of studying site-level longitudinal effects of population health interventions (SLEPHI) that can be applied to site-level research in any field.

Using the SLEPHI method, SARAVYC is evaluating recent and previous British Columbia Adolescent Health Surveys to explore the impact of GSAs (Gay Straight Alliances or Gender Sexuality Alliances). Our study into their impact on student health, found that GSAs make schools safer not only for LGBTQ2S+ students, but for all students. The research also revealed that the longer a GSA exists, the safer students feel.

Our goal now, is to use the SLEPHI method to explore other impacts of GSAs, including specific outcomes among ethnic minority LGB youth, and how GSAs effect school connectedness, bullying, and suicide.

Principal investigator: Dr. Elizabeth Saewyc

Co-authors: Gu Li, Amery D. Wu, Sheila K. Marshall, Ryan J. Watson, Jones K. Adjei, Minjeong Park

Funded by: Canadian Institutes of Health Research

Fostering healthy relationships among LGBTQ2S+ youth in British Columbia

Gender-based violence disproportionately affects people who identify as LGBTQ2S+ and gender non-conforming individuals. Trend analyses of the province-wide BC Adolescent Health Survey tell us that lesbian, gay, or bisexual youth are three to six times more likely to experience dating violence than their straight peers. In addition, our Canadian Trans Youth Health Survey finds trans and non-binary youth report even higher rates of dating violence.

Adolescence is a key time to provide young people with the knowledge and skills to develop healthy relationships that are free from violence and abuse. SARAVYC has partnered with the McCreary Centre Society and their Youth Research Academy to develop, implement, and evaluate a healthy relationship intervention with LGBTQ2S+ youth for LGBTQ2S+ youth in British Columbia.

Objectives

Develop and facilitate education modules

In collaboration with youth, we will develop education modules focused on preventing dating violence for LGBTQ2S+ adolescents. We will pilot the intervention across British Columbia, meeting queer youth in the spaces they tend to frequent— Gender Sexuality Alliance Clubs (GSAs) and LGBTQ2S+ youth community groups. We will then scale up across the country.

The proposed intervention, developed with LGBTQ2S+ youth for LGBTQ2S+ youth, incorporating trauma-informed and culturally safe approaches, should help foster healthier relationships, prevent or reduce dating violence, and in turn, reduce the health inequities faced by LGBTQ2S+ youth as a result of stigma and trauma.

At the completion of these modules, participants will:

• Have greater awareness of dating violence in LGBTQ2S+ relationships
• Be able to identify both dating violence behaviours and healthy relationships
• Experience role playing conflict management and learn effective strategies in relationships
• Define strategies for being effective bystanders and supportive friends to peers in violent dating relationships

Evaluate intervention

We will conduct surveys to evaluate the intervention and its impact on knowledge, motivation to change attitudes, and influence on behaviours that support healthy relationships.

Identify barriers

By interviewing teachers, counselors, and facilitators, we will identify barriers and improvements to support a country-wide intervention. Without these learned lessons, the most effective intervention is limited.

Measure Impact

Using BC Adolescent Health Survey (BCAHS) data from before and after the intervention, we will measure potential shifts in dating violence behavior among LGBTQ2S+ youth.

Deliverables

• An online, downloadable manual (available in English and French)
• Train the Trainer workshops throughout British Columbia
• Infographics about the intervention and its outcomes (available in French and English)
• Peer-reviewed papers
• Pre and post-intervention surveys and interviews

Our team

SARAVYC

The SARAVYC team is led by:

• Dr. Elizabeth Saewyc, Executive Director
• Dr. Ashley Taylor, Post Doctoral Fellow
• Dr. Jennifer Wolowic, Project Manager
• Quantitative and qualitative graduate research assistant

McCreary Centre Society

McCreary Centre Society (MCS) is a non-government, not-for-profit committed to improving the health of BC youth through research, evaluation and community based projects. Our vision is that all youth are supported to be healthy and connected. MCS has extensive experience coordinating youth engagement in research projects relevant to youth in British Columbia. The MCS team is led by:

• Annie Smith, Executive Director
• McCreary Centre facilitators
• Youth Research Academy