Structural Factors and Sexual Orientation Disparities in Adolescent Substance Use: A Multi-Level Model

Studies consistently find sexual orientation disparities in tobacco, alcohol and marijuana use among adolescents in the United States (Goldbach, Tanner-Smith, Bagwell, & Dunlap, 2014; Hatzenbuehler, Jun, Corliss, & Austin, 2015; Kann et al., 2018; Marshal et al., 2008; Mustanski, Van Wagenen, Birkett, Eyster, & Corliss, 2014). Having documented this elevated risk, the field has turned to identifying mediators that may explain the sexual orientation disparity in substance use behaviors. There is growing evidence that one of the mediators of sexual orientation-based health disparities is structural stigma—defined as “societal-level conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and well-being of the stigmatized” (Hatzenbuehler & Link, 2014, p.2). Structural stigma can in turn lead to greater stress and subsequent negative coping behaviors among sexual minorities (Hatzenbuehler et al., 2015; Hatzenbuehler & Link, 2014; Hatzenbuehler & McLaughlin, 2014; Pachankis, Hatzenbuehler, & Starks, 2014). However, most of this work has been conducted among adults and has focused on mental health outcomes (e.g., suicide attempts, psychiatric morbidity, mental distress) as opposed to specific substance use behaviors; further, if structural factors are found to affect sexual orientation health disparities and these can be altered, the gap between sexual minority and heterosexual substance use can be narrowed through policy change. State-level substance use policy (e.g., levels of taxation of cigarettes and alcohol, policies that remove adolescent access to driving upon substance use infractions) may also explain the gap in substance use prevalence between sexual minority and heterosexual youth because tobacco, alcohol and marijuana are also stigmatized substances and restrictive substance use environments may enhance the stigma attached to sexual minority youth. However, only one study has explored this research question, and it was conducted with an adult sample (Hatzenbuehler, Keyes, Hamilton, & Hasin, 2014). This project aims to address these gaps in the literature. It uses multi-level modeling to test the association between (1) state-level sexual minority structural stigma (SMSS) and (2) state-level substance use policy environments (SUPEs) and sexual orientation disparities in recent substance use as measured in the Youth Risk Behavior Surveillance Survey (YRBSS). Analyses were also conducted to assess the size and direction of the association between SMSS and SUPE and state-level prevalence of substance use within heterosexual and sexual minority youth subpopulations. Analyses were conducted in subpopulations of female and male youth. Support was found for the structural stigma hypothesis among girls but not boys. Higher overall measures of sexual minority structural stigma were associated with larger disparities in tobacco use, alcohol use, and marijuana use among girls. Higher scores on the SMSS scale were associated with tobacco use among sexual minority girls but not heterosexual girls. Individual indicators of structural stigma (e.g., specific state-level policies) were also associated with disparities in these outcomes, as well as with the other outcomes tested (binge drinking and drunk driving). No such associations were found among male youth. Very little support was found for the hypotheses that restrictive substance use policy environments would be associated with larger sexual orientation disparities in substance use and that heterosexual but not sexual minority youth would demonstrate lower prevalence of substance use in restrictive states. Among girls, no associations were found between scales measuring the restrictiveness of substance use and sexual orientation disparities in substance use. A smaller sexual orientation disparity in recent cigarette smoking was associated with one indicator of restrictiveness: state enforcement of underage tobacco sale laws. Among boys, no associations were found between scales measuring the restrictiveness of substance use and sexual orientation disparities in substance use; two indicators of restrictiveness were associated with smaller sexual orientation disparities in binge drinking and three indicators were associated with smaller sexual orientation disparities in drunk driving. Among heterosexual but not sexual minority boys, higher tobacco taxes were associated with lower prevalence of smoking. This study raises several questions for future research on structural factors that may explain sexual orientation disparities in substance use behaviors among youth. For instance, future work is needed to understand the gender differences in response to structural stigma among sexual minorities. Sexual minority girls may have greater rejection sensitivity than sexual minority boys and thus may be more likely to use substances in response to structural stigma; however, further research is needed to test this hypothesis. In addition, the current study lacked data on the implementation of substance use policy environments, which may have masked important effects. A study of SUPE that includes measures of implementation of restrictive substance use policies is therefore needed to expand the work reported herein. Finally, a better understanding of gender identity and expression is needed; while the YRBSS measures “sex” and not gender or gender expression in these datasets, more information about these topics will help to understand how these factors may play into experiences of structural stigma and substance use policy environments

Pocket Change: How Women and Girls of Color Do More with Less

Women and girls of color are pivotal frontline leaders and organizers in the powerful social change movements that pave the way for a more equitable and just democracy. Our report, Pocket Change: How Women and Girls of Color Do More With Less, seeks to better understand how they do this work and asks critical questions of philanthropy and donors: How is philanthropy supporting or not supporting women and girls of color? Are philanthropic practices in alignment with the breadth of advocacy and services that women of color-led organizations actually provide? How can we change our practices to center women and girls of color in our giving and hold ourselves accountable?As feminist activists and philanthropists working to advance gender and racial equity, we must grow and expand movements for equity while making space for taking care and healing. Each day brings significant challenges and pressures on women and girls of color, especially indigenous and transgender women. Pocket Change is a data-driven testament to how they rise to these challenges with ingenuity, resilience, fortitude, and integrity. These are unprecedented times, and there are many, many ways to engage in philanthropy and activism. We hope that Pocket Change will provide new tools and a mandate to give more, better, and with greater transparency to our gender and racial justice movements. The model of feminist, trust-based philanthropy that centers women and girls of color is needed now more than ever

Funding to Meet Changing Realities: LGBTI Organisations on the State of Funding in Europe and Central Asia

ILGA-Europe continues our needs assessment work in partnership with Strength in Numbers to make a case to both better align and increase funding for the work of LGBTI organisations in Europe and Central Asia.The first funding needs assessment was done in 2017 with the intention to shine a light on the activities undertaken by LGBTI organisations, particularly those that are underfunded compared to the importance that organisations give to them. The 2021 needs assessment continues this work, with additional intentions to detect changes in the funding landscape, as well as collect additional data about the lived realities of LGBTI activists and organisations operating in the context of COVID-19, and in many countries, anti-LGBTI and/or anti-gender rhetoric, threats and attacks. Ultimately, ILGA-Europe monitors the funding landscape with an eye to moving towards sustainability for LGBTI organisations, ensuring LGBTI people on the ground can access the services they need and are free from discrimination.Where sufficient data are available, it highlights disparities between regions, so donors and activists can be aware of gaps in resources identified by LGBTI activists. ILGA-Europe would like to see the report used as a tool to continue conversations between donors and movements to increase the funding available and align the priorities of donors with the needs and opportunities experienced by LGBTI movements. The report is also intended to reach LGBTI organisations, including ILGA-Europe members, with a view to enhancing our collective understanding of how funding can support the work of our movements

Funding for LGBTI Activism in Europe and Central Asia: Priorities and Access to Resources

ILGA-Europe wanted to learn more about the LGBTI movements' priorities in the rapidly-changing political, social and cultural environment we all find ourselves in. We were particularly curious to understand more about how your work is being resourced.The Funding for LGBTI Activism report distils the survey responses of 287 LGBTI organisations into one publication, written by Erin Howe and Somjen Frazer from Strength in Numbers for ILGA-Europe.Put simply, this report shows where funding is needed and signposts ways for funders to fund LGBTI activists in an ever-more strategic and sustainable way

Exploring How Disparities in Experiences of Violence and Substance Use Between Transgender and Cisgender Students Differ by Gender Expression

This report, Exploring How Disparities in Experiences of Violence and Substance Use Between Transgender and Cisgender Students Differ by Gender Expression, explores how a student's perceived gender expression intersects with their gender identity to inform health risk. A robust and growing set of evidence shows that transgender youth face higher rates of violence, substance use and other negative health outcomes. This report looks at both the rates of negative outcomes within transgender students across three categories of gender expression and also at the disparities (or gaps) between cisgender and transgender students across these categories. We use the categories "perceived feminine", "perceived androgynous" and "perceived masculine" to examine gender expression (see Figure 1 on page 6). We recognize that, with few exceptions, transgender perceived feminine youth are both most likely to experience health risks. Additionally, there are larger gaps between cisgender and transgender perceived feminine youth (compared to the gaps between cisgender and transgender perceived masculine youth or cisgender and transgender perceived androgynous students).Previous research developed by Advocates for Youth details the profound health disparities androgynous students, and transgender students, and particularly transgender students of color, endure relative to their gender conforming and cisgender peers. This project extends the previous work and contributes to answering additional questions about how transgender identity and perceived gender expression interact to explain health risks in violence and substance use

2019-2020 Tracking Report: LGBTQ Grantmaking by U.S. Foundations

The 2019-2020 Resource Tracking Report: Lesbian, Gay, Bisexual, Transgender, and Queer Grantmaking by U.S. Foundations (2022) explores the scope and character of U.S. foundation funding for LGBTQ communities and issues in calendar years 2019-2020. This 18th edition of the tracking report represents the next iteration of work from Funders for LGBTQ Issues in our ongoing effort to document the scale of philanthropic support for LGBTQ communities and issues.The report finds that foundation funding for LGBTQ communities and issues has fallen since its record high in 2018, totaling $193 million in 2019 and$201 million in 2020. This is concerning, as it comes at a time when, according to Giving USA, overall foundation support has soared. For every $100 awarded by U.S. foundations in 2020, only 23 cents specifically supported LGBTQ communities and issues

DT56a (Tofupill ® /Femarelle TM ) selectively stimulates creatine kinase specific activity in skeletal tissues of rats but not in the uterus

Abstract The novel natural product DT56a (Tofupill ® /Femarelle TM ), derived from soybean, has been shown to relieve menopausal vasomotor symptoms and to increase bone mineral density with no effect on sex steroid hormone levels or endometrial thickness. In the present study, we compared the effects of DT56a and estradiol-17␤ (E2) on bone and cartilage (Ep) of immature or ovariectomized female rats, by measuring the changes in the specific activity of the BB isozyme of creatine kinase (CK). Single short-term injection of high doses of DT56a induced estrogenic activity in bones and uterus similar to that of E2. When administered in multiple oral doses, DT56a stimulated skeletal tissues similarly to E2, but whereas E2 increased CK specific activity in the uterus, DT56a did not. The selective estrogen receptor modulator (SERM) raloxifene (Ral) blocked the stimulation of CK by either DT56a or by E2 in all tissues tested. Our findings suggest that DT56a acts as a selective estrogen receptor modulator stimulating skeletal tissues without affecting the uterus. The effect of DT56a on other systems, such as the vascular and the central nervous system, are currently under investigation

Vascularization of the dorsal root ganglia and peripheral nerve of the mouse: Implications for chemical-induced peripheral sensory neuropathies

Although a variety of industrial chemicals, as well as several chemotherapeutic agents used to treat cancer or HIV, preferentially induce a peripheral sensory neuropathy what remains unclear is why these agents induce a sensory vs. a motor or mixed neuropathy. Previous studies have shown that the endothelial cells that vascularize the dorsal root ganglion (DRG), which houses the primary afferent sensory neurons, are unique in that they have large fenestrations and are permeable to a variety of low and high molecular weight agents. In the present report we used whole-mount preparations, immunohistochemistry, and confocal laser scanning microscopy to show that the cell body-rich area of the L4 mouse DRG has a 7 fold higher density of CD31+ capillaries than cell fiber rich area of the DRG or the distal or proximal aspect of the sciatic nerve. This dense vascularization, coupled with the high permeability of these capillaries, may synergistically contribute, and in part explain, why many potentially neurotoxic agents preferentially accumulate and injure cells within the DRG. Currently, cancer survivors and HIV patients constitute the largest and most rapidly expanding groups that have chemically induced peripheral sensory neuropathy. Understanding the unique aspects of the vascularization of the DRG and closing the endothelial fenestrations of the rich vascular bed of capillaries that vascularize the DRG before intravenous administration of anti-neoplastic or anti-HIV therapies, may offer a mechanism based approach to attenuate these chemically induced peripheral neuropathies in these patients

Extracellular calcium reduction strongly increases the lytic capacity of pneumolysin from streptococcus pneumoniae in brain tissue

Background. Streptococcus pneumoniae causes serious diseases such as pneumonia and meningitis. Its major pathogenic factor is the cholesterol-dependent cytolysin pneumolysin, which produces lytic pores at high concentrations. At low concentrations, it has other effects, including induction of apoptosis. Many cellular effects of pneumolysin appear to be calcium dependent. Methods. Live imaging of primary mouse astroglia exposed to sublytic amounts of pneumolysin at various concentrations of extracellular calcium was used to measure changes in cellular permeability (as judged by lactate dehydrogenase release and propidium iodide chromatin staining). Individual pore properties were analyzed by conductance across artificial lipid bilayer. Tissue toxicity was studied in continuously oxygenated acute brain slices. Results. The reduction of extracellular calcium increased the lytic capacity of the toxin due to increased membrane binding. Reduction of calcium did not influence the conductance properties of individual toxin pores. In acute cortical brain slices, the reduction of extracellular calcium from 2 to 1 mM conferred lytic activity to pathophysiologically relevant nonlytic concentrations of pneumolysin. Conclusions. Reduction of extracellular calcium strongly enhanced the lytic capacity of pneumolysin due to increased membrane binding. Thus, extracellular calcium concentration should be considered as a factor of primary importance for the course of pneumococcal meningitis