Toward Sexual Health Equity for Gay, Bisexual, and Transgender Youth: An Intergenerational, Collaborative, Multisector Partnerships Approach to Structural Change

Abstract

Background. Gay, bisexual, and transgender youth (GBTY) experience sexual health inequities and contend with intersectional oppression. The Michigan Forward in Enhancing Research and Community Equity (MFierce) Coalition formed as an intergenerational, collaborative, multisector partnership with a focus on implementing community-identified policy, systems, and environmental (PSE) change strategies to address inequities and injustices. Aims. We describe MFierce coalition development and structural change activities organized within Collaborating for Equity and Justice (CEJ) principles and provide empirical data supporting the utility of such principles. Method. We prioritized leadership by GBTY and created personal and professional capacity-building activities to support GBTY in being change agents. Our work was grounded in community-engaged scholarship and used a shared-power community development process. Our PSE change intervention, the Health Access Initiative (HAI), was a structural change program for health facilities aimed at improving the quality of and access to sexual health care for GBTY. Results. We evaluated coalition functioning and activities through multimethod assessments and evaluated PSE changes through HAI participant surveys. Data demonstrated positive and steady coalition dynamics, multiple benefits of participation for GBTY, and strategies for collaborative multigenerational community work. HAI outcome data revealed significant increases in PSE changes. Discussion. Centering life experiences of GBTY in collaborative partnerships and building opportunities for professional and personal development can support sustainable community change. We offer recommendations for developing future intergenerational, collaborative, multisector partnerships that prioritize youth leadership. Conclusion. Collaborative methods and careful consideration of adult–youth dynamics can inform future transformative efforts focused on health equity and justice for GBTY.

Constructing a web‐based health directory for adolescent men who have sex with men: Strategies for development and resource verification

“…Identifying the unique needs of prospective users is also critical. In our study, we were keenly aware that AMSM's willingness to access local resources and their comfort in disclosing their sexual identity is likely influenced by how safe and affirming the organization and it's representatives are (Philbin et al, 2014;Sirdenis et al, 2019;Tanner et al, 2014;Wilkerson et al, 2011). Thus, user needs and specific context provides important considerations for directory developers to take into account when designing verification processes that assist in thoughtfully linking users with potentially helpful resources.…”

“…The ability to successfully buffer or compensate against these vulnerabilities requires youth to activate intrinsic assets (e.g., resilience, self‐esteem) and to have access to health‐promoting resources in their social and physical environments (Fergus & Zimmerman, 2005; Ungar et al, 2013). Although providing referrals and access to supportive agencies is a long‐standing strategy to reinforce social support, education, and learning in the adolescent health literature (Ambresin et al, 2013; Harper et al, 2012; Mazur et al, 2018), access to health services that are welcoming and affirming of sexual minorities varies widely across the United States (US) (Bauermeister et al, 2019; Sirdenis et al, 2019).…”

Identification of young people at risk of sexual ill health : implementing a new tool in youth clinics

“…For example, LGBT youth generally demonstrate poorer health outcomes compared with cisgendered 1 heterosexual youth, but LGBT youth who also belong to ethnic minorities often have even poorer health outcomes, particularly relating to substance use, sexual risk behaviours, physical/sexual violence, and suicide [111]. The intersectional perspective has gained attention in public health work in recent years helping us understand health disparities and develop comprehensive interventions that are sensitive to the multiple identities and different conditions people at risk live by [109,[112][113][114].…”

Community Voice in Cross-Sector Alignment: Concepts and Strategies from a Scoping Review of the Health Collaboration Literature

“…Such positions help connect other community members to services and have been shown to improve community health outcomes [22]. Embedding community members also helps organizations and communities build trust, which has been cited many times in the literature as an important step in engaging community voice in collaborations more broadly [18,23,31,34].…”

“…Because some community members may face barriers to participating, there are several recommendations for making these forums more community friendly. Organizations can make meetings more accessible by holding them at convenient times; assisting community members with travel, childcare, and translation services; providing compensation for their time; and providing multiple avenues for participation, for example via the internet as well as in-person [22,34].…”