Shoshanna L. Fine

Background: Sexually and gender diverse adolescents worldwide are at heightened risk of experiencing mental health issues, including depression, anxiety, and suicidal behaviours. To date, however, no studies have used nationally representative data to explore the prevalence of sexual and gender diversity and associated mental health issues among adolescents in Indonesia and Vietnam. Methods: Data were drawn from the National Adolescent Mental Health Surveys, nationally representative household surveys of mental health among adolescents aged 10–17 years in Indonesia and Vietnam. Questions about gender identity and romantic/sexual attraction were only asked to those aged 12–17. Weighted logistic regression analyses were used to assess the associations between (1) gender identity and (2) sexual orientation and past 12-month depressive symptoms, anxiety symptoms, and suicidal ideation. Results: Of 4,300 adolescents in the Indonesia sample and 4,376 adolescents in the Vietnam sample, 5.3% and 5.9% respectively reported gender diverse identities, while 9.4% and 12.6% respectively reported sexually diverse orientations. In Indonesia, gender diverse adolescents had significantly increased odds of past 12-month depressive symptoms (aOR: 2.95; 95% CI: 1.17–4.35), anxiety symptoms (aOR: 1.88; 95% CI: 1.24–2.85), and suicidal ideation (aOR: 6.16; 95% CI: 2.73–13.89) as compared to their cisgender peers. Sexually diverse adolescents had significantly increased odds of depressive symptoms (aOR: 2.64; 95% CI: 1.51–4.62), anxiety symptoms (aOR: 2.02; 95% CI: 1.41–2.89), and suicidal ideation (aOR: 3.41; 95% CI: 1.25–9.29) as compared to their heterosexual peers. In Vietnam, gender diverse adolescents only had increased odds of anxiety symptoms (aOR: 1.58; 95% CI: 1.13–2.22), whereas sexually diverse adolescents had increased odds of depressive symptoms (aOR: 2.58; 95% CI: 1.36–4.92), anxiety symptoms (aOR: 1.58; 95% CI: 1.14–2.19), and suicidal ideation (aOR: 2.84; 95% CI 1.13–7.14). Conclusions: In Indonesia and Vietnam, a considerable proportion of adolescents report gender diverse identities or sexually diverse orientations. Given that sexually and gender diverse adolescents are at increased risk of depression, anxiety, and suicidal ideation, it is critical that appropriate, culturally safe mental health and psychosocial support services are available to provide targeted assistance to these young people.

We examine peer violence trajectories among a purposive sample of urban poor adolescents over 3 years in Kinshasa, Democratic Republic of Congo (DRC); Shanghai, China, and Bandar Lampung, Denpasar, and Semarang, Indonesia. We examine peer violence experiences over time and seek to understand the relationship between gender norm perceptions and personal agency on peer violence experiences. A longitudinal (wave 1–3) panel was used from the three study sites outlined above ( n = 6,660). Adolescents were purposefully selected if they were 10 to 14 years old at wave 1 and living in urban poor communities. A repeated measure latent class analysis was used to parameterize peer violence experiences over time. Next, we conducted multinomial logistic regression models to examine the relationship between gender norms perceptions and agency (personal attribute of empowerment) with peer violence class membership. A five-class model was best fitting across all sites with four consistent classes: “low peer violence” (experienced by most); “declining violence”; “peaks in middle”; and “consistently high violence.” In the three cities in Indonesia and Kinshasa, DRC, there was an “increasing violence” class, and in Shanghai, China, there was a “high emotional victimization” class. In general, more endorsement of unequal gender norms and higher agency were associated with greater relative risk of any violence victimization and/or perpetration versus the low violence class membership. However, associations between gender norm perceptions and agency on peer violence trajectories differed within and between sites. These results compel programs to understand and address the underlying beliefs that promote peer violence. Longitudinal trends of chronic offenders extenuate the need to include family- and community-level interventions to prevent and mitigate the effects of peer violence. Additionally, there is a need to address social and structural determinants such as gender and power to promote lifelong health free of injury and violence.