Benjamin Parchem

Purpose of Review: There has been a recent rise in both positive and negative representations of sexual and gender minority (SGM) identities in the media. New forms of media have also emerged, and the ways in which youth engage with the media are evolving. Media exposure can have nuanced impacts on mental health and development. This is particularly true for SGM youth, who experience increased vulnerability to adverse mental health outcomes associated with minority stress. The mechanisms by which media can impact the mental health of SMG youth are complex and interconnected. We use the frameworks of Minority Stress Theory, Mega-Threat Theory, and the Media Effects Theory to contextualize the current literature on these mechanisms. Recent Findings: Media exposure has been associated with negative mental health effects in SGM youth, including increased anxiety, depression, rumination, physical health symptoms, fears for personal safety, and suicidal and self-harm ideation. Conversely, media exposure may confer many benefits to SGM youth, including feelings of validation, reduced isolation and loneliness, and increased hopefulness. Social media spaces have a unique, nuanced role in the development of identity and mental health of SGM youth, especially for youth with intersecting identities. Summary: Attention to the positive and negative relationships between mental health and media exposure is vital for better understanding mental health outcomes of SGM youth. Future directions include ethical reporting of suicide in the media, screening for social media use in clinical settings in the context of a child’s developmental stage, increasing media literacy, and recruiting a more intersectional group of study participants.

Objective: Medical decision-making capacity comprises understanding treatment information, appreciating the context and implications of treatment, and reasoning through risks and benefits before making a clear choice about treatment. The current study examined domains of cognitive, emotional, and executive function as predictors of decision-making capacity for pubertal suppression treatment among transgender and gender diverse (TGD) youth. Methods: A sample of 45 TGD youth [M(SD) age = 11.3 (1.3) years] primarily recruited from a multidisciplinary gender clinic in the Midwestern United States completed the MacArthur Competence Assessment Tool – Treatment (MacCAT-T) and several measures to assess cognitive, emotional, and executive functioning. Regression analyses were conducted to identify cognitive, emotional, and executive functioning predictors of each decision-making capacity domain. Results: At a bivariate level, aspects of cognitive, emotional, and executive functioning were related to each domain of decisional capacity. In regression analyses, higher cognitive functioning (β = 0.77, p < 0.001) predicted a greater ability to appreciate the decision. Higher negative affect predicted a greater ability to appreciate (β = 0.59, p = 0.01) and a lower ability to reason (β = −0.74, p = 0.01) through the decision. No cognitive, emotional, or executive functioning variables were predictive of ability to understand the decision. Conclusions: While cognitive, executive, and emotional functioning were relevant domains to decision-making capacity for pubertal suppression among TGD youth, many of these domains were not strongly predictive of decisional capacity. Cognition and negative affect are relevant correlates to assess and support through the decision-making process. Assessing domains of functioning through behavioral observation, clinical interview, and/or brief screeners may help providers to adapt their approach to counseling TGD youth around pubertal suppression treatment. Implications for Impact Statement: Cognitive, emotional, and executive function were not strongly predictive of transgender and gender diverse (TGD) youth’s capacity to make a decision regarding pubertal suppression treatment, though cognition and negative affect were most relevant. Clinicians supporting TGD youth to make informed medical decisions may benefit from adapting their approach to capitalize on youths’ individual strengths and support or accommodate challenges.

Transgender and gender diverse (TGD) children and adolescents in the United States are living in a sociopolitical climate that is devaluing and dehumanizing their existence (Parchem et al., 2024). ...

Introduction: The Transgender Congruence Scale (TCS) assesses appearance congruence and identity acceptance and has been validated among samples of TGD adults. Although the TCS has been used in studies of TGD adolescents, no studies have specifically examined the psychometric properties of the TCS in exclusively adolescent samples. The current study examined whether the TCS retains its construct and psychometric validity in a sample of TGD adolescents. Methods: Participants included 529 adolescents, ages 12–17 years, who established care at a gender health clinic within a pediatric academic medical center in the Midwestern United States between 2013 and 2019. As part of standard of care, all participants completed a battery of psychosocial measures, including the TCS and measures of gender minority stress, body dissatisfaction, and anxiety and depressive symptoms. Analyses assessed the factor structure of the TCS, as well as convergent and discriminant validity. Results: Confirmatory factor analysis identified a suboptimal fit of the two-factor model of the TCS in a sample of TGD adolescents. Subsequent exploratory factor analysis identified an optimal three-factor model reflecting appearance congruence, body congruence, and identity acceptance. Correlations indicated high internal consistency and construct validity of the three-factor model within a sample of TGD adolescents. Conclusions: The two-factor TCS model for TGD adults may not psychometrically hold for TGD adolescents, and a three-factor model that distinguishes between appearance congruence and body congruence may be more appropriate. Future confirmatory analyses are needed with another sample of TGD adolescents. Policy Implications: Results support preliminary psychometric properties of a three-factor model of the TCS for TGD adolescents, which can be used to track outcomes of gender-affirming care for minors over time in both clinical and research contexts.

Introduction: Recent studies have indicated that sleep is fundamental for adolescents' physical and mental health. Although it is known that context influences sleep, the impact of school climate on sleep duration remains understudied. Methods: Using a large, diverse, population‐based sample of adolescents attending California high schools ( N = 277,954; data collection: 2018–2019) and applying two statistical methods suggested for quantitative research using an intersectionality approach (linear regressions with interaction terms and Exhaustive Chi‐square Automatic Interaction Detection [ECHAID]), this study examined associations between school climate and sleep duration among adolescents at the intersection of multiple social positions. Results: Similar proportions of participants were assigned male and female at birth. The sample was racially and ethnically diverse (54.1% Latina/x/o). The large majority of participants were straight (85.4%) and cisgender (97.7%). On average, participants slept 6.75 h/night. Positive school climate was associated with longer and adequate sleep duration; however, this association varied across social positions, such that the effects of school climate on sleep duration were attenuated among adolescents who held some minoritized social positions. ECHAID results indicated that those reporting the lowest averages of sleep duration not only perceived school climate as negative but also held multiple minoritized identities. In contrast, those who perceive their school climate as positive are overrepresented among those who reported the highest averages of sleep duration. Conclusion: Findings underscore the impact that schools have on adolescents' sleep health. Our study indicates that adolescents with multiple minoritized social positions face additional challenges impacting their sleep. Future interventions should focus on strategies to improve school climates, given that they would benefit a large number of students.

Suicide, a leading cause of death among adolescents in the United States, is a public health crisis (Centers for Disease Control and Prevention & National Center for Injury Prevention and Control, ...

This study aimed to examine asthma disparities at the intersection of four sociodemographic characteristics, inhaled substance use, and bias-based bullying as metrics of stigma. We hypothesized that high prevalence groups for asthma would be those with marginalized social positions and those reporting bullying experiences, independent of inhaled substance use. The analytic sample (N = 90,367) included eighth, ninth, and 11th grade students who participated in the 2022 Minnesota Student Survey. Exhaustive Chi-square Automatic Interaction Detection tested all combinations of sociodemographic characteristics (gender identity, sexual orientation, racial/ethnic identity, and access to resources), inhaled substance use (none vs. any), and bias-based bullying about sexuality, gender identity/expression, racial identity, and weight/size to predict mutually exclusive groups of youth based on self-reported asthma diagnosis. Approximately 15% of the sample reported asthma. Sexually, gender, and racially/ethnically diverse youth reported higher rates of asthma relative to their heterosexual, cisgender, and White counterparts. High prevalence groups for asthma (rates between 24% and 41%) were characterized by having multiple marginalized identities, experiencing bias-based bullying, and engaging in inhaled substance use. Three of the 10 intersectional groups with a high prevalence of asthma were not inhaled substance users. These findings suggest that stigma may help explain the asthma disparities among marginalized youth. Efforts to reduce asthma disparities in marginalized youth should move beyond pathologizing the individual through overfocusing on health behaviors and attend to root causes, like experiences of stigma. Future studies should examine systemic inflammation as the potential connection between stigma and asthma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: In response to increasing anti-trans legislation targeting access to evidence-based gender-affirming healthcare in many states, the Gender Health Special Interest Group (SIG) of the Society of Pediatric Psychology started offering peer support groups for pediatric psychologists and trainees in the field of pediatric gender health. This commentary describes the impact of anti-trans legislation on the provision of pediatric gender-affirming healthcare and outlines the peer support group model, key lessons learned, and future directions for the groups. Methods: Peer support groups occurred 1–2 times monthly for pediatric psychologists, were facilitated by SIG leadership, and focused on information sharing, case consultation, and processing of the anti-trans sociopolitical climate. Trainee support groups occurred monthly, primarily for psychology trainees currently working in or interested in pediatric gender health. These were facilitated by the SIG student representatives, followed a loose structure bounded by group guidelines, and discussed a range of topics. Results: The groups drew variable, but modest, attendance. They offered a safe space for members to process the challenges of providing care in a tenuous sociopolitical climate. Logistical challenges (e.g., accommodating a variety of time availabilities) continue to be an area of growth for the groups. Conclusions: Peer support groups are a promising model for offering support, resources, and solidarity to pediatric psychologists providing care in controversial and politicized areas of healthcare. Healthcare institutions would benefit from considering ways to reduce barriers for pediatric psychologists and trainees attending support groups (e.g., counting attendance towards clinical productivity or continuing education).