Evaluation of State-Level Sexual and Gender Minority Laws for the Primary Prevention of Sexual and Intimate Partner Violence Among Sexual and Gender Minority Youth in the U.S.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Past 12-Month Sexual Violence Victimization
研究概览
简要总结
The goal of this observational study is to learn how state-level laws related to sexual and gender minority (SGM) youth affect the risk of sexual violence (SV) and intimate partner violence (IPV) among sexual minority (SM) youth in the United States. The study looks at both supportive laws (such as bans on conversion therapy and anti-bullying protections) and restrictive laws (such as limits on gender-affirming care) passed between 2017 and 2025. The main questions it aims to answer are:
Part 1:
- Do supportive SGM laws lower the risk of SV/IPV among SM youth?
- Do restrictive SGM laws raise the risk of SV/IPV among SM youth?
- Does the social climate in a state (such as levels of stigma toward SGM people) change how these laws affect SM youth?
Part 2:
-How do SGM youth themselves describe the ways that laws and social climates affect their safety and wellbeing?
Part 1 - Quantitative analysis: Researchers will use existing, publicly available survey data from the Youth Risk Behavior Surveillance System (YRBSS) to compare changes in SV/IPV risk among SM youth across states that adopted different types of SGM laws over the period of 2017-2025. No participants are enrolled for this part.
Part 2 - Qualitative interviews: Researchers will conduct one-on-one interviews with approximately 30 SGM youth ages 13-18 living across U.S. states with varying levels of adoption of supportive SGM laws. Each youth will take part in one 60-minute interview. Youth will be asked about their views on how laws and social climates affect safety, stigma, and access to resources. Youth will not be asked to share personal experiences of violence.
详细描述
Quantitative Component (Aims 1-2):
SM youth are identified using the YRBSS sexual identity item, which asks respondents "Which of the following best describes you?" Respondents indicating gay, lesbian, bisexual, describing their sexual identity some other way, or questioning are categorized as SM. Respondents indicating heterosexual (straight) are categorized as non-SM.
Primary outcomes are three individual-level YRBSS items measuring past 12-month sexual violence (SV) victimization and past 12-month intimate partner violence (IPV) victimization (physical and sexual).
Policy exposures are constructed as state-level binary indicators (present versus absent) for three types of SGM laws: gender-affirming care laws, conversion therapy bans, and enumerated identity-based anti-bullying laws. Exposure data are drawn from legal epidemiology datasets available through LawAtlas.org for years 2016, 2018, 2020, 2022, and 2024 with a one-year lag between exposure measurement and outcome assessment to ensure policies are implemented before outcome measurement. Outcome data are drawn from YRBSS survey including 29 states for the years 2017, 2019, 2021, 2023, 2025 representing 98 state-years with a total sample of approximately 357,040 youth.
Aim 1 employs a difference-in-differences (DiD) approach in a quasi-experimental framework using mixed effects DiD Poisson models to estimate the effect of SGM law adoption on SV/IPV risk among SM youth. Separate models are estimated for each law type and each outcome. Time-varying state-level covariates include population size, percentage below poverty line, and state-level demographic composition of race/ethnicity and age. Sensitivity analyses include Goodman-Bacon decomposition, doubly robust estimators, and imputation-based estimators to address potential treatment effect heterogeneity across adoption timing. Parallel pre-trends are assessed using lag and lead models with bounds adjusted for any non-parallel pre-trends. Exploratory analyses examine effects among specific racial/ethnic SM youth subgroups (Black, Hispanic/Latino, Native American/Alaska Native, and mixed race SM youth), reporting point estimates with 95 percent confidence intervals without formal hypothesis testing to provide directional evidence.
研究设计
- 研究类型
- Observational
- 观察模型
- Ecologic Or Community
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 13 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Ages 13-18 years
- •Resides in a U.S. state selected for the study
- •Self-identifies as a sexual and/or gender minority (for example, lesbian, gay, bisexual, pansexual, queer, questioning, asexual, nonbinary, transgender, or another non-heterosexual or non-cisgender identity)
- •Able to complete the interview in English
- •Sufficient literacy to review age-appropriate assent materials
排除标准
- •No additional exclusion criteria beyond not meeting inclusion criteria
研究组 & 干预措施
YRBSS state-representative cohort 2017
First year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Enumerated anti-bullying state legislation (Other)
YRBSS state-representative cohort 2017
First year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Conversion therapy state legislation (Other)
YRBSS state-representative cohort 2017
First year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Gender-affirming care state legislation (Other)
YRBSS state-representative cohort 2019
Second year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Gender-affirming care state legislation (Other)
YRBSS state-representative cohort 2019
Second year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Enumerated anti-bullying state legislation (Other)
YRBSS state-representative cohort 2019
Second year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Conversion therapy state legislation (Other)
SGM Youth Interview Participants
Sexual and gender minority youth ages 13-18 enrolled for one-on-one qualitative interviews exploring perceptions of how state-level policies and social climates affect safety, stigma, and access to resources (Aim 3).
干预措施: Enumerated anti-bullying state legislation (Other)
SGM Youth Interview Participants
Sexual and gender minority youth ages 13-18 enrolled for one-on-one qualitative interviews exploring perceptions of how state-level policies and social climates affect safety, stigma, and access to resources (Aim 3).
干预措施: Conversion therapy state legislation (Other)
SGM Youth Interview Participants
Sexual and gender minority youth ages 13-18 enrolled for one-on-one qualitative interviews exploring perceptions of how state-level policies and social climates affect safety, stigma, and access to resources (Aim 3).
干预措施: Gender-affirming care state legislation (Other)
YRBSS state-representative cohort 2021
Third year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Enumerated anti-bullying state legislation (Other)
YRBSS state-representative cohort 2021
Third year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Conversion therapy state legislation (Other)
YRBSS state-representative cohort 2021
Third year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Gender-affirming care state legislation (Other)
YRBSS state-representative cohort 2023
Fourth year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Enumerated anti-bullying state legislation (Other)
YRBSS state-representative cohort 2023
Fourth year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Conversion therapy state legislation (Other)
YRBSS state-representative cohort 2023
Fourth year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Gender-affirming care state legislation (Other)
YRBSS state-representative cohort 2025
Fifth year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Enumerated anti-bullying state legislation (Other)
YRBSS state-representative cohort 2025
Fifth year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Conversion therapy state legislation (Other)
YRBSS state-representative cohort 2025
Fifth year of primary analytic population for quantitative analyses examining the effect of state-level SGM law adoption on SV/IPV risk (Aims 1-2).
干预措施: Gender-affirming care state legislation (Other)
结局指标
主要结局
Past 12-Month Sexual Violence Victimization
时间窗: Past 12 months at each biennial YRBSS survey administration (repeated cross-sectional assessments from 2017 to 2025)
Binary self-reported YRBSS item indicating sexual violence victimization in the past 12 months. Risk ratios estimated comparing states with and without specific SGM laws.
Past 12-Month Intimate Partner Violence Victimization
时间窗: Past 12 months at each biennial YRBSS survey administration (repeated cross-sectional assessments from 2017 to 2025)
Binary composite of two self-reported YRBSS items indicating physical dating violence or sexual dating violence in the past 12 months, coded as victimization if either item is endorsed. Risk ratios estimated comparing states with and without specific SGM laws.
次要结局
- Past 12-months Suicidality(Past 12 months at each biennial YRBSS survey administration (repeated cross-sectional assessments from 2017 to 2025))
- Past 12-month Bullying(Past 12 months at each biennial YRBSS survey administration (repeated cross-sectional assessments from 2017 to 2025))