Transgender and nonbinary (TNB) individuals face disparities in nearly every aspect of health. One factor associated with poor health outcomes in other marginalized populations is health literacy, yet no identified studies examine health literacy in TNB samples. Moreover, most health literacy frameworks focus primarily on the capacities of individual patients to understand and use healthcare information, with little attention given to provider literacy and environmental factors. In partnership with a statewide LGBTQ advocacy organization, we recruited 46 transgender and nonbinary individuals to participate in seven focus groups conducted in urban, suburban, and rural locations throughout Colorado. TNB participants consistently engaged in efforts to increase their own health literacy and that of their medical providers yet faced multiple barriers to improve care. Difficulty identifying and physically reaching care, insurance and out-of-pocket expenses, negative experiences with healthcare providers and staff, provider incompetence, discriminatory and oppressive practices, and exclusionary forms and processes emerged as barriers to enacted health literacy among participants. Conversely, facilitators of enacted healthcare literacy included positive experiences with healthcare providers and staff, and inclusive forms and processes.

Background: Substance use in adolescence is associated with multiple negative outcomes. Lesbian, gay, or bisexual or transgender or nonbinary (TNB) youth, and those who question their sexual orientation or gender, are more likely to engage in substance use than straight or cisgender youth. However, the extant literature largely considers sexual orientation and gender identity independently. Accordingly, this study examines the associations between the intersectional identities of sexual orientation and gender and substance use to identify those with the greatest need for prevention interventions. Methods: Data were from 36 504 high school students aged 14 to 18 years (mean = 15.7, SD = 1.18) enrolled in the 2019 Healthy Kids Colorado Survey using a statewide stratified random sampling design. Logistic regression models examined the associations between intersectional sexual orientation and gender on marijuana use, prescription drug misuse, and polysubstance use, as well as depression and violence victimization (eg, forced sex, partner violence). Results: Adjusted odds of substance use for sexual and gender minority youth varied by intersectional identity and substance. The largest effect sizes were seen for prescription drug misuse, especially among those questioning their gender and sexual orientation and heterosexuals either questioning their gender or who identified as TNB. Effect sizes for marijuana use and polysubstance use were highest for TNB and heterosexual participants. Depression and violence victimization were significantly associated with each substance use outcome. Conclusions: Interventions to reduce substance use in these populations may benefit from targeted interventions for youth with different intersectional identities, and a focus on violence prevention and depression screening and treatment.

The contemporary Defund the Police movement has renewed interest in social work’s role in public safety, leading some to call for increased police–social work collaborations. However, claims regarding the potential virtues and pitfalls of social work–police collaborations are largely ahistorical. To contextualize current debates, a systematic investigation into the evolution of social work and its relationship with law enforcement is necessary, particularly the impact that gender norms have had on this relationship. Drawing from the National Conference on Charities and Corrections proceedings, we examined how gendered underpinnings have shaped social work’s relationship to law enforcement and the understanding of social work’s role in public safety. During the Progressive Era, social workers acted as an intervention to reform police by infusing ‘rehabilitative’, ‘protective’, ‘preventative’, and ‘quarantining’ approaches in law enforcement. What emerges from the archives is a chronicle detailing how using social work as a gendered intervention for police reform during the Progressive Era fell short of addressing the root causes of carceral issues, drawing parallels between the Progressive Era reforms and today’s contemporary reforms.

The COVID-19 pandemic introduced myriad disruptions and stressors across the globe. Some populations, such as LGBTQ+ people, who already experienced disparities in access to healthcare, social support, and employment saw those disparities worsen, contributing to mental distress. Past research indicates that spending time in nature can be an effective strategy for coping and promoting well-being, yet little is known about how LGBTQ+ people may turn to nature in times of crisis. Using a queer ecology framework, this study engages in qualitative analysis of both text- and visual-based (auto-photography) diary and interview data from 30 LGBTQ+ adults in the Southeastern United States. Findings highlight how LGBTQ+ adults turned to nature as a place to engage in physical movement, to stay connected to people, for coping, and for introspection. We detail considerations for community organizers and planners about how natural spaces are built and made accessible during times of crisis.