Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2026
Structural anti-Asian racism, structural cisheterosexism, and psychological, behavioral, and sleep health among Asian American sexual and gender minority adolescents.
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Lee Hyemin, Bhoja Arushee, Watson Ryan J, Mereish Ethan H
Аннотация
BACKGROUND: Since the COVID-19 pandemic began, a dramatic rise in anti-Asian sentiment as well as cissemxism and heterosexism (hereafter, cisheterosexism) has been documented, particularly affecting Asian American (AA) sexual and gender minority (SGM) adolescents who face intersecting oppressions.
PURPOSE: We investigated the associations between state-level structural anti-Asian racism, structural cisheterosexism, and psychological, behavioral, and sleep health outcomes among AA SGM adolescents.
METHODS: This study analyzed a subsample of AA SGM adolescents (N = 980) from a US cross-sectional national survey of 17 578 SGM adolescents aged 13-18 years old conducted in 2022. To quantify state-level structural anti-Asian racism and structural cisheterosexism, we utilized data from multiple sources including Project Implicit (implicit and explicit prejudiced attitudes), Education Week (critical race theory legislation), and Movement Advancement Project (anti-SGM laws and policies). Multivariate regression analyses examined associations between structural oppression and health outcomes, adjusting for individual demographics and state-level covariates (poverty, income inequality, conservatism, and population density).
RESULTS: Higher levels of structural anti-Asian racism were associated with greater psychological distress (adjusted b = 0.58, robust SE = 0.21) and higher odds of recent vape use (adjusted odds ratio = 2.56, 95% CI: 1.77-3.70). Structural cisheterosexism was associated with greater odds of past-year alcohol use (adjusted OR = 2.07, 95% CI: 1.27-3.38), but less sleep trouble (adjusted b = -0.31, robust SE = 0.08). The adverse effects of structural anti-Asian racism on psychological distress were amplified for AA SGM adolescents living in states with higher structural cisheterosexism.
CONCLUSIONS: These findings demonstrate how intersecting structural oppressions shape health outcomes among multiply marginalized youth, highlighting the urgent need for comprehensive policies addressing multiple forms of structural oppressions.
PURPOSE: We investigated the associations between state-level structural anti-Asian racism, structural cisheterosexism, and psychological, behavioral, and sleep health outcomes among AA SGM adolescents.
METHODS: This study analyzed a subsample of AA SGM adolescents (N = 980) from a US cross-sectional national survey of 17 578 SGM adolescents aged 13-18 years old conducted in 2022. To quantify state-level structural anti-Asian racism and structural cisheterosexism, we utilized data from multiple sources including Project Implicit (implicit and explicit prejudiced attitudes), Education Week (critical race theory legislation), and Movement Advancement Project (anti-SGM laws and policies). Multivariate regression analyses examined associations between structural oppression and health outcomes, adjusting for individual demographics and state-level covariates (poverty, income inequality, conservatism, and population density).
RESULTS: Higher levels of structural anti-Asian racism were associated with greater psychological distress (adjusted b = 0.58, robust SE = 0.21) and higher odds of recent vape use (adjusted odds ratio = 2.56, 95% CI: 1.77-3.70). Structural cisheterosexism was associated with greater odds of past-year alcohol use (adjusted OR = 2.07, 95% CI: 1.27-3.38), but less sleep trouble (adjusted b = -0.31, robust SE = 0.08). The adverse effects of structural anti-Asian racism on psychological distress were amplified for AA SGM adolescents living in states with higher structural cisheterosexism.
CONCLUSIONS: These findings demonstrate how intersecting structural oppressions shape health outcomes among multiply marginalized youth, highlighting the urgent need for comprehensive policies addressing multiple forms of structural oppressions.