{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:48:36Z","timestamp":1788410916055,"version":"build-2803163510"},"reference-count":42,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["LGBT Health"],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Transgender and gender expansive (TGE) youth experience elevated risk for substance use and other health inequities compared to cisgender peers. The purpose of this study was to examine associations between protective environments\u2014perceived community tolerance, perceived family support, and housing stability\u2014and recent binge drinking, lifetime high-risk substance use (HRSU; cocaine, methamphetamines, and\/or heroin), and self-rated health in a sample of TGE youth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This secondary analysis of 1567 TGE youth aged 13\u201324 years draws from the Centers for Disease Control and Prevention's 2018 web-based\n                      <jats:italic toggle=\"yes\">Survey of Today's Adolescent Relationships and Transitions<\/jats:italic>\n                      , which used a nonprobabilistic recruiting strategy via social media. Logistic regression was used to test the associations between protective environments and substance use and health outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 28.1% of participants reported that people who lived near them were tolerant of transgender people, 32.8% reported that their family was at least somewhat supportive of their TGE identity, and 77.0% were stably housed. In the logistic regression models, community tolerance and housing stability were associated with lower odds of self-rated poor health. Housing stability was associated with lower odds of recent binge drinking and lifetime HRSU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Perceived community tolerance and housing stability were associated with several health outcomes among TGE youth in this study. Protective factors, including safe, stable, nurturing relationships and environments, are critical to youth health and wellbeing. The findings in this study highlight the need for prevention strategies to promote protective environments and reduce known substance use and overall health inequities among TGE youth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lgbt.2021.0258","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T10:50:06Z","timestamp":1651661406000},"page":"393-400","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Protective Environments, Health, and Substance Use Among Transgender and Gender Expansive Youth"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4937-695X","authenticated-orcid":false,"given":"Katrina S.","family":"Kennedy","sequence":"first","affiliation":[{"name":"Research Participation Program at the Centers for Disease Control and Prevention, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA."},{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Harper","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Adolescent and School Health, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5543-1700","authenticated-orcid":false,"given":"Nicolas A.","family":"Suarez","sequence":"additional","affiliation":[{"name":"Division of Adolescent and School Health, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9057-2752","authenticated-orcid":false,"given":"Michelle M.","family":"Johns","sequence":"additional","affiliation":[{"name":"Division of Adolescent and School Health, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.06.024"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/19361653.2020.1727814"},{"key":"e_1_3_5_4_2","unstructured":"PFLAG. 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