{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:10:46Z","timestamp":1790644246621,"version":"4.1.0"},"reference-count":71,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,6,25]],"date-time":"2018-06-25T00:00:00Z","timestamp":1529884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R21HD088757"],"award-info":[{"award-number":["R21HD088757"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protective factors among TGD high school students in city, suburban, town, and rural locations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data come from a statewide school\u2010based survey conducted in Minnesota in 2016 (n = 2,168 TGD youth). Analysis of covariance models were used to predict the prevalence of multiple indicators of emotional distress, bullying victimization, and protective factors across the 4 location categories, with multiple adjustments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Significant linear trends were observed for 2 emotional distress outcomes and 2 bullying victimization outcomes, with urban TGD students having the lowest rates and rural having the highest prevalences. Additional significant differences in emotional distress were noted, with unexpectedly high rates of depressive symptoms and suicidal ideation among suburban students.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Helping TGD adolescents in all types of locations identify resources and supportive professionals is critical to supporting this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12311","type":"journal-article","created":{"date-parts":[[2018,6,25]],"date-time":"2018-06-25T17:13:03Z","timestamp":1529946783000},"page":"270-281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Emotional Distress, Bullying Victimization, and Protective Factors Among Transgender and Gender Diverse Adolescents in City, Suburban, Town, and Rural Locations"],"prefix":"10.1111","volume":"35","author":[{"given":"Marla E.","family":"Eisenberg","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Gower","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"McMorris","sequence":"additional","affiliation":[{"name":"School of Nursing University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Nicole","family":"Rider","sequence":"additional","affiliation":[{"name":"Program in Human Sexuality, Department of Family Medicine and Community Health University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Coleman","sequence":"additional","affiliation":[{"name":"Program in Human Sexuality, Department of Family Medicine and Community Health University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,25]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding","author":"Institute of Medicine","year":"2011"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2016.09.014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.04.014"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2016.06.012"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.11.008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2017.06.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-009-9397-9"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-008-9389-1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(01)00415-3"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550100049038"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60149-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2006.04.024"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6171.2010.00246.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2012.73.783"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301508"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pits.20173"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.123109"},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","DOI":"10.4159\/9780674028845","volume-title":"The Ecology of Human Development: Experiments by Nature and Design","author":"Bronfenbrenner U.","year":"1979"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500401"},{"key":"e_1_2_7_21_1","first-page":"462","volume-title":"Health Behavior and Health Education: Theory, Research, and Practice","author":"Sallis J","year":"2002"},{"key":"e_1_2_7_22_1","volume-title":"Urban Diversity: Space, Culture, and Inclusive Pluralism in Cities Worldwide","author":"Wanjiku Kihato C","year":"2010"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2137286"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.129.5.674"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/15574090802093562"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0029597"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/10538720.2015.990334"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-009-9412-1"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1037\/sah0000055"},{"key":"e_1_2_7_30_1","unstructured":"Demographia. Definition of Urban Terms. Available at:http:\/\/www.demographia.com\/. Accessed March5 2018."},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.122945"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1037\/rmh0000068"},{"key":"e_1_2_7_33_1","volume-title":"Out in the Country: Youth, Media, and Queer Visibility in Rural America","author":"Gray M.","year":"2009"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1300\/J137v08n02_08"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1606\/1044-3894.2016.97.11"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-3729.2003.00072.x"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/10538720.2016.1191406"},{"key":"e_1_2_7_38_1","volume-title":"Strengths and Silences: The Experiences of Lesbian, Gay, Bisexual and Transgender Students in Rural and Small Town Schools","author":"Palmer NA","year":"2012"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/13676261.2016.1273514"},{"key":"e_1_2_7_40_1","volume-title":"Changing Attitudes on Gay Marriage","author":"Pew Research Center","year":"2017"},{"key":"e_1_2_7_41_1","unstructured":"Gay and Lesbian Rights.Gallup News. Available at:http:\/\/news.gallup.com\/poll\/1651\/gay-lesbian-rights.aspx. Published2017. Accessed October 16 2017."},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2014.928582"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/10538720.2016.1155518"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2007.19.3.218"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2014.0032"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0146139"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2017.1320169"},{"key":"e_1_2_7_48_1","unstructured":"Minnesota State Demographic Center.Age race & ethnicity. Available at:https:\/\/mn.gov\/admin\/demography\/data-by-topic\/age-race-ethnicity\/. Accessed March6 2018."},{"key":"e_1_2_7_49_1","unstructured":"Minnesota State Demogaphic Center.Income & poverty. Available at:https:\/\/mn.gov\/admin\/demography\/data-by-topic\/income-poverty\/. Accessed March6 2018."},{"key":"e_1_2_7_50_1","unstructured":"Office of the Minnesota Secretary of State Steve Simon.Election results. Available at:http:\/\/www.sos.state.mn.us\/elections-voting\/election-results\/. Accessed March6 2018."},{"key":"e_1_2_7_51_1","volume-title":"The 2015 National School Climate Survey","author":"Kosciw J","year":"2016"},{"key":"e_1_2_7_52_1","unstructured":"EisenbergME GowerAL SaewycEM CorlissHL EricksonDJ MehusCJ.LGBTQ youth organizations and emotional well\u2010being among sexual minority youth in Minnesota.Society for Research on Adolescence Biennial Meeting. Minneapolis MN;2018. Available at:https:\/\/admin.allacademic.com\/one\/sra\/sra18\/. Accessed May 29 2018."},{"key":"e_1_2_7_53_1","unstructured":"Minnesota Center for Health Statistics.Minnesota Student Survey. Available at:http:\/\/www.health.state.mn.us\/divs\/chs\/mss\/. Accessed February15 2017."},{"key":"e_1_2_7_54_1","unstructured":"National Center for Education Statistics.Identification of rural locales. Available at:https:\/\/nces.ed.gov\/programs\/edge\/geographicLocale.aspx. Accessed May3 2017."},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2013.02.004"},{"key":"e_1_2_7_56_1","unstructured":"Search Institute.The developmental assets profile (DAP). Available at:http:\/\/www.search-institute.org\/surveys\/DAP. Accessed December8 2016."},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsp.2006.04.002"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000093487.78664.3C"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.23.100901.140546"},{"key":"e_1_2_7_60_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0963-7214.2005.00333.x"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1002\/pits.21791"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2015.02.017"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.64"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300517"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12517"},{"key":"e_1_2_7_67_1","unstructured":"Minnesota Department of Education. Open Enrollment. Available at:http:\/\/education.state.mn.us\/MDE\/fam\/open\/. Accessed May10 2017."},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2004.06.002"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300155"},{"key":"e_1_2_7_70_1","first-page":"e1","article-title":"Vulnerable bullies: perpetration of peer harassment in youth across sexual orientation, weight and disability status","volume":"2015","author":"Eisenberg ME","journal-title":"Am J Public Health"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntr183"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301493"}],"container-title":["The Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjrh.12311","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12311","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jrh.12311","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,7]],"date-time":"2024-07-07T18:25:01Z","timestamp":1720376701000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jrh.12311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,25]]},"references-count":71,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1111\/jrh.12311"],"URL":"https:\/\/doi.org\/10.1111\/jrh.12311","archive":["Portico"],"relation":{},"ISSN":["0890-765X","1748-0361"],"issn-type":[{"value":"0890-765X","type":"print"},{"value":"1748-0361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,25]]},"assertion":[{"value":"2018-06-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}