Longitudinal Mixed Methods Analysis of Risk and Protective Factors Influencing Psychological Distress in Sexual and Gender Minority Birthing People - Project Abstract Adverse mental health conditions are the most common complication of pregnancy and childbirth, affecting 1 in 5 birthing people in the US each year. Sexual and gender minority (SGM) individuals, including lesbian, bisexual, and queer women as well as transgender and gender nonconforming individuals, face increasing social stigma, animosity, and conflicts. Preliminary data suggests that these negative societal factors contribute to significant disparities in mental health outcomes among SGM birthing people. Two modifiable protective factors—access to quality healthcare and social support—are crucial for reducing the risk of pregnancy-related complications and mitigating adverse mental health effects. Unfortunately, SGM individuals often encounter unaffirming and inappropriate care, leading to elevated stress levels, non-compliance, and delays in seeking essential healthcare services. Additionally, the nature of support needed by SGM individuals often differs from that required by heterosexual cisgender women. Therefore, there is a pressing need for a deeper examination of SGM birthing people's experiences with medical care and social support to inform culturally sensitive interventions tailored specifically for SGM people, alongside comprehensive training for healthcare providers to deliver appropriate care. The main objective of Mx. Ezra's project is to elucidate how social support and medical care contribute to the mental health trajectories of SGM birthing people throughout the perinatal period. They will accomplish this objective by conducting a longitudinal mixed methods study to address three aims: (Aim 1) visualize and describe the trajectories of psychological distress and social support across the perinatal period among SGM birthing people; (Aim 2) explore mental health, support, and healthcare experiences of SGM birthing people during the perinatal period using qualitative longitudinal trajectory analyses; and (Aim 3) integrate the findings from Aims 1 and 2 to illuminate how psychological distress, social support, and healthcare experiences coalesce across the perinatal period for SGM birthing people. To accomplish the objective and aims of their proposed research plan, Mx. Ezra will seek out additional training to increase their conceptual, methodological, and dissemination skillsets which will augment their core training in Family Science. Their training plan combines formal coursework in family and maternal and child health, statistics, one-on-one mentoring, conference presentations, and publishing research to prepare them for a career as an independent researcher.
