O4312: Sexual and Gender Identity and Indigeneity: Understanding the Intersectionality of Identity for Indigenous Adolescents

Background: Two-Spirit and lesbian, gay, bisexual, transgender, queer, and gender-diverse (2SLGBTQ+) adolescents and young adults (AYA) in Indigenous communities face disparate physical and mental health outcomes in the absence of connection to culture and Indigiqueer identity. There are limited data on the unique needs and strengths of this population. This work aimed to highlight barriers and needs of 2SLGBTQ+ AYA, along with highlight the link between cultural connection, pride, and resilience and positive health outcomes for these adolescents.

Methods: This analysis of 15 to 25-year-old participants (Fig 1) is derived from a mixed-methods study which assessed barriers to seeking and accessing care for 2SLGBTQ+ individuals. Survey and short answer responses were collected through RedCap, and analysis was performed using SAS 9.4 (quantitative) and Atlas.ti (qualitative- short answer).

Results: Responses demonstrate high levels of pride and connectedness among 2SLGBTQ+ AYA, and that affirming healthcare is critical in supporting positive outcomes. Results also suggest a need for increased education regarding Indigenous worldviews, health, barriers to care, and historical contexts behind gender-diversity (Fig 2).

Conclusion: In conclusion, results indicate that pride and connection are inherent in 2SLGBTQ+ AYA communities, which can serve as protective factors to improve health outcomes. Using this knowledge, providers can support youth clinically as well as through policy and advocacy action. Family, community, and health provider support allows for identity formation and expression. Findings can also be applied to gender-diverse AYA in non-Indigenous communities.