Grant: Op. Gr. Adv. 2S_LGBTQI+ Heal. Thr. Res. - Advancing 2S/LGBTQI+ Health

Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, and other sexual and gender diverse (2S/LGBTQI+) youth in Canada experience higher rates of depression, anxiety, and suicidal thoughts than their heterosexual and cisgender peers. For these youth, we do not yet understand which family experiences protect or increase risk, how families affect access to mental health care, or how legislative policies shape their mental health trajectories. These questions are particularly urgent for transgender and gender diverse (TGD) youth, who often face unique social stressors, family rejection, and barriers to affirming services. Families play a powerful role in shaping youth mental health. Supportive family relationships may reduce symptoms and prevent crisis care, while conflict or rejection can increase risk. Yet, we lack strong Canadian evidence tracking how family experiences affect mental health trajectories and service use from childhood through adolescence for 2S/LGBTQI+ youth. This study will follow youth using data from the All Our Families cohort in Alberta, which has collected information from pregnancy through age 16. We will examine how family environments relate to changes in mental health symptoms, diagnoses, and service use over time. We will also link these data to provincial health records to explore how family factors influence help-seeking, mental health service use, and emergency visits, and how restrictive legislative policies may alter these pathways. Finally, we will work with 2S/LGBTQI+ youth, caregivers, service providers, and community partners to interpret results and identify the most important family-focused priorities for prevention, clinical care, and policy. By highlighting practical, modifiable family supports, especially for TGD youth, this research will inform more timely, affirming, and equitable mental health care for 2S/LGBTQI+ youth across Canada.