Pride and Community Connection for Indigenous 2SLGBTQ+ Youth: the Intersectionality of Identity for Indigenous Adolescents in the United States

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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 Indigenous identity. There are limited data on the unique needs and strengths of this population. This work aimed to highlight the barriers and needs of 2SLGBTQ+ AYA and the link between cultural connection, pride, and resilience and positive health outcomes for these adolescents. This analysis of 15–25-year-old participants is derived from a mixed-methods study, which assessed the barriers to seeking and accessing care for 2SLGBTQ+ individuals. Survey and short-answer responses were collected through REDCap, and an analysis was performed using SAS 9.4 (quantitative) and ATLAS.ti (qualitative short answer). 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 besides gender diversity. 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 allow for identity formation and expression. Findings can also be applied to gender-diverse AYA in non-Indigenous communities.