Felix McNulty | Lancaster University (original) (raw)
Papers by Felix McNulty
International journal of social determinants of health and health services, Feb 22, 2024
Research Square (Research Square), Feb 1, 2022
Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor men... more Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ adolescents, suggesting a need to intervene to affect change within the school environment. The aim of this review was to examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents? Method: A realist review was conducted utilizing the seven-step published protocol (1, 2). The review focused on all types of school-based interventions that impacted on LGBTQ+ adolescent mental health. All study designs were included. The search strategy involved comprehensive electronic database searches and additional complementary search strategies (hand searching, citation tracking). Studies were subject to an inclusion criteria and quality appraisal. Those included in the review where subject to data extraction under de ned elds of context, mechanism and outcome and synthesized to produce a programme theory. Results: In total, 4,911 titles and abstracts were screened, and 125 full papers reviewed, with 17 studies included in the nal review. The review found 8 intervention components were necessary for school-based interventions to address LGBTQ+ pupil's mental health: a rmative visual displays; external signposting to LGBTQ+ support; stand-alone input; school-based LGBTQ support groups; curriculum-based delivery; staff training; inclusion policies; trusted adult to talk to. Explaining how an intervention worked is complex and the programme theory developed emphasises the multiple causal pathways (e.g., psychological, behavioural, emotional, environmental, social) that operate to reduce poor mental health. Conclusions: We identi ed relatively few school-based interventions for this population group. The developed programme theory indicates that 'to work' school-based interventions must have a 'wholeschool' approach that addresses speci cally the dominant cis-heteronormative school environment and hence the marginalisation, silence, and victimization that LGBTQ+ pupils experience. We require more research on school interventions to reduce the inequalities in mental health in LGBTQ+ youth. We need to understand the underlying mechanisms that produce this inequality to design successful school public mental health interventions. gay (LG) youth 4 times more likely to report a history of attempted suicide (7). The restrictions due to Covid-19 have also had a disproportionate impact on LGBTQ+ young people's mental health (8), and trans and gender diverse youth have been more effected by the pandemic than cis youth (9). School climate is a leading predictor of students' emotional and behavioural outcomes (10). School climate encompasses all elements of the school experience for young people, including quality of teaching and learning, school community relationships, school organisation, and the institutional and structural features of a school environment. This contributes to the quality of interactions for students, teachers and parents, and re ects the norms, values and goals, which represent the educational and social objectives of the school (11). School climate affects students' adaptive psychosocial adjustment (12), mental health outcomes (13, 14), and self-esteem (15). Further, it has been speci cally associated with LGBTQ+ youth's experience of mental health problems, such as depression and suicidality (16). A UK-based study, which surveyed over 7,000 young people aged 16 to 25 found that most young LGBTQ+ people feel that their time at school is affected by hostility or fear, with consequences such as feeling left out, achieving lower grades, and having to move schools. Most reported that their school supported its pupils badly in respect of sexual orientation or gender identity (17). A 2021 scoping review and found that peer victimisation, bullying and safety concerns are prevalent for transgender young people within the secondary schooling environment (18), and studies consistently reported that each of these three factors are related to negative mental health outcomes. The 2016 UNESCO Out in the Open (19) report identi ed homophobic, biphobic and transphobic (HBT) violence in schools as a global problem, and young people who are perceived not to conform to prevailing sexual and gender norms, including those who are LGBTQ+ identi ed, as most vulnerable. The report concluded that a 'comprehensive approach' that involves the whole education sector was the most effective means of addressing the issue. However, only three countries had conducted a large-scale formal evaluation of interventions to tackle HBT violence in schools: the Netherlands, USA, and the UK. In the UK the intervention to tackling HBT bullying in schools (20, 21) has been evaluated nationally (21). This research remains one of the only evaluations of an intervention that seeks to tackle this issue (nationally and globally). A key nding from the evaluation was that for anti-HBT bullying initiatives to be successful they needed to be part of a 'whole school' approach (22). The 'whole school' approach addresses HBT bullying across and through involvement of the entire school rather than being limited to one area of activity (21). The 'whole school' approach attempts to move away from individually oriented approaches that focus on punishing single actors (e.g., bullies), and instead moves to, for example, creating more inclusive curricula and more positive LGBTQ+ representation. Formby (23) argues that a narrow focus on HBT bullying does not address the multi-levelled approach needed to challenge the dominant cis-heteronormative culture of schools and create an LGBTQ+ inclusive environment. National policy both in the UK and US has tended to have a limited focus on HBT-bullying in schools that concentrates on individual actors and conceals the systemic and pervasive gender and sexual minority inequalities of the wider school climate (24, 25).
International Journal of Environmental Research and Public Health, Feb 28, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Environmental Research and Public Health
Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health i... more Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison with their cisgender heterosexual peers. The school environment is a major risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ young people. The aim of this UK study was to develop a programme theory that explained how, why, for whom, and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ young people, through participation with key stakeholders. Online realist interviews were conducted in the UK with (1) LGBTQ+ young people aged between 13–18 years attending secondary schools (N = 10); (2) intervention practitioners (N = 9); and (3) school staff (N = 3). A realist retroductive data analysis strategy was employed to identify causal pathways across different interventions that improved mental health outcomes. The programme theory we produced explains how school-based interventions that directly ...
In recent decades, theorising around trans embodiment has sought to move away from narratives of ... more In recent decades, theorising around trans embodiment has sought to move away from narratives of the 'wrong' and pathological trans body. Emergent analytical and theoretical frameworks have instead highlighted the ways in which particular bodies become designated as trans, and what this means for the kinds of possibilities for embodiment that are opened up and closed down at the levels of both individual relationships and contexts, and structural and systemic constraints. The significance of weight and shape in relation to these embodied possibilities has not yet been fully explored within sociology. Drawing upon qualitative interviews with 21 participants who identified as trans and/or gender non-conforming, this thesis examines the intersection of body weight and shape with trans and gender non-conforming positionality in order to address gaps in existing knowledge around the meaning and significance of weight and shape for trans and gender non-conforming people and commun...
Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor men... more Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ adolescents, suggesting a need to intervene to affect change within the school environment. The aim of this review was to examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents?Method: A realist review was conducted utilizing the seven-step published protocol (1, 2). The review focused on all types of school-based interventions that impacted on LGBTQ+ adolescent mental health. All study designs were included. The search strategy involved comprehensive electronic database searches and additional complementary search strategies (hand searching, citation tracking). Studies were subject to an inclusion criteria and quality appraisa...
In recent decades there has been a surge in the representation of trans people, with an increasin... more In recent decades there has been a surge in the representation of trans people, with an increasing number of well-known public figures and increasingly networked communities voicing a range of experiences and perspectives that have historically been hidden or erased in various ways. Along with this surge in certain forms of visibility has come an increase in funded research on the physical and mental health of transgender populations, with findings pointing to disproportionately high levels of mental distress of various kinds.
Driven by a growing public conversation emerging around eating disorders among the transgender population, this work critically analyses two pieces of UK-based research on trans people and eating distress to identify and discuss the consequences of cisgenderist ideology, which delegitimises trans self-designations. The work will centre around the following two research questions: How can cisgenderism be seen to manifest in UK-based research on eating disorders in transgender populations? and What are the consequences of this in terms of methodology, hypotheses, and outcomes and, by extension, what are the potential consequences in practice for the group being researched? This discussion will provide the basis for identifying areas in need of urgent future attention.
International journal of social determinants of health and health services, Feb 22, 2024
Research Square (Research Square), Feb 1, 2022
Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor men... more Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ adolescents, suggesting a need to intervene to affect change within the school environment. The aim of this review was to examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents? Method: A realist review was conducted utilizing the seven-step published protocol (1, 2). The review focused on all types of school-based interventions that impacted on LGBTQ+ adolescent mental health. All study designs were included. The search strategy involved comprehensive electronic database searches and additional complementary search strategies (hand searching, citation tracking). Studies were subject to an inclusion criteria and quality appraisal. Those included in the review where subject to data extraction under de ned elds of context, mechanism and outcome and synthesized to produce a programme theory. Results: In total, 4,911 titles and abstracts were screened, and 125 full papers reviewed, with 17 studies included in the nal review. The review found 8 intervention components were necessary for school-based interventions to address LGBTQ+ pupil's mental health: a rmative visual displays; external signposting to LGBTQ+ support; stand-alone input; school-based LGBTQ support groups; curriculum-based delivery; staff training; inclusion policies; trusted adult to talk to. Explaining how an intervention worked is complex and the programme theory developed emphasises the multiple causal pathways (e.g., psychological, behavioural, emotional, environmental, social) that operate to reduce poor mental health. Conclusions: We identi ed relatively few school-based interventions for this population group. The developed programme theory indicates that 'to work' school-based interventions must have a 'wholeschool' approach that addresses speci cally the dominant cis-heteronormative school environment and hence the marginalisation, silence, and victimization that LGBTQ+ pupils experience. We require more research on school interventions to reduce the inequalities in mental health in LGBTQ+ youth. We need to understand the underlying mechanisms that produce this inequality to design successful school public mental health interventions. gay (LG) youth 4 times more likely to report a history of attempted suicide (7). The restrictions due to Covid-19 have also had a disproportionate impact on LGBTQ+ young people's mental health (8), and trans and gender diverse youth have been more effected by the pandemic than cis youth (9). School climate is a leading predictor of students' emotional and behavioural outcomes (10). School climate encompasses all elements of the school experience for young people, including quality of teaching and learning, school community relationships, school organisation, and the institutional and structural features of a school environment. This contributes to the quality of interactions for students, teachers and parents, and re ects the norms, values and goals, which represent the educational and social objectives of the school (11). School climate affects students' adaptive psychosocial adjustment (12), mental health outcomes (13, 14), and self-esteem (15). Further, it has been speci cally associated with LGBTQ+ youth's experience of mental health problems, such as depression and suicidality (16). A UK-based study, which surveyed over 7,000 young people aged 16 to 25 found that most young LGBTQ+ people feel that their time at school is affected by hostility or fear, with consequences such as feeling left out, achieving lower grades, and having to move schools. Most reported that their school supported its pupils badly in respect of sexual orientation or gender identity (17). A 2021 scoping review and found that peer victimisation, bullying and safety concerns are prevalent for transgender young people within the secondary schooling environment (18), and studies consistently reported that each of these three factors are related to negative mental health outcomes. The 2016 UNESCO Out in the Open (19) report identi ed homophobic, biphobic and transphobic (HBT) violence in schools as a global problem, and young people who are perceived not to conform to prevailing sexual and gender norms, including those who are LGBTQ+ identi ed, as most vulnerable. The report concluded that a 'comprehensive approach' that involves the whole education sector was the most effective means of addressing the issue. However, only three countries had conducted a large-scale formal evaluation of interventions to tackle HBT violence in schools: the Netherlands, USA, and the UK. In the UK the intervention to tackling HBT bullying in schools (20, 21) has been evaluated nationally (21). This research remains one of the only evaluations of an intervention that seeks to tackle this issue (nationally and globally). A key nding from the evaluation was that for anti-HBT bullying initiatives to be successful they needed to be part of a 'whole school' approach (22). The 'whole school' approach addresses HBT bullying across and through involvement of the entire school rather than being limited to one area of activity (21). The 'whole school' approach attempts to move away from individually oriented approaches that focus on punishing single actors (e.g., bullies), and instead moves to, for example, creating more inclusive curricula and more positive LGBTQ+ representation. Formby (23) argues that a narrow focus on HBT bullying does not address the multi-levelled approach needed to challenge the dominant cis-heteronormative culture of schools and create an LGBTQ+ inclusive environment. National policy both in the UK and US has tended to have a limited focus on HBT-bullying in schools that concentrates on individual actors and conceals the systemic and pervasive gender and sexual minority inequalities of the wider school climate (24, 25).
International Journal of Environmental Research and Public Health, Feb 28, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Environmental Research and Public Health
Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health i... more Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison with their cisgender heterosexual peers. The school environment is a major risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ young people. The aim of this UK study was to develop a programme theory that explained how, why, for whom, and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ young people, through participation with key stakeholders. Online realist interviews were conducted in the UK with (1) LGBTQ+ young people aged between 13–18 years attending secondary schools (N = 10); (2) intervention practitioners (N = 9); and (3) school staff (N = 3). A realist retroductive data analysis strategy was employed to identify causal pathways across different interventions that improved mental health outcomes. The programme theory we produced explains how school-based interventions that directly ...
In recent decades, theorising around trans embodiment has sought to move away from narratives of ... more In recent decades, theorising around trans embodiment has sought to move away from narratives of the 'wrong' and pathological trans body. Emergent analytical and theoretical frameworks have instead highlighted the ways in which particular bodies become designated as trans, and what this means for the kinds of possibilities for embodiment that are opened up and closed down at the levels of both individual relationships and contexts, and structural and systemic constraints. The significance of weight and shape in relation to these embodied possibilities has not yet been fully explored within sociology. Drawing upon qualitative interviews with 21 participants who identified as trans and/or gender non-conforming, this thesis examines the intersection of body weight and shape with trans and gender non-conforming positionality in order to address gaps in existing knowledge around the meaning and significance of weight and shape for trans and gender non-conforming people and commun...
Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor men... more Background: Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ adolescents, suggesting a need to intervene to affect change within the school environment. The aim of this review was to examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents?Method: A realist review was conducted utilizing the seven-step published protocol (1, 2). The review focused on all types of school-based interventions that impacted on LGBTQ+ adolescent mental health. All study designs were included. The search strategy involved comprehensive electronic database searches and additional complementary search strategies (hand searching, citation tracking). Studies were subject to an inclusion criteria and quality appraisa...
In recent decades there has been a surge in the representation of trans people, with an increasin... more In recent decades there has been a surge in the representation of trans people, with an increasing number of well-known public figures and increasingly networked communities voicing a range of experiences and perspectives that have historically been hidden or erased in various ways. Along with this surge in certain forms of visibility has come an increase in funded research on the physical and mental health of transgender populations, with findings pointing to disproportionately high levels of mental distress of various kinds.
Driven by a growing public conversation emerging around eating disorders among the transgender population, this work critically analyses two pieces of UK-based research on trans people and eating distress to identify and discuss the consequences of cisgenderist ideology, which delegitimises trans self-designations. The work will centre around the following two research questions: How can cisgenderism be seen to manifest in UK-based research on eating disorders in transgender populations? and What are the consequences of this in terms of methodology, hypotheses, and outcomes and, by extension, what are the potential consequences in practice for the group being researched? This discussion will provide the basis for identifying areas in need of urgent future attention.