Theses and Dissertations from UMD
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New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item SOCIAL AND ENVIRONMENTAL BARRIERS TO HEALTHCARE ACCESS AND UTILIZATION FOR LESBIAN, GAY, AND BISEXUAL PEOPLE IN CALIFORNIA.(2020) Akre, Ellesse-Roselee; Roby, Dylan H; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Sexual minorities, lesbian, gay and bisexual people, are exposed to chronic stigmatization and heteronormativity in their daily lives and when they access health care. There are no genetic differences between sexual minorities and their heterosexual counterparts; the literature demonstrates that chronic stress related to being a minority, experiences associated with accessing care in a system that assumes one is heterosexual, exposure to negative attitudes from others, and internalized negative attitudes regarding one’s sexuality impact health outcomes and healthcare access and utilization. While there are known barriers to healthcare access the literature does not examine how multiple social identities influence healthcare access in sexual minorities. Intersectionality posits that the interconnected nature of social identities creates an overlapping and interdependent system of disadvantage. This study had three aims: 1) To examine differences in healthcare access at the intersections of urbanicity, race/ethnicity, and sexual identity; 2) examine differences in healthcare access at the intersections of sexual identity, gender, and income; and 3) determine whether non-identifying sexual minorities have disparate access to healthcare compared to identifying sexual minorities. Using 2014-2017 California Health Interview Survey data combined with the supplemental sexual orientation special use research file, I examined the relationship between healthcare access and utilization outcomes and the intersections between sexual identity, urbanicity, gender, income, and sexual identity disclosures. Using known evidence of barriers to healthcare access as dependent variables I used predictive modeling to estimate odds ratios of experiencing barriers to healthcare access using adjusted logistic regressions. The results of my dissertation produced evidence that for sexual minorities in California, sexual identity is associated with varying levels of healthcare access when examined within the context of other social identities. That is, there are differences in access and utilization amongst sexual minorities based on income and gender, and within subgroups of sexual minorities, especially in female and bisexual subgroups. Urban and rural environment did not determine healthcare access in sexual minorities and there was not enough data to confidently estimate differences in access between urban and rural sexual minorities of color. Study findings demonstrate that the female gender has more disadvantages to healthcare access that advantages regardless of income and sexual identity. They also demonstrated that income does not fully mitigate access barriers in sexual minority women. Lastly, findings from the study demonstrate that the non-identifying sexual minority identity is associated with less access to healthcare, specifically in men. Findings from this dissertation contributes to the knowledge of how disparities in healthcare access and utilization continue to persist in the sexual minority population despite increased access to healthcare coverage. This dissertation suggests that other factors uniquely related to being female and bisexual are salient for accessing healthcare for sexual minorities. It is essential that researchers, policy makers, and healthcare providers and staff provide more data on sexual minorities, create curated policy to support the most vulnerable sexual minorities, and engage in culturally sensitive training to eliminate barriers to healthcare access for sexual minorities to eliminate healthcare access disparities.Item HETEROSEXIST HARASSMENT AND SOCIAL COGNITIVE VARIABLES AS PREDICTORS OF SEXUAL MINORITY COLLEGE STUDENTS’ ACADEMIC SATISFACTION AND PERSISTENCE INTENTIONS(2017) Morris, Taylor Robin; Lent, Robert W; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Sexual minorities face experiences of heterosexist harassment in the college environment, which may contribute to decreased academic well-being. Thus, the present study investigated whether social cognitive variables and heterosexist harassment predict sexual minority college students’ academic satisfaction and intentions to persist. The sample consisted of 731 undergraduate students who completed an online survey. Social cognitive variables were hypothesized to predict academic satisfaction, as specified by the social cognitive model of academic satisfaction, with heterosexist harassment operating as a barrier. Results suggested that the social cognitive model provided good fit to the data. Heterosexist harassment was found to be associated indirectly with academic satisfaction via perceptions of lower environmental support and it was found to negatively predict intentions to persist. Implications of the results are that heterosexism may play a role in sexual minority students’ academic development and that social cognitive career theory may offer a useful framework for interventions.Item The emotional well-being of mothers of transgender and gender non-conforming children(2015) Allen, Samuel H.; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)In recent years, mental health professionals have reported an upsurge in the number of referrals relating to transgender identities among children. While controversies exist among clinicians over treatment for these children, a growing number of practitioners are encouraging parents to accept their children's gender expressions. This practice, however, may be challenging for parents to embrace for a number of reasons, resulting in a vulnerable mental state. Using a combined theoretical framework of decentering heteronormativity within Meyer's minority stress theory (2003), the present study seeks to determine the association between various factors--gender non conformity, gender role beliefs, and child misbehavior--and the anxiety and depression in mothers of transgender and gender non-conforming children. Data were taken from Wave 1 of a longitudinal study of transgender and gender non-conforming children and their parents. Results indicated that only child misbehavior was significantly associated with maternal anxiety, and social support did not moderate this relationship. Complete findings and their implications are discussed, for both future research and further deconstruction of gender in the social sciences.Item The Role of Self-Esteem in the Relationship Between Sexual Minority Status and Depressive Symptoms(2015) Ng, Diane; Lee, Sunmin; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Sexual minority (SM) youth have been found to experience higher rates of depression and depressive symptoms compared with heterosexual youth. It has been suggested that there are mediators in the pathway between stigma-related stress and psychopathology, such as self-esteem. This study was interested in investigating whether self-esteem is a mediator between SM status by romantic attraction and the outcome depressive symptoms during the transition from adolescence to adulthood, and whether sex moderated this mediation. Results showed that those who were both-sex attracted had significantly higher depressive symptoms than their opposite-sex attracted counterparts (β=0.04,p=0.049). Further, findings showed that self-esteem is a mediator in the pathway between both-sex attraction and depressive symptoms (p=0.007). Although females were found to have higher depressive symptoms than males, no significant interaction with sexual minority status was found. These results can have implications for possible interventions to reduce depressive symptomatology for sexual minority groups transitioning into adulthood.Item Spoken Stories: A Narrative Inquiry on the Lives and Experiences of "Outsider Teachers"(2012) Makris, Sara; Valli, Linda R; Curriculum and Instruction; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)When a teacher enters a classroom, a story begins. The plot is informed by its characters and setting--the students, faculty, and the surrounding community. If a teacher comes from outside this community--whether in terms of race, class, gender identity, sexual orientation, ethnicity, ability status, or culture--the plot thickens. Existing literature examines the roles that these identity characteristics play in the classroom. Literature currently addresses "outsider teachers"--those whose identity characteristics cause them to stand out among their school communities, and in some cases, within many other communities--but it does so often at the exclusion of a holistic view of the teacher. The research tends to focus on teacher experiences in terms of only a single facet of teacher identity within any given study. This study looks at the experiences of "outsider teachers" with the intention of creating a more layered narrative by encompassing the many facets of identity that interact to create the intricate experience of an individual human being. The experiences of these outsider teachers, the ways in which they characterize their identities, and in particular, the ways that they articulate their approach to pedagogy, provide valuable insight for the teaching community at large. Using narrative inquiry, this study explores the experiences of a group of six "outsider teachers," including the researcher. The images of the participants present a more complex picture than those found in studies that examine teacher identity based upon only one or two identity categories, to the exclusion of others. Informed by intersectionality theory--which emphasizes the nuanced interaction of identity categories--the study seeks to portray depth and subtlety in descriptions of participants. This effort has implications for the viability of intersectionality theory in the discipline of education. In the telling of their stories, participants described the use of proactive inclusiveness, in which they sought to create safe spaces within their classrooms for all students. This proactive inclusiveness emerged from participant experiences of their own intersecting identities. They had felt the complexity of belonging to multiple groups--some of which did not accept the existence of others. Because of this, they came to understand that a group of students might seem cohesive on the surface, but that outsiderness often dwells just below. Proactive inclusiveness, thus, represents a mindset that acknowledges the invisible barriers and struggles that exist within all groups of individuals. They leveraged insider characteristics, using common identity characteristics to gain student trust and challenge embedded stereotypes. Participants stressed the importance of accessing memory as a tool for connecting with students whose characteristics are different from their own, arguing that the existence of an adverse experience in one's life provides some ground for connection with others. In addition, participants described a commitment to giving their students access to broader points of view in an effort to combat the inherited bigotry that can feed societal inequality. Findings also include a potentially expanded definition of "outsider teacher," to describe one who employs a teaching philosophy guided by a desire to focus on inclusion of marginalized students and the development of empathy, acceptance, and open-mindedness among students.Item A Grounded Theory of Lesbian and Gay Leadership Self-Efficacy Development(2011) Ostick, Daniel Townsend; Komives, Susan R.; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this study was to explore the experiences of gay and lesbian college students engaged in leadership and the meaning they made of their leadership self-efficacy development, particularly as it related to their identity development and various environmental assisters and constraints. The study sought to identity what shaped the development of leadership self-efficacy for these students and generated additional questions for future research. Using Grounded Theory Methodology, this study explored the primary research question: How do gay and lesbian college students engaged in leadership develop their leadership self-efficacy? Three interviews were held each with 10 students who self-identified as gay, lesbian, queer, or sexually fluid who were highly involved in leadership activities on campus. The theory that emerged from the participants' experiences centered on the individual's self-efficacy to engage in leadership defined within the context of their beliefs about the nature of leadership engagement. The self-efficacy of the students was enhanced by support, success, and deep and broad involvement and was diminished by failure and active criticism. The students‟ gay, lesbian, or queer identities served to either improve self-efficacy or leadership or had no demonstrable effect, according to the participants‟ stories. Sexual orientation served to improve self-efficacy for engagement in leadership by broadening perspectives, improving relationships and comfort within groups, allowing the participants to bring their full selves to their experiences, creating empathy and understanding, and improving personal awareness. Participants also shared that their identities were integral to their involvements, that being out increased their overall self-confidence, that greater comfort led to greater involvement, and that visibility and voice was important to their leadership self-efficacy. Students also shared that their sexual orientation did not have an appreciable effect on their leadership self-efficacy when they already had a great deal of confidence to engage in leadership, when they had already integrated their sexual orientations, when situations did not relate to their sexual orientations, or when the saliency of their sexual orientations was lower than other aspects of their personality.Item Trainees' Use of Supervision for Clinical Work with Lesbian, Gay, and Bisexual Clients: A Qualitative Study(2010) McGann, Kevin; Hoffman, Mary Ann; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Most studies considering lesbian, gay, and bisexual (LGB) clients and their therapists have primarily focused on the clients' experience in therapy (Israel, Walther, Gorcheva, & Sulzner, 2007; Liddle, 1996) or on the therapist's experience of the client (Bieschke & Matthews, 1996; Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). However, the role that clinical supervision plays in therapists' development in working with LGB clients is rarely studied. Not enough is known about how supervision is perceived from the perspective of the supervisee who is developing skills in working with LGB clients. The current study examined 12 interviews with randomly selected predoctoral interns at APA-accredited counseling centers around the country, to explore how they made use of the clinical supervision they received for their work with LGB clients. The single previous qualitative investigation of this topic (Burkard, Knox, Hess, & Shultz, 2009) examined interviews with LGB advanced doctoral students. The current study extends the investigation of this topic by interviewing six heterosexual-identified trainees in addition to six trainees who identified as LGB or queer (Q), and by investigating a more geographically heterogeneous sample. The interviews explored various aspects of the supervision experience, including trainees' expectations of their supervisor for supervision of their work with their LGB client, the contributions of trainees and their supervisors to the supervision process, and the impact of supervision on work with the LGB client and other clients. The data were analyzed using Consensual Qualitative Research (CQR; Hill, Knox, Thompson, Williams, Hess, & Ladany, 2005; Hill, Thompson, & Williams, 1997). All participants valued their supervision relationship, and found their supervisors helpful in assisting them in their therapeutic work with their LGB client. Trainees typically experienced their supervisors as multiculturally sensitive, and some felt that their supervisors helped them with LGB-specific interventions and case conceptualizations. Some differences between how heterosexual and LGB-identified trainees used supervision for their work with their LGB clients. All participants reported gains from their supervision experience with their LGB client that positively affected their work with other clients, regardless of these clients' sexual orientation.