Building Qtpi Villages of Care: Findings and Policy Implications from an Indigenist Collaborative Mixed Methods Study on Queer and Trans Pacific Islander Youth Mental Wellbeing In Washington State

Background and Purpose: Queer and Transgender Pacific Islanders (QTPI) – Indigenous Pasifika people with genders and intimacies that embody their journey beyond masculinity and femininity, including fa’afafine, gela’, and māhū – are sacred members of Pasifika communities. Yet, QTPI continue to experience challenges to their belonging and with oppression that have negative consequences to their mental wellbeing. QTPI youth’s experiences of structural oppression in schools are rooted in the intersections of cis-heteronormativity, racism, and settler colonialism. These experiences create disconnectedness between QTPI youth and their cultures, families, communities, and ancestors – sources of Indigenous wellbeing – and with their peers, educators, and schools, creating challenging and unsafe environments for learning. To address these issues, we sought to explore the mental health challenges of QTPI youth and identify school and community-centered approaches to support their well-being.

Methods: Our study is a part of an Indigenist Collaborative Research project on the educational opportunity gap among Native Hawaiian/Pacific Islander (NH/PI) students in Washington state. Using mixed methods, we examined data from the 2023 Washington Healthy Youth Survey (HYS), a statewide sample of NH/PI youth in Washington’s public schools (n= 1082), and collected semi-structured focus group interviews with NH/PI youth (n=26) and individual interviews with educators working closely with NH/PI students (n=24) in Washington state. Descriptive statistics were used to analyze differences in experiences of mental health (e.g., suicidal ideation, depression, and anxiety) and school safety between QTPI and straight and cisgender NH/PI (SCPI) students. Thematic analysis was used to identify risk and protective factors for QTPI student wellbeing. A data weaving approach, triangulating expertise from a community advisory board of NH/PI educators and leaders, was used to understand the relationship between our quantitative and qualitative findings.

Results: QTPI students were more likely to report having any mental health condition and report thoughts of suicide than SCPI students (RR = 2.5, 2.3). Notably, Transgender QTPI thoughts of suicide at a rate nearly 3 times higher than cisgender NH/PI (RR = 2.8). We also found QTPI and Transgender QTPI felt unsafe at higher rates than SCPI and cisgender NH/PI students, respectively (RRs = 2.0, 2.8). In interviews, educators and students expressed concern for QTPI students’ wellbeing, citing witnessed or personal experiences of QTPI social exclusion, bullying, and identity policing by peers and educators. However, we found that cultural programs provide affirming spaces for QTPI students to exist authentically within their identities, which allowed celebration and restoration of connectedness for QTPI students that nurtured their belonging and mental wellbeing.

Conclusion: Our study illustrates that promoting belonging for QTPI youth rooted in culture and community is crucial to addressing their mental health disparities. Education policies and programs should aim to interweave Pasifika networks of care, histories, and affirming community spaces into schools and curriculum can promote mental health equity and belonging for QTPI youth. Cultural networks of care for QTPI students have social justice implications for future research and policy reform that can further support QTPI youth.