Beyond ‘Voice’ to ‘Learning with’: A Multiple Streams Policy Analysis and Qualitative Exploration Problematizing Representations of Young LGBT+ Identities

Round 1

Reviewer 1 Report

Beyond ‘voice’ to ‘learning with’: Problematizing representations of young LGBT+ lives, informed by a Multiple Streams Approach

 

This is an interesting and relevant contribution to the journal, but the manuscript has several flaws that impede its publication. Several changes are necessary before the article can be published, but I don’t believe it has enough quality to contribute to the growing body of literature in this field. Still, if the Editor decides to continue processing this submission, I would suggest the following changes:

1.     Abstract must be rewritten. Please provide information according to the journal’s guidelines. Please include information regarding objectives, methodology, results, and conclusion.

2.     Please considering using LGBTQIA+ instead of LBGT+.

3.     Title seems unclear and vague. “LGBT+ lives” seem a very broad concept. I advise authors to reformulate this and reflect it in a new title.

4.     Please include the role of sexual minority oppression. See, for example: Pereira, H.; Esgalhado, G. Intimate Dynamics and Relationship Satisfaction among LGB Adolescents: The Role of Sexual Minority Oppression. Children 2021, 8, 231. doi: 10.3390/children8030231

5.     Figure 1 is unclear. How does it really reflect “Prioritizing youth participation in the development of the Irish LGBTI+ National Youth Strategy”? Figures should be easy and intuitive to interpret.

6.     Authors should provide a definition and references of the Multiple Streams Approach.

7.     Aims and objectives: “The overarching aim of this study was to generate an in-depth understanding of the representation of LGBT+ youth lived experience –and the social meaning constructed by LGBT+ youth – on the significance and nature of such representations.” This is vague and unclear. What is youth lived experience? And social meaning? What ground theory fundaments this?

8.     This study formed part of a larger mixed-methods project (with another aspect of the project reported elsewhere). The aim and objectives are outlined in Figure 2. Authors must provide more information regarding this larger project and where it was reported. Figure 2 doesn’t replace writing the objectives in the text.

9.     Authors must provide full information regarding the Consolidated criteria for reporting qualitative research (COREQ).

10.  Results section lacks parsimony and congruence.

11.  If young people participated in the consultations as collaborators and co-authors, how was objectivity guaranteed?

12.  Themes obtained in the results go beyond the problematized purposes. This must be discussed.

13.   An implications section must be included, emphasizing social, political, psychological and educational considerations.

Best wishes.

Author Response

Comments and response to Reviewer 1

 

Thank you for your review and encouraging comments. We particularly appreciate your comment that this is an interesting and relevant contribution to the journal. We welcome your comments that the changes are necessary before the article can be published, and we have really benefited from your feedback.

We welcome the opportunity to address your feedback and have sought to strengthen the rationale for the article. The review process has been very positive and we have really benefited from an opportunity to strengthen the article. We now address the specific points you have raised:

1. Abstract must be rewritten. Please provide information according to the journal’s guidelines. Please include information regarding objectives, methodology, results, and conclusion.

The journal guidelines specify a total of about 200 words maximum, in a single paragraph without headings (which cover 1) Background: 2) Methods: 3) Results: 4) Conclusion). Wee have made small edits to the abstract, in light of the other changes, in response to your suggestions.

2. Please considering using LGBTQIA+ instead of LBGT+

The article has been re-titled: Beyond ‘voice’ to ‘learning with’: A Multiple Streams policy analysis and qualitative exploration problematizing representations of young LGBT+ identities. The use of LGBT+ identities, rather than LGBT+ lives, seeks to more accurately reflect the content of the article and to provide clarity.

We have given careful consideration to your suggestion that the article should discuss the role of sexual minority oppression. While this has merit (and we are considering this further as we refine our next articles arising from this research project), we feel that Honneth is the most appropriate theorist in highlighting the critical importance of social justice, and recognitive justice, in particular. Using Honneth’s Recognition Theory, we outline this tripartite framework highlighting three interlinking forms of recognition: interpersonal, community and rights-based recognition. A new Figure has been included to illustrate this theory (Figure 1.).

5. Figure 1 is unclear. How does it really reflect “Prioritizing youth participation in the development of the Irish LGBTI+ National Youth Strategy”? Figures should be easy and intuitive to interpret.

We agree that Figures should be easy to and intuitive to interpret. Suggestions regarding Figure 1 have been incorporated. A new Figure has been created (now named Figure 2.) which more appropriately reflects youth participation, the various components that comprise participation, and that this was one aspect in the development of the Irish LGBTI+ National Youth Strategy.

6. Authors should provide a definition and references of the Multiple Streams Approach.

Thank you for drawing attention to this. We have provided further clarification regarding the rationale for using Cairney and Jones’ analysis of Kingdon’s Multiple Streams Approach, and further detail regarding its particular application in health and social care policy initiation.

7. Aims and objectives: “The overarching aim of this study was to generate an in-depth understanding of the representation of LGBT+ youth lived experience –and the social meaning constructed by LGBT+ youth – on the significance and nature of such representations.” This is vague and unclear. What is youth lived experience? And social meaning? What ground theory fundaments this?

In response to your very valid comments, substantive changes have been made to the aims and objectives seek to provide clarification of the terminology was unclear or vague. These now align with the definition of recognitive justice.

8. This study formed part of a larger mixed-methods project (with another aspect of the project reported elsewhere). The aim and objectives are outlined in Figure 2. Authors must provide more information regarding this larger project and where it was reported. Figure 2 doesn’t replace writing the objectives in the text.

This has been amended to state “…which will be reported in forthcoming articles”. Citations for relevant author publications from the broader research project are included throughout, where appropriate. We have described Figure 2 (now renamed as Figure 3).

9. Authors must provide full information regarding the Consolidated criteria for reporting qualitative research (COREQ).

We have also completed the Standards for Reporting Qualitative Research, consistent with reflexive thematic analysis. https://www.equator-network.org/reporting-guidelines/srqr/

10. Results section lacks parsimony and congruence.

While we note suggestions that the article lacks parsimony and congruence, qualitative research specifically seeks out depth, detail and complexity. This is particularly relevant in ethnography which provides a more nuanced picture of the meanings, understandings, and experiences of a group. We have strengthened our reference to this and included that ‘Such insider approaches, are considered beneficial in researching LGBT+ communities…’ While, there is broad alignment in the young people’s accounts, it is essential to capture the diversity within their narratives. This is a strength of qualitative research.

11. If young people participated in the consultations as collaborators and co-authors, how was objectivity guaranteed?

Thank you for the opportunity to discuss objectivity. Qualitative research does not seek objectivity, rather subjectivity is regarded as part and parcel of research relationships and processes. However, we have attended to Tracy and Hinrich’s eight criteria for qualitative quality throughout the methods section. These are 1. worthy topic; 2. rich rigor; 3. sincerity; 4. credibility; 5. resonance; 6. significant contribution; 7. ethics; and 8. meaningful coherence.

12. Themes obtained in the results go beyond the problematized purposes. This must be discussed.

By restructuring the article, we have sought to provide clarity regarding the problematization of the representations of LGBT+ youth identities, almost solely in relation to mental health risk, as inextricably linked to the invisibility and silence of these identities, particularly within curricular, with the potential to reinscribe stigma as a consequence. This article challenges the stigmatization of LGBT+ identities through problematizing such representations.

13. An implications section must be included, emphasizing social, political, psychological and educational considerations.

Thank you for your suggestion that the article could be improved through more focus on the implications, which aligns with the other reviewers. To address this, we have restructured the discussion, drawing from Honneth’s three interconnected spheres of recognition: interpersonal, LGBT+ human rights and community recognition. This provides a framework for particular attention to reorienting policy, practice and future research directions.

 

We note your comment that the article lacks enough quality to contribute to the growing body of literature in this field. We feel that this article makes an important contribution to the limited qualitative literature, not least because it seeks to amplify the voices of seldom heard LGBT+ youth. The theme of ‘seen and heard’ speaks directly to how LGBT+ identities are represented, often with negative connotations due to the invisibility and silence of these identities within curricular. We consider this revised manuscript (and future manuscripts arising from the project) has been strengthened by addressing your comments and suggestions.

Author Response File: Author Response.pdf

Reviewer 2 Report

Youth

Review Letter to Authors

 

 

Manuscript Title:           Beyond ‘voice’ to ‘learning with’: Problematizing

                                      representations of young LGBT+ lives, informed by a

                                      Multiple Streams Approach

 

Manuscript ID:             None Provided.

 

Date:                              Friday, August 5, 2022

_________________________________________________________

This exploratory work evaluated the authenticity of recent research highlighting mental health disparities for these populations led to the formation of the Irish LGBTI+ National Youth Strategy, which prioritized youth participation through a Youth Advisory Group (YAG). A policy analysis of the initiation of the Strategy outlines the convergence of problems, policies and politics using Kingdon’s Multiple Streams Approach (MSA), with quantitative literature suggesting substantial vulnerabilities. This policy analysis highlighted the views of six youth co-authors, with experiential expertise, who were YAG members.

 

I found this topic quite interesting and I enjoyed reading this manuscript because of the limited qualitative research that has examined the experiences of LGBT+ youth. It is in the spirt of strengthening the manuscript that I provide the following questions, comments, and recommendations:  

 

Introduction

 

On Page 3, you wrote:

 

The review informed the plan to introduction a new curriculum as part of Social, Personal and Health Education (SPHE) in a staged process in primary and secondary schools [39,40].

 

 

 

 

Change to:

 

The review informed the plan to introduce a new curriculum as part of Social, Personal and Health Education (SPHE) in a staged process in primary and secondary schools [39,40].

 

On Page 2, you provided this footnote:

 

1 The use of the LGBT+ acronym evolved iteratively through the LGBT+ National Youth Strategy policy-making process. The acronym encompasses a broad range of sexual orientations, gender identities as well as diverse sex development. This article focused on sexual and gender minority populations and the LGBT+ acronym is used to reflect this.

 

However, on Page 4, you wrote:

 

1.3. Rationale

The initiation of LGBTI+ Strategy, as part of a cross-governmental commitment, provides an opportunity to critically examine the window of opportunity through the lens of the Multiple Streams Approach. This conceptualizes how three streams: problems, politics and policies, converge to frame issues in terms of problems requiring policy formation [47].

 

This policy analysis is enhanced by a participatory project aligned to the goals and objectives of the Strategy which was launched in 2018 with three overarching goals: 1. Create a safe, supportive, inclusive environment; 2. Improve LGBTI+ youth physical, mental and sexual health; and 3. Develop the research and data environment to better understand the lives of LGBTI+ young people [26]. Prioritization of research within the Strategy is noted in objective 15(g) which calls for research into positive mental health for LGBT+ youth [26] (p. 31).

 

This project provides a parallel process, prioritizing the participation of young people with expertise by experience, including lived experience as LGBT+ youth, alongside experience of participation of policy-making for the Strategy. It draws from Baker and Beagan’s emphasis on ‘learning with’ LGBT+ communities [48,49].

 

·        You use LGBTI+ and LGBT+. Why the inconsistency? Is there a difference between these terms? If so, explain the difference.  

 

On Page 7, you wrote:

 

Participants were given a gift card in acknowledgement of their time and contribution

 

Change to:

 

Participants received a gift card to acknowledge their time and contribution.

 

·        Add a period at the end of this sentence. Also, provide the monetary value of the gift card.

 

On Page 8, you wrote:

 

3.1.1. Problem stream

MSA notes that this form of streaming commonly occurs where “attention lurches to a policy problem” [47] (p. 4). Thus, The LGBTIreland Report: national study of the mental health and wellbeing of lesbian, gay, bisexual, transgender and intersex people in Ireland [21], identified that, in comparison to the My World National Youth Mental Health Study [68], LGBT+ youth experienced twice the level of self-harm, three times the level of attempted suicide and four times the level of severe/extremely severe stress, anxiety or depression [21] (p.3).

 

Change to:

 

3.1.1. Problem stream

MSA notes that this form of streaming commonly occurs where “attention lurches to a policy problem” [47] (p. 4). Thus, The LGBTIreland Report: National Study of the Mental Health and Wellbeing of Lesbian, Gay, Bisexual, Transgender and Intersex People in Ireland [21], identified that, in comparison to the My World National Youth Mental Health Study [68], LGBT+ youth experienced twice the level of self-harm, three times the level of attempted suicide and four times the level of severe/extremely severe stress, anxiety or depression [21] (p. 3).

 

On Page 9, you wrote:

 

Bryan highlighted concerns regarding comparison of “a nationally representative, random sample in the case of the My World Survey versus an online, convenience-based sample in the case of the LGBTIreland study” [69] (p.260).

 

Change to:

 

Bryan highlighted concerns regarding comparison of “a nationally representative, random sample in the case of the My World Survey versus an online, convenience-based sample in the case of the LGBTIreland study” [69] (p. 260).

 

On Page 11, you wrote:

 

The youth co-authors are now aged 21-24 years, providing consent for participation in their own right.

 

·        Provide descriptive information regarding your 6 youth coauthors, specifically the number that were 21, 22, 23, and 24 years of age.

 

On Page 18, you wrote:

 

However, it was stressed that attempts ‘to simplify this for people who

are non-LGBT+’ can prevent LGBT+ communities ‘being centred in the

work’.

 

Change to:

 

However, it was stressed that attempts ‘to simplify this for people who

are non-LGBT+’ can prevent LGBT+ communities from ‘being centred in the

work’.

 

On Page 20, you wrote:

 

However, it is of concern that consultations on the draft curriculum has resulted in, often problem-informed, media coverage [76,110], with comments that “children are not ready to hear information about sexual orientation” [76] (p.1.).

 

Change to:

 

However, it is of concern that consultations on the draft curriculum has resulted in, often problem-informed, media coverage [76,110], with comments that “children are not ready to hear information about sexual orientation” [76] (p. 1.).

 

 

Discussion

 

In what ways can future scholars build on your work? What recommendations would you provide for future research?

 

This study focused on policy and views of LGBT+ youth in Ireland. How might the findings of this research be applicable for youth in other countries, particularly in countries where youth receive Relationship Education (RE)?

Author Response

Comments and response to Reviewer 2

 

Thank you for your review and encouraging comments. We particularly appreciate your feedback that you found the topic quite interesting, particularly because of the limited qualitative research that has examined the experiences of LGBT+ youth.

 

Your questions, comments, and recommendations in the spirt of strengthening the manuscript, are very welcome.

 

Thank you for your attention to the typos in the article. We have corrected these as follows:

• Page 3: The review informed the plan to introduce a new curriculum as part of Social, Personal and Health Education
• Page 4: (p. 31); ( 221)
• Page 8: ( 4)
• Page 8: The LGBTIreland Report: National study of the mental health and wellbeing of lesbian, gay, bisexual, transgender and intersex people in Ireland
• Page 9: (p. 3); (p. 260)
• Page 9: The LGBTIreland Report Key Findings
• Page 11: ( 143)
• Page 11: can prevent LGBT+ communities from‘being centred
• Page 20: ( 1)

To address your point about the recommendations for future research, we have contextualized the article within a recognitive justice framework using Honneth’s Recognition Theory. This has helped give structure to the analysis and discussion, so that the implications for policy, practice and research are clearly outlined.

While this study focused on the views of LGBT+ youth in Ireland, we believe that the findings are applicable beyond Ireland, as this research reflects recommendations from other jurisdictions, which we have cited. We have also drawn specific attention to the recent developments in the US with the introduction of what the media have termed the ‘Don’t Say Gay’ bill in the state of Florida, and the legislation preventing affirming care for trans youth in Texas. We have emphasized that this underscores the potential for educational curricula and policies which are inclusive and comprehensive to contribute to destigmatizing and depathologizing LGBT+ youth identities, and promote wellbeing.

Thank you, again for your review and your comment that you enjoyed reading the paper, We think the revised manuscript has been strengthened by addressing your suggestions.

Author Response File: Author Response.pdf

Reviewer 3 Report

The aim of the study is to reflect on the representation of LGBT+ youth lived experience and the social meanings constructed by LGBT+ youth on the significance and nature of such representations. The analysis is based on a qualitative study that includes a qualitative online consultation as the core data collection method. The methodology and the design of the study as well as the processes of interpretation and validation of the results are clearly described. The interpretation of the results is supported with the participants’ responses on certain themes and it is very well grounded in the empirical material. This study reveals also the necessity to avoid the top down approach of policy making and to replace it with an evidence based approach that takes into account also the perspectives of the beneficiaries of certain policies. My suggestion to authors is to include also reflections on the specific vulnerabilities experienced by the participants in the study as potential domains of policy measures and interventions that can protect health and wellbeing of LGBT+ youth.

Author Response

Comments and response to Reviewer 3

 

Thank you for your review and encouraging comments. We particularly appreciate your feedback that the methodology and the design of the study as well, as the processes of interpretation and validation of the results are clearly described. We also appreciated your comments that the interpretation of the results is supported with the participants’ responses on certain themes and it is very well grounded in the empirical material.

 

We have given consideration to your comment that the article reveals the necessity to move beyond top-down policy making and ensure that this considers the perspectives of those will benefit from the policy. This has a parallel within qualitative research and we have sought to strengthen this within the article. We have included reference to Tracy and Hinrich who suggest that research must investigate a “worthy topic”. This aligns with Rubin and Rubin who emphasized that qualitative research necessarily extends beyond a topic to “learning about what is important to those being studied”.

 

Thank you for your suggestion of how the article can be improved through including reflections on the specific vulnerabilities experienced by the participants in the study as potential domains of policy measures and interventions that can protect health and wellbeing of LGBT+ youth.

In relation to the reflections on the specific vulnerabilities experienced by the participants. The young people were not asked about their personal experience, rather ethical approval was granted to seek participants’ general views on the protective factors that promote LGBTI+ youth wellbeing. We have included this in the article.

To address your point about the potential domains of policy measures and interventions, we have contextualized the article within a recognitive justice framework using Honneth’s Recognition Theory. This has helped give structure to the analysis and discussion, so that the implications for policy, practice and research are clearer.

Thank you, again for your review and feedback. The revised manuscript has been strengthened by addressing your comments.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Despite the changes implemented, I still believe the paper lacks originality and contribution to the field. Nevertheless, if the editor feels that this is not the case, I agree with the publication in its current form.

Best wished.