Archived
This content is available here for research, reference, and/or recordkeeping.
Author ORCID Identifier
https://orcid.org/0009-0009-4195-367X
Date Available
5-13-2028
Year of Publication
2026
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Social Work
Department/School/Program
Social Work
Faculty
Natalie Pope
Abstract
Sexual and gender minority (SGM) emerging and early adults experienced disproportionate mental health burdens, yet the social and place-based conditions shaping distress and well-being remained understudied, particularly in Appalachia. This dissertation addressed that gap by examining mental health, well-being, and protective relational factors among SGM individuals across emerging and early adulthood, with focused attention to Appalachian contexts. Guided by the Resilience and Identity Through Embodiment (RITE) conceptual model, the study conceptualized resilience as dynamic, embodied, relational, and shaped by place.
This three-paper dissertation included one quantitative paper and two qualitative papers. Paper One used 2022 Behavioral Risk Factor Surveillance System (BRFSS) data from states administering the Sexual Orientation and Gender Identity module to examine SGM emerging adults ages 18 to 29. It tested associations among life satisfaction, caregiver neglect, adult emotional safety and support, and frequent mental distress, and assessed whether these associations differed by Appalachian versus non-Appalachian context using survey-weighted descriptive, bivariate, and multivariable analyses.
Papers Two and Three used semi-structured interviews with SGM emerging and early adults ages 18 to 32 who lived in Appalachia or had spent adolescence there. Using a basic interpretive qualitative design and reflexive thematic analysis, Paper Two examined self-worth and subjective well-being in relation to distress and coping, while Paper Three explored early caregiving experiences, embodiment, identity, belonging, and resilience across Appalachian places.
Across the three papers, the dissertation examined how protective factors and stress processes operated within layered sociocultural contexts. Quantitative analyses were constrained by state-level geographic measurement and Sexual Orientation and Gender Identity module availability, while qualitative findings provided contextual depth for interpreting variation in mental health experiences across place. This dissertation advanced the RITE model, contributed region-sensitive evidence on distress and protective factors among SGM emerging and early adults, and offered implications for social work, public mental health, and policy.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2026.159
Archival?
Archival
Funding Information
This study was supported by the University of Kentucky Appalachian Center & Appalachian Studies Program.
Recommended Citation
Dillman, Holden, "WE ARE HERE: NATIONAL AND APPALACHIAN ACCOUNTS OF YOUTH-TO-ADULTHOOD MENTAL HEALTH AND WELL-BEING AMONG SEXUAL AND GENDER MINORITY EMERGING AND EARLY ADULTS" (2026). Theses and Dissertations--Social Work. 52.
https://uknowledge.uky.edu/csw_etds/52
