Transforming the mental health system for immigrant and refugee girls requires a culturally grounded, community-centered approach to health promotion, prevention, and clinical care. Systemic change begins with institutional commitment to reshape care in clinical spaces to better serve diverse communities, and this commitment must be guided by the expertise of clinicians working collaboratively and respectfully with these populations. Through the sharing of personal narratives, the authors blend lived experiences with clinical and academic perspectives, offering practical insights that can be applied both within and beyond clinical settings.

The objectives of this clinical review will be to (1) understand the diagnosis of eating disorders in girls across systems of care, (2) understand cultural and other barriers that may impede a patient and family's ability to engage in care, (3) understand interventions for eating disorder treatment for girls across systems care, and (4) recognize when there is a need for advocacy for more intensive and specialized treatment for eating disorders. This review will focus on anorexia nervosa, bulimia nervosa, and avoidant restrictive food intake disorder.

The mental health of immigrant and refugee girls deserves increased attention given the historic and current sociopolitical context and how it impacts this population's health, wellness, and access to care. Clinicians can enhance their clinical care for this population through the use of culturally-attuned, family-based, and evidence-based approaches to promoting collective health within mental health systems of care.

Sexual violence is a traumatic experience that is prevalent among women and is often experienced before the age of 18 years. A trauma-informed systems approach is recommended to support the recovery and well-being of girls impacted by sexual trauma. Comprehensive school-based interventions that promote healthy dating relationships more generally are found to reduce risk of sexual assault victimization and perpetration among youth. Treatment recommendations include addressing immediate safety, stabilization, and support in the initial weeks after the assault and referral for evidence treatments for ongoing symptoms.

Sexual and gender minority (SGM) girls face unique challenges in school, child welfare, and legal settings due to identity-linked discrimination, stigma, and marginalization. Inequities in school harassment, school discipline, and family support are especially harmful, given they increase the risk of homelessness and legal contact. Black and Latinx SGM girls are particularly impacted given the compounding inequities they face in today's society. Despite these tremendous inequities, providers in different settings can make positive impacts for systems-involved SGM girls by creating a safe and affirming environment, building on well-established protective factors, and increasing agency.

The article explores the complex relationship between social media use and the mental health of adolescent girls. It discusses the negative impacts, such as increased anxiety, depression, and self-objectification, while also acknowledging positive aspects like social connection and creative expression. Gender differences in social media behavior are noted as adolescent girls face unique challenges in online spaces reflective of larger societal pressures and expectations on girls. Parental involvement, educational initiatives, policy change, and clinical guidance for those working with teen girls may help them effectively navigate the complexities of social media.

Youth with disabilities are over-represented in school discipline and the juvenile legal system. Studies examining this over-representation often overlook the unique needs and behaviors of cognitively diverse girls. System-impacted cognitively diverse girls hold a range of unique needs and qualities and are deserving of individualized, culturally competent, and evidence-based care. This article presents the unique risk factors for girls impacted by the legal system in disaggregated summaries of the literature, and as illustrated by 2 case studies, to better understand the clinical needs of system-impacted girls.

Our current scan of the digital health and intervention programming spaces for girls online well-being will provide an overview of current clinical-based, community-based, and school-based programs that emphasize the unique needs of girls from the preteen and adolescent years. Sections will include digital health interventions (eg, sleep and body image), girls' youth development programs, and a case study of the development and implementation of a digital well-being workshop for girls and allies with girls. We will offer current trends and recommendations for stakeholders to utilize resources that are available and forthcoming in the field of girls digital well-being.

Adolescent substance use continues to be a public health concern. Yet, most intervention research focuses on samples of boys in outpatient care, with adolescent girls accounting for less than 20% of samples, and even smaller percentages for girls in the child welfare or legal systems. System-involved girls experience unique needs when presenting to and engaging in substance use treatment as compared to boys. It is imperative that substance use treatment is responsive to girls' intersectional needs, including targeting trauma and incorporating relational approaches that also address societal and structural factors that impact girls' experiences and vulnerability for substance use.

Despite progress, girls face significant educational barriers compared to boys. Systemic, institutional, social, and cultural barriers all hinder girls from attending and benefitting fully from school. Gender bias, violence, and harassment disproportionately harm girls, while neurodivergent girls and those with intersectional identities face compounded challenges. Comprehensive, systemic, and culturally relevant interventions are necessary to address these barriers effectively. Tackling these issues will not only benefit girls but also strengthen communities and societies as a whole.

Sexual and reproductive health are linked to mental health in girls. However, addressing these topics with girls can be challenging due to religious/cultural norms, gender diversity, and political landscape. Considering each patient's individual identity and how it may impact clinical practice are essential steps toward building the therapeutic alliance necessary to obtain this critical information. Empowering patients to understand the importance of sexual and reproductive health in mental health care will help normalize the information gathering process. Ultimately, providers should empower and educate girls on sexual and reproductive health for improved mental health outcomes.

Trauma occurs when an event or series of events overwhelms an individual's capacity to cope, invoking feelings of fear, terror, or powerlessness. Girls have higher prevalence rates of traumatic experiences and subsequent posttraumatic stress disorder, depression, and anxiety compared to boys. The authors reviewed these prevalence rates within a socioecological context using a social constructions of gender framework to understand mechanisms of risk, best practices of measurement in research, and identification of targets for intervention. Clinical care points include promotion, prevention, and treatment strategies for mental health that are gender sensitive.

Girls face a distinctive set of mental health challenges that require specialized attention and care. These challenges arise from a complex interplay of biological, psychological, and social factors that significantly shape their mental well-being. A more comprehensive understanding of these factors is essential for developing targeted interventions and effective support systems to address these unique needs. This article reviews and uses cases to illustrate a framework for family and community-based multisystem approaches for girls.

Boys of Latin American background encounter significant intersectional challenges influenced by sociocultural factors that impact their identity development and mental health outcomes. Hence, in this article, we use the term Latinx intentionally to describe not only individuals of Latin American origin or descent but those who face challenges beyond being gender binary. The term Latinx embraces fluid gender expressions and identities and celebrates the diverse and indigenous roots of the various national origins within this subgroup.

Asian American boys benefit psychologically from a well-integrated bicultural identity, supported by bilingualism and same-ethnic or mixed-ethnic friendships. They face higher risks of peer discrimination than girls, leading to depressive symptoms. While pop culture has challenged traditional masculinity in America, many Asian American boys still adhere to these masculine norms, causing internal conflict. Family values of collectivism and respect influence parenting, with bicultural and supportive approaches fostering better developmental outcomes in children, while "tiger parenting" may cause stress and anxiety. Acculturation gaps between parents and children can strain their relationships. Future research should consider ethnic diversity and immigration context.

This article explores the psychological development of Arab boys, focusing on how cultural, familial, socioeconomic, and migration histories may shape mental health. It highlights the challenges Arab boys face in identity formation, navigating often conflicting values and influences. The article discusses the roles of parents, peer groups, education systems, media, technology, religion, and gender expectations in shaping experiences, as well as the need for culturally responsive mental health services to support Arab boys' well-being.

The mental health risks for American Indian/Alaskan Native (AI/AN) boys and adolescents are stark: the highest death by suicide rate among demographic groups-2 to 3 times more likely to die by suicide than non-Hispanic white peers, the highest rates of alcohol and drug addiction, and the highest rates of poverty. It is important to start discussion about AI/AN people by saying that this demographic category used by the US Census and many researchers comprises 574 federally recognized tribes and 63 state recognized tribes. Cultural practices can be interventions and protective factors.

According to the World Health Organization, 1 in 7 youth ages 10 to 19 years old experience mental health disorders, including anxiety, depression, and behavioral difficulties. There are sex biases in prevalence rates of mental health disorders; females are more likely diagnosed with anxiety and depression, while males are more often diagnosed with behavioral disorders. There is a reciprocal interaction between the decline in educational outcomes and mental health among young males. This article highlights the intersection between psychiatric disorders, gender norms, and educational outcomes and provides clinical recommendations to support a positive developmental and educational trajectory for male youth.

Historically, there is a dramatic overrepresentation of males involved in the juvenile legal system as compared with their female counterparts with males representing 71.3% of all criminal offenses committed by juveniles in 2022. Through decades of research, it has become clear that there is no single risk factor that predicts antisocial or delinquent behavior, but rather a perfect storm of risk factors that interacts to contribute to a complex constellation of behaviors. Child and adolescent psychiatrists and other medical and mental health professionals have responsibility of breaking this intergenerational cycle by advocating for system reform.

This article explores the emotional and behavioral patterns and mental health outcomes among boys in the US military, in regards to both adolescent males entering military service, as well as male dependents of active duty service members. Active duty forces remain predominantly male and young, providing an opportunity to explore the psychologic and social factors contributing to enlistment and subsequent trajectory of boys' mental health through military service. Furthermore, it is well-known the unique vulnerabilities, and strengths, faced by military families compared to their civilian counterparts.

This article will review the literatureregarding the impact of trauma and violence on boys and young men, includingthose who identify as Gay, Bisexual, Transgender, and Queer. Currently males under18 make up roughly half of the 73.1 million children in the US-about 22% of theUS population. The child and adolescent mental health clinician must be awareof and able to recognize how violence affects trans, nonbinary, andgender-nonconforming people who are targeted for defying gender norms andexpressions.

There is substantial evidence that physical activity and participation in team sports is protective against anxiety, depression, and peer problems in children. Unfortunately, the social milieu of some sports teams or clubs can reinforce ideas that boys should be stoic, dominant, or even misogynistic. However, when parents select the right team or club environment for their son, the experience of playing team sports can support boys' development into healthy and flexible adult men.

This article explores the impact of media on the development of traditional gender roles and masculinity in boys, emphasizing the prevalence of hypermasculine and heteronormative stereotypes. It examines how media shapes boys' attitudes toward aggression, body image, and sexual behaviors, often reinforcing toxic ideals. The unique vulnerabilities of boys of color and the risks of cyberbullying and radicalization linked to media consumption are highlighted. The authors strongly encourage media literacy in parents and psychiatric providers. They also call for more diverse and positive media representations to foster healthier masculine identities among boys.

This article reviews the history of masculinity in the western context, including the biological and cultural norms that shape manhood and boyhood. There is a focus on psychopathology, unique psychiatric presentations of mental illness in boys, and review of impact of masculinity on mental health outcomes. Separately, there is a discussion on how masculine cultural norms can lead to a more violent societal outcome. Lastly, there is considerations about cultural changes that can promote more healthy ideology of masculinity.

The development of racial identity in Black boys is a critical aspect of their overall mental health and well-being. This article explores the unique societal and cultural challenges faced by Black boys in the context of identity formation and mental health outcomes. It critiques the one size fits all approach in clinical settings and advocates for an equitably tailored approach that emphasizes cultural competence, cultural responsiveness, and the importance of understanding the lived experiences of Black youth. By integrating these elements into clinical practice, mental health professionals can provide more effective and compassionate care promoting their mental health and resilience.

Parents face complex and evolving challenges raising boys in today's society. The authors address societal expectations, gender constructs, and diverse family structures, emphasizing the importance of evidence-based parenting practices. The article outlines the influence of authoritative parenting, emotional attunement, and mindfulness across developmental stages, from infancy to young adulthood. The article also highlights strategies to nurture boys' emotional intelligence, resilience, and healthy identity formation, providing clinicians and parents with practical tools to promote boys' psychological well-being and adaptation in a rapidly changing cultural landscape.

Suicide ranks as the 11th leading cause of death. Males, although representing half of the population, account for nearly 80% of completed suicides across all age groups. Certain aspects of traditional masculinity, particularly self-reliance, increase the risk of suicidal behavior. Psychosocial stressors also significantly contribute to suicide in children and adolescents, independently of psychiatric illnesses. This article will explore the gender differences in suicidal behavior and risk factors among male adolescents, with implications for prevention and improvement in mental health outcomes. The authors will focus on suicidal ideation, suicide attempts, and completed suicide.

Psychodynamic theory and approaches have shaped the fundamental frameworks used to care for and educate young children from infancy through adolescence. Early child psychoanalytic perspectives focused on the role of early life experiences and development, and how these factors influenced adult character. Over time, this conceptualization evolved to recognize the complex nature of the vulnerable child's psychological needs within the context of their environment, with psychodynamic psychotherapy becoming a major component of youth mental health treatment. This modern understanding of childhood has also informed public policy, including child labor practices and protections for children living in poverty.