Attitude of Medical Students in Paraguay Towards Homosexuality

INTRODUCTION

The attitude of medical students towards homosexuality may affect the quality of care for homosexual patients. This study aimed to describe the attitude of medical students at the National University of Asuncion, Paraguay towards homosexuality.

METHODS

This observational, cross-sectional study was conducted in June 2016 in consecutive medical students from the National University of Asunción (Santa Rosa del Aguaray branch), Paraguay. The 10-item attitude towards homosexuality scale (EAH-10) was used to assess participants' acceptance/ rejection of homosexuals as individuals, homosexuality as a sexual orientation, and public manifestations of homosexuality.

RESULTS

A total of 48 female and 29 male participants (mean age, 21 ± 2 years) were included. Most were Catholic (71.4%), followed by non-Catholic Christian (10.4%), agnostic (9.1%), atheist (2.6%), and other (6.5%). 71.4% reported having at least one homosexual friend. The mean EAH-10 score was 27.23 ± 9.379. 42.9% of participants were indifferent or undecided in their attitude towards homosexuality and 28.6% were discriminatory. Having homosexual friends was associated with a lower EAH-10 score (t = -3.447 [75], p = 0.001).

CONCLUSION

Education about health issues of homosexuals is needed for medical students in Paraguay.

Heterosexual College Students Who Hookup with Same-Sex Partners

Individuals who identify as heterosexual but engage in same-sex sexual behavior fascinate both researchers and the media. We analyzed the Online College Social Life Survey dataset of over 24,000 undergraduate students to examine students whose last hookup was with a same-sex partner (N = 383 men and 312 women). The characteristics of a significant minority of these students (12% of men and 25% of women) who labelled their sexual orientation "heterosexual" differed from those who self-identified as "homosexual," "bisexual," or "uncertain." Differences among those who identified as heterosexual included more conservative attitudes, less prior homosexual and more prior heterosexual sexual experience, features of the hookups, and sentiments about the encounter after the fact. Latent class analysis revealed six distinctive "types" of heterosexually identified students whose last hookup was with a same-sex partner. Three types, comprising 60% of students, could be classified as mostly private sexual experimentation among those with little prior same-sex experience, including some who did not enjoy the encounter; the other two types in this group enjoyed the encounter, but differed on drunkenness and desire for a future relationship with their partner. Roughly, 12% could be classified as conforming to a "performative bisexuality" script of women publicly engaging in same-sex hookups at college parties, and the remaining 28% had strong religious practices and/or beliefs that may preclude a non-heterosexual identity, including 7% who exhibited "internalized heterosexism." Results indicate several distinctive motivations for a heterosexual identity among those who hooked up with same-sex partners; previous research focusing on selective "types" excludes many exhibiting this discordance.

Minority stressors, rumination, and psychological distress in monozygotic twins discordant for sexual minority status

BACKGROUND

Lesbian, gay, and bisexual (LGB) individuals report higher levels of depression and anxiety than heterosexual people. Genetic factors may be a 'common cause' of sexual minority status and psychological distress. Alternatively, these may be correlated because of non-genetic environmental factors (e.g. minority stressors). This study investigated minority stressors and distress in monozygotic twins discordant for sexual minority status. This design provides a test of the role of non-shared environmental factors while minimizing differences due to genetics.

METHODS

Thirty-eight twin pairs in which one was heterosexual and the other was LGB completed a survey. Differences between twin pairs in minority stressors, rumination, psychological distress, and gender non-conformity were examined. Associations between these variables were also tested.

RESULTS

Although there were no significant group differences for distress, LGB twins had higher rumination, a vulnerability factor for distress, than heterosexual co-twins. LGB twins also had higher scores than heterosexual co-twins on expectations of rejection, active concealment, self-stigma, prejudice events, childhood gender non-conformity, and lower scores on sexual orientation disclosure. Differences between twin pairs in rumination were positively associated with differences in acceptance concerns and self-stigma. Finally, self-stigma was positively associated with rumination in the full sample of heterosexual co-twins and microaggressions were positively associated with rumination when looking at exclusively heterosexual co-twins.

CONCLUSIONS

These results support environmental factors as a causal explanation for disparities in rumination between LGB and heterosexual individuals. These factors likely include minority stressors. Rumination may also be associated with minority stressors in heterosexual MZ co-twins of LGB individuals.

Loving the love of boys: Motives for consuming yaoi media

In recent years, yaoi has been increasingly popular among youth interested in Japanese media such as anime and manga. Yaoi is defined as commercial and fan-created media that thematically focus on the romantic love between two men, often in a sexually explicit way. Despite the widespread popularity of this Japanese subgenre, there is a lack of empirical studies on the motives for consuming yaoi media that analyze the full range of motives using reliable research methods. The present study aimed to explore and operationalize the motives for yaoi media consumption based on previous qualitative research (Pagliassotti, 2008). Using an online survey, 724 yaoi consumers (58% male; M_age = 30.1 years, SD = 10.4) completed the Yaoi Consumption Motives Questionnaire (YCMQ). According to confirmatory factor analyses, the bi-factor model of nine motives yielded closer fit to the data than the theoretically proposed, first-order ten-factor model and a second-order nine-factor model. The nine-factor YCMQ demonstrated strong psychometric properties in terms of factor structure, internal consistency, and measurement invariance. These results indicate that the 31-item YCMQ is an appropriate instrument to assess individuals’ motives for consuming yaoi media.

Attitude of Indian Medical Students Towards Homosexuality

INTRODUCTION

It is important to understand the attitude of medical students towards homosexuality, as this may affect patient care.

METHODS

Year 2 and 3 students at Calcutta National Medical College, Kolkata, India were asked to selfadminister an 18-item questionnaire anonymously. Internal consistency of the questionnaire statements was high (Cronbach's alpha of 0.91). There were five responses for each statement: strongly agree, generally agree, unsure, generally disagree, and strongly disagree.

RESULTS

Of 290 students, 270 (93.1%) [148 males and 122 females] completed the questionnaire and were included in the analysis. Overall, 55.6% strongly disagreed that homosexuality was an illness; 70.8% agreed that homosexuals were capable of forming stable relationships. Only 31.1% believed that homosexual doctors would better understand homosexual patients. About 71.8% reported that talking about homosexuality did not embarrass them, and 81.8% believed that problems associated with homosexuality could be reduced if society was more liberal. Nonetheless, negative attitudes were reflected in the stereotypical image of homosexuality. About 15.9% of respondents believed that homosexuality was an illness; 24.8% considered homosexuals neurotic, 28.1% considered homosexuals promiscuous; and 8.2% thought that they posed a danger to children.

CONCLUSION

Although the overall attitude of Indian medical students towards homosexuality is positive, the percentage of students with negative attitudes remains quite high. Further work on the medical curriculum is needed to change these negative attitudes so that patients receive appropriate care.

[More sensitive approach to question of sexual orientation]

Doctors encounter lesbian, gay and bisexual (LGB) patients. Most LGBs are physically and mentally healthy, but LGBs also have unique healthcare needs, that is mental health issues, sexually-transmitted diseases including HIV infection, substance use, and avoidance of healthcare. Sexual minority stress due to stigmatisation, rejection, internalised homophobia, bullying and violence is a causal issue. Optimising care for LGBs involves knowing patients' sexual orientation by asking them. As sexual orientation comprises the domains of sexual identity, sexual attraction and sexual behaviour, all should be addressed appropriately as these domains together or separately determine the impact on health. Sexual identity correlates closely, but not completely, with sexual behaviour. Individuals may engage in same-sex sexual behaviour, but not identify themselves as lesbian, gay or bisexual. Patients are willing to answer questions about their sexual orientation. Doctors should take the initiative to discuss sexual orientation and avoid making heteronormative assumptions. The uptake of LGB-related issues in guidelines and educational programmes may improve doctors' awareness.

The Promise and Perils of Population Research on Same-Sex Families

As a follow-up to our 2016 study, this article presents new findings examining the relationship between same-sex family structure and child health using the 2008-2015 National Health Interview Survey (NHIS). After discussing NIHS data problems, we examine the relationship between family structure and a broad range of child well-being outcomes, including school days lost, behavior, parent-rated health, emotional difficulties, and activity limitations. We find both similarities (school days lost, behavior, parent-rated health) and differences (emotional difficulties and activity limitations) across our two studies using different survey years, but our overall conclusions are robust. We further discuss the implications of our findings for future research on this topic, including how to account for biological relatedness in a study on child health in same-sex families.

Before and After "I Do": Marriage Processes for Mid-Life Gay and Lesbian Married Couples

This qualitative study examines how mid-life gay and lesbian married individuals articulate their decision to marry. Using 2013 data from 30 mid-life couples in Massachusetts, this study challenges previous literature that conceptualized marriage as entirely positive or negative for same-sex individuals. Mid-life individuals' unique social and historical context influence their experiences of marriage, as mid-life individuals have witnessed the rise and feasibility of marriage equality, have formed relationships outside of the bounds of marriage, and have been in committed relationships long before they married. Using the framework of ambivalence, our findings provide three main contributions to the literature. First, we show that marital ambivalence is a common experience in our sample. Second, we detail how marital ambivalence is indicative of the age, life-course stage, and length of relationship for mid-life lesbian and gay individuals. Third, we explore ambivalence at the level of the relationship, not just as an individual experience. This study provides new insight into how sexuality shapes both intimate relationship dynamics as well as the effect of same-sex marriage on LGBT communities and identities.

Controlled Comparison of Attitudes of Psychiatrists, General Practitioners, Homosexual Doctors and Homosexual Men to Male Homosexuality

A controlled analysis of the attitudes of doctors and homosexual men to male homosexuality is reported. Not surprisingly the homosexual men held the most liberal attitudes which served as a yard-stick against which the doctors' attitudes could be assessed. The implications of these data, collected before the AIDS era, are discussed in terms of the current needs of homosexual patients.

The Emergence and Persistence of Queerness: Conversing Through Visual Culture Within a Generation

In this article, the authors explore the work of becoming queer within the Millennial generation. Collaborative in nature, their investigation turns to three key popular-culture texts of the 1990s-Will & Grace, Rent, and MTV's Spring Break-that were central to their then-emerging sense of self. Staged as an intragenerational conversation, the authors look to create space to unpack the connections, anecdotal by design, between popular texts and changing ideas of queer identity and community. Since neither author grew up within the confines of a gay ghetto-Boystown of Chicago, the Castro of San Francisco, the East Village of New York City-where they may have encountered and been enamored by the avant-garde queer subcultures so often praised in queer scholarship (for important reasons), they turn instead to experiences with popular culture that opened up lessons in becoming gay, in rural and Midwestern locales where queerness operated and emerged differently.

"Some University Lecturers Wear Gay Pride T-shirts. Get Over It!": Denials of Homophobia and the Reproduction of Heteronormativity in Responses to a Gay-Themed T-shirt

This article explores an incident involving a gay pride T-shirt, printed with the slogan "Some people are gay. Get over it!," that I wore during a university lecture, and students' predominantly negative responses to it. I use the lens of modern prejudice research, particularly discursive psychological approaches to modern prejudice, to interpret the students' responses to a qualitative survey about their views on the T-shirt. They related strong feelings of upset and anger, particularly because I had-in their view-implicitly accused them of being homophobic. They passionately refused this supposed accusation on the grounds that "everything's equal now" and "gay people are no different from us." I argue that the ideological themes of cultural heterosexism and compulsory heterosexuality provide a productive framework for making sense of the students' responses, as they sanction a rational neoliberal subject who is both non-homophobic and inculcated into heteronormativity.

Black LGB Identities and Perceptions of Same-Sex Marriage

The 2015 SCOTUS ruling legalizing same-sex marriage was hailed as a universal victory for the lesbian, gay, and bisexual (LGB) community, but the pervasive support mobilized to achieve this goal may mask important dissension and inequality within the community. Specifically, how race may shape or perpetuate inequalities in the LGB community through same-sex marriage largely has been absent from the discussion. Focusing on the perceived impact of same-sex marriage in respondents' lives, I investigate the relationship between Black LGBs' perception of same-sex marriage legalization and their intersectional identities and community membership. Drawing from the 2010 Social Justice Sexuality Project survey, I explain the complexity of the attitudes of Black LGBs to the legalization of same-sex marriage and illustrate that (1) Black LGBs exhibit heterogeneous interpretation of the effects of same-sex marriage legalization on their lives based on their racial and sexual identities, and (2) same-sex marriage may provide Black LGBs the rationale to affirm their racial community membership as sexual minorities. This study pushes our understanding of the relationship between intersectional identities and individuals' perceptions of the self, identity-based community memberships, and social institutions.

Unraveling Health Disparities Among Sexual and Gender Minorities: A Commentary on the Persistent Impact of Stigma

LGBT (lesbian, gay, bisexual, and transgender) populations experience disparities in health outcomes, both physical and mental, compared to their heterosexual and cisgender peers. This commentary confronts the view held by some researchers that the disparate rates of mental health problems reported among LGBT populations are the consequences of pursuing a particular life trajectory, rather than resulting from the corrosive and persistent impact of stigma. Suggesting that mental health disparities among LGBT populations arise internally, de novo, when individuals express non-heterosexual and non-conforming gender identities ignores the vast body of evidence documenting the destructive impact of socially mediated stigma and systemic discrimination on health outcomes for a number of minorities, including sexual and gender minorities. Furthermore, such thinking is antithetical to widely accepted standards of health and wellbeing because it implies that LGBT persons should adopt and live out identities that contradict or deny their innermost feelings of self.

Violence as Mediating Variable in Mental Health Disparities Associated to Sexual Orientation Among Mexican Youths

In this study, we explored the role of sex as an effect-modifying variable in the association between sexual orientation and mental health in Mexican youth. In addition, we tested if violent experiences in the family and the school and attitudes toward homosexuality could act as mediating variables in such association. Data from three representative surveys performed in 2007, 2009, and 2013 among Mexican high school students were analyzed. Two dimensions of sexual orientation were evaluated: romantic partnership and sexual behavior. The outcomes were negative and positive mood, suicidal ideation and intent, self-concept, and self-esteem. There were differences by gender because in males, there were more disparities in mental health associated with sexual orientation (suicidal ideation and attempt, negative and positive mood, negative self-concept, and family-related self-esteem) than in females (suicidal ideation and negative mood). Experiences of school violence were mediators in the relationship between sexual orientation and most health outcomes in males.

Predicting Ambivalence: When Same-Sex Sex is Only "Sometimes Wrong"

Despite Americans' growing acceptance of LGBTQ people and their sexual behaviors over the past 40 years, approximately 10% of the population consistently expresses conflicted feelings, reporting that same-sex sex is only sometimes wrong. This research employs a theory of socially structured ambivalence to examine how individuals with ambivalence toward the morality of same-sex sex differ from those with strong moral stances. Using multinomial regression analysis of General Social Survey data, we find that socio-structural conflicts-e.g. simultaneous membership in institutions with conflicting normative messages-are predictive of ambivalent attitudes, and the presence of these structured conflicts appears to have a cumulative effect. These findings provide evidence of the predictive power of socially structured conflicts in producing ambivalent attitudes and expand the existing literature on ambivalence and attitudes about same-sex relations. We propose that scholars conceptualize ambivalence as a distinctly socio-structural and relational construct that may help to signal fertile ground for social change.

BDSM Role Fluidity: A Mixed-Methods Approach to Investigating Switches Within Dominant/Submissive Binaries

This mixed-methods study of BDSM investigates the nuances of BDSM participants' role identities, role frequencies, and role fluidities-shifts in identities and play across time, location, scene, and play partner. Data were gathered from 202 online surveys and 25 semistructured interviews about participants' roles given their gender and sexual identities. These data reveal that men tend to self-identify as Dominant, Master, Top, or Sadist (DMTS) and always perform dominant roles, while women tend to self-identify as Submissive, Slave, Bottom, or Masochist (SSBM) and always perform submissive roles. Although this would seem to support the theory that BDSM reinforces gendered dominant/submissive binaries, further analyses indicate that women and queer/pansexual individuals disrupt this binary through their Switch identities and roles. Switching and queer identities, thus, offer the possibility for transforming dominant/submissive and other binaries.

The paedophile and his inner world: Theoretical and clinical considerations on the analysis of a patient

The main feature of the treatment of the paedophile is the distance that separates the analyst from the patient. However hard the analyst tries to understand his patient, the paedophile's world appears to him, especially at the beginning of the treatment, incomprehensible, disheartening and distant. This paper describes the analytic therapy of a paedophile patient. The psychopathological organization that dominates his inner world originates from a delusional nucleus in which an object (a child or an adolescent) is idealized and worshipped in place of the parents. This object promises all manner of pleasure and happiness. The positive outcome of this patient leads one to believe that, if analytically treated, some paedophile patients are open to therapeutic transformation.

Out in the Open: The Consequences of Intimate Partner Violence for Victims in Same-Sex and Opposite-Sex Relationships

Intimate partner violence (IPV) is a major public health problem in the United States. While our understanding of this form of violence has grown substantially over the past several decades, the majority of research involving victims of IPV has focused almost exclusively on female heterosexual victims. Unfortunately, little attention has been paid to how this form of violence affects specific populations, such as gay and lesbian victims. It is possible that gay and lesbian victims may experience more maladaptive outcomes as a result of unique components of same-sex IPV, their sexual minority status in American society, and the lack of appropriate services tailored to victims of this violence. Using data from the second wave of the National Longitudinal Study of Adolescent to Adult Health, this study contributes to the research on gay and lesbian victims of IPV by investigating same-sex and opposite-sex adolescent victims' experiences with depression, alcohol-related problems, marijuana use, violent delinquency, and property delinquency. Results indicate that opposite-sex victims experienced more depressive symptoms, alcohol problems, and marijuana use than non-victims and engaged in higher levels of violent and property delinquency than non-victims. IPV within the context of same-sex relationships led to more depressive symptoms and greater involvement in violent delinquency, with the impact of IPV on violent delinquency being greater for victims of same-sex IPV compared with opposite-sex IPV. The implications of this study could inform interventions for victims of same-sex IPV and lead to more comprehensive services to address the needs of gay and lesbian victims of this violence.

Suicidal and Help-Seeking Behaviors Among Youth in an Online Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Social Network

LGBTQ youth have a great burden for suicidal ideation/behavior compared to their non-LGBTQ peers. While scholars have explored risk factors for suicidal behaviors, little is known about protective factors among LGBTQ youth, let alone within group differences in terms of help-seeking. Data were collected from 203 TrevorSpace (e.g., a social network for LGBTQ youth) users via online survey to examine suicidal and help-seeking behaviors among LGBTQ individuals. Among participants who reported suicidal ideation/behavior, a large proportion did not seek help (73.1% of gay men, 33.3% of bisexual men, 42.9% of bisexual women, 14.3% of lesbian women, 41.2% of queer individuals) when they considered or attempted suicide. Among those who sought support, reaching out to a friend was most common. However, family support was associated with fewer suicidal behaviors. Our findings underscore the need to examine the effectiveness of specific sources of help and the impact of exposure to social connectedness.

Egalitarian: From Homophile to Helicophile in Post-World War II America

The presidency of gender in the Anglo-American taxonomy of sexualities historically has been haunted by the irruption of "other" parameters of medicalization, censure, and caesura, not in the least absolute and relative measures of age. Where today's clinical psychologists feel the need to age-specify adult homosexuality in such Hirschfeldian terms as androphilia, however, the felt need is indeed still essentially clinical. That cosmopolitan expressions such as homosexual, LGB, or queer rarely require such specifications relies on a protracted and today, arguably, complete disarticulation of sex/gender and age/maturity as parameters of sexual orientation, accreditation, and mobilization. Notably disconnected discursive frames gave voice to this Anglophone crystallization of "the normal homosexual" (circa 1950-1980): criminological, psychiatric, psychophysiological, and psychodynamic typologies of "sexual deviation" (variably tending to correlate, align, or subsume same-sex and age-disparate intimacies); territorializing apologias of gay, but also of "Greek," "pederast," and "man-boy," socialities; anthropological-historical exotification of "age-stratified homosexualities"; and mostly European, proto-queer critiques of all "bourgeois" sexual classification.

Beyond Men, Women, or Both: A Comprehensive, LGBTQ-Inclusive, Implicit-Bias-Aware, Standardized-Patient-Based Sexual History Taking Curriculum

Introduction

This standardized-patient-based module prepares medical students to take inclusive, comprehensive sexual histories from patients of all sexual orientations and gender identities. Health disparities faced by lesbian, gay, bisexual, transgender, and queer (LGBTQ) people are at least partially the result of inadequate access to health care and insufficient provider training. This module incorporates implicit bias activities to emphasize the important role providers can play in mitigating these disparities through compassionate, competent care. Furthermore, two of the three included cases highlight the negative impact sexual dysfunction can have on emotional well-being.

Methods

Over 3 hours, students participate in a 30-minute large-group lecture and three 40-minute small-group standardized patient encounters with debrief. Prework consists of a short video on sexual history taking, assigned readings, and an implicit bias activity. These materials are included in this resource, along with lecture slides, facilitator guide, and standardized patient cases. Though the cases are adaptable to all levels of medical education, this module is designed for second-year and early third-year medical students.

Results

Qualitative student evaluations were positive, and postparticipation surveys revealed statistically significant improvement in comfort with their ability to take a sexual history in general, and take one from patients with a differing sexual orientation. Deployed in the second year of our Doctoring curriculum, this module continues to receive positive evaluations.

Discussion

Introducing these skills begins to address the curricular deficiencies seen across medical education and lays the foundation for a more competent health care workforce to address the needs of LGBTQ patients.

Not a "mom thing": Predictors of gatekeeping in same-sex and heterosexual parent families

The current study is the first to examine parental gatekeeping in both same-sex (57 female, 51 male) and heterosexual (n = 82) couples, all of whom became parents via adoption. Aspects of the individual, the couple, and the work context, measured preadoption, were examined as predictors of gatekeeping. Gatekeeping refers to attitudes and behaviors aimed at regulating and limiting the involvement of the other parent in housework and child care and was measured 2 years postadoption. Findings revealed that women in heterosexual relationships reported higher gatekeeping compared with all other groups, and men in same-sex relationships reported higher gatekeeping compared with women in same-sex relationships and men in heterosexual relationships. Across the full sample, lower job autonomy predicted higher gatekeeping in both housework and child care, whereas greater relationship ambivalence, greater perceived parenting skill, and lower perceived partner parenting skill predicted higher gatekeeping in child care. Findings provide insight into how gatekeeping behaviors and beliefs are enacted in diverse types of couples and suggest that work factors should be taken into account when conducting research on, and seeking to improve, coparenting relationships. (PsycINFO Database Record

Religious Coping with Sexual Stigma in Young Adults with Same-Sex Attractions

The present study assessed religious coping with sexual stigma in 260 young adults with same-sex attractions. Although the majority of the sample rarely utilized religious coping, a significant minority of participants frequently turned to religion to deal with sexual stigma. Controlling for demographic and general religious variables, positive religious coping (e.g., connecting with God) was associated with beneficial outcomes, and negative religious coping (e.g., frustrations with one's spiritual community) related to poorer adjustment to sexual stigma. Data are presented on how religious coping varied as a function of religiosity and sexual identity development (e.g., disclosure of sexual orientation to others).

Sandor Rado, American psychoanalysis, and the question of bisexuality

The Hungarian-born physician and psychoanalyst Sandor Rado (1890-1972), who practiced for most of his career in the United States, played a central role in shaping American psychoanalysts' views toward homosexuality. Historians have pointed to Rado's rejection of Freud's notion of constitutional bisexuality as the key theoretical maneuver that both pathologized homosexuality and inspired an optimistic approach to its treatment. Yet scholarly analysis of the arguments that Rado made for his rejection of bisexuality is lacking. This article seeks to provide that analysis, by carefully reviewing and evaluating Rado's arguments by the standards of his own day. Because one of Rado's main arguments is that bisexuality is an outdated concept according to modern biology, I consider what contemporary biologists had to say on the topic. The work of behavioral endocrinologist Frank Beach (1911-1988) is important in this context and receives significant attention here. Rado ultimately distanced himself from Beach's behavioral endocrinology, appealing instead to evolutionary discourse to buttress his claim that homosexuality is pathological. This tactic allowed him to refashion psychoanalysis into a moralistic discipline, one with closer ties to a medical school. (PsycINFO Database Record