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Sorensen JL, West MM, Racila AM, Amao OA, Matt BJ, Bentler S, Kahl AR, Charlton ME, Seaman AT, Nash SH. Challenges in collecting information on sexual orientation and gender identity for cancer patients: perspectives of hospital and central cancer registry abstractors. Cancer Causes Control 2024:10.1007/s10552-024-01897-x. [PMID: 38954307 DOI: 10.1007/s10552-024-01897-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Sexual and gender minority (SGM) populations experience cancer treatment and survival disparities; however, inconsistent sexual orientation and gender identity (SOGI) data collection within clinical settings and the cancer surveillance system precludes population-based research toward health equity for this population. This qualitative study examined how hospital and central registry abstractors receive and interact with SOGI information and the challenges that they face in doing so. METHODS We conducted semi-structured interviews with 18 abstractors at five Surveillance, Epidemiology, and End Results (SEER) registries, as well as seven abstractors from commission on cancer (CoC)-accredited hospital programs in Iowa. Interviews were transcribed, cleaned, and coded using a combination of a priori and emergent codes. These codes were then used to conduct a descriptive analysis and to identify domains across the interviews. RESULTS Interviews revealed that abstractors had difficulty locating SOGI information in the medical record: this information was largely never recorded, and when included, was inconsistently/not uniformly located in the medical record. On occasion, abstractors reported situational recording of SOGI information when relevant to the patient's cancer diagnosis. Abstractors further noticed that, where reported, the source of SOGI information (i.e., patient, physician) is largely unknown. CONCLUSION Efforts are needed to ensure standardized implementation of the collection of SOGI variables within the clinical setting, such that this information can be collected by the central cancer registry system to support population-based equity research addressing LGBTQ + disparities.
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Affiliation(s)
- J L Sorensen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - M M West
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - A M Racila
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - O A Amao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - B J Matt
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - S Bentler
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - A R Kahl
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - M E Charlton
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - A T Seaman
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - S H Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, IA, USA.
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA.
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West BT, Engstrom CW, Schepis TS, Tani IJ, McCabe SE. How a "Something Else" Response Option for Sexual Identity Affects National Survey Estimates of Associations Between Sexual Identity, Reproductive Health, and Substance Use. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:107-126. [PMID: 37853260 PMCID: PMC10794379 DOI: 10.1007/s10508-023-02710-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023]
Abstract
This randomized experiment tested whether the inclusion of a "something else" response option for a question about sexual identity in a national health survey would significantly moderate estimated differences between sexual identity subgroups in terms of various health outcomes, including substance use and reproductive health. We conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (NSFG; 2015-2019), where two large national half-samples were randomly assigned to receive one of two different versions of a question about sexual identity (a four-category version that included a "something else" response option or a three-category version omitting this option). We focused on national estimates of differences between subgroups defined by sexual identity. Multivariable models indicated that the estimated subgroup differences changed in a statistically significant fashion when using the four-category version of the sexual identity question for several measures, including 16% of male measures (household size, past-year cigarette use, and past-year illicit drug use) and 15% of female measures (wanting a/another child, ever had a sexually transmitted disease, and past-year marijuana use). The absence of a "something else" response option for questions about sexual identity in national health surveys may cause respondents to select options that do not accurately describe their identities, and this can have a significant effect on national estimates of differences between sexual identity subgroups in terms of selected health outcomes.
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Affiliation(s)
- Brady T West
- Survey Research Center, 4118 Institute for Social Research, University of Michigan-Ann Arbor, 426 Thompson St., Ann Arbor, MI, 48106, USA.
| | - Curtiss W Engstrom
- Program in Survey and Data Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Ilmul J Tani
- Program in Survey and Data Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
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Young SK, Bond MA. A scoping review of the structuring of questions about sexual orientation and gender identity. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2592-2617. [PMID: 37088990 DOI: 10.1002/jcop.23048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 05/03/2023]
Abstract
The purpose of this scoping review is to map the extent of the current research on how to best structure questions asking respondents to self-identify their sexual orientation and gender identity and to ascertain what further issues about measurement need to be explored. Using the Arksey and O'Malley framework for scoping reviews, 52 articles describing primary research about how to structure sexual orientation and gender identity (SOGI) questions, published in the years 2000-2021, were identified and analyzed. The domain of sexuality being asked about (e.g., self-label vs. behavior) needs to be clarified, and gender identity should be asked through a multipart item differentiating current identity from the sex assigned at birth. The terms used in the response options should be defined and may vary based on the study population or context. Contrary to expectations given the wide range of question formats currently being used in the field, there is considerable consensus around the basic tenets for structuring questions designed to assess SOGI dimensions.
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Affiliation(s)
- Sarah K Young
- Department of Psychology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Meg A Bond
- Department of Psychology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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4
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Drabble LA, Mericle AA, Munroe C, Cerezo A, Karriker-Jaffe KJ, Hughes TL, Trocki KF. Examining the differential protective effects of women's spirituality and religiosity on alcohol and marijuana use by sexual identity. Addict Behav Rep 2022; 16:100450. [PMID: 36034970 PMCID: PMC9399474 DOI: 10.1016/j.abrep.2022.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/23/2022] [Accepted: 08/09/2022] [Indexed: 10/29/2022] Open
Abstract
The current study explored how religiosity and spirituality may differentially influence substance use by sexual identity based on a sample of adult sexual minority women (SMW; n = 437 lesbian; n = 323 bisexual) relative to a heterosexual comparison sample (n = 636). We examined three questions: (1) whether spirituality was differentially associated with alcohol and marijuana use by sexual identity; (2) whether religiosity was differentially associated with alcohol and marijuana use by sexual identity; (3) whether observed differences between spirituality or religiosity and substance use by sexual identity persisted after adjusting for religious environment. Measures included spirituality (importance of spirituality), religiosity (importance of religion, attending religious services), and past year substance use (alcohol use disorder [AUD], any marijuana use, and regular marijuana use). Higher levels of spirituality were associated with increased odds of AUD among both lesbian and bisexual respondents relative to heterosexuals. Higher levels of religiosity among lesbian participants were associated with increased odds of AUD relative to heterosexuals with higher levels of religiosity. Consistent with theories of minority stress, findings suggest that spirituality and religiosity are less protective for SMW than heterosexual women and, in some cases, may contribute to greater risk of substance use.
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Affiliation(s)
- Laurie A Drabble
- San José State University College of Health and Human Sciences, One Washington Square, San Jose, CA 95192-0049, USA
| | - Amy A Mericle
- Alcohol Research Group, Public Health Institute, USA
| | - Cat Munroe
- Alcohol Research Group, Public Health Institute, USA
| | - Alison Cerezo
- Department of Counseling, Clinical & School Psychology, University of California Santa Barbara, USA
| | | | - Tonda L Hughes
- School of Nursing & Department of Psychiatry, Columbia University, USA
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Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug Alcohol Depend 2022; 235:109433. [PMID: 35395502 DOI: 10.1016/j.drugalcdep.2022.109433] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts. METHODS A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity. RESULTS Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men. CONCLUSIONS These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.
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West BT, McCabe SE. Choices Matter: How Response Options for Survey Questions about Sexual Identity Affect Population Estimates of Its Association with Alcohol, Tobacco, and Other Drug Use. FIELD METHODS 2021; 33:335-354. [PMID: 34880713 PMCID: PMC8651075 DOI: 10.1177/1525822x21998516] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study presents results from a randomized experiment in the 2015-2017 National Survey of Family Growth, where a large national sample of U.S. individuals aged 15-49 was randomly assigned to one of two different versions of a survey question about sexual identity (one with three response options, including heterosexual, gay/lesbian, and bisexual, and one adding the option "something else"). Analyses of changes in the associations of sexual identity with alcohol, tobacco, and other drug use across these treatments revealed evidence of significant differences in the associations that remained robust after adjusting for socio-demographics. The results suggest that when individuals choose their sexual identity from a more limited number of response options, the heterogeneity of the sexual identity subgroups increases, weakening estimated associations of sexual identity with these behaviors. Open-ended questions may therefore be necessary to measure sexual identity and estimate its associations with substance use behaviors accurately in surveys.
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Affiliation(s)
- Brady T. West
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Sean Esteban McCabe
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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7
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Hughes TL, Wilsnack SC, Martin K, Matthews A(P, Johnson TP. Alcohol use among sexual minority women: Methods used and lessons learned in the 20-Year Chicago Health and Life Experiences of Women Study. INTERNATIONAL JOURNAL OF ALCOHOL AND DRUG RESEARCH 2021; 9:30-42. [PMID: 37946724 PMCID: PMC10634638 DOI: 10.7895/ijadr.289] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Background Two decades ago, there was almost no research on alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual). Since then, a growing body of scientific literature documents substantial sexual orientation-related disparities in alcohol use and alcohol-related problems. Research has identified multiple risk factors associated with high-risk/hazardous drinking among SMW. However, this research has almost exclusively used cross-sectional designs, limiting the ability to draw conclusions about processes through which sexual minority status affects alcohol use. Longitudinal designs, although very rare in research on alcohol use among SMW, are important for testing mediational mechanisms and necessary to understanding how changes in social determinants impact alcohol use. Aim To describe the processes and lessons learned in conducting a 20-year longitudinal study focused on alcohol use among SMW. Methods The Chicago Health and Life Experiences of Women (CHLEW) study includes five waves of data collection (2000-present) with an age and racially/ethnically diverse sample of 815 SMW (ages 18-83) originally recruited in the Chicago Metropolitan Area in Illinois, a midwestern state in the United States (U.S.). Measures and focus have evolved over the course of the study. Results The CHLEW study is the longest-running and most comprehensive study of SMW's drinking in the U.S. or elsewhere. Findings reported in more than 50 published manuscripts have contributed to understanding variations in SMW's risk for hazardous/harmful drinking based on sexual identity, age, race/ethnicity, sex/gender of partner, and many other factors. Conclusions By describing the process used in conducting this long-term study, its major findings, and the lessons learned, we hope to encourage and support other researchers in conducting longitudinal research focused on SMW's health. Such research is critically important in understanding and ultimately eliminating sexual orientation-related health disparities.
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Affiliation(s)
- Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University
| | - Sharon C. Wilsnack
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences
| | - Kelly Martin
- School of Nursing and Department of Psychiatry, Columbia University
| | | | - Timothy P. Johnson
- Center for Clinical and Translational Science, University of Illinois at Chicago
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8
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Lorenz TK. Relying on an "Other" Category Leads to Significant Misclassification of Sexual Minority Participants. LGBT Health 2021; 8:372-377. [PMID: 34097503 DOI: 10.1089/lgbt.2020.0449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study assessed which sexual minority participants selected "Other" if their identity was absent. Methods: This was an online survey; 905 participants saw a limited set of sexual orientation options (bisexual, gay/lesbian, heterosexual, other), and later in the same survey, saw an expanded list. Results: Twenty-one percent of participants chose different orientation labels across questions. When not presented with a "mostly heterosexual" option, 78% of mostly heterosexual participants chose "heterosexual"; 3% chose "other." However, when not presented with an "asexual" label, 100% of asexual participants chose "other." Conclusion: These findings suggest that "other" categories could misclassify a substantial proportion of sexual minority participants.
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Affiliation(s)
- Tierney K Lorenz
- Department of Psychology and Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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9
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Social-Ecological Examination of Non-Consensual Sexting Perpetration among U.S. Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249477. [PMID: 33348870 PMCID: PMC7766393 DOI: 10.3390/ijerph17249477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 11/29/2022]
Abstract
Adolescent sexting is a serious public health concern and is associated with adverse psychosocial outcomes, including depression, anxiety, low self-esteem, declining academic performance, and health problems. Effective prevention of sexting requires a comprehensive and deep understanding of the multiple contexts whereby sexting is likely to occur. The present study explores individual and contextual risk and protective factors that are associated with sexting behavior among a large sample of adolescents. Participants were high school students in midwestern U.S. (N = 2501; LGB n = 309, 76.4% female; non-LGB n = 2192, 47.4% female) who completed self-report measures of sexting and risk (e.g., pornography exposure, impulsivity) and protective (e.g., social support) factors. Path analysis models were conducted with the sexting outcome for groups of LGB and non-LGB students. Among LGB students, results indicated a significant association between sexting and parental monitoring (b = −0.08, p < 0.01); pornography exposure (b = 0.13, p < 0.05); dating partners (b = 0.01, p < 0.01); bullying perpetration (b = 0.17, p < 0.001); and delinquency (b = 0.13; p < 0.001). Among non-LGB students, significant associations were found between sexting and alcohol/substance use (b = 0.05, p < 0.001); bullying (b = 0.08, p < 0.001); and delinquency (b = 0.06, p < 0.001). Moderation analyses suggest that parental monitoring may have a buffering effect between sexting and several risk factors. Recommendations for practitioners include considering the protective factors of sexting perpetration and encouraging appropriate levels of parental monitoring and the continued importance of bullying and alcohol and drug prevention programming to decrease risk factors of sexting perpetration.
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Swiatlo AD, Kahn NF, Halpern CT. Intimate Partner Violence Perpetration and Victimization Among Young Adult Sexual Minorities. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2020; 52:97-105. [PMID: 32462714 PMCID: PMC7669537 DOI: 10.1363/psrh.12138] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 01/17/2020] [Accepted: 03/04/2020] [Indexed: 05/24/2023]
Abstract
CONTEXT Intimate partner violence (IPV) among sexual minority young adults has been understudied, and victimization and perpetration estimates are needed. METHODS Data on 13,653 women and men aged 24-32 who participated in Wave 4 of the National Longitudinal Study of Adolescent to Adult Health were used to examine associations between sexual orientation and IPV perpetration and victimization in respondents' current or most recent relationship. Logistic regression analyses were used to identify associations between respondent characteristics and three IPV categories (physical violence, threatened violence and forced sex). RESULTS Some 94% of males and 80% of females identified as 100% heterosexual; 4% of males and 16% of females as mostly heterosexual; 1% of males and 2% of females as bisexual; and 2% of males and females as either mostly homosexual or 100% homosexual. Compared with their heterosexual counterparts, mostly heterosexual women were more likely to report having perpetrated or been a victim of physical IPV (odds ratios, 1.9 and 1.6, respectively), having threatened violence (2.0) and having been a victim of threatened violence and forced sex (1.6 for each); mostly heterosexual males were more likely to have been a perpetrator or victim of physical IPV (3.1 and 1.8, respectively) and a perpetrator of forced sex and threatened violence (2.0 and 1.8, respectively). Bisexual males had elevated odds of physical violence victimization (3.3) and forced sex victimization (4.9) and perpetration (5.0). CONCLUSIONS Some sexual minority groups are disproportionately affected by IPV, indicating a need for increased prevention efforts and for studies exploring the mechanisms underlying these differences.
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Affiliation(s)
- Alison D Swiatlo
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill
| | - Nicole F Kahn
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill
| | - Carolyn T Halpern
- Department of Maternal and Child Health and Carolina Population Center, University of North Carolina at Chapel Hill
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11
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Hughes TL, Veldhuis CB, Drabble LA, Wilsnack SC. Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review. PLoS One 2020; 15:e0229869. [PMID: 32187200 PMCID: PMC7080264 DOI: 10.1371/journal.pone.0229869] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/15/2020] [Indexed: 12/31/2022] Open
Abstract
Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.
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Affiliation(s)
- Tonda L. Hughes
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Cindy B. Veldhuis
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Laurie A. Drabble
- San Jose State University, San Jose, California, United States of America
| | - Sharon C. Wilsnack
- University of North Dakota, Grand Forks, North Dakota, United States of America
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12
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Lewis RJ, Ehlke SJ, Shappie AT, Braitman AL, Heron KE. Health Disparities Among Exclusively Lesbian, Mostly Lesbian, and Bisexual Young Women. LGBT Health 2019; 6:400-408. [PMID: 31738644 DOI: 10.1089/lgbt.2019.0055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Health disparities have been identified between groups of diverse young sexual minority women (SMW) and heterosexual women. This approach may generate sufficient group sizes for statistical analyses but obscures important differences. Moreover, some young women may not identify as "lesbian" or "bisexual" but somewhere in between. This study examined health and sexual minority identity-specific outcomes among three groups of SMW-women who identify as "exclusively lesbian," "mostly lesbian," and "bisexual." Methods: Participants were 990 young (18-30 years old) SMW (exclusively lesbian: n = 305, mostly lesbian: n = 133, bisexual: n = 552) who completed an online survey, including information about mental and physical health symptoms, hazardous drinking, and identity uncertainty. Those who reported alcohol use in the past 30 days responded to questions about their alcohol use and alcohol-related negative consequences. Results: Controlling for demographic differences, health outcomes varied significantly by identity. Mostly lesbian and bisexual women reported the most depression, anxiety, and physical health symptoms; mostly lesbian women reported the highest levels of hazardous drinking. Among those who reported drinking, mostly lesbian women drank the most frequently and reported the most alcohol-related consequences. Mostly lesbian women reported the most identity uncertainty. Conclusion: Mostly lesbian women were similar to bisexual women on several health outcomes. They appear unique, however, in drinking behavior and identity uncertainty. Collapsing across identities in health research may affect outcomes.
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Affiliation(s)
- Robin J Lewis
- Department of Psychology, Old Dominion University, Norfolk, Virginia.,Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia
| | - Sarah J Ehlke
- Department of Psychology, Old Dominion University, Norfolk, Virginia
| | | | - Abby L Braitman
- Department of Psychology, Old Dominion University, Norfolk, Virginia.,Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia
| | - Kristin E Heron
- Department of Psychology, Old Dominion University, Norfolk, Virginia.,Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia
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13
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Wilson MN, Asbridge M, Woolcott C, Langille DB. Sexual orientation and alcohol-related harms in Canadian youth. Canadian Journal of Public Health 2019; 109:233-241. [PMID: 29981031 DOI: 10.17269/s41997-018-0032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine associations between experiencing alcohol-related harm, sex, and sexual orientation among Canadian high school students. METHODS We used data from the 2012 Atlantic Student Drug Use Survey (ASDUS), including a comprehensive six-category measure of sexual orientation and nine different alcohol-related harms for analyses. Simple logistic regression was used to determine the association between experiencing any of the nine harms and each specific alcohol-related harm and sexual orientation, stratified by sex. Analysis was limited to those who indicated they had consumed alcohol in the year prior to the survey. RESULTS High rates of having any alcohol-related harm were seen among both males (41.7%) and females (46.0%) attending Atlantic Canadian high schools. Mostly heterosexual males had a lower odds ratio for experiencing any alcohol-related harm compared to heterosexual males. Mostly heterosexual females and bisexual females had higher odds ratios for experiencing any alcohol-related harm than heterosexual females. CONCLUSIONS High rates of alcohol-related harm in this population suggest that youth may benefit from a harm reduction approach to alcohol use. While we found that mostly heterosexual and bisexual female youth experience higher levels of alcohol-related harm than heterosexual females, further research is required to confirm this association and to determine its relevance to harm reduction strategies.
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Affiliation(s)
- Maria N Wilson
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Clinical Research Centre 5790 University Avenue, Halifax, NS, B3H 1V7, Canada.
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Clinical Research Centre 5790 University Avenue, Halifax, NS, B3H 1V7, Canada
| | - Christy Woolcott
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Donald B Langille
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Clinical Research Centre 5790 University Avenue, Halifax, NS, B3H 1V7, Canada
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Flentje A, Brennan J, Satyanarayana S, Shumway M, Riley E. Quantifying Sexual Orientation Among Homeless and Unstably Housed Women in a Longitudinal Study: Identity, Behavior, and Fluctuations Over a Three-Year Period. JOURNAL OF HOMOSEXUALITY 2018; 67:244-264. [PMID: 30403568 PMCID: PMC6504620 DOI: 10.1080/00918369.2018.1536417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Sexual orientation has been linked to certain health conditions, and yet quantifying sexual orientation in longitudinal studies is challenging. This study examined different methods of accounting for sexual orientation in a cohort study of 300 homeless and unstably housed women followed every 6 months over 3 years. Altogether, 39.7% (n = 119) could be considered sexual minority at one or more time points based on identity and/or behavior; 16.3% (n = 49) reported shifts in sexual identity. Only 24.0% (n = 72) were identified as sexual minority through a single measure of sexual identity, 27.0% (n = 81) were identified with a single measure of identity and behavior, 33.0% (n = 99) were identified through annual measures of identity and behavior, and 22.0%-22.3% (n = 66-67) were identified through latent class analysis including all identity/behavior measures. This study found that sexual fluidity is common in unstably housed women, and many sexual minority women would be missed in longitudinal studies with different methods of accounting for sexual orientation.
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Affiliation(s)
- Annesa Flentje
- Community Health Systems, School of Nursing, University of California, San Francisco University of California, San Francisco
| | - James Brennan
- Department of Psychology, The University of Montana, Missoula, Montana
| | | | - Martha Shumway
- Department of Psychiatry, School of Medicine, University of California, San Francisco
| | - Elise Riley
- Department of Medicine, School of Medicine, University of California, San Francisco
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15
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Health service use by same-sex attracted Australian women for alcohol and mental health issues: a cross-sectional study. BJGP Open 2018; 2:bjgpopen18X101565. [PMID: 30564720 PMCID: PMC6184099 DOI: 10.3399/bjgpopen18x101565] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/20/2018] [Indexed: 12/05/2022] Open
Abstract
Background Same-sex attracted women (SSAW) have higher rates of alcohol and mental health problems than heterosexual women, but utilisation of and satisfaction with treatment is limited. Aim This study investigated the influences on health service use for alcohol and mental health problems among SSAW. Design & setting The Gelberg-Andersen behavioural model of health service utilisation was used to generate outcome variables. Method A convenience sample of 521 community-connected Australian SSAW completed an online survey. Health service use according to sexual identity was compared using χ2 analysis. Binary logistic regression examined associations between the independent variables with treatment utilisation. Results Reports of alcohol treatment were very low. Only 41.1% of participants with service need had utilised mental health and alcohol treatment. Bisexual women (adjusted odds ratio [AOR] = 2.76) and those with ‘other’ identities (AOR = 2.38) were more likely to use services than lesbian women. Enablers to service use were having a regular GP (AOR = 3.02); disclosure of sexuality to the GP (AOR = 2.42); lesbian, gay, bisexual and transgender (LGBT) community-connectedness (AOR = 1.11); and intimate partner violence ([IPV] AOR = 2.51). Social support was associated with a reduction in treatment use (AOR = 0.97). Significant access barriers included not feeling ready for help, and previous negative experiences related to sexual identity. Conclusion Disclosing sexual identity to a regular, trusted GP correlated with improved utilisation of alcohol and mental health treatment for SSAW. The benefits of seeking help for alcohol use, and of accessing LGBT-inclusive GPs to do so, should be promoted to SSAW.
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Galupo MP, Mitchell RC, Davis KS. Face Validity Ratings of Sexual Orientation Scales by Sexual Minority Adults: Effects of Sexual Orientation and Gender Identity. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1241-1250. [PMID: 28733825 DOI: 10.1007/s10508-017-1037-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 01/31/2017] [Accepted: 07/07/2017] [Indexed: 06/07/2023]
Abstract
The present research explored sexual minority individuals' ratings of two traditional (Kinsey and Klein Sexual Orientation Grid [KSOG]) and two novel (Sexual-Romantic and Gender Inclusive) sexual orientation scales with regard to how well they capture their sexuality. Participants included 363 sexual minority individuals who identified as lesbian, gay, bisexual, pansexual, or queer, and included individuals who identified as transgender (n = 85) and cisgender (n = 278). The findings indicated clear patterns of responses across both sexual orientation and gender identity, where participants differed in the degree to which they felt the scales captured their sexuality. A main effect of sexual orientation was found for all four scales, where participants endorsing monosexual (lesbian/gay) identities rated the scales more positively than did participants endorsing plurisexual (bisexual and pansexual/queer) identities. Bisexual individuals had a unique pattern of ratings, which sometimes aligned with those of lesbian/gay participants and sometimes aligned with pansexual/queer participants. A main effect of gender identity was found for the Kinsey, KSOG, and Sexual-Romantic (but not Gender Inclusive) scales, where cisgender individuals rated the scales more positively than did transgender individuals. There were no significant interaction effects between sexual orientation and gender identity for any of the four scales. The present findings can be used to understand sexual minority individuals' assessment of the face validity of four sexual orientation measures. Discussion focused on the implications for using traditional measures of sexual orientation in research as well as for the development of new measures that better capture the range of sexual minority experience.
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Affiliation(s)
- M Paz Galupo
- Psychology Department, Towson University, 8000 York Road, Towson, MD, 21252-0001, USA.
| | - Renae C Mitchell
- Psychology Department, Towson University, 8000 York Road, Towson, MD, 21252-0001, USA
| | - Kyle S Davis
- Psychology Department, Towson University, 8000 York Road, Towson, MD, 21252-0001, USA
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17
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Drabble L, Veldhuis CB, Riley BB, Rostosky S, Hughes TL. Relationship of Religiosity and Spirituality to Hazardous Drinking, Drug Use, and Depression Among Sexual Minority Women. JOURNAL OF HOMOSEXUALITY 2017; 65:1734-1757. [PMID: 28929909 PMCID: PMC5860995 DOI: 10.1080/00918369.2017.1383116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. Among SMW with high religiosity, African American SMW were more likely than White SMW to report hazardous drinking. Latina SMW with higher spirituality were more likely than White SMW to report drug use. Results suggest that religiosity and spirituality affect subgroups differently, which should be considered in future research on resiliency among SMW.
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Affiliation(s)
- Laurie Drabble
- a School of Social Work, San José State University , San Jose , California , USA
| | - Cindy B Veldhuis
- b School of Nursing , Columbia University , New York , New York , USA
| | - Barth B Riley
- c Independent Research Consultant, Chicago, Illinois, USA
| | - Sharon Rostosky
- d Educational, School, & Counseling Psychology , University of Kentucky , Lexington , Kentucky , USA
| | - Tonda L Hughes
- e School of Nursing & Department of Psychiatry , Columbia University , New York , New York , USA
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18
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Stoffel C, Carpenter E, Everett B, Higgins J, Haider S. Family Planning for Sexual Minority Women. Semin Reprod Med 2017; 35:460-468. [PMID: 29073685 DOI: 10.1055/s-0037-1604456] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractThe family planning needs of sexual minority women (SMW) are an understudied but growing area of research. SMW have family planning needs, both similar to and distinct from their exclusively heterosexual peers. Specifically, SMW experience unintended pregnancies at higher rates than their exclusively heterosexual peers, but factors that increase this risk are not well understood. Contraception use is not uncommon among SMW, but lesbian women are less likely to use contraception than bisexual or exclusively heterosexual women. High rates of unintended pregnancy suggest contraception is underused among SMW. Contraception counseling guidelines specific to SMW do not yet exist, but greater adoption of current best practices is likely to meet the needs of SMW. SMW may have unique needs for their planned pregnancies as well, for which obstetrics and gynecology (Ob/Gyn) providers should provide care and referrals. In general, understandings of the distinct family planning needs for SMW are limited and further research is needed, with particular attention to issues of overlapping health disparities related to status as a SMW and other factors such as race/ethnicity that may add additional layers of stigma and discrimination. Clinical resources are needed to help Ob/Gyns make their practice more welcoming to the needs of SMW.
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Affiliation(s)
- Cynthia Stoffel
- Department of Academic Internal Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Emma Carpenter
- Madison School of Social Work, University of Wisconsin, Madison, Wisconsin
| | - Bethany Everett
- Department of Sociology, University of Utah, Salt Lake City, Utah
| | - Jenny Higgins
- Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, Wisconsin
| | - Sadia Haider
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
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19
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Shahab L, Brown J, Hagger-Johnson G, Michie S, Semlyen J, West R, Meads C. Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey. BMJ Open 2017; 7:e015058. [PMID: 29074508 PMCID: PMC5665254 DOI: 10.1136/bmjopen-2016-015058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 06/09/2017] [Accepted: 06/30/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics. DESIGN Cross-sectional household survey conducted in 2014-2016. SETTING England, UK. PARTICIPANTS Representative English population sample (pooled n=43 866). MAIN OUTCOMES Sexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ≥8). All outcomes were self-reported. RESULTS Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95% CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95% CI 25.9% to 39.6%; men: 30.7%, 95% CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95% CI 13.5% to 17.8%) but not men (22.7%, 95% CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95% CI 17.0% to 18.0%; men: 20.4%, 95% CI 19.9% to 21.0%; p<0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian/gay (women: 19.0%, 95% CI 14.0% to 25.3%; men: 30.0%, 25.2%-35.3%) and bisexual participants (women: 24.4%, 95% CI 18.7% to 31.3%; men: 24.3%, 95% CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95% CI 3.0% to 5.4%; men: 13.7%; 95% CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95% CI 7.9% to 8.7%; men: 18.4%, 95% CI 17.9% to 18.9%; p<0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men. CONCLUSIONS In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women.
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Affiliation(s)
- Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Gareth Hagger-Johnson
- Administrative Data Research Centre for England (ADRC-E), Farr Institute, University College London, London, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joanna Semlyen
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Catherine Meads
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK
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20
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Slater ME, Godette D, Huang B, Ruan WJ, Kerridge BT. Sexual Orientation-Based Discrimination, Excessive Alcohol Use, and Substance Use Disorders Among Sexual Minority Adults. LGBT Health 2017; 4:337-344. [PMID: 28876167 DOI: 10.1089/lgbt.2016.0117] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to examine relationships between sexual orientation-based discrimination and excessive alcohol use and substance use disorders and to identify how these relationships differ by sexual identity, sex, race, Hispanic origin, and education among sexual minorities. METHODS We used logistic regression to analyze associations between discrimination and substance use measures among 1351 gay/lesbian, bisexual, or unsure adults from a nationally representative survey. Differential effects by sexual identity, sex, race, Hispanic origin, and education were assessed using interaction models followed by stratified models. RESULTS Discrimination was associated with increased odds of the following: exceeding weekly drinking limits [adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.12-2.08] among bisexuals, any substance use disorder (aOR = 2.04, 95% CI: 1.41-2.95) and nicotine use disorder (aOR = 1.52, 95% CI: 1.08-2.14) among Hispanic sexual minorities, and exceeding weekly drinking limits (aOR = 1.56, 95% CI: 1.08-2.26) among those with a high school degree or less. CONCLUSION Sexual orientation-based discrimination was associated with select substance use outcomes, especially among bisexuals, Hispanics, and less educated sexual minority adults, highlighting potential disparities associated with experiencing discrimination.
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Affiliation(s)
| | - Dionne Godette
- 2 National Institute on Alcohol Abuse and Alcoholism , Rockville, Maryland
| | - Boji Huang
- 2 National Institute on Alcohol Abuse and Alcoholism , Rockville, Maryland
| | - W June Ruan
- 2 National Institute on Alcohol Abuse and Alcoholism , Rockville, Maryland
| | - Bradley T Kerridge
- 3 Department of Epidemiology, Columbia University Mailman School of Public Health , New York, New York
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21
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Greaves LM, Barlow FK, Lee CHJ, Matika CM, Wang W, Lindsay CJ, Case CJB, Sengupta NK, Huang Y, Cowie LJ, Stronge S, Storey M, De Souza L, Manuela S, Hammond MD, Milojev P, Townrow CS, Muriwai E, Satherley N, Fraser G, West-Newman T, Houkamau C, Bulbulia J, Osborne D, Wilson MS, Sibley CG. The Diversity and Prevalence of Sexual Orientation Self-Labels in a New Zealand National Sample. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1325-1336. [PMID: 27686089 DOI: 10.1007/s10508-016-0857-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/03/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Abstract
In this study, we asked participants to "describe their sexual orientation" in an open-ended measure of self-generated sexual orientation. The question was included as part of the New Zealand Attitudes and Values Study (N = 18,261) 2013/2014 wave, a national probability survey conducted shortly after the first legal same-sex marriages in New Zealand. We present a two-level classification scheme to address questions about the prevalence of, and demographic differences between, sexual orientations. At the most detailed level of the coding scheme, 49 unique categories were generated by participant responses. Of those who responded with the following, significantly more were women: bisexual (2.1 % of women, compared to 1.5 % of men), bicurious (0.7 % of women, 0.4 % of men), and asexual (0.4 % of women and less than 0.1 % of men). However, significantly fewer women than men reported being lesbian or gay (1.8 % of women, compared to 3.5 % of men). Those openly identifying as bicurious, bisexual, or lesbian/gay were significantly younger than those with a heterosexual orientation. This study shows diversity in the terms used in self-generated sexual orientations, and provides up-to-date gender, age, and prevalence estimates for the New Zealand population. Finally, results reveal that a substantial minority of participants may not have understood the question about sexual orientation.
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Affiliation(s)
- Lara M Greaves
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Fiona Kate Barlow
- School of Applied Psychology and Menzies Health Institute, Griffith University, Mount Gravatt, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Carol H J Lee
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Correna M Matika
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Weiyu Wang
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Cinnamon-Jo Lindsay
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Claudia J B Case
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Nikhil K Sengupta
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Yanshu Huang
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Lucy J Cowie
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Samantha Stronge
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Mary Storey
- Department of Psychology, California State University, Bakersfield, CA, USA
| | - Lucy De Souza
- Department of Psychology, Wesleyan University, Middletown, CT, USA
| | - Sam Manuela
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Matthew D Hammond
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Petar Milojev
- School of Psychology, Massey University, Auckland, New Zealand
| | - Carly S Townrow
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Emerald Muriwai
- Te Rōpū Whāriki, College of Health, Massey University, Auckland, New Zealand
| | - Nicole Satherley
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Gloria Fraser
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Tim West-Newman
- Ngā Pae o te Māramatanga, University of Auckland, Auckland, New Zealand
| | - Carla Houkamau
- Department of Management and International Business, University of Auckland, Auckland, New Zealand
| | - Joseph Bulbulia
- School of Art History, Classics, and Religious Studies, Victoria University of Wellington, Wellington, New Zealand
| | - Danny Osborne
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Marc S Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Chris G Sibley
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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22
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Gilbert PA, Drabble L, Daniel-Ulloa J, Trocki KF. Alcohol Outcomes by Sexual Orientation and Race/Ethnicity: Few Findings of Higher Risk. J Stud Alcohol Drugs 2017; 78:406-414. [PMID: 28499108 PMCID: PMC5440365 DOI: 10.15288/jsad.2017.78.406] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 12/06/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study sought to confirm a previously identified race by sexual orientation interaction and to clarify men's alcohol-related risk by using an expanded classification of sexual orientation. METHOD We collapsed three waves of National Alcohol Survey data, restricting the analytic sample to White (n = 5,689), Black (n = 1,237), and Latino (n = 1,549) men with complete information on sexual orientation and alcohol use. Using self-reported sexual identity and behavior, respondents were categorized as exclusively heterosexual (referent), behaviorally discordant heterosexuals (i.e., heterosexual identity and same-sex partners), or gay/bisexually identified men. We used multivariable logistic regression to model lifetime alcohol dependence symptoms, lifetime drinking-related consequences, and past-year hazardous drinking, controlling for age, education, employment, and relationship status and accounting for the complex survey design. RESULTS There was no difference in risk of past-year hazardous drinking and lifetime drinking-related consequences between heterosexual, behaviorally discordant heterosexual, and gay/bisexual men, independent of race/ ethnicity. Among Black men, behaviorally discordant heterosexuals had three-fold higher odds of lifetime alcohol dependence symptoms than exclusively heterosexual peers (aOR = 3.30, 95% CI [1.19, 9.18], p = .02). Gay/bisexual Latino men had marginally significantly lower odds of lifetime alcohol dependence symptoms (aOR = 0.36, 95% CI [0.12, 1.03], p = .06). CONCLUSIONS There is little support for broad statements of greater alcohol risk among gay/bisexual men; however, for some subgroups and outcomes the direction and degree of risk depend on race/ ethnicity. Thus, this study underscores the importance of considering the potential interaction of sexual orientation and race/ethnicity, which may exacerbate or attenuate.
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Affiliation(s)
- Paul A. Gilbert
- Department of Community and Behavioral Health and Prevention Research Center, University of Iowa College of Public Health, Iowa City, Iowa
| | - Laurie Drabble
- School of Social Work, San Jose State University, San Jose, California
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health and Prevention Research Center, University of Iowa College of Public Health, Iowa City, Iowa
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Abstract
BACKGROUND Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatically in the United States over the past decade. OBJECTIVES This paper investigates the use of risky substances among adolescents, and examines disparities between sexual minority (i.e., mostly heterosexual and lesbian, gay, bisexual; LGB) and heterosexual adolescents in use of novel and emerging substances. Given the public health risk and the imminence of these substances in the media, emerging drug use was examined in a county wide sample of adolescents in a Southern state. METHODS A probability sample of middle and high school students (N = 3012; ages 11-18) using random cluster methods was obtained in a mid-sized school district in the Southeastern United States. RESULTS LGB adolescents reported higher past-30 day and lifetime use of cigarettes (AORs =2.77, 2.90, respectively), smokeless tobacco (lifetime only: AOR = 1.88), e-cigarettes (lifetime only; AOR = 1.92), alcohol (AORs = 1.7, 2.20), marijuana (AORs = 3.02, 3.06), synesthetic marijuana (AORs = 3.77, 2.48), and prescription drugs (AORs = 3.82, 2.55). Adolescents who self-identified as "mostly heterosexual" reported higher lifetime cigarette use, and past 30-day use of e-cigarettes and prescription drugs as compared with heterosexual adolescents. CONCLUSIONS Our results are notable given the dearth of data documenting use of increasingly emerging or "trendy" substances such as prescription drugs. More research is needed to understand the underlying cause of these disparities, and efforts should be targeted toward this population to reduce negative outcomes from misuse.
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Affiliation(s)
- Jeremy T Goldbach
- a School of Social Work, University of Southern California , Los Angeles , California , USA
| | - Ethan H Mereish
- b Center for Alcohol and Addiction Studies, Brown University , Providence , Rhode Island , USA
| | - Claire Burgess
- c Department of Clinical Science , University of Southern California , Los Angeles , California , USA
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24
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Seto MC. The Puzzle of Male Chronophilias. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:3-22. [PMID: 27549306 DOI: 10.1007/s10508-016-0799-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 06/15/2016] [Accepted: 06/22/2016] [Indexed: 05/24/2023]
Abstract
In this article, I return to the idea that pedophilia, a sexual interest in prepubescent children, can be considered a sexual orientation for age, in conjunction with the much more widely acknowledged and discussed sexual orientation for gender. Here, I broaden the scope to consider other chronophilias, referring to paraphilias for age/maturity categories other than young sexually mature adults. The puzzle of chronophilias includes questions about etiology and course, how chronophilias are related to each other, and what they can tell us about how human (male) sexuality is organized. In this article, I briefly review research on nepiophilia (infant/toddlers), pedophilia (prepubescent children), hebephilia (pubescent children), ephebophilia (postpubescent, sexually maturing adolescents), teleiophilia (young sexually mature adults, typically 20s and 30s), mesophilia (middle-aged adults, typically 40s and 50s), and gerontophilia (elderly adults, typically 60s and older) in the context of a multidimensional sexual orientations framework. Relevant research, limitations, and testable hypotheses for future work are identified.
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Affiliation(s)
- Michael C Seto
- Royal Ottawa Health Care Group, Ottawa, ON, K1Z 7K4, Canada.
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25
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Abstract
Many studies, reviews, and meta-analyses have reported elevated mental health problems for sexual minority (SM) individuals. This systematic review provides an update by including numerous recent studies, and explores whether SM individuals are at increased risk across selected mental health problems as per dimensions of sexual orientation (SO), genders, life-stages, geographic regions, and in higher quality studies. A systematic search in PubMed produced 199 studies appropriate for review. A clear majority of studies reported elevated risks for depression, anxiety, suicide attempts or suicides, and substance-related problems for SM men and women, as adolescents or adults from many geographic regions, and with varied SO dimensions (behaviour, attraction, identity), especially in more recent and higher quality studies. One notable exception is alcohol-related problems, where many studies reported zero or reversed effects, especially for SM men. All SM subgroups were at increased risk, but bisexual individuals were at highest risk in the majority of studies. Other subgroup and gender differences are more complex and are discussed. The review supports the long-standing mental health risk proposition for SM individuals, overall and as subgroups.
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Affiliation(s)
- Martin Plöderl
- a Department of Suicide Prevention , University Clinic of Psychiatry and Psychotherapy, University Institute of Clinical Psychology, Christian Doppler Clinic, Paracelsus Medical University , Salzburg , Austria
| | - Pierre Tremblay
- b Faculty of Social Work, University of Calgary , Calgary, Alberta , Canada
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26
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Everett BG, McCabe KF, Hughes TL. Unintended Pregnancy, Depression, and Hazardous Drinking in a Community-Based Sample of Sexual Minority Women. J Womens Health (Larchmt) 2016; 25:904-11. [PMID: 26977978 PMCID: PMC5311462 DOI: 10.1089/jwh.2015.5290] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
CONTEXT Unintended pregnancy is a stressful life event with important implications for women's health. Little research has examined sexual minority women's (SMW; lesbian, bisexual, mostly heterosexual) experiences of unintended pregnancy, and no studies have examined the relationship between unintended pregnancy, mental health, and negative coping behaviors in this population. METHODS We used the Chicago Health and Life Experiences of Women (CHLEW) Study (n = 454), a diverse sample of SMW, to examine the relationship between self-reported unintended pregnancy, depressive symptoms, and hazardous drinking. We used generalized linear model-building techniques and adjusted for key sociodemographic controls, as well as unintended pregnancy risk factors, including childhood physical and sexual abuse and age of sexual debut. RESULTS Twenty-four percent of the sample reported an unintended pregnancy. SMW who reported unintended pregnancies also reported significantly more depressive symptoms and greater risk of hazardous drinking. Adjusting for childhood abuse explained the relationship between unintended pregnancy and depressive symptoms, but not the relationship between unintended pregnancy and hazardous drinking. CONCLUSIONS Unintended pregnancy among SMW is an understudied topic. Our results suggest that unintended pregnancy is not uncommon among SMW and highlight the need for more research to investigate the mechanisms that link unintended pregnancy to depression and to hazardous drinking within this population.
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Affiliation(s)
| | - Katharine F. McCabe
- Department of Sociology, University of Illinois at Chicago, Chicago, Illinois
| | - Tonda L. Hughes
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
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Talley AE, Grimaldo G, Wilsnack SC, Hughes TL, Kristjanson AF. Childhood Victimization, Internalizing Symptoms, and Substance Use Among Women Who Identify as Mostly Heterosexual. LGBT Health 2016; 3:266-74. [PMID: 27269733 DOI: 10.1089/lgbt.2015.0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The current article examines substance use behavior and associated factors that contribute to risk of substance misuse, such as history of childhood victimization and reports of internalizing symptoms among women from various sexual identity subgroups. METHODS We recruited a convenience sample of 332 community and university student women (M age = 20.88). Approximately 61.1% of the sample (n = 203) identified as exclusively heterosexual (or "straight"; EH) at the time of the survey, whereas 21.4% (n = 71) identified as primarily heterosexual (or "mostly heterosexual"), 6.6% (n = 22) as bisexual (or "equally gay/lesbian and heterosexual"), 3.0% (n = 10) as primarily gay/lesbian (or "mostly gay/lesbian") and 7.8% (n = 26) as exclusively gay/lesbian. RESULTS Mostly heterosexual women were more likely than EH women to report childhood physical abuse and lifetime tobacco and marijuana use. Mostly heterosexual women also had higher levels of past-year alcohol use disorder symptomology, recent tobacco and marijuana use, and depressive symptoms. Mostly heterosexual women were more likely than bisexual women to have ever tried marijuana, although, among lifetime users, bisexual women reported more frequent recent use. CONCLUSION Mostly heterosexual women reported levels of pathological alcohol use, lifetime rates of tobacco and marijuana use, and recent depressive symptoms that were higher than EH women and relatively similar to lesbian and mostly lesbian women. Bisexual women reported heavier current use of marijuana and were more likely than mostly heterosexual women to report childhood sexual abuse. Implications for mental health services for clients who identify as non-EH are discussed.
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Affiliation(s)
- Amelia E Talley
- 1 Department of Psychological Sciences, Texas Tech University , Lubbock, Texas
| | - Gabriella Grimaldo
- 1 Department of Psychological Sciences, Texas Tech University , Lubbock, Texas
| | - Sharon C Wilsnack
- 2 Department of Psychiatry and Behavioral Science, University of North Dakota , Grand Forks, North Dakota
| | - Tonda L Hughes
- 3 Department of Health Systems Science, University of Illinois at Chicago , Chicago, Illinois
| | - Arlinda F Kristjanson
- 2 Department of Psychiatry and Behavioral Science, University of North Dakota , Grand Forks, North Dakota
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Drabble L, Trocki KF, Klinger JL. Religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: Findings from the National Alcohol Survey. Drug Alcohol Depend 2016; 161:127-34. [PMID: 26857897 PMCID: PMC4792700 DOI: 10.1016/j.drugalcdep.2016.01.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 01/23/2016] [Accepted: 01/25/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Despite research documenting disparities in risk for alcohol-related problems among sexual minority women, few studies explore potential protective factors within this population. This study examines how religiosity may function as a protective or risk factor for alcohol-problems or other substance use among sexual minorities compared to heterosexuals. METHOD Data from 11,169 women who responded to sexual identity and sexual behavior questions from three population-based National Alcohol Survey waves (2000, 2005, 2010) were utilized for analyses of religiosity in relation to lifetime drinking, past year hazardous drinking, and past year drug use. RESULTS Religiosity was significantly greater among exclusively heterosexual women compared to all sexual minority groups (lesbian, bisexual and heterosexual women who report same sex partners). Lesbians reported the lowest rates of affiliation with religions/denominations discouraging alcohol use. Past year hazardous drinking and use of any illicit drugs were significantly lower among exclusively heterosexual women compared to all sexual minority groups. High religiosity was associated with lifetime alcohol abstention and was found to be protective against hazardous drinking and drug use among both sexual minority and heterosexual women. Reporting religious norms unfavorable to drinking was protective against hazardous drinking among exclusively heterosexual women but not sexual minority women. CONCLUSIONS Findings reveal the importance of considering sexual minority status in evaluation of religion or spirituality as protective among women. Future studies should explore religiosity in the context of other individual and environmental factors, such as positive identity development and community-level acceptance, which may be salient to resiliency among sexual minorities.
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Affiliation(s)
- Laurie Drabble
- San José State University School of Social Work, One Washington Square, San José, CA 95192-0124, United States.
| | - Karen F Trocki
- Alcohol Research Group, Public Health Institute, 6475 Christie Ave. Suite 400, Emeryville, CA 94608, United States.
| | - Jamie L Klinger
- Alcohol Research Group, Public Health Institute, 6475 Christie Ave. Suite 400, Emeryville, CA 94608, United States.
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Matthews DD, Blosnich JR, Farmer GW, Adams BJ. Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors. LGBT Health 2016; 1:42-9. [PMID: 25110718 DOI: 10.1089/lgbt.2013.0002] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. METHODS Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. RESULTS Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as "not sure" also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors. CONCLUSION Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations.
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Affiliation(s)
- Derrick D Matthews
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R Blosnich
- Department of Psychiatry, University of Rochester, Rochester, New York ; VISN-2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York
| | - Grant W Farmer
- Department of Epidemiology, Saint Louis University College for Public Health & Social Justice, St. Louis, Missouri
| | - Brian J Adams
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Coulter RWS, Marzell M, Saltz R, Stall R, Mair C. Sexual-orientation differences in drinking patterns and use of drinking contexts among college students. Drug Alcohol Depend 2016; 160:197-204. [PMID: 26827292 PMCID: PMC4767549 DOI: 10.1016/j.drugalcdep.2016.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/08/2016] [Accepted: 01/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Evidence suggests there are important sexual-orientation differences in alcohol consumption, particularly among women. Little is known about where gay/lesbian and bisexual college students drink or differences in drinking patterns derived from graduated frequency measures between heterosexual, gay/lesbian, and bisexual students. The goal of this analysis was to examine patterns of alcohol consumption-including drinking prevalence, quantity, frequency, and contexts of use-by sexual orientation. METHODS Data on sexual identity, gender, drinking behaviors, and drinking contexts were examined from repeated cross-sectional samples of undergraduate students attending 14 public California universities from 2003-2011 (n=58,903). Multivariable statistical techniques were employed to examine sexual-orientation differences stratified by gender. RESULTS Gay males, lesbians, and bisexual females were significantly more likely to report drinking alcohol in the current semester than their same-gender heterosexual peers (relative risks ranged from 1.07 to 1.10, p-values <0.01). Among current drinkers, bisexual females consumed 7 or more drinks and lesbians consumed 10 or more drinks on significantly more days than heterosexual females. On the other hand, gay male drinkers consumed 8 or more drinks on significantly fewer days than heterosexual male drinkers. Compared to their same-gender heterosexual peers: lesbian/gay and bisexual students drank less frequently at Greek parties (incidence rate ratios [IRRs] ranged from 0.52 to 0.73, p-values <0.01); lesbians (IRR=0.84, p=0.043) and bisexual males (IRR=0.82, p=0.009) drank less frequently at off-campus parties; and gay males drank more frequently outdoors (IRR=1.63, p<0.001) and at bars/restaurants (IRR=1.21, p=0.013). CONCLUSIONS Alcohol prevention programs and future research should consider sexual-orientation differences in drinking patterns and use of drinking contexts.
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Affiliation(s)
- Robert W S Coulter
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States.
| | - Miesha Marzell
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa,145 N. Riverside Drive, Iowa City, IA 52242, United States
| | - Robert Saltz
- Prevention Research Center, Pacific Institute for Research & Evaluation, 180 Grand Avenue, Oakland, CA 94612, United States
| | - Ron Stall
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States
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Litt DM, Lewis MA, Rhew IC, Hodge KA, Kaysen DL. Reciprocal relationships over time between descriptive norms and alcohol use in young adult sexual minority women. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2015; 29:885-93. [PMID: 26478944 DOI: 10.1037/adb0000122] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Young adulthood, roughly ages 18-25, is a period of great risk for excessive consumption of alcohol, especially among sexual minority women (SMW). Despite the substantial literature examining the relationships between social norms and behavior in general, little attention has been given to the role of descriptive norms on the drinking behaviors of sexual minorities. The present study had 3 aims: to compare both typical woman descriptive norms and sexual minority-specific descriptive normative perceptions among a sample of SMW, to examine reciprocal associations between sexual minority-specific descriptive norms and alcohol consumption over time, and to examine whether these reciprocal associations were moderated by sexual orientation (i.e., whether 1 identifies as lesbian or bisexual). A national sample of 1,057 lesbian and bisexual women between the ages of 18 and 25 was enrolled in this study. Participants completed an online survey at 4 time points that assessed the constructs of interest. Results indicated that SMW consistently perceived that SMW drank more than their nonsexual minority peers; that SMW-specific descriptive drinking norms and alcohol consumption influenced 1 another over time in a reciprocal, feed-forward fashion; and that these associations were not moderated by sexual orientation. These findings highlight the importance of considering SMW-specific norms as an important factor in predicting alcohol consumption in SMW. Results further support the development and testing of normative interventions for high-risk drinking among SMW.
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Affiliation(s)
- Dana M Litt
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Melissa A Lewis
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Kimberley A Hodge
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Debra L Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington
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Hughes TL, Wilsnack SC, Kristjanson AF. Substance use and related problems among U.S. women who identify as mostly heterosexual. BMC Public Health 2015; 15:803. [PMID: 26289792 PMCID: PMC4546044 DOI: 10.1186/s12889-015-2143-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 08/11/2015] [Indexed: 11/22/2022] Open
Abstract
Background We used data from a nationally representative sample to compare substance use outcomes among adult women who identified as mostly heterosexual with those who identified as exclusively (only) heterosexual. Method We analyzed data from mostly heterosexual women and only heterosexual women in Wave 5 (2001) of the National Study of Health and Life Experiences of Women (weighted n = 1085). Results Mostly heterosexual women were significantly more likely than only heterosexual women to report every alcohol-related outcome included in our analyses except lifetime treatment. Odds of lifetime and past-year marijuana and cocaine use showed larger differences, with mostly heterosexual women nearly four times as likely as only heterosexual women to report lifetime cocaine use and five times as likely to report past-year use. Conclusions We recommend that researchers use measures of sexual identity that include more nuanced response options, and that health care providers learn about the existence, large numbers, and risk/protective factors associated with substance use patterns of mostly heterosexual women.
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Affiliation(s)
- Tonda L Hughes
- Building Interdisciplinary Research Careers in Women's Health (BIRCWH), University of Illinois at Chicago, College of Nursing (M/C 802), 845 S. Damen Ave Room 1160, IL 60612-7350, Chicago, U.S.
| | - Sharon C Wilsnack
- Department of Psychiatry and Behavioral Science, University of North Dakota, School of Medicine & Health Sciences, 501 North Columbia Road Stop 9037, 58202-9037, Grand Forks, ND, U.S.
| | - Arlinda F Kristjanson
- Department of Psychiatry and Behavioral Science, University of North Dakota, School of Medicine & Health Sciences, 501 North Columbia Road Stop 9037, 58202-9037, Grand Forks, ND, U.S.
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Smoking characteristics among lesbian, gay, and bisexual adults. Prev Med 2015; 74:123-30. [PMID: 25485860 PMCID: PMC4390536 DOI: 10.1016/j.ypmed.2014.11.026] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 11/26/2014] [Accepted: 11/29/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cigarette smoking is the leading preventable cause of death and disease in the United States. Sexual minorities (lesbians, gay men, and bisexuals), smoke at higher rates than the general population. However, little else is known about sexual minority smokers. Furthermore, the sexual minority population is diverse and little research exists to determine whether subgroups, such as lesbians, gay men, and female and male bisexuals, differ on smoker characteristics. We examine differences in smoking characteristics (advertising receptivity, age of first cigarette, non-daily smoking, cigarettes per day, nicotine dependence, desire to quit and past quit attempts) among lesbians, gay men, and female and male bisexual adults in the United States. METHODS Secondary analysis of the CDC's (Centers for Disease Control and Prevention) 2009-2010 National Adult Tobacco Survey (N=118,590). RESULTS Controlling for age, race, socioeconomic status and geographic region, identifying as a female bisexual was associated with fewer past quit attempts, lower age at first cigarette, and higher nicotine dependence when compared to heterosexual women. There were no differences in desire to quit between male or female sexual minorities and their heterosexual counterparts. CONCLUSION Sexual minority individuals smoke at higher rates than heterosexuals and yet similarly desire to quit. Tailored efforts may be needed to address smoking among bisexual women.
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Persson TJ, Pfaus JG, Ryder AG. Explaining mental health disparities for non-monosexual women: Abuse history and risky sex, or the burdens of non-disclosure? Soc Sci Med 2015; 128:366-73. [DOI: 10.1016/j.socscimed.2014.08.038] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/25/2014] [Accepted: 08/27/2014] [Indexed: 11/12/2022]
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Persson TJ, Pfaus JG, Ryder AG. Reply to: Are stressful childhood experiences relevant in non-monosexual women? Soc Sci Med 2014; 128:336-7. [PMID: 25459207 DOI: 10.1016/j.socscimed.2014.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 10/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Tonje J Persson
- Center for Studies in Behavioral Neurobiology, Department of Psychology (SP 244), Concordia University, 7141 Sherbrooke Street West, Montréal, QC H4B 1R6, Canada.
| | - James G Pfaus
- Center for Studies in Behavioral Neurobiology, Department of Psychology (SP 244), Concordia University, 7141 Sherbrooke Street West, Montréal, QC H4B 1R6, Canada.
| | - Andrew G Ryder
- Centre for Clinical Research in Health, Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montréal, QC H4B 1R6, Canada; Culture and Mental Health Research Unit and Lady Davis Institute, Jewish General Hospital, Canada.
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Hughes TL, Johnson TP, Steffen AD, Wilsnack SC, Everett B. Lifetime Victimization, Hazardous Drinking, and Depression Among Heterosexual and Sexual Minority Women. LGBT Health 2014; 1:192-203. [PMID: 26789712 DOI: 10.1089/lgbt.2014.0014] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Substantial research documents sexual-orientation-related mental health disparities, but relatively few studies have explored underlying causes of these disparities. The goals of this article were to (1) understand how differences in sexual identity and victimization experiences influence risk of hazardous drinking and depression, and (2) describe variations across sexual minority subgroups. METHODS We pooled data from the 2001 National Study of Health and Life Experiences of Women and the 2001 Chicago Health and Life Experiences of Women study to compare rates of victimization, hazardous drinking, and depression between heterosexual women and sexual minority women (SMW), and to test the relationship between the number of victimization experiences and the study outcomes in each of five sexual identity subgroups. RESULTS Rates of each of the major study variables varied substantially by sexual identity, with bisexual and mostly heterosexual women showing significantly higher risk than heterosexual women on one or both of the study outcomes. The number of victimization experiences explained some, but not all, of the risk of hazardous drinking and depression among SMW. CONCLUSION Although victimization plays an important role, sexual-minority-specific stressors, such as stigma and discrimination, likely also help explain substance use and mental health disparities among SMW.
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Affiliation(s)
- Tonda L Hughes
- 1 Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago , Chicago, Illinois
| | - Timothy P Johnson
- 2 Survey Research Laboratory, University of Illinois at Chicago , Chicago, Illinois
| | - Alana D Steffen
- 1 Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago , Chicago, Illinois
| | - Sharon C Wilsnack
- 3 Department of Clinical Neuroscience, University of North Dakota School of Medicine & Health Sciences , Grand Forks, North Dakota
| | - Bethany Everett
- 4 Department of Sociology, University of Illinois at Chicago , Chicago, Illinois
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Lhomond B, Saurel-Cubizolles MJ, Michaels S. A multidimensional measure of sexual orientation, use of psychoactive substances, and depression: results of a national survey on sexual behavior in france. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:607-619. [PMID: 23743831 DOI: 10.1007/s10508-013-0124-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 03/06/2013] [Accepted: 03/09/2013] [Indexed: 06/02/2023]
Abstract
Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity.
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Affiliation(s)
- Brigitte Lhomond
- Triangle, CNRS, ENS de Lyon, Universités de Lyon, 9 quai Jean Moulin, 69001, Lyon, France,
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Vrangalova Z, Savin-Williams RC. Psychological and physical health of mostly heterosexuals: a systematic review. JOURNAL OF SEX RESEARCH 2014; 51:410-45. [PMID: 24754361 DOI: 10.1080/00224499.2014.883589] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We reviewed whether mostly heterosexuals, a sexual orientation group characterized by a small amount of same-sex sexuality, differ from heterosexuals and bisexuals on a variety of mental and physical health outcomes (e.g., internalizing problems, body dissatisfaction and disordered eating, obesity, sexual/reproductive health, physical health), health risk behaviors (e.g., substance use, sexual risk taking), and risk and protective factors (e.g., victimization, stressful/risky environment, socioeconomic status, personal and social relationships, gender nonconformity). A narrative and quantitative literature review was conducted of 60 papers covering 22 samples from five Western countries. Individual, mean, and median effect sizes (Cohen ds) were calculated whenever possible. Mostly heterosexuals reported higher levels of risk in most reviewed outcomes compared to heterosexuals (unweighted mean effect sizes ranged from 0.20 to 0.50) but typically somewhat lower than bisexuals (unweighted mean effect sizes ranged from -0.10 to -0.30). Various risk factors frequently reduced, but rarely eliminated, health disparities between mostly heterosexuals and heterosexuals. Findings are discussed through the lens of three potential explanations of elevated health risks among nonheterosexuals: minority stress, nonheterosexual lifestyles, and common causes. Because data on many outcomes were scarce or missing, particularly for men and in comparison with bisexuals, further research is needed.
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Dearing RL, Hequembourg AL. Culturally (in)competent? Dismantling health care barriers for sexual minority women. SOCIAL WORK IN HEALTH CARE 2014; 53:739-761. [PMID: 25255338 DOI: 10.1080/00981389.2014.944250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lesbian and bisexual (LB) women exhibit elevated rates of a variety of behaviors (i.e., smoking, excessive caloric intake, physical inactivity, heavy alcohol consumption) that put them at risk for adverse health consequences. Furthermore, LB women experience numerous barriers to obtaining culturally competent health care. In this article we review risk behaviors and health care barriers and we discuss the role of stress as an important contributing factor in LB women's health outcomes. We suggest future research, health care delivery changes, and training improvements that will prepare social workers to effectively address the needs of their LB clients.
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Affiliation(s)
- Ronda L Dearing
- a Research Institute on Addictions, University at Buffalo, The State University of New York , Buffalo , New York , USA
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Talley AE, Hughes TL, Aranda F, Birkett M, Marshal MP. Exploring alcohol-use behaviors among heterosexual and sexual minority adolescents: intersections with sex, age, and race/ethnicity. Am J Public Health 2013; 104:295-303. [PMID: 24328614 DOI: 10.2105/ajph.2013.301627] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined sexual orientation status differences in alcohol use among youths aged 13 to 18 years or older, and whether differences were moderated by sex, age, or race/ethnicity. METHODS We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys and conducted weighted analyses, adjusting for complex design effects. We operationalized sexual orientation status with items assessing sexual orientation identity, sexual behavior, sexual attraction, or combinations of these. RESULTS Compared with exclusively heterosexual youths, sexual-minority youths were more likely to report each of the primary study outcomes (i.e., lifetime and past-month alcohol use, past-month heavy episodic drinking, earlier onset of drinking, and more frequent past-month drinking). Alcohol-use disparities were larger and more robust for (1) bisexual youths than lesbian or gay youths, (2) girls than boys, and (3) younger than older youths. Few differences in outcomes were moderated by race/ethnicity. CONCLUSIONS Bisexual youths, sexual-minority girls, and younger sexual-minority youths showed the largest alcohol-use disparities. Research is needed that focuses on identifying explanatory or mediating mechanisms, psychiatric or mental health comorbidities, and long-term consequences of early onset alcohol use, particularly frequent or heavy use, among sexual-minority youths.
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Affiliation(s)
- Amelia E Talley
- Amelia E. Talley is with the Department of Psychology, Texas Tech University, Lubbock. Tonda L. Hughes and Frances Aranda are with the Department of Health Systems Science, the University of Illinois at Chicago. Michelle Birkett is with the Department of Medical Social Sciences, Northwestern University, Chicago. Michael P. Marshal is with the Department of Psychiatry and Pediatrics, the University of Pittsburgh, Pittsburgh, PA
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Cardom R, Rostosky S, Danner F. Does "it get better" for depressed sexual minority youth in young adulthood? J Adolesc Health 2013; 53:671-3. [PMID: 24035131 DOI: 10.1016/j.jadohealth.2013.07.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/22/2013] [Accepted: 07/22/2013] [Indexed: 12/01/2022]
Abstract
PURPOSE To examine depressive symptoms and suicidality in adolescence and adulthood in a sample of depressed adolescents in five sexual identity groups (heterosexual, mostly heterosexual, bisexual, mostly gay, and gay). METHODS Depressed adolescents (N = 1,591) from the National Longitudinal Study of Adolescent Health were examined again in young adulthood. RESULTS Paired t-tests revealed that depressive symptoms declined significantly in all five sexual identity groups. McNemar chi-square tests revealed that the percentage of participants reporting suicidal ideation decreased significantly in all groups except for the mostly gay group. The percentage of participants reporting suicide attempts declined in all groups except the bisexual group. CONCLUSIONS Within-group differences are important to consider in delivering effective mental health services. Although depressive symptoms diminished in young adulthood in all groups, suicidality did not. Mostly gay and bisexual young adults did not report the same significant declines as their peers.
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Affiliation(s)
- Robert Cardom
- Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky.
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McNair R, Brown R. Clinical translation of the research article titled "the influence of early drinking contexts on current drinking among adult lesbian and bisexual women". J Am Psychiatr Nurses Assoc 2013; 19:255-8. [PMID: 24071821 DOI: 10.1177/1078390313505642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Ruth McNair
- Ruth McNair, PhD, MBBS, DRANZCOG, DA(UK), FRACGP, The University of Melbourne, Melbourne, Victoria, Australia; Northside Clinic, Melbourne, Victoria, Australia
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Hagger-Johnson G, Taibjee R, Semlyen J, Fitchie I, Fish J, Meads C, Varney J. Sexual orientation identity in relation to smoking history and alcohol use at age 18/19: cross-sectional associations from the Longitudinal Study of Young People in England (LSYPE). BMJ Open 2013; 3:e002810. [PMID: 23985386 PMCID: PMC3758978 DOI: 10.1136/bmjopen-2013-002810] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Information about the health behaviours of minority groups is essential for addressing health inequalities. We evaluated the association among lesbian, gay or bisexual (LGB) sexual orientation identity and smoking and alcohol use in young people in England. DESIGN Data drawn from wave 6 of the Longitudinal Study of Young People in England (LSYPE). SETTING Self-completion questionnaires during home visits, face-to-face interviews and web-based questionnaires. PARTICIPANTS Data from 7698 participants (3762 men) with information on sexual orientation identity and health behaviours at age 18/19. OUTCOME MEASURES Cigarette smoking history, alcohol drinking frequency and risky single occasion drinking (RSOD). RESULTS LGB identity was reported by 3.1% of participants (55 gay, 33 lesbian, 35 bisexual male, 111 bisexual female), 3.5% when adjusting for the survey design. Adjusting for a range of covariates, identification as lesbian/gay was found to be associated with smoking (OR=2.23, 95% CI 1.42 to 3.51), alcohol drinking >2 days/week (OR=1.99, 95% CI 1.25 to 3.17) and RSOD (OR=1.80, 95% CI 1.13 to 2.86) more than weekly. Bisexual identity was associated with smoking history (OR=1.84, 95% CI 1.30 to 2.61) but not alcohol drinking >2 days/week (OR=1.20, 95% CI 0.79 to 1.81) or RSOD (OR=1.04, 95% CI 0.71 to 2.86). CONCLUSIONS In a sample of more than 7600 young people aged 18/19 years in England, lesbian/gay identity is associated with cigarette smoking, drinking alcohol frequency and RSOD. Bisexual identity is associated with smoking but not RSOD or frequent alcohol drinking.
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Affiliation(s)
- Gareth Hagger-Johnson
- MRC Centre of Epidemiology for Child Health, University College London, London, UK
- Department of Epidemiology and Public Health, University College London, London, UK
- Gay and Lesbian Association of Doctors and Dentists (GLADD), London, UK
| | - Rafik Taibjee
- Gay and Lesbian Association of Doctors and Dentists (GLADD), London, UK
- Merton Medical Practice, London, UK
| | - Joanna Semlyen
- Department of Psychology, London Metropolitan University, London, UK
| | - Isla Fitchie
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Julie Fish
- Department of Social Work, De Montfort University, Leicester, UK
| | - Catherine Meads
- Health Economics Research Group, Brunel University, London, UK
| | - Justin Varney
- Gay and Lesbian Association of Doctors and Dentists (GLADD), London, UK
- NHS Barking & Dagenham/London Borough of Barking and Dagenham, London, UK
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Goldberg S, Strutz KL, Herring AA, Halpern CT. Risk of substance abuse and dependence among young adult sexual minority groups using a multidimensional measure of sexual orientation. Public Health Rep 2013; 128:144-52. [PMID: 23633729 DOI: 10.1177/003335491312800304] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We examined associations between two definitions of sexual minority status (SMS) and substance abuse and/or dependence among young adults in a national population. METHODS A total of 14,152 respondents (7,529 women and 6,623 men) interviewed during wave four of the National Longitudinal Study of Adolescent Health were included in the study (age range: 24-32 years). We used two definitions of SMS based on self-reported attraction, behavior, and identity: 1-indicator SMS (endorsing any dimension) and 3-indicator SMS (endorsing all dimensions). Outcomes included nicotine dependence as well as ≥3 signs of substance dependence, any sign of substance abuse, and lifetime diagnosis of abuse or dependence for alcohol, marijuana, and a composite measure of other drugs. Weighted logistic regression models were fit to estimate the odds of each outcome for each of the sexual minority groups (compared with the heterosexual majority), controlling for sociodemographic covariates. RESULTS SMS women were more likely than exclusively heterosexual women to experience substance abuse and dependence, regardless of substance or SMS definition. In adjusted models for women, 3-indicator SMS was most strongly associated with abuse/dependence (adjusted odds ratio [AOR] range: 2.74-5.17) except for ≥3 signs of cannabis dependence, where 1-indicator SMS had the strongest association (AOR=3.35). For men, the 1-indicator SMS group had higher odds of nicotine dependence (AOR=1.35) and the 3-indicator SMS group had higher odds of ≥3 signs of alcohol dependence (AOR=1.64). CONCLUSIONS Young adult female sexual minority groups, regardless of how defined, are at a higher risk than their heterosexual peers of developing alcohol, drug, or tobacco abuse and dependence.
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Affiliation(s)
- Shoshana Goldberg
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Maternal and Child Health, Chapel Hill, NC 27599, USA.
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Alvy LM, Hughes TL, Kristjanson AF, Wilsnack SC. Sexual identity group differences in child abuse and neglect. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:2088-111. [PMID: 23345571 PMCID: PMC3717255 DOI: 10.1177/0886260512471081] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Childhood abuse and neglect are pervasive problems among girls and young women that have numerous health consequences. Research suggests that sexual minority women are more likely than heterosexual women to report childhood abuse and neglect, but little is known about which sexual minority women are at greatest risk for these early adverse experiences. Using data from a pooled sample of women in a national probability study and in a large community-based study of sexual minority women designed to replicate the national study's methodology (pooled n = 953), we investigated rates and characteristics of childhood sexual abuse, physical abuse, and neglect among women from five sexual identity groups. As predicted, heterosexual women reported significantly less childhood abuse and neglect than did women who identified as mostly heterosexual, bisexual, mostly lesbian, or lesbian. We found considerable variability across the sexual minority subgroups, including severity of abuse, highlighting the need for research that distinguishes among these groups. To the extent that differences reported by women in the sample reflect the actual prevalence and severity of abuse experiences, sexual identity group differences in childhood abuse have important clinical and public health implications.
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Affiliation(s)
- Lisa M Alvy
- Department of Psychology, University of Illinois Chicago, 1007 W. Harrison St., M/C 285, Chicago, IL 60607, USA.
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Plöderl M, Wagenmakers EJ, Tremblay P, Ramsay R, Kralovec K, Fartacek C, Fartacek R. Suicide risk and sexual orientation: a critical review. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:715-727. [PMID: 23440560 DOI: 10.1007/s10508-012-0056-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 01/22/2012] [Accepted: 08/19/2012] [Indexed: 06/01/2023]
Abstract
Many studies have reported higher rates of suicide attempts among sexual minority individuals compared with their heterosexual counterparts. For suicides, however, it has been argued that there is no sexual orientation risk difference, based on the results of psychological autopsy studies. The purpose of this article was to clarify the reasons for the seemingly discrepant findings for suicide attempts and suicides. First, we reviewed studies that investigated if the increased suicide attempt risk of sexual minorities resulted from biased self-reports or less rigorous assessments of suicide attempts. Second, we reanalyzed the only two available case-control autopsy studies and challenge their original "no difference" conclusion by pointing out problems with the interpretation of significance tests and by applying Bayesian statistics and meta-analytical procedures. Third, we reviewed register based and clinical studies on the association of suicides and sexual orientation. We conclude that studies of both suicide attempts and suicides do, in fact, point to an increased suicide risk among sexual minorities, thus solving the discrepancy. We also discuss methodological challenges inherent in research on sexual minorities and potential ethical issues. The arguments in this article are necessary to judge the weight of the evidence and how the evidence might be translated into practice.
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Affiliation(s)
- Martin Plöderl
- Suicide Prevention Research Program, Institute of Public Health, Paracelsus Private Medical University, Salzburg,
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Savin-Williams RC, Vrangalova Z. Mostly heterosexual as a distinct sexual orientation group: A systematic review of the empirical evidence. DEVELOPMENTAL REVIEW 2013. [DOI: 10.1016/j.dr.2013.01.001] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Mayer KH, Bekker LG, Stall R, Grulich AE, Colfax G, Lama JR. Comprehensive clinical care for men who have sex with men: an integrated approach. Lancet 2012; 380:378-87. [PMID: 22819653 PMCID: PMC5603076 DOI: 10.1016/s0140-6736(12)60835-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Men who have sex with men (MSM) have unique health-care needs, not only because of biological factors such as an increased susceptibility to infection with HIV and sexually transmitted infections associated with their sexual behaviour, but also because of internalisation of societal stigma related to homosexuality and gender non-conformity, resulting in depression, anxiety, substance use, and other adverse outcomes. Successful responses to the global HIV/AIDS epidemic will require the development of culturally sensitive clinical care programmes for MSM that address these health disparities and root causes of maladaptive behaviour (eg, societal homophobia). Health-care providers need to become familiar with local outreach agencies, hotlines, and media that can connect MSM with positive role models and social opportunities. Research is needed to understand how many MSM lead resilient and productive lives in the face of discrimination to develop assets-based interventions that build on community support. Optimum clinical care for sexual and gender minorities is a fundamental human right. MSM deserve to be treated with respect, and health-care providers need to interact with them in ways that promote disclosure of actionable health information.
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Affiliation(s)
- Kenneth H Mayer
- Fenway Health, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. khmayer@gmail
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Talley AE, Sher KJ, Steinley D, Wood PK, Littlefield AK. Patterns of alcohol use and consequences among empirically derived sexual minority subgroups. J Stud Alcohol Drugs 2012; 73:290-302. [PMID: 22333337 DOI: 10.15288/jsad.2012.73.290] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The current study develops an empirically determined classification of sexual orientation developmental patterns based on participants' annual reports of self-identifications, sexual attractions, and sexual behaviors during the first 4 years of college. A secondary aim of the current work was to examine trajectories of alcohol involvement among identified subgroups. METHOD Data were drawn from a subsample of a longitudinal study of incoming first-time college students at a large, public university (n = 2,068). Longitudinal latent class analysis was used to classify sexual minority participants into empirically derived subgroups based on three self-reported facets of sexual orientation. Multivariate repeated-measures analyses were conducted to examine how trajectories of alcohol involvement varied by sexual orientation class membership. RESULTS Four unique subclasses of sexual orientation developmental patterns were identified for males and females: one consistently exclusively heterosexual group and three sexual minority groups. Despite generally similar alcohol use patterns among subclasses, certain sexual minority subgroups reported elevated levels of alcohol-related negative consequences and maladaptive motivations for use throughout college compared with their exclusively heterosexual counterparts. CONCLUSIONS Elevations in coping and conformity motivations for alcohol use were seen among those subgroups that also evidenced heightened negative alcohol-related consequences. Implications and limitations of the current work are discussed.
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Affiliation(s)
- Amelia E Talley
- University of Missouri and the Midwest Alcoholism Research Center, Columbia, Missouri 65211, USA.
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Savin-Williams RC, Joyner K, Rieger G. Prevalence and stability of self-reported sexual orientation identity during young adulthood. ARCHIVES OF SEXUAL BEHAVIOR 2012; 41:103-110. [PMID: 22302504 DOI: 10.1007/s10508-012-9913-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Based on date from Wave 3 and Wave 4 from National Longitudinal Survey of Adolescent Health (N=12,287), known as Add Health, the majority of young adults identified their sexual orientation as 100% heterosexual. The second largest identity group,‘‘mostly heterosexual,’’was larger than all other nonheterosexual identities combined. Comparing distributions across waves, which were approximately 6 years apart, stability of sexual orientation identity wasmore common than change. Stability was greatest among men and those identifying as heterosexual. Individuals who identified as 100% homosexual reported nearly the same level of stability as 100% heterosexuals. The bisexual categorywas themost unstable, with one quarter maintaining that status at Wave 4. Bisexual men who changed their identity distributed themselves among all other categories; among bisexual women, themost common shiftwas toward mostly heterosexual. Reflecting changes in identity, the proportion of heterosexuals decreased between the two waves.
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