Does maltreatment in childhood affect sexual orientation in adulthood?

Genetic and Environmental Influences on Sexual Orientation: Moderation by Childhood Gender Nonconformity and Early-Life Adversity

Existing evidence indicates genetic and non-genetic influences on sexual orientation; however, the possibility of gene-environment interplay has not been previously formally tested despite theories indicating this. Using a Finnish twin cohort, this study investigated whether childhood gender nonconformity and early-life adversities independently moderated individual differences in sexual orientation and childhood gender nonconformity, the relationship between them, and the etiological bases of the proposed moderation effects. Sexual orientation, childhood gender nonconformity, and early-life adversities were assessed using standard questionnaires. Structural equation twin model fitting was carried out using OpenMx. Childhood gender nonconformity was significantly associated with reduced phenotypic variance in sexual orientation (β =  - 0.14, 95% CI - 0.27, - 0.01). A breakdown of the underlying influences of this moderation effect showed that this was mostly due to moderation of individual-specific environmental influences which significantly decreased as childhood gender nonconformity increased (βE =  - 0.38; 95% CI - 0.52, - 0.001) while additive genetic influences were not significantly moderated (βA = 0.05; 95% CI - 0.30, 0.27). We also observed that the relationship between sexual orientation and childhood gender nonconformity was stronger at higher levels of childhood gender nonconformity (β = 0.10, 95% CI 0.05, 0.14); however, significance of the underlying genetic and environmental influences on this relationship could not be established in this sample. The findings indicate that beyond a correlation of their genetic and individual-specific environmental influences, childhood gender nonconformity is further significantly associated with reduced individual-specific influences on sexual orientation.

Adverse Childhood Experiences and Sexual Orientation: An Intersectional Analysis of Nationally Representative Data

INTRODUCTION

This study compared the prevalence of adverse childhood experiences across intersections of sexual orientation, gender, race/ethnicity, and economic status.

METHODS

Data collected between 1994 and 2018 from 12,519 participants in the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2023 to generate adverse childhood experience prevalence estimates. Unadjusted 1-way ANOVAs and multivariate regressions were performed to compare differences in independent and cumulative adversity measures by sexual orientation, gender, race/ethnicity, and poverty status. A multilevel analysis of individual heterogeneity and discriminatory accuracy was conducted to estimate adversity scores across 24 groups that were stratified by sexual orientation, gender, race/ethnicity, and poverty status.

RESULTS

Adolescents with same-sex attractions and adults who identified with a sexual minority group reported more adverse childhood experiences overall than straight participants, although associations varied by type of adversity. Strikingly, adversity scores were higher among White youth with same-sex attractions than among Black youth with same-sex attractions, among more economically advantaged bisexual adults than among poorer ones, and among poor White participants than among poor Black and Hispanic participants, suggesting that the combination of disadvantaged and marginalized statuses does not necessarily correspond with greater childhood adversity. A multilevel analysis of individual heterogeneity and discriminatory accuracy interaction model showed that sexual orientation and poverty status contributed significant variance to cumulative adversity scores, whereas gender and race/ethnicity did not.

CONCLUSIONS

The results show that disparities in adverse experiences can be more fully and accurately represented when sexual orientation and other social identities are modeled as intersectional configurations. Given that adverse childhood experiences are linked to morbidity and mortality, the findings have salient implications for understanding health disparities that affect population subgroups.

Prevalence of Diverse Genders and Sexualities in Australia and Associations With Five Forms of Child Maltreatment and Multi-type Maltreatment

This study presents the most comprehensive national prevalence estimates of diverse gender and sexuality identities in Australians, and the associations with five separate types of child maltreatment and their overlap (multi-type maltreatment). Using Australian Child Maltreatment Study (ACMS) data (N = 8503), 9.5% of participants identified with a diverse sexuality and .9% with a diverse gender. Diverse identities were more prevalent in the youth cohort, with 17.7% of 16-24 years olds identifying with a diverse sexuality and 2.3% with a diverse gender. Gender and sexuality diversity also intersect - for example, with women (aged 16-24 and 25-44) more likely than men to identify as bisexual. The prevalence of physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence was very high for those with diverse sexuality and/or gender identities. Maltreatment was most prevalent for participants in the youth cohort with diverse gender identities (90.5% experiencing some form of child maltreatment; 77% multi-type maltreatment) or diverse sexualities (85.3% reporting any child maltreatment; 64.3% multi-type maltreatment). The strong association found between child maltreatment and diverse sexuality and gender identities is critical for understanding the social and mental health vulnerabilities of these groups, and informing services needed to support them.

Sexual orientations in association between childhood maltreatment and depression among undergraduates in mainland of China

BACKGROUND

There is growing evidence that sexual minorities including lesbian, gay, bisexual and questioning individuals (LGBQ) have significantly higher rates of childhood maltreatment than heterosexuals. However, few studies focused on the association between different type of childhood maltreatment and depression in LGBQs.

METHODS

Cross-sectional study by random sampling was conducted among the undergraduates in mainland of China. A total of 1920 undergraduates from different majors and colleges completed self-report questionnaires to record depression, childhood maltreatment, sexual orientation and other related information. The associations were examined via a set of logistic regression analysis.

RESULTS

Compared to the participants who had never experienced childhood maltreatment, the participants who reported emotional abuse (p < 0.001) and sexual abuse (p < 0.05) had higher odds of depression. The LGBQs have higher risk of being the victims of childhood maltreatment. The prevalence of depression was much higher in the LGBQ than that in the heterosexuals (33.9 % vs 16.1 %, χ2 = 43.627, p < 0.001). Compared to heterosexual adolescents, LGBQs had significantly higher odds of depression (p < 0.001).

LIMITATIONS

Cross-sectional design, self-reported information, and unable to examine underlying protective factors.

CONCLUSIONS

Emotional abuse, emotional neglect and sexual abuse have stronger association with LGBQ than other kind of childhood maltreatment. Emotional abuse and sexual abuse have stronger association with depression. Sexual abuse has stronger association with depression in LGBQs than heterosexuals. More attention to the mental health should be paid especially in LGBQs to reduce the risk of depression.

Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women

Despite the continued prevalence of HIV and condoms' proven effectiveness in HIV prevention, many young men continue to engage in condom use resistance (CUR). Research shows that sexual compulsivity and childhood sexual abuse (CSA) victimization are risk factors for CUR. Given that sexual activity between men is the most common method through which HIV is transmitted, and that men who have sex with men and women (MSMW) are up to five times as likely to contract or transmit HIV as men who have sex with women only (MSWO), understanding the CUR behaviors of MSMW is uniquely important. Young, single men who had had sex with a woman in the past year (N = 623) completed questionnaires assessing their previous sexual experiences with men and women, history of CSA, sexual compulsivity, and CUR to determine how MSMW classification may moderate the associations between these variables. Results revealed full, moderated mediation, such that CSA was significantly associated with sexual compulsivity among MSMW, but not MSWO. Furthermore, sexual compulsivity was subsequently associated with CUR, in a model accounting for 5.35% of CUR variance. Such findings suggest that exposure to CSA may render MSMW especially susceptible to maladaptive, sexually compulsive desires and behaviors. As a result, MSMW may be more likely to disregard the inherent risks associated with condomless sexual activity and engage in CUR. Thus, intervention programs seeking to reduce the transmission of HIV and other STIs should prioritize targeting MSMW who experienced CSA to reduce sexual compulsivity and increase condom use.

Adverse Childhood Experiences Among Lesbian, Gay, Bisexual, and Queer Veterans

INTRODUCTION

Adverse childhood experiences portend vulnerability to numerous physical and mental health concerns across the lifespan. Separate bodies of work suggest that both lesbian, gay, bisexual, and queer individuals and military veterans are more likely to report adverse childhood experiences than their non-lesbian, gay, bisexual, and queer and non-veteran counterparts, respectively. Although lesbian, gay, bisexual, and queer veterans experience health disparities compared with non-lesbian, gay, bisexual, and queer veterans, the prevalence of adverse childhood experiences among individuals with both lesbian, gay, bisexual, and queer and veteran identities is yet unknown.

METHODS

Participants were U.S. military veterans (N=14,461) from 18 states that included Sexual Orientation and Gender Identity and adverse childhood experiences modules in the 2019 and 2020 Behavioral Risk Factor Surveillance System survey. Multivariable logistic regression was used to determine the odds of adverse childhood experiences reported by lesbian, gay, bisexual, and queer veterans compared with those reported by non-lesbian, gay, bisexual, and queer veterans. Analyses were conducted in 2023.

RESULTS

While accounting for sociodemographic factors, lesbian, gay, bisexual, and queer veterans were more likely to report living with someone who experienced mental illness (AOR=2.17, 95% CI=1.35, 3.51), emotional abuse (AOR=1.58, 95% CI=1.11, 2.25), and sexual abuse (AOR=2.21, 95% CI=1.29, 3.76) than non-lesbian, gay, bisexual, and queer veterans.

CONCLUSIONS

With past work indicating that childhood abuse experiences are especially predictive of adverse health in adulthood, these findings suggest that a higher prevalence of adverse childhood experiences among lesbian, gay, bisexual, and queer veterans may contribute to health disparities among this population.

Fertility Intentions and Sexual Orientation: Evidence from the 2020 Youth Survey in Estonia

Attitudes towards sexual minorities have undergone a transformation in Western countries recently. This has led to an increase in research into the experiences of sexual minorities in a variety of life domains. Although parenthood is a valued life goal only a few small-scale studies have looked into the parenthood goals of individuals in relation to their sexual orientation. The aims of this study are to analyse the diversity of sexual orientation, the factors associated with it and the relationship to fertility intentions among adolescents aged 16 to 19. The study draws on a nationally representative youth survey conducted in 2020 in Estonia (N = 1624), and employs descriptive methods and logistic and linear regression models. The results show that adolescents in Estonia exhibit considerable diversity of sexual orientation, with one-fifth reporting some degree of attraction to their own sex. The minority sexual orientation is more frequent among groups which can be regarded as more open or exposed to new behaviours, but is also associated with a disadvantaged family background. The results reveal a clear negative association between the intended number of children and the minority sexual orientation, which is not explained by other available variables.

Childhood Sexual Abuse and Associated Suicidal Ideation and Attempts Among Gay and Bisexual Men in China: A Moderated Mediation Model

Childhood sexual abuse (CSA) is a critical risk factor for suicidal ideation and attempts, especially among gay and bisexual men who experience living as a minority. However, whether internalized homophobia (IH) underlies suicide risk and the role of outness to one's family in this association warrants investigation to inform preventive interventions. Using a cross-sectional survey of 570 gay and bisexual men in China, we examined the relationship between CSA and suicidality in the Chinese context and tested a moderated mediation model in this relationship. Nearly 65.6% of the participants had experienced suicidal ideation and 36.8% had attempted suicide. Participants with a history of CSA had higher suicidal ideation (r = 0.33, p < .01) and attempts (r = 0.48, p < .01). Our bootstrapped mediation analysis showed that IH partially mediated the relationship between CSA and suicidal ideation and attempts. Moreover, outness to one's family (parents and other family members) strengthened the direct association of CSA and IH, and the indirect relationship between CSA and suicidal ideation and attempts. These findings highlight the significance of identifying risk factors and mechanisms for suicidality among Chinese gay and bisexual men, suggesting the importance of early intervention, especially for those who have experienced CSA, to eliminate their IH and to improve family support for coming out to prevent the onset of suicidal ideation and attempts.

Severe impact of late diagnosis of congenital adrenal hyperplasia on gender identity, sexual orientation and function: case report and review of the literature

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) represents the most frequent form of CAH and of 46, XX disorder of sex development in female newborns. In the majority of cases, particularly in developed countries, female patients suffering from the classic forms of CAH reach the diagnosis at birth or in the early childhood, allowing a prompt treatment with a correct gender assignment. The current manuscript describes an unusual case of an Italian 46-year-old woman, homeborn in the 60s, receiving an extraordinarily late diagnosis of simple virilising classic form of CAH due to 21-OHD, determining a relevant impairment of both physical and psychosexual development. The patient presented primary amenorrhea, height under target, overweight with visceral adiposity, hypercholesterolemia and insulin resistance, hirsutism with a typical male-pattern hair growth, external genital ambiguity, and a severe impairment in the entire series of psychological dimensions, particularly severe depressive symptoms, together with gender dysphoria relative to the female gender assigned at birth, cross-gender behaviours, and body image discomfort, which were associated with homosexual orientation, and sexual dysfunction. Following diagnosis and glucocorticoid (GC) replacement therapy, the hyperandrogenism control and familial and socio-cultural factors changes, particularly, living alone and the interruption of social isolation, were accompanied by menarche appearance, improvement in hirsutism and metabolic profile, and a resolution in all psychological dimensions, depressive symptoms, and gender dysphoria. The patient began to perceive homosexual orientation without discomfort, and ameliorating sexual function. Few cases of female patients with CAH due to 21-OHD receiving an extremely delayed diagnosis have been published. However, to the best of our knowledge, this is the first case including a complete psychosexual assessment at diagnosis with a detailed re-evaluation after 5 years of disease treatment.

Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual, homosexual and bisexual Danes

Non-heterosexual persons more often report adverse childhood experiences (ACEs) than heterosexuals, and they generally bear a greater burden of mental health challenges. However, population-based data on this topic are scarce. In a nationally representative study within the Project SEXUS, one of the world's largest cohort studies on sexual health, we used data from 57,479 individuals in Denmark to explore the interplay between ACEs and mental health problems among self-identified heterosexual, homosexual and bisexual persons, and among self-identified heterosexuals with or without same-sex sexual experience. Compared to heterosexuals, non-heterosexual persons were more likely to report most of the studied ACEs, with odds ratios (ORs) for the ACE category "abuse" ranging from 1.38 to 1.75 for homosexual women, from 1.76 to 2.65 for homosexual men, from 2.52 to 3.64 for bisexual women, and from 1.58 to 6.07 for bisexual men. Furthermore, non-heterosexual persons had consistently and statistically significantly higher odds for mental health problems (ORs: 1.50 to 4.63). Combinations of ACEs with a non-heterosexual identity resulted in markedly elevated odds for mental health problems, particularly among bisexual individuals. This included high odds for suicidal thoughts/attempts among bisexual persons with a history of "neglect" (women: OR=12.82; men: OR=35.24) and "abuse" (women: OR=11.81; men: OR=11.65). Among self-identified heterosexuals, combinations of ACEs with same-sex sexual experience were associated with consistently elevated odds for mental health problems (ORs: 2.22 to 12.04). The greater burden of ACEs among self-identified homosexuals and, most notably, bisexuals may account for part of their excess risk of mental health problems. These findings emphasize the public health importance of preventive measures to minimize the burden of ACEs and avert their harmful long-term effects. Moreover, they highlight the need to safeguard the welfare of children and adolescents with non-conforming expressions of sexuality.

What Do We Know About Child Sexual Abuse? Myths and Truths in Spain

Child sexual abuse (CSA) is a terrible type of maltreatment that can have serious physical and psychological consequences for victims. These consequences include shame and are often taboo in conversation, which makes CSA very difficult to see. Therefore, multiple myths exist about CSA that can lead to misperceptions regarding issues such as its context, prevalence, and consequences. What is unknown cannot be addressed; therefore, the aim of this work was to investigate Spanish participants' knowledge about CSA as well as examine gender and educational level differences. A 10-item questionnaire comprising myths and truths about CSA was developed, taking into account existing literature. Participants (N = 1,540) had to rate their level of agreement with the statements. Some important aspects of CSA remain unclear, particularly in terms of the background of the victims (e.g., gender, educational level, CSA prevalence). Significant differences in the perception of CSA between men and women and among those with various educational levels were found: Men and people with lower levels of education held more myths about CSA. In conclusion, better knowledge about CSA is needed to get people involved in its prevention. We must consider the myths and truths about CSA when designing prevention programs and tailor educational programs to the target population.

The Chicago Health and Life Experiences of Women Couples Study: Protocol for a Study of Stress, Hazardous Drinking, and Intimate Partner Aggression Among Sexual Minority Women and Their Partners

BACKGROUND

Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; eg, lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable population. Given the traditionally gendered lens with which women are primarily viewed as victims and men as perpetrators, understanding the dynamics of IPA in same-sex female couples can also advance research and practice related to IPA more generally.

OBJECTIVE

Guided by a recent extension of the minority stress model that includes relational (couple-level) sexual minority stress and the I-cubed theoretical perspective on IPA, we will collect individual and dyadic data to better characterize the links between hazardous drinking and IPA among SMW and their partners. First, this study aims to examine the associations among minority stress, hazardous drinking, and IPA in SMW and their partners. Minority stressors will be assessed as both individual and couple-level constructs, thus further extending the minority stress model. Second, we aim to examine potential mediators and moderators of the associations among minority stress, hazardous drinking, and IPA. Finally, we aim to test models guided by the I-cubed theoretical perspective that includes instigating (eg, relationship conflict), impelling (eg, negative affect and trait anger), and inhibiting (eg, relationship commitment and emotion regulation) or disinhibiting (eg, hazardous drinking) influences on IPA perpetration.

METHODS

This United States National Institutes of Health-funded project will draw from a large and diverse cohort of SMW currently enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study-a 21-year longitudinal study of risk factors and consequences associated with SMW hazardous drinking. SMW currently enrolled in the CHLEW and their partners will be invited to participate in the CHLEW Couples Study. By analyzing dyadic data using actor-partner interdependence models, we will examine how each partner's minority stress, hazardous drinking, and IPA experiences are associated with both her own and her partner's minority stress, hazardous drinking, and IPA perpetration.

RESULTS

Data collection began in February 2021 and will likely continue through 2023. Initial results should be available by mid-2024.

CONCLUSIONS

The CHLEW Couples Study will fill important gaps in knowledge and provide the basis for future research aimed at clarifying the causal pathways linking hazardous drinking and IPA among SMW. This will support the development of culturally appropriate targeted individual and dyadic prevention and intervention strategies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28080.

The Effect of Early Traumatic Experiences on Attachment Styles in Sexual Gender Minority Individuals

PURPOSE

This study was carried out to specify the attachment characteristics of sexual gender minority individuals and to determine the effects of childhood traumatic experiences on attachment styles.

DESIGN AND METHODS

A descriptive cross-sectional study was conducted on 141 sexual gender minority individuals from 2016 to 2017.

FINDINGS

The number of childhood physical and sexual trauma episodes was found to be high in sexual minorities; in particular, the traumatized narratives were found to be associated with an avoidant attachment style (p > 0.05).

PRACTICE IMPLICATIONS

The study results may contribute to healthcare professionals' understanding of childhood trauma as it relates to sexual identity development and attachment disorders sexual identity development and attachment disorders.

Effect of adverse childhood experiences and DNA methylation on male sexual orientation

The causes for male sexual orientation are complicated, which have not yet been clarified. Recent years have witnessed fruitful progress in the field of biology, while the impact of environment has received little attention. Adverse childhood experiences (ACEs), identified as a special environment in the early stage of development, can affect the individual phenotype by DNA methylation. Given the relationships among male sexual orientation, ACEs, and DNA methylation, as well as based on the existing theory, this article proposes the model "ACEs-DNA methylation-male sexual orientation"from the perspective of environment and epigenetics, aiming to provide a theoretical basis for future research.

Mediating Factors Explaining the Association Between Sexual Minority Status and Dating Violence

Dating violence presents a serious threat for individual health and well-being. A growing body of literature suggests that starting in adolescence, individuals with sexual minority identities (e.g., individuals who identify as gay, lesbian, or bisexual) may be at an increased risk for dating violence compared with heterosexuals. Research has not, however, identified the mechanisms that explain this vulnerability. Using a diverse sample of young adults (n = 2,474), the current study explored how minority stress theory, revictimization theory, sex of sexual partners, and risky sexual behavior explained differences in dating violence between sexual minority and heterosexual young adults. Initial analyses suggested higher rates of dating violence among individuals who identified as bisexual, and individuals who identified as gay or lesbian when compared with heterosexuals, and further found that these associations failed to differ across gender. When mediating and control variables were included in the analyses, however, the association between both sexual minority identities and higher levels of dating violence became nonsignificant. Of particular interest was the role of discrimination, which mediated the association between bisexual identity and dating violence. Other factors, including sex and number of sexual partners, alcohol use, and childhood maltreatment, were associated with higher rates of dating violence but did not significantly explain vulnerability among sexual minority individuals compared with their heterosexual peers. These findings suggest the importance of minority stress theory in explaining vulnerability to dating violence victimization among bisexuals in particular, and generally support the importance of sexual-minority specific variables in understanding risk for dating violence within this vulnerable population.

Childhood Maltreatment, Gender Nonconformity, and Adolescent Sexual Orientation: A Prospective Birth Cohort Study

This study tested whether associations between childhood maltreatment and adolescent sexual orientation were accounted for by childhood gender nonconforming behavior (GNCB) in a prospective birth cohort (N = 5,007). Childhood parental maltreatment (physical and emotional) and GNCB were assessed on multiple occasions up to age 6 years, and sexual orientation at 15.5 years. Boys with a history of maltreatment were significantly more likely to be nonheterosexual. Using propensity score weighting, maltreatment was associated with a 3.5% (p = .03) increase in the prevalence of nonheterosexuality accounting for confounders not including GNCB, and by 2.9% (p = .06) when also accounting for GNCB. These findings suggest that maltreatment is associated with an increased prevalence of nonheterosexuality in boys but may be explained by confounding factors including GNCB.

Factors associated with unwanted sexual experiences of young Australian females: an observational study

Background Behavioural and lifestyle factors associated with childhood unwanted sexual experiences (USE) have yet to be investigated in Australian females aged less than 18 years.

METHODS

Women aged 16-25 years living in Victoria were recruited via targeted advertising on Facebook. A web-based validated questionnaire was used to collect information on participant demographics, mental health, USE and sexual behaviours. Multivariable logistic regression was used to determine associations between a history of childhood (<16 years) and adolescent (16-18 years) USE and indices of sexual orientation.

RESULTS

Data were collected from 639 females (mean±s.d. age 22±3 years). Approximately 14% reported childhood USE and 15% reported adolescent USE. Approximately 37% of survivors of childhood USE reported penile-genital contact in relation to their USE. Participants who reported depression were almost four times as likely to have experienced childhood USE than those who did not report suffering from depression (odds ratio 3.6, 95% confidence interval 2.1-6.0, P<0.001). Positive associations between childhood USE, same-sex relationships and smoking were also detected.

CONCLUSIONS

A strong relationship between childhood USE, depression and same-sex sexual behaviours was found, but results did not determine the direction of this association. Longitudinal studies should be conducted to investigate whether there are groups of individuals who are at a high risk of experiencing childhood USE, so that appropriate support systems can be put in place.

Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized

Organized and ritual child sexual abuse (ORA) is often rooted in the child’s own family. Empirical evidence on possible associations between ORA and trauma-related symptoms in those who report this kind of extreme and prolonged violence is rare. The aim of our study was to explore socio-demographic and clinical characteristics of the individuals reporting ORA experiences, and to investigate protective as well as promotive factors in the link between ORA and trauma-related symptom severity. Within the framework of a project of the Independent Inquiry into Child Sexual Abuse in Germany, we recruited 165 adults who identified themselves as ORA victims via abuse- and trauma-specific networks and mailing lists, and they completed an anonymous online survey. We used variance analyses to examine correlations between several variables in the ORA context and PTSD symptoms (PCL-5) as well as somatoform dissociation (SDQ-5). Results revealed a high psychic strain combined with an adverse health care situation in individuals who report experiences with ORA. Ideological strategies used by perpetrators as well as Dissociative Identity Disorders experienced by those affected are associated with more severe symptoms (η²_p = 0.11; η²_p = 0.15), while an exit out of the ORA structures is associated with milder symptoms (η²_p = 0.11). Efforts are needed to improve health care services for individuals who experience severe and complex psychiatric disorders due to ORA in their childhood.

Perceptions of Physical Sexual Health Among Young Men Who Have Sex with Men with a Previous History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) has been reported to be disproportionately higher among young men who have sex with men (YMSM) than among heterosexual men. Most research and public health programs among YMSM CSA survivors have been mainly infectious disease-based, and research on the physical sexual health among this group is limited. This study sought to further understand components of physical sexual health among YMSM with CSA histories. Sixteen participants were recruited, and through a phenomenological approach, semi-structured interviews were conducted. Four themes were found, participants (1) reported a one-dimensional definition of sexual health; (2) had limitations in health insurance hindering preventative care; (3) described reoccurring anal pain during sexual intercourse; and (4) conveyed a positive perception of sexual satisfaction. These findings indicate a need for healthcare providers, health educators, and researchers to increase awareness about the comprehensive needs of YMSM with CSA histories.

Maternal Exposure to Childhood Abuse is Associated with Mate Selection: Implications for Autism in Offspring

Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits-presumably related to genetic predisposition-accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR = 3.98, 95% CI = 1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.

Does Sexual Orientation Precede Childhood Sexual Abuse? Childhood Gender Nonconformity as a Risk Factor and Instrumental Variable Analysis

Research suggests that there is a relation between childhood sexual abuse (CSA) and adulthood nonheterosexual orientation. To explore whether nonheterosexual orientation increases the risk of CSA, we recruited a large sample, added the variable of childhood gender nonconformity (CGNC), and applied the instrumental variable method. We found that heterosexual and nonheterosexual men who were more gender nonconforming in childhood were significantly more likely to report having a history of CSA than their gender-conforming counterparts. There was no relation between CSA and CGNC for heterosexual and nonheterosexual women. The instrumental variable analysis revealed that the increased prevalence of CSA experienced by nonheterosexuals compared with heterosexuals may be due to the influence of sexual orientation on CSA. In sum, the results suggest that nonheterosexuality may increase the risk of childhood sexual abuse.

A Review and Critique of Research on Same-Sex Parenting and Adoption

Are the outcomes for children of gay, lesbian, or bisexual parents in general the same as those for heterosexual parents? That controversial question is discussed here in a detailed review of the social science literature in three parts: (1) stability of same-sex parental relationships, (2) child outcomes, and (3) child outcomes in same-sex adoption. Relationship instability appears to be higher among gay and lesbian parent couples and may be a key mediating factor influencing outcomes for children. With respect to part 2, while parental self-reports usually present few significant differences, social desirability or self-presentation bias may be a confounding factor. While some researchers have tended to conclude that there are no differences whatsoever in terms of child outcomes as a function of parental sexual orientation, such conclusions appear premature in the light of more recent data in which some different outcomes have been observed in a few studies. Studies conducted within the past 10 years that compared child outcomes for children of same-sex and heterosexual adoptive parents were reviewed. Numerous methodological limitations were identified that make it very difficult to make an accurate assessment of the effect of parental sexual orientation across adoptive families. Because of sampling limitations, we still know very little about family functioning among same-sex adoptive families with low or moderate incomes, those with several children, or those with older children, including adolescents or how family functioning may change over time. There remains a need for high-quality research on same-sex families, especially families with gay fathers and with lower income.

Victimization of Lesbian, Gay, and Bisexual People in Childhood: Associations with Attempted Suicide

Higher rates of attempted suicide have been documented among people who identify themselves as gay, lesbian, and bisexual (LGB) compared with heterosexuals. This study sought to ascertain the association between childhood abuse and neglect and attempted suicide, comparing LGBs and heterosexuals. Childhood sexual abuse among men and childhood sexual and physical abuse among women were found to mediate the association between LGB identity and attempted suicide. The experience of childhood abuse likely plays a significant role in the relationship between LGB identity and attempted suicide, but other factors such as experience of discrimination are also important.

The Relationship Between Childhood Gender Nonconformity and Experiencing Diverse Types of Homophobic Violence

Experiences of homophobic violence seem to differ for various sexual-minority subgroups. Previous research has outlined that experiences differ for men and women, and for gender conforming and nonconforming lesbian, gay, and bisexual men and women (LGBs). In this article, these relationships are studied by making a distinction between four types of homophobic violence: verbal, physical, material, and sexual. In 2013, an online survey was designed to ask Flemish LGBs about their experiences of homophobic violence. The final sample consists of 1,402 Flemish sexual-minority individuals. The results show that gay and bisexual men experienced significantly more physical, material, and sexual violence during their lifetime than lesbian and bisexual women did. Moreover, LGBs who reported more childhood gender nonconformity also reported more homophobic violence, and this positive relationship is confirmed for the four forms of violence. For verbal and physical violence, however, the relationship between childhood gender nonconformity and violence varies according to the gender of the respondents. This relationship is much stronger for gay and bisexual men than for lesbian and bisexual women.

Professional Care for Unwanted Same-Sex Attraction: What Does the Research Say?

In recent years, national and international medical and mental-health associations typically have emphasized the potential harmfulness of professional care for unwanted same-sex attraction (SSA or homosexuality) and behavior. State legislatures in the US and legislative bodies in other countries either have passed or are considering passing laws which would penalize professionals who provide professional care for unwanted SSA—to minors and/or adults—including the loss of the license to practice. This paper was written as a response to the present situation in the UK. The paper reviews the universal ethics of all medical and mental-health professionals to avoid harm and do good (non-maleficence/non-malfeasance and beneficence); discusses the documented potential for harm when using every mental-health treatment for every presenting problem; clarifies steps taken by the Alliance for Therapeutic Choice and Scientific Integrity (Alliance), its clinical and research divisions, the National Association for Research and Therapy of Homosexuality Institute (NARTH Institute) and its international division, the International Federation for Therapeutic Choice (IFTC), to promote ethical professional care for unwanted SSA; clarifies the injustice and presumed ideological biases of the medical and mental-health associations’ warning about the potential for harm for psychotherapy only for unwanted SSA and not all psychotherapy approaches; and documents that the research purporting to show this harmfulness, in the research authors own words, does not do so. Recommendations to promote scientific integrity in the conduct and reporting of relevant research are offered.

Lay Summary: There has been a lot of controversy about the potential harmfulness of professional care for unwanted same-sex attraction and behavior (SSA or homosexuality). This paper reviews the ethics of all medical and mental health professionals to avoid harm and do good; discusses the known potential for harm when using any mental health treatment for any problem; clarifies steps taken to promote ethical professional care for unwanted SSA; notes the injustice and possible biases of those who warn about the potential for harm of psychotherapy for unwanted SSA; and documents that the research said to show this harmfulness, in the research authors′ own words, does not do so.

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings

PURPOSE

The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking.

METHOD

NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized.

RESULT

The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers.

CONCLUSIONS

Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.

Professional care for unwanted same-sex attraction: What does the research say?

In recent years, national and international medical and mental-health associations typically have emphasized the potential harmfulness of professional care for unwanted same-sex attraction (SSA or homosexuality) and behavior. State legislatures in the US and legislative bodies in other countries either have passed or are considering passing laws which would penalize professionals who provide professional care for unwanted SSA-to minors and/or adults-including the loss of the license to practice. This paper was written as a response to the present situation in the UK. The paper reviews the universal ethics of all medical and mental-health professionals to avoid harm and do good (non-maleficence/non-malfeasance and beneficence); discusses the documented potential for harm when using every mental-health treatment for every presenting problem; clarifies steps taken by the Alliance for Therapeutic Choice and Scientific Integrity (Alliance), its clinical and research divisions, the National Association for Research and Therapy of Homosexuality Institute (NARTH Institute) and its international division, the International Federation for Therapeutic Choice (IFTC), to promote ethical professional care for unwanted SSA; clarifies the injustice and presumed ideological biases of the medical and mental-health associations' warning about the potential for harm for psychotherapy only for unwanted SSA and not all psychotherapy approaches; and documents that the research purporting to show this harmfulness, in the research authors own words, does not do so. Recommendations to promote scientific integrity in the conduct and reporting of relevant research are offered. Lay Summary: There has been a lot of controversy about the potential harmfulness of professional care for unwanted same-sex attraction and behavior (SSA or homosexuality). This paper reviews the ethics of all medical and mental health professionals to avoid harm and do good; discusses the known potential for harm when using any mental health treatment for any problem; clarifies steps taken to promote ethical professional care for unwanted SSA; notes the injustice and possible biases of those who warn about the potential for harm of psychotherapy for unwanted SSA; and documents that the research said to show this harmfulness, in the research authors own words, does not do so.

Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress

Persons with autistic traits may be at elevated risk for interpersonal victimization across the life course. Children with high levels of autistic traits may be targeted for abuse, and deficits in social awareness may increase risk of interpersonal victimization. Additionally, persons with autistic traits may be at elevated risk of posttraumatic stress disorder (PTSD) symptoms subsequent to trauma. We examined retrospectively reported prevalence of childhood abuse, trauma victimization and PTSD symptoms by autistic traits among adult women in a population-based longitudinal cohort, the Nurses' Health Study II (N=1,077). Autistic traits were measured by the 65-item Social Responsiveness Scale. We estimated odds ratios (OR) for childhood sexual and physical/emotional abuse and PTSD symptoms by quintiles of autistic traits. We examined possible mediation of PTSD risk by abuse and trauma type. Women in the highest versus lowest quintile of autistic traits were more likely to have been sexually abused (40.1% versus 26.7%), physically/emotionally abused (23.9% versus 14.3%), mugged (17.1% versus 10.1%), pressured into sexual contact (25.4% versus 15.6%) and have high PTSD symptoms (10.7% versus 4.5%). Odds of PTSD were elevated in women in the top three quintiles of autistic traits compared with the reference group (OR range=1.4 to 1.9). Childhood abuse exposure partly accounted for elevated risk of PTSD in women with autistic traits. We identify for the first time an association between autistic traits, childhood abuse, trauma victimization, and PTSD. Levels of autistic traits that are highly prevalent in the general population are associated with abuse, trauma and PTSD.

Prevalence of Childhood Sexual Abuse among Lesbian, Gay, and Bisexual People: A Meta-Analysis

In order to determine the prevalence of childhood sexual abuse among gay, lesbian, and bisexual individuals, we conducted a meta-analysis that compiled the results of 65 articles across 9 countries. The results revealed no significant difference in the prevalence of child sexual abuse between homosexual and bisexual people for both sexes. The prevalence of child sexual abuse among female sexual minorities was significantly higher than that among male sexual minorities. The lowest prevalence was found in South America, followed by Asia. The definition of child sexual abuse, dimension used to measure sexual orientation, year of data collection, and the mean age of participants at the time of assessment influenced the estimated prevalence of child sexual abuse. We conclude that many variables influence the reported prevalence of child sexual abuse among sexual minorities.

Sexual interest in children among an online sample of men and women: prevalence and correlates

The purpose of the present study was to explore the extent to which men and women in the general population report sexual interest in children and to examine distinct developmental experiences associated with self-reported sexual interest. Participants (262 females and 173 males) were recruited online and completed a questionnaire assessing sexual interest and adverse childhood experiences. Among men, 6% indicated some likelihood of having sex with a child if they were guaranteed they would not be caught or punished, as did 2% of women. Nine percent of males and 3% of females indicated some likelihood of viewing child pornography on the Internet. Overall, nearly 10% of males and 4% of females reported some likelihood of having sex with children or viewing child pornography. Males and females with any sexual interest in children reported higher likelihoods of engaging in other antisocial or criminal behaviors and also reported more dysfunctional childhoods (i.e., histories of sexual abuse, insecure parent-child attachments). Theoretical implications of the findings and suggestions for preventing the sexual victimization of children are provided.

Childhood sexual abuse and HIV-related risks among men who have sex with men in Washington, DC

Childhood sexual abuse (CSA) has been reported to be disproportionately higher among men who have sex with men (MSM) than among heterosexual men; it has also been found to be significantly positively associated with HIV status and HIV risk factors, including unprotected anal intercourse. The purpose of this study was to assess the correlates of CSA in a sample of community-recruited MSM, investigate race as a potential effect modifier, and describe the independent association between CSA and HIV infection in Washington, DC. A total of 500 MSM were recruited by venue-based sampling in 2008 as part of the National HIV Behavioral Surveillance. More than one-half of MSM identified as White, while one-third identified as Black. CSA was reported by 17.5 % of the 451 MSM, with the first instance of abuse occurring at a median age of 8.3 (interquartile range = 5.0, 11.0). In multivariable analysis, HIV-positive men were significantly more likely to report a history of CSA compared to HIV-negative men after adjusting for intimate partner violence in the last 12 months, having been arrested in the last 12 months, and depressive symptoms. HIV-positive MSM had more than four times the odds of reporting CSA after controlling for other correlates (aOR = 4.19; 95 % CI 2.26, 7.75). Despite hypothesizing that race modified the effect of CSA on HIV infection we found this was not the case in this sample. More research is needed to investigate the potential pathway between a history of CSA and HIV infection, and how this contributes to driving the HIV epidemic among MSM in Washington, DC.

Same-sex sexual attraction does not spread in adolescent social networks

Peers have a powerful effect on adolescents' beliefs, attitudes, and behaviors. Here, we examine the role of social networks in the spread of attitudes towards sexuality using data from the National Longitudinal Study of Adolescent Health (Add Health). Although we found evidence that both sexual activity (OR = 1.79) and desire to have a romantic relationship (OR = 2.69) may spread from person to person, attraction to same sex partners did not spread (OR = 0.96). Analyses of comparable power to those that suggest positive and significant peer-to-peer influence in sexual behavior fail to demonstrate a significant relationship on sexual attraction between friends or siblings. These results suggest that peer influence has little or no effect on the tendency toward heterosexual or homosexual attraction in teens, and that sexual orientation is not transmitted via social networks.

Victimization among female and male sexual minority status groups: evidence from the British Crime Survey 2007-2010

International surveys of victims show crime rates in England and Wales, including hate crimes, are among the highest in Europe. Nevertheless, sexual minority status is a less considered risk factor in general victimization research. This study used sexual minority status and sex to predict victimization across British Crime Surveys from 2007-2010. Logistic regression analyses showed sexual minority status groups were more likely than heterosexuals to be victimized from any and some specific crimes. However, bisexuals rather than lesbians or gay men were more consistently victimized, notably by sexual attacks and within the household. Implications for understanding victimization among these groups are discussed.

Homosexual orientation-from nature, not abuse: A critique of Roberts, Glymour, and Koenen (2013)

Roberts, Glymour, and Koenen (2013), using instrumental variable models, argued that child abuse causes homosexual orientation, defined in part as any same-sex attractions. Their instruments were various negative family environment factors. In their analyses, they found that child sexual abuse (CSA) was more strongly related to homosexual orientation than non-sexual maltreatment was, especially among males. The present commentary therefore focused on male CSA. It is argued that Roberts et al.'s "abuse model" is incorrect and an alternative is presented. Male homosexual behavior is common in primates and has been common in many human societies, such that an evolved human male homosexual potential, with individual variation, can be assumed. Cultural variation has been strongly influenced by cultural norms. In our society, homosexual expression is rare because it is counternormative. The "counternormativity model" offered here holds that negative family environment weakens normative controls and increases counternormative thinking and behavior, which, in combination with sufficient homosexual potential and relevant, reinforcing experiences, can produce a homosexual orientation. This is a benign or positive model (innate potential plus release and reinforcement), in contrast to Roberts et al.'s negative model (abuse plus emotional compensation or cognitive distortion). The abuse model is criticized for being based on the sexual victimological paradigm, which developed to describe the female experience in rape and incest. This poorly fits the gay male experience, as demonstrated in a brief non-clinical literature review. Validly understanding male homosexuality, it is argued, requires the broad perspective, as employed here.

Association of maternal exposure to childhood abuse with elevated risk for autism in offspring

IMPORTANCE

Adverse perinatal circumstances have been associated with increased risk for autism in offspring. Women exposed to childhood abuse experience more adverse perinatal circumstances than women unexposed, but whether maternal abuse is associated with autism in offspring is unknown.

OBJECTIVES

To determine whether maternal exposure to childhood abuse is associated with risk for autism in offspring and whether possible increased risk is accounted for by a higher prevalence of adverse perinatal circumstances among abused women, including toxemia, low birth weight, gestational diabetes, previous induced abortion, intimate partner abuse, pregnancy length shorter than 37 weeks, selective serotonin reuptake inhibitor use, and alcohol use and smoking during pregnancy.

DESIGN AND SETTING

Nurses' Health Study II, a population-based longitudinal cohort of 116 430 women.

PARTICIPANTS

Nurses with data on maternal childhood abuse and child's autism status (97.0% were of white race/ethnicity). Controls were randomly selected from among children of women who did not report autism in offspring (participants included 451 mothers of children with autism and 52 498 mothers of children without autism).

MAIN OUTCOME MEASURES

Autism spectrum disorder in offspring, assessed by maternal report and validated with the Autism Diagnostic Interview-Revised in a subsample.

RESULTS

Exposure to abuse was associated with increased risk for autism in children in a monotonically increasing fashion. The highest level of abuse was associated with the greatest prevalence of autism (1.8% vs 0.7% among women not abused, P = .005) and with the greatest risk for autism adjusted for demographic factors (risk ratio, 3.7; 95% CI, 2.3-5.8). All adverse perinatal circumstances except low birth weight were more prevalent among women abused in childhood. Adjusted for perinatal factors, the association of maternal childhood abuse with autism in offspring was slightly attenuated (risk ratio for highest level of abuse, 3.0; 95% CI, 1.9-4.8).

CONCLUSIONS AND RELEVANCE

We identify an intergenerational association between maternal exposure to childhood abuse and risk for autism in the subsequent generation. Adverse perinatal circumstances accounted for only a small portion of this increased risk.

Disparities in adverse childhood experiences among sexual minority and heterosexual adults: results from a multi-state probability-based sample

BACKGROUND

Adverse childhood experiences (e.g., physical, sexual and emotional abuse, neglect, exposure to domestic violence, parental discord, familial mental illness, incarceration and substance abuse) constitute a major public health problem in the United States. The Adverse Childhood Experiences (ACE) scale is a standardized measure that captures multiple developmental risk factors beyond sexual, physical and emotional abuse. Lesbian, gay, and bisexual (i.e., sexual minority) individuals may experience disproportionately higher prevalence of adverse childhood experiences.

PURPOSE

To examine, using the ACE scale, prevalence of childhood physical, emotional, and sexual abuse and childhood household dysfunction among sexual minority and heterosexual adults.

METHODS

Analyses were conducted using a probability-based sample of data pooled from three U.S. states' Behavioral Risk Factor Surveillance System (BRFSS) surveys (Maine, Washington, Wisconsin) that administered the ACE scale and collected information on sexual identity (n = 22,071).

RESULTS

Compared with heterosexual respondents, gay/lesbian and bisexual individuals experienced increased odds of six of eight and seven of eight adverse childhood experiences, respectively. Sexual minority persons had higher rates of adverse childhood experiences (IRR = 1.66 gay/lesbian; 1.58 bisexual) compared to their heterosexual peers.

CONCLUSIONS

Sexual minority individuals have increased exposure to multiple developmental risk factors beyond physical, sexual and emotional abuse. We recommend the use of the Adverse Childhood Experiences scale in future research examining health disparities among this minority population.