Changes in American Adults' Reported Same-Sex Sexual Experiences and Attitudes, 1973-2014

Divergence in Chinese Sexual Attitudes: An Age-Period-Cohort Analysis

A crucial component of comprehending societal change is understanding how sexual attitudes have evolved over time. The substantial and typical changes in China have created an ideal quasi-experimental design and a wealth of empirical data for tracking the evolution of sexual attitudes. However, existing research has failed to adequately analyze the temporal trends in Chinese sexual attitudes. This study employed an age-period-cohort framework to investigate changes in public sexual attitudes, including premarital sex, extramarital sex, and homosexuality. And it further delved into these attitudes in light of two unique aspects of Chinese society: urban-rural divide and political status. It explored the contributing elements and potential processes of changing public sexual attitudes in China using data from seven waves of national social survey conducted from 2010 to 2021. The findings indicated that public sexual attitudes became more conservative with age; the period effect exhibited a fluctuating upward trend, indicating a general increase in acceptance of the three sexual attitudes; notable differences in sexual attitudes among cohorts were identified. The divergence in sexual attitudes was significantly influenced by urban-rural divide and political status.

Knowledge gaps in existing research exploring sexual fluidity and mental health among young adults

While there is a large body of evidence indicating that sexual minority youth experience inequitably high rates of mental health problems (eg, depression, suicidality), we know little about how temporal changes in sexual attractions, identities and behaviour may impact mental health (and other) outcomes. In this essay, we review existing research regarding sexual fluidity and mental health among young adults in order to identify critical knowledge gaps with respect to an epidemiological understanding of the relationship between these factors. We describe three gaps that in turn inform a larger public health research agenda on this topic. First, there are a number of methodological challenges given that fluidity can occur over short or long periods of time and across multiple dimensions of sexual orientation (eg, attractions, identities and behaviour) with various patterns (eg, directionality of change). Tailored measures that accurately and inclusively reflect diversities of sexual fluidity trajectories are needed. Second, causal relationships between sexual fluidity and mental health remain uncertain and unquantified. Third, little is known about how features of context (eg, gender norms and political climate) influence youth experiences with sexual fluidity and mental health. Finally, we propose a set of recommendations to address these knowledge gaps to improve the quality of epidemiological research involving young people.

Homophobic beliefs and attitudes among mid-adolescent boys: exploring the ideas of hybrid masculinities

Introduction

Homophobia is well-documented as key to social regulation of masculine behavior and practices in Western settings. Yet, empirical data from a number of Western settings has shown a decline in overt homophobic attitudes in the past decade, leading some to suggest that the nature of masculinities is also changing. However, theorizing on the changing nature of masculinities among adolescents has received limited quantitative attention. Research is needed to better understand shifts in adolescent masculinities in contemporary Western settings.

Methods

In this paper, we investigate the application of one newer approach to explore masculinities in context - hybrid masculinities - in a sample of cisgender, heterosexual, mid-adolescent boys in one province in Western Canada (N = 873, mean age (SD) = 14.39 (0.37)). Data were collected from nine cohorts of grade 9 youth over a 10-year period (2013-2022) as part of the baseline survey of an ongoing evaluation of a gender-transformative healthy relationships program.

Results and discussion

We hypothesized that if the ideas of hybrid masculinities held in our sample, we would find that overt homophobic attitudes and adherence to related patriarchal norms (e.g., avoidance of femininity) would decline over this period, but that the use of homophobic name-calling would remain differentiated in terms of to whom it was directed (e.g., a friend, someone they thought was gay). We did find a significant decline in homophobic attitudes and norms related to emotional restriction and avoidance of femininity over the 10-year period, but also found that homophobic name-calling remained differentiated, with significantly higher name-calling toward a friend than toward someone the youth thought was gay. Thus, our hypotheses were supported. We discuss the implications of our findings for future theory and research on understanding adolescent masculinities in context.

Sexual Dysfunction After Menopause: Guidelines for Assessment and Management

Female sexual dysfunction commonly occurs during the menopause transition and post-menopause due to hormonal, physiologic, and psychosocial factors. Sexuality is important to aging women; however, many are reluctant to seek treatment for their sexual concerns. Clinicians should be adept at managing and treating sexual dysfunction in this population. A multi-dimensional treatment approach that addresses modifiable mental, physical, and psychosocial factors is warranted to improve sexual function and quality of life.

The Moderating Role of Sexual Orientation in the Association Between Religiosity and Sexual Behaviors Among College Students

Past research has shown that religiosity can impact sexual behaviors of college-aged youth in both positive and negative directions. As many world religions promote doctrines that include negative views toward sexual minorities, the current study aimed to examine the potentially differential ways religiosity is related to sexual behaviors across various sexual orientations. College/university students across Oregon (N = 1553) completed an online cross-sectional survey in which they provided information about their sexual orientation, levels of religiosity, religious affiliation, and endorsed recent sexual behavior outcomes. Using logistic models in PROCESS, sexual orientation was examined as a moderator of the relations between religiosity (assessed via the Centrality of Religiosity Scale; Huber & Huber) and religious affiliation and the occurrence (yes vs. no) of three sexual behaviors in the past 6 months: birth control use during sex, sexual activity under the influence of substances, and testing positive for an STI. Covariates were age and natal sex. Religiosity was related to reduced birth control use in heterosexual and gay/lesbian individuals. Religiosity was not associated with sexual behaviors in bi/pansexual college students. Findings show that religiosity was a salient construct for understanding sexual behaviors in heterosexual and gay/lesbian college students, but not in bi/pansexual college students. Given that religiosity has differential effects for various sexual behaviors that can heighten risk of negative sexual health outcomes, recommendations are made for increased and tailored sexual health education to religiously identified college students.

What About the Sexual Orientation of the Offspring of Lesbian and Gay Parents? A Multidimensional, Time and Gender-Based Answer

This study examined the sexual orientation of 30 young adult children of lesbian and gay parents, analyzing three dimensions (sexual behavior, sexual attraction and sexual self-identification), their evolution over time and the possible influence of gender (19 women and 11 men). Sexual orientation was measured using KSOG. The results revealed that most participants defined themselves as heterosexual only, although percentages varied between 87% for sexual behavior to 67% for sexual attraction and 60% for sexual self-identification. Gender differences were found for sexual attraction and self-identification, with men having a polarized profile (responses at both ends of the scale) and women reporting a less exclusive and more fluid sexuality. These findings are discussed in light of the complex nature of sexual orientation, the freedom of these young adults for defining their sexual orientation, and the role played by gender and family experiences.

A Need for More Research: How to Understand Elevated Rates of Sexual Assault Among Bisexual College Women

Bisexual college women exhibit some of the highest rates of sexual assault among all college students. Existing research relies on sexual orientation-related stigma as an explanation for these disparities. In this study, we use data from the Online College Social Life Survey (OCSLS) to explore factors that elevate the risk of sexual assault for bisexual college women compared to heterosexual women. Results show that bisexual women exhibit higher rates of sexual assault since the beginning of college for all types of sexual assault, compared to heterosexual women. We find that perceived sexual disrespect, sexual interactions with men, alcohol use, earlier sexual debut, and multiple ongoing partnerships are associated with a higher risk of sexual assault for both bisexual and heterosexual women. Compared to heterosexual women, bisexual women exhibited higher odds of experiencing sexual assault across the majority of risk factors. We envision this study as a preliminary exploration that can inform ongoing work examining which bisexual women are at the highest risk for sexual assault. Implications for future research and intervention are discussed.

Is everyone a mix of straight and gay? A social pressure theory of sexual orientation, with supporting data from a large global sample

Sigmund Freud, Alfred Kinsey, E.O. Wilson, and others have suggested that social pressure suppresses natural tendencies for humans to express bisexuality, the apparent norm for one of our two closest genetic relatives, the bonobo. An analysis of data obtained from a new online sample of 1,150,938 people in 215 countries and territories (63.9% from the United States, United Kingdom, and Canada) who completed the English version of a validated questionnaire of sexual orientation lends support to this idea. A histogram of scores from 0 (exclusive opposite-sex inclinations) to 18 (exclusive same-sex inclinations) forms a near-normal distribution. Although this distribution was likely caused to some extent by sampling bias, it may also reflect the unusual honesty people show when taking online tests anonymously, as an increasing body of evidence demonstrates. We present a formal mathematical expression of a social pressure theory of sexual orientation, along with empirical evidence and computational explorations that support the theory. We also present an analysis of the new data set. Among other findings: sexual orientation labels corresponded to broad, skewed, overlapping distributions of scores. Self-labeled gays/lesbians and, to a greater extent, self-labeled straights, reported that the larger the mismatch between their sexual orientation label and their actual sexual inclinations, the more distress they felt regarding their sexual orientation, a finding that is predictable from cognitive dissonance theory. Educating the public about the true nature of sexual orientation might quell the often rancorous public debates on this topic, as well as give comfort to a large number of mislabeled people.

Predictors of Participation for Sexuality Items in a U.S. Population-Based Online Survey

Online surveys are a popular tool in sex research and it is vital to understand participation bias in these surveys to improve inferences. However, research on this topic is limited and out of date given the increase in online survey methodology and changes in sexual attitudes. This study examined whether demographics and sexual abuse and assault history predict opting into online survey questions about sex. The sample was recruited for a longitudinal mental health study using a probability-based sampling panel developed to represent the US household population. Participants were masked to the inclusion of sexual content and given a choice to opt into sex questions. Analyses were run on raw and weighted responses to adjust for sampling bias. Of the total sample (n = 476, 62.6% female), 69% opted into sex questions. Raw analysis showed that participants were more likely to be younger, have higher education and income, and have a history of sexual abuse or assault. No racial, gender, relationship status, or regional differences were found. After weighting, effect sizes were reduced for most predictor variables, and only a history of sexual abuse or assault still significantly predicted participation. Results suggest that key demographic features do not have a strong association with participation in sex survey questions. Reasons for participation bias stemming from sexual abuse or assault history should be examined further. This study demonstrates how researchers should continue to monitor participation bias in sex survey research as online methodologies and sexual attitudes evolve over time.

Change and Continuity in Attitudes Toward Homosexuality Across the Lifespan

This study examines differential stability in attitudes toward homosexuality using panel data representative of the American adult population. While attitudes toward homosexuality have shifted considerably on the aggregate-level over the past few decades, this study shows that such attitudes are remarkably stable on the individual-level. Employing conditional change models, this study also provides a test of the aging-stability hypothesis with regard to attitudes toward homosexuality. That hypothesis is confirmed, as attitude stability is found to gradually increase with age. However, no other socio-demographic variables are found to have a consistent relationship with stability. The finding of an age-graded increase in stability suggests that attitudes toward homosexuality are formed predominantly early in life and that susceptibility to attitude change declines across the adult lifespan. This finding also supports a generational replacement explanation of recent changes in American public opinion on homosexuality as aging-stability translates into cohort effects on the aggregate-level.

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.

Whose Rights are Civil Rights? Evaluating Group Threat as an Explanation for Racial Differences in Attitudes Toward Same-Gender Sexuality

The alleged prevalence of anti-gay bias among Black communities in the United States has received ample popular and academic attention in recent decades. But just how consistent is the purported relationship between race and homophobia? In this paper, we use the American National Election Studies and the General Social Survey to show that public claims about "Black homophobia" have been dangerously overstated. Moreover, where racial differences in attitudes toward same-gender sexuality do occur, we find that the two most prevalent scholarly explanations for such gaps-religious institutions and gender ideologies-do not predict anti-gay bias for Black survey respondents. We thus derive an alternative explanation from scholarship on group threat: that perceived competition for political resources is what motivates racial differences in antagonism toward same-gender sexuality. Our results support that alternative and, in so doing, evince the importance of a relational approach to homophobia in academic and activist spheres alike.

Findings From a Community Survey of Individuals Who Engage in Pup Play

This study presents findings from a community survey on pup play. Pup play is a kink activity and a form of role play that is growing in popularity internationally, and gaining increasing attention in sexology, yet prior research on pup play has almost entirely employed qualitative methods and primarily involved gay and bisexual men. Using survey data of 733 pup play participants primarily from the US, but also internationally, this study reports on the demographics of participants, how they engage in pup play, its social and sexual elements, and how it relates to social identity and mental health. Unique pup names and identifying with breeds of dogs were used to foster a sense of individuality within pup play, while the majority of participants owned and wore gear when engaging in pup play. We also found significant associations between being younger and identifying as a pup. Most participants reported that pup play improved their mental health. Binary logistic regression analyses indicated that having a mental health diagnosis was associated with identifying with a more social style of pup play and self-reporting the mental health benefits of pup play. We find that the conceptualization of pup play in the existing literature to be accurate to this international sample and highlight areas where further research is needed, alongside limitations of the study.

An Empirical Investigation of Variations in Outcomes Associated with Heterosexual Adults' Most Recent Mixed-Sex Threesome Experience

Research reveals that a substantial proportion of North American adults report interest in and experience with mixed-sex threesomes (MSTs; sexual activity involving three people at the same time in which persons of more than one sex are present). Despite the prevalence of MST participation, little is known about the outcomes of MST experiences. Thus, the current study assessed MST outcomes using various metrics including the extent to which one's most recent MST met expectations, the likelihood of participating in the MST again, and whether an orgasm was experienced. In addition, the extent to which one's sex, the sex of those involved, and the inclusion of one's romantic partner impacted outcomes was examined. Data from 276 heterosexual adults (217 men, 59 women) revealed that, overall, adults report fairly positive outcomes from their most recent MST and that males reported more positive outcomes than did females (particularly when engaging in a MST with two members of the other sex). In addition, MSTs involving one's romantic partner resulted in more positive outcomes than did those with casual partners. These results confirm that MSTs can be a satisfying experience particularly for heterosexual males and those participating with a romantic partner. Implications for educators looking to destigmatize various forms of nonmonogamies and for practitioners who intend to assist adults interested in safely exploring multi-person sexual behavior are discussed.

Heterosexual Identification and Same-Sex Partnering: Prevalence and Attitudinal Characteristics in the USA

This paper used the 2011-2017 National Survey of Family Growth to estimate population sizes and attitudinal characteristics of heterosexual-identified men who have sex with men (MSM) and women who have sex with women (WSW) aged 15-44 years. Analyses estimated population sizes in stages: after excluding respondents who reported only one lifetime same-sex partner, which happened before the age of 15; after excluding males who reported nonconsensual male-male sex; after excluding respondents who reported only one lifetime same-sex partner, regardless of the age at which that experience occurred; after excluding respondents who reported only two lifetime same-sex partners, the first of which occurred before age 15; and after excluding males who reported male-male sex work. The broadest criteria included many individuals with limited same-sex sexual histories or those who experienced nonconsensual sex or potentially coerced sex in youth. After excluding those respondents, analyses showed that heterosexual-identified MSM and WSW had a diversity of attitudes about gender and LGB rights; only a distinct minority were overtly homophobic and conservative. Researchers should carefully consider whether to include respondents who report unwanted sexual contact or sex at very young ages when they analyze sexual identity-behavior discordance or define sexual minority populations on the basis of behavior.

Sexual Identity-Behavior Discordance in Canada

This paper uses two surveys to examine sexual identity-behavior discordance in Canada. The first is the Sex in Canada survey (SCS), which is a private survey of 2,303 Canadians. The second is the 2015-2016 Canadian Community Health Survey (CCHS), which is a large nationally representative government-administered survey with 109,659 respondents. Results from the CCHS show that identity-behavior discordance and overall rates of same-sex contact are lower in Canada than in the US, UK, or Australia. An estimated .7 percent of males and 2.7 percent of females aged 15-64 who had had lifetime sex identified as heterosexual yet have had same-sex contact, figures which equate to an estimated 65,700 males and 255,100 females. Few demographic factors were associated with discordance. Results from the SCS show that about two-thirds of heterosexuals with identity-behavior discordance were moderately supportive of LGBQ rights and one-third were moderately homophobic. Future research will need to uncover why a lower proportion of Canadians report same-sex partners and identity-behavior discordance than their counterparts in the US, UK, or Australia. Cet article utilise deux enquêtes pour examiner la discordance entre l'identité sexuelle et le comportement au Canada. La première est l'enquête Sex in Canada (SCS), qui est une enquête privée menée auprès de 2 303 Canadiens. La seconde est l'Enquête sur la santé dans les collectivités canadiennes (ESCC) de 2015-2016, qui est une grande enquête représentative à l'échelle nationale administrée par le gouvernement auprès de 109 659 répondants. Les résultats de l'ESCC montrent que la discordance identité-comportement et les taux globaux de contacts entre personnes de même sexe sont plus faibles au Canada qu'aux États-Unis, au Royaume-Uni ou en Australie. On estime que 0,7 % des hommes et 2,7 % des femmes âgés de 15 à 64 ans ayant eu des rapports sexuels au cours de leur vie se sont identifiés comme hétérosexuels, mais ont eu des contacts avec des personnes du même sexe, ce qui correspond à environ 65 700 hommes et 255 100 femmes. Peu de facteurs démographiques étaient associés à la discordance. Les résultats de l'enquête SCS montrent qu'environ deux tiers des hétérosexuels présentant une discordance entre identité et comportement étaient modérément favorables aux droits des LGBQ et qu'un tiers était modérément homophobe. Les recherches futures devront découvrir pourquoi une plus faible proportion de Canadiens déclarent avoir des partenaires de même sexe et être en désaccord avec leur identité et leur comportement que leurs homologues aux États-Unis, au Royaume-Uni ou en Australie.

Parents ASSIST: Acceptability and Feasibility of a Video-Based Educational Series for Sexuality-Inclusive Communication between Parents and Gay, Bisexual, and Queer Sons

Young men who have sex with men (YMSM) between the ages of 13 and 24 are a key population for HIV prevention. The parents of gay, bisexual, and queer (GBQ) adolescent males and the sex communication they have with their sons has yet to be explored as an HIV prevention intervention. We developed an online video series called Parents ASSIST (Advancing Supportive and Sexuality-Inclusive Sex Talks) to educate parents about sexual health topics pertinent to GBQ males. We pilot tested the series with a sample of 54 parents of GBQ males using a single-group post-test design. Participants viewed the videos and completed a survey measuring the acceptability and feasibility of an online video series to educate parents. Most of the parents (70.4%) believed that the videos would make parents more likely to initiate talking about sex with their sons. The results suggest that online videos are an acceptable way for parents to learn about GBQ sexual health topics.

A poststructural discourse analysis of the attitudes, beliefs, and values of undergraduate Canadian university students regarding sexual orientation

The socio-politico-cultural context of sexual orientation often influences the attitudes, beliefs, and values produced in a given society. This study employed a qualitative methodology to explore the current attitudes, beliefs, and values of Canadian undergraduate students about sexual orientation. Students in a large human sexuality course at a Canadian university completed open-ended questions on the educational platform Top Hat. The data were analyzed using discourse analysis and four threads of discourse emerged: 1) The Nature of Sexual Orientation, 2) Gender Norms and Bisexuality, 3) Shared Connections, and 4) Foundations of Friendships. These findings contribute to the growing body of knowledge relating to changing attitudes, beliefs, and values about sexual orientation of Canadian university students.

Examining Variations in Participation and Outcomes of Consensual and Nonconsensual Extradyadic Behavior among Ashley Madison Users

Despite the abundance of studies investigating individual differences associated with extradyadic behavior (EB), nearly all have adopted retrospective measures in which the data is likely plagued by recall biases. In addition, few studies have explored individual differences or outcomes associated with EB between those with consenting and nonconsenting primary partners. Thus, the current study investigated the extent to which Ashley Madison users participated in a wide range of EBs, whether age, gender, and sexual identity predicted participation, and the extent to which outcomes were impacted by partner consent. The results from 1460 adults (962 men, 498 women) revealed that users reported engaging in three categories of behaviors: sexual/explicit, technology/online, and emotional/affectionate behaviors and that women and those older in age reported participating in EBs more frequently than men and those younger in age. Finally, 16.9% of the sample had a primary partner that consented to their Ashley Madison use and those with consenting partners reported greater perceived improvement in their primary relationship than did those with nonconsenting partners. Our findings highlight the importance of assessing the multitude of behaviors that Ashley Madison users participate in and whether consent was obtained. Implications for educators and practitioners are discussed.

Prevalence and Sociodemographic Correlates of Identifying as Mainly Heterosexual: Stability and Change across Three Cohorts of Australian Women

In recent decades, the ways in which sexual minorities identify have changed dramatically. In response, social and health surveys have begun offering a greater range of response options within sexual orientation questions-for example, intermediate categories for "mainly heterosexual" and "mainly lesbian/gay" alongside the more common response options of "heterosexual," "bisexual," and "lesbian/gay." Recent studies indicate that women who identify as "mainly heterosexual" report poorer health, greater health-risk behaviors, and higher rates of victimization than women identifying as "exclusively heterosexual." However, we know very little about the demographic profile of women who choose the "mainly heterosexual" identity label compared to the adjacent "exclusively heterosexual" or "bisexual" labels or about changes over time in the prevalence and correlates of "mainly heterosexual" identification. This study addressed these knowledge gaps by modeling unique, high-quality survey data from three national cohorts of Australian women (Australian Longitudinal Study on Women's Health, 2000-2017, n = 76,930 observations). Consistent with the facilitative environments model, we document stark cross-cohort increases in the percentage of Australian women identifying as "mainly heterosexual"-from ∼1% of those born in 1946-1951 to ∼26% of those born in 1989-1995, coinciding with comparable declines in the percentage of women identifying as "exclusively heterosexual." We also found evidence of cohort differences in the associations between key sociodemographic factors-such as age, education, and socioeconomic status-and the likelihood of women identifying as "mainly heterosexual." Finally, our results indicate that same-sex sexual attractions were more strongly associated with "mainly heterosexual" identification than was same-sex sexual behavior.

Timing of First Sexual Experience with a Same-Sex Partner: A Life Course Approach

Theories of sexual identity development recognize the initiation of sexual experience with same-sex partners (SESSP) to be a significant event in the coming-out process, yet the research literature lacks a population-based description of its timing and variation across population subgroups. Using data from the 2011-2017 National Survey of Family Growth and guided by the life course paradigm, we explored the timing and correlates of first SESSP among individuals (1425 women; 545 men) who identified as lesbian (n = 307), gay (n = 285), or bisexual (n = 1378) (LGB). Descriptive findings revealed that the median age at first SESSP was about 19 years for lesbian women and gay men and one to two years later for bisexual women and men. Notably, initiation of SESSP occurred over a wide age range, particularly among bisexual men. Multivariable results indicated that the probability of first SESSP did not vary by demographic characteristics or family background among men. Among women, nativity status, family stability, and independent living were associated with probability of first SESSP. Coital experience predicted timing among both women and men. Tests for statistical interactions suggested that age at first SESSP was contingent on mother's education (women), sexual identity (men), family stability (men), and birth cohort (women and men). Our findings highlight the complicated nature of LGB sexual experiences, and we end with a call for greater effort to ensure that LGB individuals are represented in national surveys designed to provide data on sexual and reproductive health.

Assessing the Effects of a Real-Life Contact Intervention on Prejudice Toward LGBT People

Prejudice against sexual and gender minorities (e.g., LGBT people) is quite prevalent and is harmful. We examined an existing-and often-used-contact intervention in pre-existing groups in an educational setting and assessed its effectiveness in reducing different forms of LGBT negativity. We focused particularly on modern LGBT negativity: a relatively subtle form of prejudice, involving ambivalence, denial, and/or the belief that there is too much attention for LGBT prejudice. We used a mixed design in which condition (experimental vs. control group) was the between-participants factor, which was randomized at the group level, and time (pretest vs. posttest vs. follow-up) was the within-participants factor (N = 117). Interventions were video recorded and the behavior of LGBT educators and participants was coded. Participants responded positively to the intervention, especially to the LGBT educator's "coming-out story." Exploratory analysis of the video data indicated that the perceived effectiveness of the intervention was higher in groups where participants were more engaged, although caution is necessary in interpreting this finding. The most important measure indicated that modern LGBT negativity decreased in the intervention groups directly after the intervention, but returned to baseline levels one week later. However, in the control condition, modern LGBT negativity had increased over time. Taken together, this suggests that an actual reduction in modern LGBT negativity was short-lived (i.e., the intervention effect disappeared within 7 days).

Increased Support for Same-sex Marriage in the US: Disentangling Age, Period, and Cohort Effects

Previous research established a substantial increase in support for same-sex marriage in the US, but it is unclear if this increase is due to cohort (a change that affects only the younger generation) or time period (a change that affects those of all ages). In a nationally representative sample of American adults (n = 13,483) in 1988 and 2004-2018, increased support for same-sex marriage was primarily due to time period (from 11.1% in 1988 to 66.7% in 2018). There was a smaller cohort effect, with a fairly linear increase between cohorts born in the 1960s and those born in the 1990s. Time period increases in support for same-sex marriage appeared among across gender, race, education levels, regions, and levels of religious service attendance, though differences in support still remain. The results suggest Americans of all ages modified their beliefs about same-sex marriage over time.

The New Genetic Evidence on Same-Gender Sexuality: Implications for Sexual Fluidity and Multiple Forms of Sexual Diversity

In September of 2019, the largest-ever (N = 477,522) genome-wide-association study of same-gender sexuality was published in Science. The primary finding was that multiple genes are significantly associated with ever engaging in same-gender sexual behavior, accounting for between 8-25% of variance in this outcome. Yet an additional finding of this study, which received less attention, has more potential to transform our current understanding of same-gender sexuality: Specifically, the genes associated with ever engaging in same-gender sexual behavior differed from the genes associated with one's relative proportion of same-gender to other-gender behavior. I review recent research on sexual orientation and sexual fluidity to illustrate how these findings speak to longstanding questions regarding distinctions among subtypes of same-gender sexuality (such as mostly-heterosexuality, bisexuality, and exclusive same-gender experience). I conclude by outlining directions for future research on the multiple causes and correlates of same-gender expression.

Comparability of estimates and trends in adolescent sexual and contraceptive behaviors from two national surveys: National Survey of Family Growth and the Youth Risk Behavior Survey

OBJECTIVE

To compare adolescents' reports of sexual and contraceptive behaviors between the National Survey of Family Growth (NSFG) and the Youth Risk Behavior Survey (YRBS).

METHODS

For each survey, we estimated the year- and sex-specific prevalence of sexual and contraceptive behaviors among a comparably defined sample of US respondents ages 15-19 currently attending high school. We used logistic regression to test for changes in prevalence from 2007-2019 and conducted sensitivity analyses to investigate between-survey differences.

RESULTS

We found differences in both prevalence and trends between the YRBS and NSFG when limited to a comparably defined sample. Compared to the NSFG, adolescents in the YRBS were more likely to report being sexually experienced, less likely to report use of prescription methods for both sexes, and less likely to report condoms among males. Only the YRBS estimated significant declines in sexual experience for both sexes, and significant increases in prescription methods and declines in condom use among males. Differences between surveys in the prevalence of specific contraceptive methods reflected greater combined use of methods in the NSFG. We identified differences in question-wording and other aspects that may influence these differential patterns.

CONCLUSIONS

The NSFG and YRBS produced inconsistent prevalence estimates and trends for sexual and contraceptive behaviors among in-school adolescents. Further efforts to improve these national surveillance systems are critical to inform policy and research efforts that support adolescent sexual and reproductive health and wellbeing.

Changes in Sexual Identity Labels in a Contemporary Cohort of Emerging Adult Women: Patterns, Prevalence and a Typology

Sexual attraction, behavior and identity are subject to change across the life course for some individuals, and certain developmental periods such as emerging adulthood appear particularly conducive to this. However, the evidence documenting these phenomena comes overwhelmingly from data collected 10-20 years ago. In the brief interlude since, the socio-political context has changed markedly and increasing numbers of women are reporting non-heterosexuality. Drawing on contemporary data from the Australian Longitudinal Study on Women's Health (n = 16,870), we provide up to date evidence on changes in sexual identity labels among emerging adult women. We found that 19% of women changed their sexual identity label from one survey wave to the next, and 30.6% changed their identity label at least once across the four waves. Mostly heterosexual and bisexual labels were both more common and more stable in our sample than in previous studies. We propose a new typology of sexual identity sequences and fit this to our data, providing a blueprint for researchers looking to define sexual minority status longitudinally. Findings suggest that the ways women perceive and label their sexual orientation should be treated as dynamic phenomena situated within the nested temporalities of biographical and historical time.

The Normalization of Leisure Sex and Recreational Drugs: Exploring Associations Between Polydrug Use and Sexual Practices by English Festival-Goers

The relationship between drug use and sexual practice is complex. Significant focus has been placed on risky practices, yet the broader associations between drug use and sexual activities remain elusive outside such contexts. This is despite similar trends of liberalizing attitudes and practices being identified in each area, theorized as the normalization of recreational drug use and the liberalization of consensual sexual practice. In this article, we draw on convenience sample surveys of 966 festival-goers at an English music festival in 2016 and 2019 to assess prevalence of polydrug use and to examine whether people who consume illicit drugs are more likely to engage in sexual behaviors considered more liberal than the traditional norm. We show that people who reported polydrug use in the last 12 months were significantly more likely to engage in non-traditional sexual behaviors, including sex with a friend and anal sex, in that same time period. In combining and comparing two usually distinct discourses, this exploratory study suggests that the normalization of drugs and the liberalization of consensual sexual practices are related and can be conceptualized as part of a broader societal acceptance and cultural accommodation of illicit drug use and particular sexual practices as leisure activities, despite markedly different policy and legal contexts for each activity. We conclude that the concept of “normalization” may be more appropriate to understanding changes in sexuality than “liberalization” in the context of “leisure sex” and call for further cross-disciplinary research on drugs and sex using this approach.

An Experimental Investigation of Variations in Judgments of Hypothetical Males and Females Initiating Mixed-Gender Threesomes: An Application of Sexual Script Theory

Although many young adults are interested in mixed-gender threesomes (MGTs), little research has assessed attitudes toward them. Yet, MGTs offer a rare context to investigate how consensually nonmonogamous sexual encounters and involvement with same-sex others influence attitudes. Thus, by adopting sexual script theory as a framework, the current study compared three dimensions of character judgments (cognitive abilities, morality, partner quality) and assumptions about the sexual history of hypothetical males and females who initiated a MGT (two females and one male; two males and one female) or mixed-sex dyadic sexual activity with a casual or committed partner. To do so, a between-subject design was adopted in which 690 U.S. adults (405 women, 285 men) evaluated a hypothetical initiator described in one of 12 vignettes. On average, participants made neutral judgments about the initiator, yet those initiating dyadic sexual behavior were judged more favorably and as having a less extensive sexual history than MGT initiators. Male initiators were judged more favorably than female initiators, particularly by men. Those initiating in the context of a committed relationship were judged as more moral and as higher-quality partners than those initiating within a casual relationship; female (but not male) initiators in the committed context were judged as having a less extensive sexual history than female initiators in the casual context. These results confirm the presence of mononormativity biases and the sexual double standard and have implications for educators and practitioners related to stigma reduction and the promotion of inclusive sexual education.

Religious and Spiritual Development from Adolescence to Early Adulthood in the U.S.: Changes over Time and Sexual Orientation Differences

Adolescence is a critical time in the U.S. for religious development in that many young people eschew their religious identity as they enter adulthood. In general, religion is associated with a number of positive health outcomes including decreased substance use and depression. The current study compared the developmental patterns of religiosity and spirituality in heterosexual and sexual minority youth. The design was a secondary data analysis of the first five waves of the Longitudinal Study of Adolescent Health and Wellness (N = 337, 71.8% female). Using multilevel linear (for spirituality) and quadratic (for religiosity) growth models, the initial level and change over time in religiosity and spirituality, as well as the correlations between growth processes, were compared between heterosexual and sexual minority individuals. The heterosexual group had significantly higher initial religiosity levels than the sexual minority group. Religiosity decreased over time at a similar rate for the heterosexual and sexual minority groups. Spirituality significantly increased over time for the sexual minority group but not for the heterosexual youth. The change over time in religiosity and spirituality were significantly and positively correlated for heterosexual individuals but were uncorrelated for sexual minority individuals. Results indicate there are differences in religious development based on sexual minority status. Future research should take into account how these differential religious and spiritual developmental patterns seen in heterosexual and sexual minority youth might predict various health outcomes.

Experienced Homophobia and HIV Infection Risk Among U.S. Gay, Bisexual, and Other Men Who Have Sex with Men: A Meta-Analysis

Purpose: Experienced homophobia-negative treatment and perceptions that gay, bisexual, and other men who have sex with men (MSM) encounter because of their sexual orientations-may promote HIV infection among MSM. We conducted a rapid review and meta-analysis to examine experienced homophobia in relation to HIV infection risk. Methods: We searched Embase, MEDLINE, PsycINFO, and Sociological Abstracts to acquire data from U.S. studies published during 1992-2017. Studies examined experienced homophobia in relation to sexual risk behavior, poor HIV care continuum engagement, and diagnosed HIV infection. Random-effects models yielded summary odds ratios (ORs) and 95% confidence intervals (CIs). Results: Experienced homophobia was associated with having any sexual risk behavior (OR = 1.33, 95% CI = 1.25-1.42, I² = 89.2%), receptive condomless anal sex (CAS) (OR = 1.33, 95% CI = 1.14-1.56, I² = 63.6%), HIV-discordant CAS (OR = 1.66, 95% CI = 1.29-2.13, I² = 85.3%), an increased number of sex partners (OR = 1.16, 95% CI = 1.13-1.19, I² = 0.0%), diagnosed HIV infection (OR = 1.34, 95% CI = 1.10-1.64, I² = 86.3%), and poor HIV care continuum engagement among MSM living with HIV (OR = 1.45, 95% CI = 1.02-2.08, I² = 47.0%). Effect sizes for any sexual risk behavior were larger in samples with ≥50% Black or Latino (vs. White) MSM and for family-based mistreatment and perceived sexual minority stigma (vs. other homophobia types). Conclusion: Experienced homophobia is associated with HIV infection risk among MSM. Its association with sexual risk behavior may be stronger among Black and Latino (vs. White) MSM and for family-based mistreatment and perceived sexual minority stigma (vs. other homophobia types). Research is needed to better understand causality in these relationships and the role of interventions to reduce homophobia.

Intersecting Sexual Identities, Oppressions, and Social Justice Work: Comparing LGBTQ Baby Boomers to Millennials Who Came of Age After the 1980s AIDS Epidemic

In this study we analyze 50 interviews with racially diverse, predominantly low-income, LGBTQ participants living in the San Francisco Bay Area. Rooted in intersectional theory that conceptualizes identities as shaped by interlocking forms of oppression and privilege, we compared interviews with "Baby Boomers" to those with "Millennial" participants, who came into adulthood in a time of greater legal and social inclusion for LGBTQ people. Our analysis focused on three questions: How do participants understand their sexual identities? How are the identities of sexual minority participants co-constructed with intersecting forms of oppression? What motivates LGBTQ people in our sample to engage in social justice work? We found that white LGBTQ people tended to see their sexualities as primary to their identity, compared to LGBTQ Black and/or Indigenous People of Color (BIPOC) who tended to see their identities in intersectional terms. Younger LGBTQ people were more likely to delink sex and gender identity; consequently, they were more likely to frame their sexual identities with terms not rooted in a gender binary (e.g., pansexual or queer). Experiences with homophobia were prevalent across generations, and intersected with racism and economic oppressions, but younger people more often described support from institutional agents. Participants' sense of community and commitment to giving back after experiences of trauma motivated them to engage in social justice work. Our findings highlight the intersectional nature of oppressions faced by LGBTQ people and the need for organizations to move away from focusing exclusively on homophobic oppression as a monolith.

The Role of Sexual Orientation in the Associations Between Religiousness and Hypertension

This study assessed the cross-sectional associations between organizational religious activity (ORA), intrinsic religiosity (IR), and hypertension in a US nationally representative sample. Data were from Wave IV of the National Longitudinal Study of Adolescent to Adult Health, collected in 2008. The sample (N = 5115, M_age = 28.96 years, 54% female) was divided into three sexual orientation categories: heterosexual, mostly heterosexual, and sexual minority. Dependent variables were systolic and diastolic blood pressure and binary cut-scores of clinical hypertension. ORA and IR were independent variables, with sexual orientation as the moderator. Multivariable analyses revealed greater ORA was associated with increased blood pressure (BP)/hypertension for the sexual minority group. There was a trend in the heterosexual group where ORA was associated with decreased BP. Generally, ORA was not associated with BP/hypertension in the mostly heterosexual group. There were no significant effects for IR. Future research should continue to examine the complex ways ORA and IR are associated with health based on sexual orientation and use longitudinal methodology to examine how ORA may impact BP/hypertension across the lifespan.

Assessing Implicit Associations with Consensual Non-monogamy Among U.S. Early Emerging Adults: An Application of the Single-Target Implicit Association Test

Research has demonstrated that implicit and explicit attitudes toward consensual nonmonogamy (CNM; sexually and/or emotionally nonexclusive romantic relationships) are less favorable than those toward monogamy. Although this general pattern of results is often reported, it is not clear to what extent this implicit difference reflects negative associations with CNM. To investigate this issue, the current study assessed 355 U.S. early emerging adults' (89 men, 265 women, one gender nonconforming) implicit associations with CNM and monogamy using the Single-Target Implicit Association Test (ST-IAT). In addition, the convergent (using explicit measures), postdictive, and concurrent validity of the CNM ST-IAT was also investigated. The results revealed that although early emerging adults demonstrated a positive implicit association with monogamy (mean D score = 0.38), a neutral implicit association emerged for CNM (mean D score = 0.00). Additionally, young women and those without previous CNM experience demonstrated more negative implicit associations with CNM as compared to men and those with previous CNM experience. Finally, implicit associations with CNM predicted willingness to allow one's partner to participate in CNM, but not one's own interest in CNM. These results support previous research suggesting that a disparity in attitudes toward CNM and monogamy exists and provides further clarification reflecting positive implicit associations with monogamy and neutral associations with CNM. These results also confirm that monogamous relationships continue to be upheld as the ideal relationship structure in the U.S. and that educators/practitioners should work to reduce negative implicit bias toward CNM in an attempt to promote relationship equity.

Ambivalent Homoprejudice towards Gay Men: Theory Development and Validation

Myriad social groups are targets of hostile and benevolent (i.e., ambivalent) prejudice. However, prejudice toward gay men is typically conceptualized as hostile, despite the prevalence of benevolence toward gay men in popular media. This article aims to compare gay men with other targets of ambivalent prejudice (i.e., women and elderly people) and draw on the stereotype content and microaggressions literatures in order to develop a theory of ambivalent homoprejudice. The resultant framework, comprising repellent, adversarial, romanticized, and paternalistic homoprejudice was investigated using seven focus groups of heterosexuals and gay men (N = 22), and the findings were consistent with stereotype content theory. Directions for future research into the deleterious effects of ambivalent homoprejudice and possible empowering interventions are discussed.

Sexual Minority Women in Longitudinal Survey Research: Is Attrition a Problem?

As more longitudinal surveys collect information on sexual orientation, evaluating the quality of these data and understanding how sexual minorities engage with the survey process are increasingly important endeavors. This study constitutes the first systematic analysis of sexual orientation as a predictor of attrition from longitudinal surveys. Drawing upon the minority stress model, we developed testable hypotheses about how sexual identity and sexual identity change relate to panel attrition. These hypotheses were subsequently tested using data from two national cohorts of Australian women from the Australian Longitudinal Study on Women's Health (one born 1973-1978, n = 11,262, and one born 1989-1995, n = 16,689). In the older cohort, sexual minority women were more likely to attrit from the survey than exclusively heterosexual women-largely due to noncontact rather than noncooperation. The associations faded once sociodemographic and health-related covariates were included in the models. Further, higher rates of noncontact were observed among women who changed their sexual identity in a more same-sex-oriented direction, compared to women with a stable sexual identity. None of these associations were apparent in the younger cohort. Taken together, our results suggest that sexual minority status may be a risk factor for panel attrition among older but not younger cohorts of women and that improved efforts to locate and contact participants who are generally vulnerable could increase the retention of sexual minorities in longitudinal studies. Effect sizes were nevertheless small, suggesting that existing research on sexual orientation using longitudinal surveys is unlikely to be biased by non-random attrition of non-heterosexual individuals.

Innovation and Integration of Sexuality in Family Life Education

As a fundamental aspect of the human experience, sexuality is experienced at every stage in the lifespan. Sexual values, behaviors, and health are important components of individual and family well-being. Educating about such a fundamental aspect of life is both obvious and crucial. In this article, we consider the potential of sexuality education in the field and profession of family life education (FLE). We critique sexuality education in the United States, and we critique the marginal place of human sexuality in the FLE field. We then offer recommendations for incorporating lifespan, socio-ecological, family systems and intersectionality into sexuality education, and recommendations for FLE and sexuality education research and practice. We argue that educating about sexuality in the context of FLE-and activating the profession of FLE for sexuality education-will strategically advance sexuality education, sexual health, and the field of FLE.

A qualitative study of heterosexual men's attitudes toward and practices of receiving anal stimulation

This study examines the practice of and attitudes toward anal sexual stimulation among 30 heterosexual undergraduate men attending a UK university. While scientific and popular belief throughout the twentieth century has considered anal pleasure to be only for gay or gender non-conforming men, we find participants discuss such pleasure openly, and some have explored physically receiving anal pleasure. Participants did not stigmatise sexual pleasure derived from anal play, challenging cultural narratives that conflate anal receptivity with being gay. We document how ignorance around the best practices for anal sex may impede pleasure and the further exploration of sexual pleasure and highlight areas where sexual health and education interventions may be beneficial.

Does Socio-structural Context Matter? A Multilevel Test of Sexual Minority Stigma and Depressive Symptoms in Four Asia-Pacific Countries

In the Asia-Pacific region, individual sexual stigma contributes to elevated rates of depression among sexual minority men. Less well understood is the role of socio-structural sexual stigma despite evidence that social context influences the experience of stigma. We use data from the United Nations Multi-country Study on Men and Violence to conduct a multilevel test of associations between individual- and cluster unit-level indicators of sexual stigma and depressive symptoms among sexual minority men (n = 562). In the full model, individual-level sexual stigma is not associated with depressive symptoms, although there is significant variation in the association between individual stigma and depressive symptoms across clusters. Contrary to expectation, at the community level, homophobic injunctive norms are negatively associated with depressive symptoms. We discuss the implications for policies, programs, and future research to improve mental health among sexual minority men in the region.

Organizational Religious Activity, Hypertension, and Sexual Orientation: Results From a Nationally Representative Sample

Background

Hypertension is a major public health concern, given prevalence and morbidity. Among the general population, greater religious attendance is associated with lower blood pressure (BP). However, no known studies have examined the association between religious attendance and BP among sexual minorities.

Purpose

To examine the association between BP/hypertension and organizational religious activity as a function of sexual orientation.

Methods

Data were utilized from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a publicly available, U.S. nationally representative data set. Of the 4,874 individuals included in analyses, 366 participants were identified as a sexual minority. An organizational religious activity variable was created by summing responses of two separate items. BP was measured as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Increasing levels of clinical severity of hypertension were also examined. Relevant covariates were controlled for in two separate models. Significant interactions between religious attendance and sexual orientation were explored in simple slope analyses.

Results

Overall, results indicated that sexual orientation moderated the association between organizational religious activity, and BP/hypertension. Crossover interactions were present for the dependent variables SBP, DBP, and prehypertension and higher (prehypertension, and hypertension 1 and 2). Generally, a negative association between organizational religious activity and hypertension was revealed among the heterosexual group, whereas a positive association was found among the sexual minority group.

Conclusions

Organizational religious activity is differentially associated with BP/hypertension among sexual minority versus heterosexual individuals. Organizational religious activity may represent a risk factor for hypertension among sexual minority individuals.

Minority Stress, Emotion Regulation, and Executive Function: An Experimental Investigation of Gay and Lesbian Adults

Minority stress is associated with emotional, cognitive, and health consequences for sexual minority individuals. Mechanisms remain poorly understood. Theory and preliminary evidence suggests that stress associated with minority identity results in negative emotions and attempts at suppression, which may contribute to depletion of executive function. This study was an experimental investigation of gay and lesbian adults (N = 141). Participants engaged in a stressful interpersonal task with a confederate with anti-gay or pro-gay attitudes. We examined how condition affected executive function, along with potential mediators (state anger, anxiety, expressive suppression). Contrary to hypotheses, participants in the anti-gay condition showed better postmanipulation cognitive performance than the pro-gay condition. This effect was partially mediated by anger. Participants in the anti-gay condition reported greater attempts at suppression, but this variable did not emerge as a mediator. This study was the first to experimentally manipulate exposure to anti-gay attitudes and measure effects on executive function.

The Denominator problem: estimating the size of local populations of men-who-have-sex-with-men and rates of HIV and other STIs in Switzerland

OBJECTIVES

There is no estimate of the current number of men who have sex with men (MSM) in Switzerland, or of their geographical distribution. We aimed to (1) estimate MSM concentration factors and population sizes for 83 Swiss postal code areas (PCA), including the nine largest Swiss cities, and (2) calculate MSM-specific local HIV prevalence and yearly rates of diagnosed HIV, hepatitis C virus (HCV), syphilis and gonorrhoea.

METHODS

We triangulated data from general population estimates, MSM online surveys, published data on HIV prevalence and Swiss notification data for HIV and STDs. We compared two different formulae for the estimation of local MSM populations and calculated Bayesian 95%-credible-intervals (CrI) for each PCA.

RESULTS

Across Switzerland, we estimate the MSM population aged 15-64 at roughly 80 000 men (95% CrI 64 000-96 000). (1) MSM in Switzerland were most concentrated in the five largest cities of Zurich, Geneva, Lausanne, Bern and Basel. (2) We estimate that in 2012, 6300 MSM, or 8.0%, were living with HIV, both diagnosed and undiagnosed and 1700 MSM, or 2.2%, had non-suppressed HIV infection. Between 2010 and 2013, average yearly rates of diagnosed HIV, HCV, syphilis and gonorrhoea were 0.3%, 0.02%, 0.4 % and 0.4 %, respectively.

CONCLUSIONS

Combining general population data, MSM online surveys and notification data allows the calculation of realistic estimates of local MSM populations and thus proportions of MSM with diagnosed HIV and other STIs, with implications for prevention planning, commissioning of health services and counselling MSM on HIV/STI risk. Our methodology for Switzerland is transferable to other countries with similar data sources.

Changing Trends in Substance Use and Sexual Risk Disparities among Sexual Minority Women as a Function of Sexual Identity, Behavior, and Attraction: Findings from the National Survey of Family Growth, 2002-2015

Components of sexual minority (SM) status-including lesbian or bisexual identity, having same-sex partners, or same-sex attraction-individually predict substance use and sexual risk behavior disparities among women. Few studies have measured differing associations by sexual orientation components (identity, behavior, and attraction), particularly over time. Data were drawn from the 2002-2015 National Survey of Family Growth female sample (n = 31,222). Multivariable logistic regression (adjusted for age, race/ethnicity, education, marital/cohabitation status, survey cycle, and population-weighted) compared past-year sexual risk behavior, binge drinking, drug use, and sexually transmitted infection treatment among sexual minority women (SMW) versus sexual majority women (SMJW) by each sexual orientation component separately and by all components combined, and tested for effect modification by survey cycle. In multivariable models, SM identity, behavior, and attraction individually predicted significantly greater odds of risk behaviors. SM identity became nonsignificant in final adjusted models with all three orientation components; non-monosexual attraction and behavior continued to predict significantly elevated odds of risk behaviors, remaining associated with sexual risk behavior and drug use over time (attenuated in some cases). Trends in disparities over time between SMW versus SMJW varied by sexual orientation indicator. In a shifting political and social context, research should include multidimensional sexual orientation constructs to accurately identify all SMW-especially those reporting non-monosexual behavior or attraction-and prioritize their health needs.