1
|
Metheny N, Mkhize SP, Scott D, Hatcher A. Violence Victimization and Depressive Symptoms Among a Sub-Sample of Sexual and Gender Minority Adults in a Population-Based South African Study. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:4699-4721. [PMID: 38654528 DOI: 10.1177/08862605241243348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Sexual and gender minority (SGM) adults in South Africa face high levels of violence and poor mental health outcomes. Interventions to prevent these negative health implications are hampered by a lack of representative data among this population. This study aims to quantify the associations between three forms of violent victimization and depressive symptoms in a sub-sample of SGM drawn from a population-based cross-sectional study in Gauteng, South Africa. Data come from the sixth Quality of Life survey conducted in South Africa's Gauteng province. Brief screeners assessed childhood sexual abuse (CSA), past-year intimate partner violence (IPV), non-partner violence, and depressive symptoms. Three survey-weighted logistic regression analyses were fit to model associations between elevated depressive symptoms and CSA, past-year IPV, and past-year non-partner violence, controlling for socio-demographics (age, race, sex, area of residence, education, socioeconomic status, and recent employment). N = 1,328 SGM respondents were included. Over 40% (n = 537) reported depressive symptoms, while 17% (n = 222) reported CSA, 5% (n = 67) reported IPV, and 16% (n = 208) reported non-partner violence. CSA and non-partner violence were associated with significantly higher odds of reporting depressive symptoms (aOR: 1.51, 95% CI [1.03, 2.23]; aOR: 1.84, [1.24, 2.73], respectively). IPV was not associated with elevated depressive symptoms (aOR: 1.17, [0.64, 2.16]). In all models, employment in the past 7 days was associated with significantly lower odds of reporting depressive symptoms. Recent and childhood violence is a major burden that is associated with elevated symptoms of depression among SGM in urban South Africa. Community-tailored interventions and policy-related advocacy related to employment and violence prevention may alleviate depressive symptoms in SGM adults in Gauteng.
Collapse
Affiliation(s)
| | - Sthembiso Pollen Mkhize
- University of Johannesburg, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - Abigail Hatcher
- University of the Witwatersrand, Johannesburg, South Africa
- University of North Carolina, Chapel Hill, USA
| |
Collapse
|
2
|
Gitelman J, Smith B, Warren CM, Andreacchi AT, Pabayo R, Hobin E. Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020. LGBT Health 2024. [PMID: 38968343 DOI: 10.1089/lgbt.2023.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024] Open
Abstract
Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.
Collapse
Affiliation(s)
- Julian Gitelman
- Public Health and Preventive Medicine Residency Program, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Brendan Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Christine M Warren
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | | | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| |
Collapse
|
3
|
Bonomo JA, Luo K, Ramallo JA. LGBTQ+ cardiovascular health equity: a brief review. Front Cardiovasc Med 2024; 11:1350603. [PMID: 38510198 PMCID: PMC10951381 DOI: 10.3389/fcvm.2024.1350603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. Data shows that social drivers of health (SDOH), including economic stability, racial/cultural identity, and community, have a significant impact on cardiovascular morbidity and mortality. LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and other gender and sexual minority) patients face a variety of unique health risk factors and bear a disproportionate burden of CVD compared to cis-gender, heterosexual peers. There is a paucity of research assessing the etiologies of CVD health disparities within the LGBTQ+ community. Herein, we seek to explore existing literature on LGBTQ+ health disparities with a focus on cardiovascular disease, examine trends impacting LGBTQ+ health equity, and identify strategies and interventions that aim to promote LGBTQ+ cardiovascular health equity on a regional and national level.
Collapse
Affiliation(s)
- Jason A. Bonomo
- Inova Scar Heart and Vascular, Inova Health System, Falls Church, VA, United States
| | - Kate Luo
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Jorge A. Ramallo
- Inova Pride Clinic, Inova Health System, Falls Church, VA, United States
| |
Collapse
|
4
|
Dyar C, Crosby S, Newcomb ME, Mustanski B, Kaysen D. Doomscrolling: Prospective associations between daily COVID news exposure, internalizing symptoms, and substance use among sexual and gender minority individuals assigned female at birth. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2024; 11:139-152. [PMID: 38737889 PMCID: PMC11081596 DOI: 10.1037/sgd0000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Cross-sectional studies have demonstrated associations between COVID news exposure, anxiety, and depression. However, longitudinal research examining the directionality of these associations is extremely limited. Further, most studies have focused on the general population and neglected sexual and gender minority individuals (SGM), a population disproportionately impacted by the pandemic. To address these limitations, the current study utilized data from a 30-day diary study of SGM assigned female at birth (N = 429). We examined concurrent and prospective associations between COVID news exposure, depressed and anxious affect, COVID distress, substance use, and motives for use. Further, we examined associations between cumulative COVID news exposure across the diary period and prospective changes in anxiety, depression, and COVID distress. When participants were exposed to more COVID news, they experienced more depressed and anxious affect, more COVID distress, less positive affect, and were more likely to use alcohol and cannabis to cope. Further, when participants were exposed to more COVID news, they experienced subsequent increases in depressed affect, decreases in positive affect, and increases in the likelihood of using cannabis to cope. Findings also provided evidence of bi-directional prospective associations between COVID news exposure and COVID distress and of a cumulative impact of COVID news exposure on anxiety, depression, and COVID distress. Findings suggest that individuals should balance the need to remain informed about the pandemic and their own mental health when considering how much COVID news to consume.
Collapse
Affiliation(s)
| | | | - Michael E. Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| |
Collapse
|
5
|
van Doornik SFW, Glashouwer KA, Ostafin BD, de Jong PJ. The Effects of a Meaning-Centered Intervention on Meaning in Life and Eating Disorder Symptoms in Undergraduate Women With High Weight and Shape Concerns: A Randomized Controlled Trial. Behav Ther 2024; 55:177-190. [PMID: 38216231 DOI: 10.1016/j.beth.2023.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/31/2023] [Accepted: 05/28/2023] [Indexed: 01/14/2024]
Abstract
Low meaning in life has been proposed as an important factor in the maintenance of eating disorders and previous findings suggest that targeting meaning might optimize treatment effectiveness. The current randomized controlled trial aimed to investigate the efficacy of meaning-centered psychotherapy adjusted for eating disorders (MCP-ED) to improve meaning in women with high weight and shape concerns. Female students with high weight and shape concerns (N = 134) were randomly assigned to the waiting-list control condition or the experimental condition, in which they followed six weekly individual sessions of MCP-ED. Self-report measures of meaning, eating disorder symptoms, general distress, psychological well-being, and satisfaction with meaningful life domains were completed at baseline, after the final session of MCP-ED or a 7-week waiting period, and at 4-week follow-up. Participants in the experimental condition showed a stronger increase in meaning than participants in the waiting-list condition after the intervention and at follow-up. The intervention also resulted in lower eating disorder symptoms and general distress, and higher psychological well-being and satisfaction with meaningful life domains. Findings support the efficacy of MCP-ED as an intervention to increase meaning and point to the relevance of examining whether adding MCP-ED to regular treatment might increase treatment effectiveness in individuals with eating disorders.
Collapse
|
6
|
Sucaldito AD, Tanner AE, Mann-Jackson L, Alonzo J, Garcia M, Chaffin JW, Faller R, McGuire T, Jibriel M, Mertus S, Kline DM, Russell L, Stafford J, Aviles LR, Weil PH, Wilkin AM, Rhodes SD. Exploring Individual and Contextual Factors Associated With Sexual Risk and Substance Use Among Underserved GBQMSM and Transgender and Nonbinary Persons in South Central Appalachia. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:495-506. [PMID: 38096454 PMCID: PMC11075819 DOI: 10.1521/aeap.2023.35.6.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Gay, bisexual, queer, and other men who have sex with men (GBQMSM) and transgender and nonbinary persons are at elevated risk for HIV, sexually transmitted infections (STIs), and hepatitis C (HCV); in Appalachia, these communities experience more disease burden. However, little is known about the factors influencing risk. Sixteen semistructured in-depth interviews were conducted examining factors influencing prevention and care. Data were analyzed using constant comparison methodology. Fifteen themes emerged within four domains: social environment (e.g., microaggressions across gender, sexual orientation, and racial identities), substance use (e.g., high prevalence, use as coping mechanism), sexual health (e.g., misinformation and denial of risk for HIV and STIs), and access to health care (e.g., cost and transportation barriers, lack of local respectful care). Findings highlighted salient barriers and assets influencing prevention and care and suggest that multilevel interventions are needed to improve access to and use of HIV, STI, and HCV prevention and care services.
Collapse
Affiliation(s)
- Ana D Sucaldito
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Amanda E Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - John W Chaffin
- Western North Carolina AIDS Project, Asheville, North Carolina
| | - Rachel Faller
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Tucker McGuire
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Mohammed Jibriel
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Sulianie Mertus
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - David M Kline
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Laurie Russell
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jeanette Stafford
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Lucero Refugio Aviles
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Peggy H Weil
- Western North Carolina AIDS Project, Asheville, North Carolina
| | - Aimee M Wilkin
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
7
|
López DJ, Yuan Y, Booth J, Wei K, Friedman MR. Discrimination and Rejection: The Effects of Ethnic and Sexuality-Based Discrimination Against Latino Gay and Bisexual Men. JOURNAL OF HOMOSEXUALITY 2023; 70:2828-2847. [PMID: 35801832 DOI: 10.1080/00918369.2022.2081105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Latino gay and bisexual men (GBM) may experience discrimination attributed to their sexual orientation and ethnicity, necessitating an examination of their experiences from an intersectional lens. While relationships between discrimination and the internalization of those messages have been previously researched, less is known about experiencing discrimination attributed to different identities and its relationships with discrete attributions of internalized stigma. Understanding how different attributes of identity-based discrimination are related to different attributes of identity-based internalization of stigma among gay and bisexual men of color may be important in the design of interventions to help Latino GBM cope with discrimination and prevent negative mental health outcomes. In order to achieve this aim, the current study utilized data from the Latino MSM Community Involvement: HIV Protective Effects Study, which included 571 self-identified Latino GBM. Results demonstrate that experiences of external anti-Latino discrimination were significantly linked to both internalized ethnicity- and sexuality-based stigma, whereas experiences of external sexuality-based discrimination were not significantly linked with internalized ethnicity- or sexuality-based stigma. Results suggest a need for future research to further examine effects of external ethnic discrimination on the psychosocial health of Latino GBM.
Collapse
Affiliation(s)
- Daniel Jacobson López
- School of Social Work, Boston University, Boston, Massachusetts, USA
- Yale University, School of Public Health, New Haven, CT, USA
| | - Yan Yuan
- School of Social Work, University of Pittsburgh, Pennsylvania, USA
| | - Jamie Booth
- School of Social Work, University of Pittsburgh, Pennsylvania, USA
| | - Kai Wei
- School of Social Work, University of Pittsburgh, Pennsylvania, USA
| | - M Reuel Friedman
- Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
8
|
Hughes M, Butchard S, Giebel C. The role of identity in the experiences of dementia care workers from a minority ethnic background during the COVID-19 pandemic: A qualitative study. Health Expect 2023; 26:1668-1678. [PMID: 37078475 PMCID: PMC10349238 DOI: 10.1111/hex.13772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Care home staff working during the COVID-19 pandemic experienced higher levels of stress and increased workloads. People from diverse ethnic backgrounds were disproportionately affected by the COVID-19 pandemic. This study explored the identity experiences of care home staff from diverse ethnic backgrounds in the context of working during the COVID-19 pandemic. METHODS Fourteen semistructured interviews were conducted between May 2021 and April 2022 with ethnic minority care home staff in England, who worked during the pandemic. Participants were recruited using convenience and theoretical sampling. Interviews were conducted via telephone or online platforms. A social constructivist grounded theory methodology was utilised in analysing the data. FINDINGS Participants described five key processes which facilitated or hindered the impact that their experiences had on their identity: dealing with uncertainty and transitioning into a COVID-19 world; difficult emotions; experiences of discrimination and racism; the response from the care home and societal systems; and the personal vs collective responsibility. When participants' physical and psychological needs went unmet by support structures within the care home and/or society, they experienced a sense of injustice, lack of control and being unvalued or discriminated against by others. CONCLUSIONS This study highlights the importance of recognising the unique needs of staff from diverse ethnic backgrounds working in care homes and adapting working practices to improve impact on identity, job satisfaction and staff retention. PATIENT AND PUBLIC INVOLVEMENT One care home worker was involved in developing the topic guide and helping to interpret the findings.
Collapse
Affiliation(s)
- Mishca Hughes
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
| | - Sarah Butchard
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
- Mersey Care NHS TrustLiverpoolUK
| | - Clarissa Giebel
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
| |
Collapse
|
9
|
Scheadler TR, Haus KR, Mobley TA, Mark KP. LGBTQ+ Grassroots Activism: An Opportunity for Resilience. JOURNAL OF HOMOSEXUALITY 2023; 70:1675-1700. [PMID: 35196213 DOI: 10.1080/00918369.2022.2040928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lesbian, gay, bisexual, transgender, queer, and other gender and sexual minority (LGBTQ+) individuals have a long history of mobilizing to raise awareness and initiate social and political change for LGBTQ+ related issues. The present study explored how grassroots activism impacted resilience among LGBTQ+ people. In-depth and semi-structured interviews were conducted with 15 LGBTQ+ activists from one statewide grassroots organization aiming to ban conversion therapy. Grounded theory analysis was used to identify a central theme and six interrelated subthemes. The central theme was that outness, activism, and resilience have cyclical relationships. Subthemes were related to identity exploration, affirmation, and synthesis; responsibility and humility; psychological skills; coping; social support; and negative experiences. These data may be helpful for LGBTQ+ grassroots activism and community leaders aiming to boost the resilience and strengthen well-being of their organization members.
Collapse
Affiliation(s)
| | - Katherine R Haus
- Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
| | | | - Kristen P Mark
- Department of Family Medicine & Community Health, University of Minnesota Medical School, Minnesota, Minneapolis, USA
| |
Collapse
|
10
|
Moore JX, Andrzejak SE, Casanova T, Langston ME, Estvold S, Adsul P. Investigating the Joint Effect of Allostatic Load among Lesbian, Gay, and Bisexual Adults with Risk of Cancer Mortality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6120. [PMID: 37372707 DOI: 10.3390/ijerph20126120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Sexual minorities (SM) have higher chronic physiologic stress as indicated by allostatic load (AL), which may be explained in part by consistent experiences of discriminatory practices. This is one of the first studies to examine the joint effects of SM status and AL on the association with long-term risk for cancer death. Retrospective analyses were conducted on 12,470 participants using National Health and Nutrition Examination Survey (NHANES) from years 2001 through 2010 linked with the National Death Index through December 31, 2019. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of cancer deaths between groups of SM (those reporting as gay, lesbian, bisexual, or having same-sex sexual partners) status and AL. SM adults living with high AL (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.55, 95% CI: 1.40-4.65) when compared to straight/heterosexual adults living with low AL (n = 6674). Among those living with high AL, SM (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.26, 95% CI: 1.33-3.84) when compared to straight/heterosexual adults with high AL (n = 4957). SM with high AL have an increased risk of cancer mortality. These findings highlight important implications for promoting a focused agenda on cancer prevention with strategies that reduce chronic stress for SM adults.
Collapse
Affiliation(s)
- Justin Xavier Moore
- Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Sydney Elizabeth Andrzejak
- Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
| | - Tracy Casanova
- Department of Psychiatry and Health Behavior, Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA
| | - Marvin E Langston
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 49305, USA
| | - Søren Estvold
- Department of Family Medicine, Augusta University, Augusta, GA 20912, USA
| | - Prajakta Adsul
- Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico, Albuquerque, NM 87131, USA
- Cancer Control and Population Sciences Research Program, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA
| |
Collapse
|
11
|
Jones RL, Jen S, Reiter B. "Courage to cobble something new": Women's queer and creative narratives of bisexuality and ageing. J Aging Stud 2023; 65:101133. [PMID: 37268378 DOI: 10.1016/j.jaging.2023.101133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/21/2023] [Indexed: 06/04/2023]
Abstract
Critical gerontologists have called for more diverse and inclusive visions of a good old age, and especially for imaginings that do not depend on health, wealth and heterosexuality. They have suggested that LGBTQ people, alongside other marginalized groups, may have particular contributions to make to the project of reimagining ageing. In this paper, we bring together this work with Jose Muñoz's concept of 'cruising utopia' to examine possibilities for imagining a more utopian, queer life course. We present findings from a narrative analysis of Bi Women Quarterly, a grassroots online bi community newsletter with an international readership, analyzing three issues published between 2014 and 2019 that focused on the intersection of ageing and bisexuality. We found several ways in which the authors told counter-narratives that queered normative visions of successful ageing. They queered norms around the stability and reification of sexual and gender identities. They challenged current forms of LGBTQ activism. They embraced and celebrated ageing, through such activities as croning ceremonies, and directly addressed and contemplated death. Finally, they queered the narrative form, by giving accounts of personal experience that were dreamlike, poetic or inconclusive. We conclude that counter-normative spaces, such as activist newsletters, offer valuable resources to progress the wider project of reimagining successful ageing more inclusively.
Collapse
Affiliation(s)
- Rebecca L Jones
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Walton Hall, Milton Keynes MK7 6AA, United Kingdom.
| | - Sarah Jen
- University of Kansas, School of Social Welfare, Twente Hall, Lawrence, KS 66044, USA
| | - Bea Reiter
- Emporia State University, School of Library and Information Management, Campus Box 4025, 1 Kellogg Circle, Emporia, KS 66801, USA
| |
Collapse
|
12
|
Arreola S, Santos GM, Solares D, Tohme J, Ayala G. Barriers to and enablers of the HIV services continuum among gay and bisexual men worldwide: Findings from the Global Men's Health and Rights Study. PLoS One 2023; 18:e0281578. [PMID: 37141206 PMCID: PMC10159196 DOI: 10.1371/journal.pone.0281578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 01/26/2023] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVES To assess ecological, structural, community and individual level correlates of health services utilization along a continuum of HIV care, and sexual health and support services among gay and bisexual men worldwide. METHODS Using a nonprobability internet sample of 6,135 gay and bisexual men, we assessed correlates of utilization of health services. Chi-Square Tests of Independence were performed to assess drop off along a continuum of HIV care. Multivariable logistic regression analyses using generalized estimating equation models were conducted adjusting for geographic region and clustering by country. In multivariable analyses, we determined the association between utilization outcomes, and ecologic, structural, community and individual correlates by fitting separate generalized estimating equation (GEE) logistic regression models for each of the outcomes, fitted with robust SEs, and accounting for clustering by country. Stratified by sexual identity, analyses adjusted for variables that could influence HIV-related health outcomes including racial/ethnic minority status, participant age, insurance, ability to make ends meet, as well as country-level income (income of country of residence defined by the World Bank). RESULTS Among men living with HIV (n = 1001), being in HIV care (n = 867) was associated with being on ART (X2 = 191.17, p < .001), and viral load suppression (X2 = 14.03, p < .001); and using ART (n = 840) was associated viral load suppression (X2 = 21.66, p < .001). Overall, the pattern of utilization outcomes were similar for both gay and bisexual men. For example, utilization of PrEP, being in HIV care and utilization of most of the sexual health and support services were negatively associated with sexual stigma. Whereas, utilization of most HIV prevention, and sexual health and support services were positively associated with provider discrimination. Utilization of all HIV prevention and all sexual health services were positively associated with greater community engagement, and receiving services from LGBT-led organizations. Bisexual men had higher odds of reporting provider discrimination when utilizing condom services (gay: AOR = 1.14, [0.95-1.36]; bisexual: 1.58, [1.10-2.28]), PrEP (gay: AOR = 1.06, [0.77-1.45]; bisexual: AOR = 2.14, [1.18-3.89], mental health services (gay: AOR = 1.03, [0.86-1.23]; bisexual: AOR = 1.32, [1.07-1.64]), and community-based support (gay: AOR = 1.23, [1.05-1.45]; bisexual: AOR = 1.49, [1.14-1.93]) than gay men. Bisexual men also reported higher odds of accessing services from LGBT-led organizations when utilizing PrEP (gay: AOR = 5.26, [2.50-11.05]; bisexual: AOR = 7.12, [3.16-16.04]), and community-based support/self-help groups/individual counseling (gay: AOR = 2.63, [1.72-4.01]; bisexual: AOR = 3.35, [2.30-4.88]. CONCLUSIONS It is essential that barriers to health services utilization be addressed at structural and community levels. Structural interventions should be designed to reduce sexual stigma, as well as train and sensitize healthcare providers; and strengthen community level interventions that bring gay and bisexual men together to lead comprehensive health services.
Collapse
Affiliation(s)
- Sonya Arreola
- Division of Prevention Science, University of California, San Francisco, San Francisco, California, United States of America
- Arreola Research, San Francisco, California, United States of America
| | - Glenn-Milo Santos
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, California, United States of America
- School of Nursing, University of California San Francisco, San Francisco, California, United States of America
| | - Diego Solares
- Consultant for MPact Global Action, Auckland, New Zealand
| | - Johnny Tohme
- MPact, Oakland, California, United States of America
| | - George Ayala
- Alameda County Department of Public Health, Oakland, California, United States of America
| |
Collapse
|
13
|
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) populations experience significant health disparities, theorized to result from LGBT specific minority stressors. The fully conceptualized Minority Stress Model was published more than 15 years ago. Minority stressors include external conditions and events, such as discrimination and victimization. Internal minority stressors include expectations of rejection and discrimination, concealment of minority identity, and internalizations of negative dominant cultural attitudes, beliefs, stereotypes, and values. Connection to sexual and gender minority communities is theorized to moderate the effects of minority stressors. In this integrative review, I examine two decades of research on minority stress. Based on this review, I highlight strengths and limitations of the model, and suggest next steps for moving minority stress research forward.
Collapse
|
14
|
Górska P, Stefaniak A, Matera J, Marchlewska M. The different effects of collective narcissism and secure ingroup identity on collective action and life satisfaction among LGBTQ+ individuals. GROUP PROCESSES & INTERGROUP RELATIONS 2023. [DOI: 10.1177/13684302221147125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
Abstract
For LGBTQ+ community members, one way to cope with the discrimination they experience is through a stronger ingroup identity. However, not all types of ingroup identity may be equally beneficial to LGBTQ+ individuals. A longitudinal ( N = 1,044) and a cross-sectional ( N = 8,464) study among LGBTQ+ people in Poland demonstrated that collective narcissism was a positive predictor of group-based anger (Study 2) and had a positive reciprocal relationship with group relative deprivation (GRD; Study 1), however, it was negatively related to life satisfaction and exhibited a stronger positive link with nonnormative than normative collective action. Secure LGBTQ+ identification was not longitudinally predicted by GRD (Study 1) and showed a weaker positive association with group-based anger (Study 2). It had a reciprocal positive relationship with life satisfaction and was a stronger predictor of normative than nonnormative collective action. These results show that whereas secure ingroup identity is a clearly positive coping mechanism, the effects of collective narcissism are mixed.
Collapse
Affiliation(s)
- Paulina Górska
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Anna Stefaniak
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Joanna Matera
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | | |
Collapse
|
15
|
Lam J, Campbell A. Trajectories of Loneliness Among Older Women and Men: Variation by Sexual Identity? THE GERONTOLOGIST 2023; 63:328-337. [PMID: 35452512 PMCID: PMC9960021 DOI: 10.1093/geront/gnac058] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study is to contribute to the literature on variation in later-life outcomes by sexual identity. Drawing on the Iridescent Life Course framework, we examined differences in loneliness trajectories, and tested the roles of social connectedness and support, and socioeconomic and health statuses in explaining any observed disparities. RESEARCH DESIGN AND METHODS Using growth models, we analyzed 19 years of data (2001-2019) from adults aged 50 years and older from the Household, Income and Labour Dynamics in Australia Survey (n = 5,500 individuals), where a question on sexual identity was asked twice in the study. RESULTS One percent of our sample reported a change in their sexual identity, which we grouped with individuals who reported as bisexual. Our sample comprised of 45.3% heterosexual men, 52.2% heterosexual women, 0.6% gay men, 0.6% lesbian women, 0.6% bisexual-plus men, and 0.6% bisexual-plus women. We found bisexual-plus men were vulnerable to loneliness as they aged. This group had the highest levels of loneliness at age 50, and differences compared with heterosexual men persisted over time. Loneliness of bisexual-plus men increased steeply from age 70. Socioeconomic and health statuses did not explain the increased loneliness of older bisexual-plus men. Lower social support and connectedness partly accounted for these disparities. DISCUSSION AND IMPLICATIONS Findings are discussed with regards to existing research and theories on social disadvantage and resilience over the life course. We expand knowledge on factors explaining loneliness and how it varies in women and men by sexual identity.
Collapse
Affiliation(s)
- Jack Lam
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia.,Australian Research Council of Excellence on Children and Families over the Life Course, Brisbane, Queensland, Australia
| | - Alice Campbell
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia.,Australian Research Council of Excellence on Children and Families over the Life Course, Brisbane, Queensland, Australia
| |
Collapse
|
16
|
Vázquez I, Gato J, Coimbra S, Tasker F, Barrientos J, Miscioscia M, Cerqueira-Santos E, Malmquist A, Seabra D, Leal D, Houghton M, Poli M, Gubello A, Ramos MDM, Guzmán-González M, Urzúa A, Ulloa F, Wurm M. Psychological Adjustment Profiles of LGBTQ+ Young Adults Residing with Their Parents during the COVID-19 Pandemic: An International Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3188. [PMID: 36833881 PMCID: PMC9964666 DOI: 10.3390/ijerph20043188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has been associated with poor mental health symptoms, particularly among vulnerable populations such as LGBTQ+ individuals. In the present study, we aimed to (i) identify different psychological adjustment profiles among LGBTQ+ young adults during the COVID-19 pandemic and compare LGBTQ+ young adults in relation to (ii) sociodemographic characteristics and COVID-19-related experiences and (iii) the internal and external protective resources associated with each adjustment profile. An online questionnaire was administered to 1699 LGBTQ+ young adults from six countries (Brazil, Chile, Italy, Portugal, Sweden, and the UK). A cluster analysis was conducted, and four profiles of psychological adjustment were identified: unchallenged, resilient, distressed, and at-risk. The at-risk cluster scored lowest in social support (particularly from family). The profiles of participants who experienced the highest levels of pandemic adversity (at-risk and resilient) comprised mostly South American participants, those under lockdown at the time of survey completion, those who self-identified as transgender and non-binary, and those with a plurisexual sexual orientation. Interventions should consider strategies to help young adults maintain support systems and reinforce the value of positive family relationships. Specific groups within the LGBTQ+ community that seem to be in a particularly vulnerable situation may need additional tailored support.
Collapse
Affiliation(s)
- Inês Vázquez
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
| | - Jorge Gato
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Centre for Psychology, University of Porto, 4200-135 Porto, Portugal
| | - Susana Coimbra
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Centre for Psychology, University of Porto, 4200-135 Porto, Portugal
| | - Fiona Tasker
- Department of Psychological Sciences, Birkbeck, University of London, London WC1E 7HX, UK
| | - Jaime Barrientos
- Faculty of Psychology, University Alberto Hurtado, Santiago 6500620, Chile
| | - Marina Miscioscia
- Department of Women’s and Children’s Health, University of Padua, 35122 Padua, Italy
- Department of Developmental Psychology and Socialization, University of Padua, 35122 Padua, Italy
| | | | - Anna Malmquist
- Division of Psychology, Linköping University, 581 83 Linköping, Sweden
| | - Daniel Seabra
- Center for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC), University of Coimbra, 3000-115 Coimbra, Portugal
| | - Daniela Leal
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
| | - Marie Houghton
- Department of Psychological Sciences, Birkbeck, University of London, London WC1E 7HX, UK
| | - Mikael Poli
- Department of Developmental Psychology and Socialization, University of Padua, 35122 Padua, Italy
| | - Alessio Gubello
- Department of Women’s and Children’s Health, University of Padua, 35122 Padua, Italy
- Department of Developmental and Family Psychology, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | | | | | - Alfonzo Urzúa
- School of Psychology, Universidad Católica del Norte, Antofagasta 0610, Chile
| | - Francisco Ulloa
- MUMS—Movimiento por la Diversidad Sexual, Santiago 578, Chile
| | - Matilda Wurm
- School of Behavioral, Social and Legal Sciences, Örebro University, 702 81 Örebro, Sweden
| |
Collapse
|
17
|
Edwards OW, Lev E, Obedin-Maliver J, Lunn MR, Lubensky ME, Capriotti MR, Garrett-Walker JJ, Flentje A. Our pride, our joy: An intersectional constructivist grounded theory analysis of resources that promote resilience in SGM communities. PLoS One 2023; 18:e0280787. [PMID: 36735687 PMCID: PMC9897522 DOI: 10.1371/journal.pone.0280787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 12/20/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Sexual and gender minority (SGM) communities, including lesbian, gay, bisexual, transgender, queer, intersex, asexual, and Two-Spirit people, have historically been researched from a deficits-based approach that fails to highlight the ways communities survive and thrive in the face of adversity. This study endeavored to create a model of resources that promote SGM resilience using a sample that amplified traditionally underrepresented perspectives, including individuals from racial and/or ethnic minority groups, trans and/or gender diverse individuals, individuals on the asexual spectrum, and older adults. METHODS Participant responses to three open-ended questions from The PRIDE Study's (an online national longitudinal cohort study of SGM people) 2018 Annual Questionnaire were analyzed using constructivist grounded theory. These questions examined what brings people joy and what they appreciate most about their SGM identity. Participants (n = 315) were randomly selected from a larger sample of people who had responded to demographic questions and at least one open-ended question (N = 4,030) in a manner to ensure diverse representation across race/ethnicity, gender identity, sexual orientation, age, and region of residence. RESULTS The proposed model includes social resources (Connecting with Others, Cultivating Family, Helping Others, Participating in Culture and Spirituality), affective generative resources (Engaging in Enriching Pursuits, Accessing Economic Resources), and introspective resources (Exploring One's Authentic Self, Persevering through Hardship) that are theorized to contribute to SGM resilience across the life course. CONCLUSIONS SGM communities may tap into various resources to promote resilience. As public health practitioners, we can help to foster this resilience by resourcing and supporting initiatives that foster social connection, create spaces for community members to engage with various types of enrichment, facilitate access to economic resources, and provide support and inclusion for all SGM community members.
Collapse
Affiliation(s)
- O. Winslow Edwards
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, United States of America
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Eliot Lev
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, United States of America
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, United States of America
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, United States of America
| | - Mitchell R. Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Micah E. Lubensky
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, United States of America
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, United States of America
| | - Matthew R. Capriotti
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, United States of America
- Psychology Department, San Jose State University, San Jose, California, United States of America
| | - J. J. Garrett-Walker
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Annesa Flentje
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California, United States of America
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Psychiatry, Alliance Health Project, School of Medicine, University of California, San Francisco, California, United States of America
| |
Collapse
|
18
|
Budenz A, Gaber J, Crankshaw E, Malterud A, Peterson EB, Wagner DE, Sanders EC. Discrimination, identity connectedness and tobacco use in a sample of sexual and gender minority young adults. Tob Control 2022:tc-2022-057451. [PMID: 36601779 DOI: 10.1136/tc-2022-057451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Studies show that tobacco use among sexual and gender minority (SGM) populations is disproportionately higher than heterosexual or cisgender populations. However, few studies have examined tobacco use among SGM subgroups by race/ethnicity or associations between SGM-specific discrimination and connection to SGM identity and tobacco use. METHODS This study analysed survey data from 11 313 SGM (gay, lesbian, bisexual, other sexual minority or gender minority) young adults in the USA and reported current cigarette, e-cigarette, other tobacco (cigar, smokeless tobacco, hookah) and polytobacco use. We used multinomial logistic regression to estimate associations between (a) SGM subgroup, race/ethnicity, SGM-specific discrimination and SGM identity connection and (b) each tobacco use outcome (vs never use of tobacco). We conducted postestimation testing to assess predicted probabilities of tobacco use against the sample average. RESULTS Lesbian females (particularly black lesbian females) had higher-than-average probability of polytobacco use. White bisexual and lesbian participants had higher-than-average probability of cigarette and e-cigarette use, respectively. Higher levels of discrimination were associated with polytobacco use. Higher levels of identity connectedness were protective against certain tobacco use behaviours among gender minority participants and participants with high levels of discrimination experience. CONCLUSIONS We found variations in tobacco use by SGM subgroups overall and by race/ethnicity. Discrimination may be a risk factor for certain tobacco use behaviours. However, SGM identity connectedness may be protective against tobacco use among gender minority individuals and individuals experiencing SGM-specific discrimination. These findings can inform targeted approaches to reach SGM subgroups at greater risk of tobacco use.
Collapse
Affiliation(s)
- Alex Budenz
- Center for Tobacco Products, Office of Health Communication and Education, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Jennifer Gaber
- Center for Health Analytics, Media and Policy, RTI International, Durham, NC, USA
| | - Erik Crankshaw
- Center for Health Analytics, Media and Policy, RTI International, Durham, NC, USA
| | - Andie Malterud
- Center for Tobacco Products, Office of Health Communication and Education, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Emily B Peterson
- Center for Tobacco Products, Office of Health Communication and Education, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Dana E Wagner
- Research Department, Rescue Agency, San Diego, CA, USA
| | - Emily C Sanders
- Center for Tobacco Products, Office of Health Communication and Education, U.S. Food and Drug Administration, Silver Spring, MD, USA
| |
Collapse
|
19
|
Cannas Aghedu F, Blais M, Philibert M, Côté I, Samoilenko M, Chamberland L. Social resource patterns and health outcomes among Canadian LGBTQ2+ adults: A latent class analysis. Soc Sci Med 2022; 314:115476. [PMID: 36327629 DOI: 10.1016/j.socscimed.2022.115476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 08/18/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Decades of research have shown a strong association between wellbeing, health, and social resources. LGBTQ2+ communities are among those who historically have been excluded from accessing quality social resources. However, little is known about how access to different types of resources influences mental health and wellbeing. METHOD Data were drawn from an online sample of 3890 LGBTQ2+ people aged 18 years and older in Quebec, Canada. We identified key social resource patterns (from family of origin, friends, partner, neighbourhood, and LGBTQ2+ community) and investigated differences in socio-demographic and health outcomes across classes. RESULTS A five-class solution best fitted the data, highlighting distinctive patterns in access to five key social resources: moderate friend support access (42.14%), overall high support access (23.51%), high friend support access (18.06%), only close ties support access (10.90%) and overall low support access (5.39%). Marginalized groups (trans and non-binary people, racialized or disabled people, immigrants) were less likely to access diverse, high-quality social resources. Accessing diverse social resources, particularly close ties (e.g., family of origin), was associated with better health outcomes. In the absence of close ties, having at least one other social resource was associated with better health outcomes compared to having limited access to all resources. CONCLUSIONS We found a major imbalance in social resource access among LGBTQ2+ people. Creating safe spaces for LGBTQ2+ people and ensuring access to high-quality social resources is important in sustaining their health and wellbeing.
Collapse
Affiliation(s)
- Fabio Cannas Aghedu
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada.
| | - Martin Blais
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada; Département de Sexologie, Université Du Québec à Montréal, Canada
| | | | - Isabel Côté
- Département de Travail Social, Chaire de Recherche Du Canada sur La Procréation pour Autrui et Les Liens Familiaux, Université Du Québec en Outaouais, Québec, Canada
| | - Mariia Samoilenko
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada
| | - Line Chamberland
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada; Département de Sexologie, Université Du Québec à Montréal, Canada
| |
Collapse
|
20
|
Kamen CS, Reichelt M, Dadgostar P, Alpert AB, Doucette C, Vaughan P, Keuroghlian AS, Yousefi-Nooraie R. Sexual and gender minority cultural humility training for oncology settings: An example of iterative adaptation and implementation. FRONTIERS IN HEALTH SERVICES 2022; 2:958274. [PMID: 36925900 PMCID: PMC10012625 DOI: 10.3389/frhs.2022.958274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022]
Abstract
Background Multiple national organizations recommend that cancer care providers and oncology practices be responsive to the needs of sexual and gender minority (SGM) patients. Oncology practices have attempted to incorporate this recommendation through SGM-focused cultural humility training interventions. It is unclear how best to adapt and implement such training across practices. This manuscript outlines one process for adapting a widely-used SGM training from The Fenway Institute to the context of oncology settings using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) model. Methods We conducted training sessions in two oncology care settings: a breast oncology center and a radiation oncology department. Subsequently, we conducted in-depth interviews with the three trainers involved in adapting The Fenway Institute's training to these two practices. Two independent investigators coded the interviews using components of the FRAME model as an analytic guide. Results Training team members described the mechanisms by which FRAME adaption occurred both proactively and reactively; the importance of involving SGM-identified trainers of diverse backgrounds as well as champions from within oncology practices in which trainings were conducted; the importance of adapting both the context and content of training to be relevant to oncology audiences; and the ways in which fidelity to the core principles of improving health care for SGM patients was maintained throughout the process. Discussion SGM cultural humility training for oncology providers and staff must undergo iterative adaptation to address the political and social context of specific practice environments and advocate for broader institutional culture change to achieve responsiveness to SGM health needs.
Collapse
Affiliation(s)
| | | | | | - Ash B. Alpert
- Brown University School of Public Health, Providence, RI, United States
| | | | | | | | | |
Collapse
|
21
|
Plant K, Connell A, Hosking W, Lyons A. Internalized Homonegativity and Mental Health Among Chinese Gay and Bisexual Cisgender Men: Exploring the Moderating Influences of Psychosocial and Sexual Identity Factors. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3541-3556. [PMID: 35999423 DOI: 10.1007/s10508-022-02314-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 06/15/2023]
Abstract
Much research on Chinese gay and bisexual men has focused on sexual health and, in particular, HIV-related issues. However, relatively little research has considered psychosocial aspects of being a gay or bisexual man in China. The present study was designed to address this gap by examining psychosocial predictors of mental health from a minority stress perspective. Results from an online survey of 1,786 Chinese gay and bisexual cisgender men revealed that higher levels of internalized homonegativity predicted greater psychological distress and a lower sense of positive well-being. Higher self-esteem, social support, and resilience were strong predictors of lower psychological distress and higher well-being, but these psychosocial factors mostly did not moderate associations between internalized homonegativity and mental health. A stronger sense of sexual identity superiority weakened the associations between internalized homonegativity and both mental health measures, but sexual identity centrality only moderated the association between internalized homonegativity and positive well-being. This study is among the first to examine minority stressors and psychosocial factors, distinct from the HIV-focussed literature, in a Chinese context. These findings may inform interventions targeting increased self-esteem, social support, and resilience, which could be beneficial for the mental health of Chinese gay and bisexual cisgender men.
Collapse
Affiliation(s)
- Kylie Plant
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC, 8001, Australia
| | - Aneira Connell
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC, 8001, Australia
| | - Warwick Hosking
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC, 8001, Australia.
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| |
Collapse
|
22
|
Maiolatesi AJ, Wang K, Burton CL, Harkness A, Esserman DA, Safren SA, Pachankis JE. Rejection Sensitivity and Sexual Minority Men's Social Anxiety Disorder: The Moderating Role of Sexual Identity Strength. SELF AND IDENTITY 2022; 22:563-591. [PMID: 37346170 PMCID: PMC10281756 DOI: 10.1080/15298868.2022.2125062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/09/2022] [Indexed: 10/14/2022]
Abstract
Although gay-related rejection sensitivity (RS) is associated with social anxiety among sexual minority men, little attention has been given to the validity of gay-related RS measures and to individual differences that might moderate the association between gay-related RS and social anxiety. In a population-based sample of sexual minority men, Study 1 (N = 114) investigated the incremental validity of gay-related RS and showed that gay-related RS scores significantly added to the prediction of social anxiety symptoms, even after controlling for personal RS scores. In a clinical sample of sexual minority men, Study 2 (N = 254) examined interrelationships among gay-related RS, sexual identity strength, and current social anxiety symptoms and disorder diagnosis. Results revealed that the expected count of current social anxiety symptoms and the odds of social anxiety disorder diagnosis, as assessed with a structured diagnostic interview, increased as a function of gay-related RS scores. Sexual identity strength moderated these relationships, such that the associations between gay-related RS scores and interviewer-assessed social anxiety symptoms and disorder were only significant for those high, but not low, in sexual identity strength. Together, results from the present studies lend support to the incremental validity of gay-related RS scales in predicting social anxiety symptoms and suggest that sexual minority men who consider their sexual orientation to be self-defining might be particularly vulnerable to the mental health correlates of gay-related RS.
Collapse
Affiliation(s)
- Anthony J Maiolatesi
- Department of Social and Behavioral Sciences, Yale School of Public Health
- Department of Psychology, Yale University
| | - Katie Wang
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | - Charles L Burton
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | - Audrey Harkness
- Department of Public Health Sciences, Miller School of Medicine, University of Miami
| | - Denise A Esserman
- Department of Biostatistics, Yale University School of Public Health
| | | | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health
- Department of Psychology, Yale University
| |
Collapse
|
23
|
Gómez F, Cumsille P, Barrientos J. Mental Health and Life Satisfaction on Chilean Gay Men and Lesbian Women: The Role of Perceived Sexual Stigma, Internalized Homophobia, and Community Connectedness. JOURNAL OF HOMOSEXUALITY 2022; 69:1777-1799. [PMID: 34080955 DOI: 10.1080/00918369.2021.1923278] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Minority Stress Model has proposed that connectedness to a specific minority community may be a protective factor for stigmatized groups. This study evaluated the mediational role of connectedness with the gay men's and lesbian women's community on the relationship between two minority stressors (internalized homophobia and perceived sexual stigma) with anxiety-depressive symptomatology and life satisfaction. The sample consisted of 467 Chilean self-identified as gay men (57%) and lesbian women (43%). Results revealed that the two minority stressors were associated with anxiety-depressive symptomatology, but only internalized homophobia was associated with life satisfaction. The mediation hypothesis was partially supported by the relationship between internalized homophobia and life satisfaction. Unexpectedly, we found a negative association between connectedness with the gay men's and lesbian women's community and life satisfaction. This finding introduces a view that contrasts with the literature, which proposes that connectedness with the specific community would be a protective factor against sexual stigma.
Collapse
Affiliation(s)
- Fabiola Gómez
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricio Cumsille
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Barrientos
- Facultad de Psicología, Universidad Alberto Hurtado, Santiago, Chile
| |
Collapse
|
24
|
Antebi-Gruszka N, Friedman AA, Balsam KF. Multiple forms of discrimination, mental distress, and well-being among lesbian, gay, bisexual, and queer individuals: The role of brooding. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2089425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Nadav Antebi-Gruszka
- Department of Psychology, Columbia University, New York, New York, USA
- Heartspace Therapy (Private Practice), New York, New York, USA
| | - Ariel A. Friedman
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Kimberly F. Balsam
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| |
Collapse
|
25
|
Brennan DJ, Kesler MA, Davies AWJ, Ablona A, Collict D. Online Sexual Health Information Seeking Patterns Differentiated by Social Location and Physical Location among Gay and Bisexual Men in Ontario, Canada. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:627-643. [PMID: 38596392 PMCID: PMC10903633 DOI: 10.1080/19317611.2022.2091076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 04/11/2024]
Abstract
Objective This research aimed to understand the varying needs of diverse gay and bisexual men (GBM) in relation to online sexual health information-seeking dependent upon differing social sociodemographic variables and geographic location. Methods A total of 1802 GBM in Ontario participated in this study. Multivariable regressions were conducted to analyze differences in information-seeking based on ethnicity group, HIV status, recent sexual behavior and regionality (urban and rural location). Results There were significant differences in online sexual health information-seeking content based on these demographic variables. Conclusions Implications for sexual health outreach and service provision for diverse GBM are discussed as well.
Collapse
Affiliation(s)
- David J. Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Maya A. Kesler
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Adam W. J. Davies
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Aidan Ablona
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - David Collict
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| |
Collapse
|
26
|
A call for ACTion: A systematic review of empirical evidence for the use of Acceptance and Commitment Therapy (ACT) with LGBTQI+ individuals. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
27
|
Mernitz S, Perez J, Frost DM, Russell ST. Relationship Identities Among Lesbian, Gay, and Bisexual Adults: An Exploratory Study. COUPLE & FAMILY PSYCHOLOGY 2022; 11:89-101. [PMID: 36089940 PMCID: PMC9451025 DOI: 10.1037/cfp0000202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Relationship identities are established through romantic interactions and informed by sociohistorical context. The associations between lesbian, gay, and bisexual (LGB) identities and identities in other domains, including relationship identities, have yet to receive sufficient attention from researchers. In this exploratory study, through a qualitative analysis of life-history interviews from the Generations Study, we identified participants who described their identity in terms of a romantic relationship (e.g., partner, husband/wife). In describing their relationship identities, two themes emerged: (a) negotiation of a relationship identity with other identities, such as gender or race/ethnicity and (b) navigating being visible or invisible within the LGB community and/or at the societal level. Together these themes suggest that relationships may be salient components of personal identity when sexual minority individuals in a couple either individually or jointly feel that they stand out (or that they become invisible).
Collapse
Affiliation(s)
- Sara Mernitz
- Population Research Center, The University of Texas at Austin
| | - Jessica Perez
- Human Development and Family Sciences, The University of Texas at Austin
| | | | - Stephen T. Russell
- Human Development and Family Sciences, The University of Texas at Austin
| |
Collapse
|
28
|
Thorpe S, Malone N, Hargons CN. Black sexual minority women's social well-being and psychological distress. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2022; 92:505-515. [PMID: 35511548 PMCID: PMC9977194 DOI: 10.1037/ort0000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Black sexual minority women (SMW), the largest racial group among the sexual minority community, often report high psychological distress and decreased psychological health and social well-being. Strong, positive, social relationships positive within group identities, and support networks are a key component in coping with minority stressors and promoting overall well-being. This study explored the association between minority stressors, social support, and Black SMW's social well-being and psychological distress. Participants consisted of individuals identifying as Black (including biracial identities, n = 48) cisgender women (N = 149) who responded to the Generations Study's initial round of surveys collected in 2016-2017. Participants were between the ages of 18-60, with a mean of 29.3 years old. Descriptive and bivariate correlations were conducted for lesbian, gay, and bisexual (LGB) stigma, internalized homophobia, gender presentation, ethnic identity affiliation, LGB community connectedness, and social support. Multiple regression models were conducted to analyze correlates of social well-being and psychological distress, controlling for age and education level. LGB stigma and internalized homophobia were significant predictors of social well-being and psychological distress. Low internalized homophobia, distress, and stigma were associated with higher social well-being as were high connection to LGB and ethnic communities. Implications for therapy are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Shemeka Thorpe
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | - Natalie Malone
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | - Candice N. Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| |
Collapse
|
29
|
Frost DM, Meyer IH, Lin A, Wilson BDM, Lightfoot M, Russell ST, Hammack PL. Social Change and the Health of Sexual Minority Individuals: Do the Effects of Minority Stress and Community Connectedness Vary by Age Cohort? ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2299-2316. [PMID: 35411489 PMCID: PMC9192485 DOI: 10.1007/s10508-022-02288-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This study examined the extent to which social stress stemming from a stigmatized social status (i.e., minority stress) was associated with three domains of health in younger as compared with older age cohorts of sexual minority individuals. Data were analyzed from the Generations Study, a longitudinal study using a probability sample (N = 1518) of age cohorts of sexual minority individuals in the USA. Exposure to a variety of minority stressors was associated with poorer health for all age cohorts. We hypothesized that because of improved social and legal environments in recent years, the associations between minority stress and health would be diminished in the younger cohort. As expected, we found that the associations between some minority stressors and health outcomes were diminished in the younger cohort compared to older cohorts. Positive associations between community connectedness and mental health and social well-being were observed for all participants but were attenuated in the younger cohort. Findings demonstrate the continuing negative association between minority stress and health among sexual minorities, which, despite some attenuation, persists even for young cohorts of sexual minority individuals in a more equal and accepting social climate.
Collapse
Affiliation(s)
- David M Frost
- Social Research Institute, University College London, 27-28 Woburn Square, London, WC1H 0AA, UK.
| | - Ilan H Meyer
- The Williams Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andy Lin
- The Williams Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bianca D M Wilson
- The Williams Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marguerita Lightfoot
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Phillip L Hammack
- Psychology Department, University of California, Santa Cruz, Santa Cruz, CA, USA
| |
Collapse
|
30
|
de Barros AC, Morrison TG. Development and validation of the Positive Bisexual Identity (PBI) scale. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2057868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Todd G. Morrison
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
31
|
Wang AY, Feinstein BA. The perks of being bi+: Positive sexual orientation-related experiences among bisexual, pansexual, and queer male youth. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2022; 9:58-70. [PMID: 35755165 PMCID: PMC9231256 DOI: 10.1037/sgd0000459] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous research on sexual minority health has largely focused on negative experiences related to one's sexual orientation with limited attention to the ways in which being a sexual minority can contribute to positive experiences. This is especially true of bisexual, pansexual, and queer (bi+) male youth, whose experiences have not been represented in the literature. To address these gaps, the goal of the current study was to characterize positive experiences related to one's sexual orientation in a sample of 46 bi+ male youth (ages 14-17) who were interviewed as part of a larger study. Interviews were transcribed and thematically analyzed. Almost all of the participants described at least one positive experience related to their bi+ identity. The positive experiences fell into six categories: (1) experiences with LGBTQ+ people in general; (2) experiences with other bi+ people; (3) experiences in LGBTQ+ environments; (4) experiences disclosing bi+ identities; (5) romantic and sexual experiences; and (6) experiences with allies. Participants described eight reasons for these experiences being positive: (1) feeling a sense of belonging in a community; (2) the normalization, acceptance, and visibility of one's identity or community; (3) providing or receiving support; (4) discussing shared experiences; (5) the promotion of authenticity; (6) celebrating one's identity or community; (7) experiencing personal growth; and (8) not feeling limited by gender when it came to romantic and sexual experiences. In sum, bi+ male youth report a range of positive experiences related to their sexual orientation, which may have important implications for promoting resilience and wellbeing.
Collapse
Affiliation(s)
| | - Brian A. Feinstein
- Depatment of Psychology, Rosalind Franklin University of Medicine and Science
| |
Collapse
|
32
|
Mi T, Lan G, Yang X, Li X, Qiao S, Shen Z, Zhou Y. HIV-Related Stigma, Sexual Identity, and Depressive Symptoms Among MSM Living With HIV in China: A Moderated Mediation Modeling Analysis. Am J Mens Health 2022; 16:15579883221087531. [PMID: 35343811 PMCID: PMC8966094 DOI: 10.1177/15579883221087531] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate analysis, and path analysis were applied to examine our hypotheses. Bivariate analysis demonstrated that participants who self-identified as gay reported a lower level of HIV-related stigma and depression. Path analysis revealed an insignificant direct effect of identifying as gay on depression. Yet, the indirect pathway was significant, with identifying as gay being associated with a lower level of HIV stigma and thus a lower level of depression. This indirect effect was moderated by age. The conditional indirect effect was significant in the younger group yet ceased in the older group. The study provided information to better understand the effect of sexual identity on mental health among stigmatized sexual and gender minorities by highlighting the mediating effect of HIV-related stigma and the protective effect of age. Interventions targeting mental health of MSM living with HIV might consider placing greater emphasis on addressing HIV-related stigma among younger MSM.
Collapse
Affiliation(s)
- Tianyue Mi
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Guanghua Lan
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Xueying Yang
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, China
| |
Collapse
|
33
|
Kittle KR, Boerner K, Kim K, Fredriksen-Goldsen KI. Social Resource Variations Among LGBT Middle-Aged and Older Adults: The Intersections of Sociodemographic Characteristics. THE GERONTOLOGIST 2022; 62:1324-1335. [PMID: 35106592 PMCID: PMC9579464 DOI: 10.1093/geront/gnac021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Understanding the influence of social resources on health is crucial in gerontological research. However, access to social resources may differ by one's particular lesbian, gay, bisexual, and transgender (LGBT) identity and the intersection of LGBT identity with other sociodemographic characteristics, including age. RESEARCH DESIGN AND METHODS Using 2010 data from Caring and Aging With Pride (N = 2,536), this study examined how access to social resources varied by LGBT identity and whether the effect of LGBT identity was modified by additional sociodemographic characteristics among LGBT adults aged 50-95 years. RESULTS Lesbian respondents had larger social networks than gay male respondents, and gay male respondents had smaller networks than transgender respondents. Lesbian respondents reported more social support and community belonging than other identity groups. Bisexual male respondents and transgender respondents had less support than gay male respondents, and bisexual male respondents reported less community belonging than gay male respondents. Age and education moderated the association between LGBT identity and social support. DISCUSSION AND IMPLICATIONS This study demonstrated differences in access to social resources according to environmental circumstances that can intersect and govern access to social resources. Findings highlight the importance of considering social support separately from social network size; thus, large social networks do not necessarily provide ample social support. LGBT older adults had different perceptions of social support than their middle-aged counterparts. Health and human service professionals should not only consider the sexual and gender identity of their LGBT clients, but also education and age when assessing access to social resources.
Collapse
Affiliation(s)
- Krystal R Kittle
- Address correspondence to: Krystal R. Kittle, PhD, Department of Environmental and Occupational Health, Social & Behavioral Health Program, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Parkway, Suite #335, Las Vegas, NV 89119, USA. E-mail:
| | - Kathrin Boerner
- Department of Gerontology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Kyungmin Kim
- Department of Child Development and Family Studies, Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | | |
Collapse
|
34
|
Facciani M, McKay T. Network loss following the 2016 Presidential Election among LGBTQ+ adults. APPLIED NETWORK SCIENCE 2022; 7:41. [PMID: 37168138 PMCID: PMC10168680 DOI: 10.1007/s41109-022-00474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Growing levels of political polarization in the United States have been associated with political homogeneity in the personal networks of American adults. The 2016 Presidential Election in the United States was a polarizing event that may have caused further loss of connections to alters who had different politics. Kinship may protect against loss of politically different ties. Additionally, loss of ties with different political views may be particularly pronounced among LGBTQ+ people as they are more likely to be impacted by public policy decisions compared to their heterosexual counterparts. We analyzed two waves of the University of California, Berkeley Social Networks Study's (UCNets) Main Sample and LGBTQ+ Oversample of older adults that occurred in 2015 and 2017, which provided an opportunity to assess alter loss after the 2016 Presidential Election. When evaluating all adults, we found that politically different alters were more likely to reflect kin ties than partner or friend ties. We also found that politically different kin are less likely to be dropped suggesting that kinship acts as a moderating effect of different political views on alter loss. LGBTQ+ respondents were more likely to drop kin alters with different political views than their cisgender heterosexual counterparts. We discuss the implications these results have for political polarization interventions as well as the social networks impact politics can have on LGBTQ+ individuals.
Collapse
|
35
|
Frey JJ, Hall WJ, Goldbach JT, Lanier P. “Here in the Bible Belt, It’s Predominantly Negative”: Sexual Identity Stigma in the American South, 50 Years After Stonewall. Front Psychol 2021; 12:804064. [PMID: 34992572 PMCID: PMC8724198 DOI: 10.3389/fpsyg.2021.804064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/22/2021] [Indexed: 12/02/2022] Open
Abstract
Lesbian, gay, bisexual, and pansexual (LGB+) individuals have disproportionate rates of mental illness. Minority stress and sexual identity stigma are posited as the primary social determinants of LGB+ mental health disparities. Discussions in the literature have questioned the impact of sexual identity stigma in a world increasingly accepting of sexual minorities. Additionally, the LGB+ population in the United States South is often overlooked in American research. This article details a qualitative study exploring experiences related to sexual identity stigma among adults who identify as LGB+ in the United States South. Semi-structured interviews with 16 individuals were analyzed using content analysis. Six thematic categories of stigma emerged from participants’ experiences: (a) navigating an LGB+ identity, (b) social acceptability of an LGB+ identity, (c) expectation of LGB+ stigma, (d) interpersonal discrimination and harassment, (e) structural stigma, and (f) relationship with the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Findings suggest that sexual identity stigma remains a common experience among these Southern United States participants. Further, thematic categories and subcategories primarily aligned with extant theory with one exception: Intracommunity stigma, a form of stigma emanating from the LGBTQ community, emerged as a stigma type not currently accounted for in theoretical foundations underpinning mental health disparities in this population.
Collapse
Affiliation(s)
- Joseph J. Frey
- Department of Social Work, University of North Texas, Denton, TX, United States
- *Correspondence: Joseph J. Frey,
| | - William J. Hall
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jeremy T. Goldbach
- The Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Paul Lanier
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| |
Collapse
|
36
|
Li JJ, Hyun S, Stevens C, Chen JA, Liu CH. Binge drinking and sexual risk behavior among US sexual and gender minority college students. Am J Addict 2021; 31:22-30. [PMID: 34907619 DOI: 10.1111/ajad.13244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/14/2021] [Accepted: 11/16/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Binge drinking and sexual risk behaviors have historically been associated with lesbian, gay, bisexual, and transgender (LGBT) adults; however, few studies have described this association among broader sexual and gender minority (SGM) students, who often identify outside of LGBT (e.g., asexual, queer). This study examined the relationship between binge drinking and sexual risk behaviors among SGM versus non-SGM college students. METHODS A retrospective analysis was conducted with cross-sectional data from the Spring 2017 American College Health Association-National College Health Assessment (ACHA-NCHA) survey among US undergraduates (n = 47,821) across 92 institutions. Binge drinking was measured as more than five drinks consumed the last time the student socialized; sexual risk behavior was measured as the number of sexual partners in the past 12 months. RESULTS Numerous undergraduates nationally identify as SGM (19.9%), with bisexual (32.7%), other SGM (26.1%), and asexual (25.4%) students comprising the largest subgroups. Prevalent among both SGM (28.1%) and non-SGM (29.6%) students, binge drinking had a significant main effect on the number of sexual partners. A significant interaction effect was observed between SGM identity and binge drinking on the number of sexual partners, such that this association was stronger in SGM versus non-SGM students. This effect remained significant across multiple SGM subgroups. DISCUSSION AND CONCLUSIONS SGM students are more prevalent and diverse than previously reported. While prevalent overall, binge drinking may be uniquely sexualized among SGM students. SCIENTIFIC SIGNIFICANCE In the first large-scale study assessing drinking among disaggregated SGM college students, data suggest tailoring alcohol interventions to SGM students, particularly those identifying outside of LGBT.
Collapse
Affiliation(s)
- Jason J Li
- Harvard Medical School, Boston, Massachusetts, USA
| | - Sunah Hyun
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry and Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Courtney Stevens
- Department of Psychiatry and Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Psychology, Willamette University, Salem, Oregon, USA
| | - Justin A Chen
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry, Massachussetts General Hospital, Boston, Massachusetts, USA
| | - Cindy H Liu
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychiatry and Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
37
|
MacCarthy S, Saunders CL, Elliott MN. Sexual Minority Adults in England Have Greater Odds of Chronic Mental Health Problems: Variation by Sexual Orientation, Age, Ethnicity, and Socioeconomic Status. LGBT Health 2021; 9:54-62. [PMID: 34882021 DOI: 10.1089/lgbt.2021.0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose: Sexual minority adults report worse mental health than heterosexual peers, although few empirical studies are large enough to measure variation in these disparities by sexual orientation, age, ethnicity, and socioeconomic status (SES). We investigate chronic mental health problems among sexual minority adults. Methods: Sex-disaggregated logistic regressions examined associations between self-reported chronic mental health problems and sexual orientation, age, ethnicity, and SES in a 2015-2017 dataset from the nationally representative English General Practice Patient Survey data (n = 1,341,339). Results: Bisexual adults, especially young bisexual females, reported the highest rates of chronic mental health problems. Sexual minority females 18-24 years of age had five times the odds of reporting chronic mental health problems of their heterosexual peers, with 32% of sexual minority females 18-24 years of age reporting the outcome. Sexual minority identity was also strongly associated with chronic mental health problems for adults who were White and lived in more affluent areas. Conclusion: The very high odds of chronic mental health problems among bisexual adults, especially younger bisexual females, may reflect simultaneous isolation from sexual minority and heterosexual communities. Elevated odds at younger ages may reflect disproportionate social media use and bullying. It is plausible that those who are subject to minority stress associated with SES and ethnicity may develop resilience strategies that they then apply to sexual minority stress. The results suggest that sexual minority identity is a source of minority stress, even for those who are affluent. Clinicians should be alert to the need to support the specific mental health concerns of their sexual minority patients.
Collapse
Affiliation(s)
| | - Catherine L Saunders
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | |
Collapse
|
38
|
Hall WJ, Dawes HC, Plocek N. Sexual Orientation Identity Development Milestones Among Lesbian, Gay, Bisexual, and Queer People: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:753954. [PMID: 34777153 PMCID: PMC8581765 DOI: 10.3389/fpsyg.2021.753954] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/15/2021] [Indexed: 01/19/2023] Open
Abstract
This paper is a systematic review and meta-analysis on sexual orientation identity development milestones among people who are lesbian, gay, bisexual, or another sexual minority identity (LGB+). Common milestones measured in the 30 studies reviewed were becoming aware of queer attractions, questioning one's sexual orientation, self-identifying as LGB+, coming out to others, engaging in sexual activity, and initiating a romantic relationship. Milestones occurred in different sequences, although attraction was almost always first, often followed by self-identification and/or sexual activity; coming out and initiating a romantic relationship often followed these milestones. Meta-analysis results showed that the mean effect sizes and 95% confidence intervals varied by milestone: attraction [M age=12.7 (10.1, 15.3)], questioning one's orientation [M age=13.2 [12.8, 13.6]), self-identifying [M age=17.8 (11.6, 24.0)], sexual activity [M age=18.1 (17.6, 18.6)], coming out [M age=19.6 (17.2, 22.0)], and romantic relationship [M age=20.9 (13.2, 28.6)]. Nonetheless, results also showed substantial heterogeneity in the mean effect sizes. Additional meta-analyses showed that milestone timing varied by sex, sexual orientation, race/ethnicity, and birth cohort. Although patterns were found in LGB+ identity development, there was considerable diversity in milestone trajectories.
Collapse
Affiliation(s)
- William J Hall
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Hayden C Dawes
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Nina Plocek
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| |
Collapse
|
39
|
Selice L, Morris KL. Mindfulness and Sexual Dysfunction: A Systematic Research Synthesis. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:323-342. [PMID: 34693896 DOI: 10.1080/0092623x.2021.1991536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Throughout the previous decade, research exploring the associations between mindfulness and sexual dysfunction has grown exponentially. Researchers have highlighted inverse associations between mindfulness and various sexual dysfunctions, including erectile dysfunction, hypersexuality, and sexual distress, as well as positive associations between mindfulness and sexual desire, sexual satisfaction, and overall sexual functioning. This study sought to describe the state of extant literature exploring the association between mindfulness and sexual dysfunction, identify areas for future study within this area of research, and inform clinical practice when working with those experiencing sexual dysfunction. A systematic search of peer-reviewed journal articles revealed a final sample of 18 articles. After collecting data from all included articles, results support the inverse association between mindfulness and various sexual dysfunctions. Additionally, results highlight that current mindfulness and sexual dysfunction literature focuses more on the individual's experience and does not fully consider how the couple system is often impacted by, and may contribute to, the maintenance of sexual dysfunction. Furthermore, results demonstrate the importance of including LGBTQ + populations in future research, as extant literature in this area has focused primarily on the heterosexual experience.
Collapse
Affiliation(s)
- Lauren Selice
- Department of Human Development and Family Science, Florida State University, Tallahassee, Florida, USA
| | - Katherine L Morris
- Department of Human Development and Family Science, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
40
|
Scoggins D, Khan AS, Dai H. Hierarchical Analysis of Disparities in Suicidal Outcomes With Intersection of Sexual Minority and Gender Among U.S. Youth, 2017. HEALTH EDUCATION & BEHAVIOR 2021; 49:569-583. [PMID: 34628973 DOI: 10.1177/10901981211045933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexual minority youth have a higher risk of suicidal behaviors than their straight peers. Despite this alarming trend, there is limited information on how health-risk factors are systematically associated with suicidal outcomes in relation to the intersection of sex and sexual orientation identity. Data from the 2017 Youth Risk Behavior Survey (Grades 9-12, N = 14,108) were analyzed to examine three distinct suicidal outcomes (i.e., suicidal ideation, suicide planning, and suicide attempt). Separate hierarchical logistic regression models were performed to gradually adjust for influencing factors in examining the association between suicidal outcomes and sexual orientation identity (i.e., heterosexual, gay/lesbian, bisexual, and unsure), stratified by self-reported sex. There exist significant differences in youth suicidal behaviors based on sexual orientation identity and sex: lesbians (adjusted odds ratio [AOR] = 2.7, 95% CI [1.5, 5.0]), bisexual girls (AOR = 1.9, 95% CI [1.3, 2.6]) and bisexual boys (AOR = 2.6, 95% CI [1.3, 5.2]) had higher odds of suicide attempts than their straight peers. Unsure boys and girls also reported higher risks of suicidal ideation and suicide plan as compared with their straight peers. Having a very short sleep duration, reporting ever use of illicit drugs, being bullied, and feeling sad/hopeless were associated with elevated risks of suicidality across males and females. This study identified potential disparities in suicidal outcomes by sexual orientation identity as well as factors that attenuate or strengthen this relationship in a representative sample of adolescents across the United States. An improved understanding of the differences in suicidal outcomes will serve as an opportunity to ameliorate any potential inequalities and improve sexual minority youth' health outcomes.
Collapse
Affiliation(s)
| | - Ali S Khan
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Hongying Dai
- University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
41
|
Pereira H, Silva P. The Importance of Social Support, Positive Identity, and Resilience in the Successful Aging of Older Sexual Minority Men. Geriatrics (Basel) 2021; 6:geriatrics6040098. [PMID: 34698189 PMCID: PMC8544553 DOI: 10.3390/geriatrics6040098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the relationship between social support, positive identity, and resilience and the successful aging of older sexual minority men. The study involved having 210 self-identified gay and bisexual men aged between 50 and 80 years complete a cross-sectional online survey comprised of sociodemographic information; the Portuguese version of the Multidimensional Scale of Perceived Social Support; the Lesbian, Gay, and multifactor Bisexual Positive Identity Measure; the Connor–Davidson Resilience Scale 10; and the Successful Aging Perceptions Scale. The results showed that self-identified gay participants showed higher levels of positive identity, while bisexual participants scored higher for resilience, mental health, and successful aging. Higher levels of social support, resilience, and positive identity were significant predictors of mental health (28%), physical health (18%), and successful aging (10%) in our sample. These results offer similarities with the growing body of literature on the positive factors of successful aging in the gay and bisexual men communities, which is an important step in the development of aging and health preventive initiatives among this population.
Collapse
Affiliation(s)
- Henrique Pereira
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal;
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Correspondence:
| | - Patrícia Silva
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal;
| |
Collapse
|
42
|
Meanley SP, Plankey MW, Matthews DD, Hawk ME, Egan JE, Teplin LA, Shoptaw SJ, Surkan PJ, Stall RD. Lifetime Prevalence and Sociodemographic Correlates of Multifactorial Discrimination Among Middle-Aged and Older Adult Men Who Have Sex with Men. JOURNAL OF HOMOSEXUALITY 2021; 68:1591-1608. [PMID: 31860386 PMCID: PMC7305044 DOI: 10.1080/00918369.2019.1702353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study describes multifactorial discrimination (discrimination attributed to multiple social identities) among middle-aged and older adult MSM. MSM aged 40+ years (N = 1,193) enrolled in the Multicenter AIDS Cohort Study completed behavioral surveys ascertaining experiences of discrimination and their social identity attributions. Non-proportional odds regressions assessed multifactorial discrimination by age, race/ethnicity, HIV status, and covariates. Twenty-seven percent of participants reported multifactorial discrimination. Adjusted models indicated that middle-aged men were more likely to report multifactorial discrimination compared to older adult men. Racial/ethnic minorities were more likely to report multifactorial discrimination compared to non-Hispanic white participants. These same patterns emerged among the sub-sample of participants living with HIV. To our knowledge, this is the first assessment of multifactorial discrimination in middle-aged and older MSM. Our findings support the deleterious association between multiple-marginalization and multifactorial discrimination. Multilevel interventions targeting interconnected experiences of stigma may improve the health of MSM in transition to older age.
Collapse
Affiliation(s)
- Steven P. Meanley
- University of Pennsylvania School of Nursing, Department of Family and Community Health, Philadelphia, PA
| | - Michael W. Plankey
- Georgetown University Department of Medicine, Division of Infectious Diseases, Washington, DC
| | - Derrick D. Matthews
- University of Pittsburgh Graduate School of Public Health, Department of Infectious Diseases and Microbiology, Pittsburgh, PA
| | - Mary E. Hawk
- University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA
| | - James E. Egan
- University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA
| | - Linda A. Teplin
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL
| | - Steven J. Shoptaw
- University of California – Los Angeles, Department of Family Medicine and Psychiatry and Biobehavioral Sciences, Los Angeles, CA
| | - Pamela J. Surkan
- Johns Hopkins University Bloomberg School of Public Health, Department of International Health, Baltimore, MD
| | - Ron D. Stall
- University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA
| |
Collapse
|
43
|
Schuler MS, Prince DM, Collins RL. Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015-2018 National Survey on Drug Use and Health. LGBT Health 2021; 8:330-339. [PMID: 34101498 PMCID: PMC8252906 DOI: 10.1089/lgbt.2020.0390] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: We characterize disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants in a nationally representative sample. Methods: Data on 153,939 adults (including 11,133 LGB adults) were from the 2015-2018 National Survey on Drug Use and Health. Separate Poisson regression models were used to estimate the relative risk (RR) that gay/lesbian and bisexual adults, respectively, experienced each health determinant, relative to heterosexual adults of the same gender and age group (ages 18-25, 26-34, 35-49, and 50-64). Statistically significant RR estimates were interpreted as a disparity. Results: Bisexual females exhibited disparities on all economic/health care access factors (no college degree, household poverty, means-tested assistance, unemployment, and lacking health insurance) across nearly all age groups; lesbian/gay females exhibited disparities in means-tested assistance and health insurance for some age groups. Notably fewer economic disparities were observed among gay and bisexual males. LGB adults (across identity, gender, and age group) were more likely to live alone, to have never been married, and to report low religious service attendance. Bisexual and lesbian/gay females, across age groups, had 1.7-2.2 times the risk of a lifetime arrest for a criminal offense, relative to same-age heterosexual females. Conclusions: Our results highlight that LGB females, particularly bisexual females, experience significant disparities in economic determinants of health, and all LGB subgroups exhibited disparities in some of the examined social determinants of health. The observed disparities, which spanned across age groups, likely contribute to disparities in physical and mental health observed among LGB adults.
Collapse
Affiliation(s)
| | - Dana M. Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | | |
Collapse
|
44
|
Stuhlsatz GL, Kavanaugh SA, Taylor AB, Neppl TK, Lohman BJ. Spirituality and Religious Engagement, Community Involvement, Outness, and Family Support: Influence on LGBT+ Muslim Well-Being. JOURNAL OF HOMOSEXUALITY 2021; 68:1083-1105. [PMID: 33764281 DOI: 10.1080/00918369.2021.1888585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The current study utilized data from the Social Justice Sexuality Project to investigate influences on psychological well-being of LGBT+ Muslims (N = 75) in the United States. Specifically, path analyses were used to examine the association between spiritual and religious engagement, LGBT community involvement, outness, and family support with psychological well-being. Control variables included lifespan Islam involvement, age, income, and the age at which the participant came out to themselves. Findings illustrate spiritual and religious engagement, outness, and income were all positively related to psychological well-being. Moreover, individuals who had converted to Islam but were not raised in the faith had significantly lower psychological well-being than those who had a consistent experience with Islam from their childhood until the time of the study. The present investigation provides critical contributions to the study of gender and sexual minorities in the United States and the experiences of currently practicing LGBT+ Muslims and those who were raised Muslim. Clinical implications and future research suggestions are discussed.
Collapse
Affiliation(s)
- Greta L Stuhlsatz
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | | | - Ashley B Taylor
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia, Vancouver, Canada
| | - Tricia K Neppl
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Brenda J Lohman
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| |
Collapse
|
45
|
Xie H, Li Y, Turner C. Sexual Orientation Identity and Its Implication in the Disparities in Psychological Health-Related Quality of Life. Am J Health Promot 2021; 35:1121-1124. [PMID: 34032118 DOI: 10.1177/08901171211019898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine disparities in psychological health-related quality of life (HRQoL) among sexual minority women within racial/ethnic subgroups. DESIGN A secondary analysis of the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS). SETTING United States. SUBJECTS Noninstitutionalized, cisgender, adult women in the U.S (unweighted n = 81,947). MEASURES Socioeconomics, health behaviors, and healthcare access as risk factors, whereas 1 item measures psychological HRQoL as an outcome. ANALYSIS Weighted multivariable logistic regressions to estimate the odds of having adversely psychological HRQoL in relation to sexual orientation and other correlates within a racial/ethnic subgroup independently. RESULTS The prevalence of adverse psychological HRQoL was greater in bisexual and "other" sexual orientation women. Both bisexual (adjusted odds ratio [aOR] = 1.58; 95% confidence interval [CI] = 1.26-2.00) and "other" sexual orientation (Aor = 1.93; 95%CI = 1.26-2.96) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in non-Hispanic White women. Bisexual women (aOR = 3.42; 95%CI = 1.98-5.88) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in Latinas. No similar pattern was observed in non-Hispanic Black women. CONCLUSION Disparities in psychological HRQoL varied by sexual orientation identities within different racial/ethnic subgroups. The magnitude of the association for Latina bisexual women was strong. Implications for bisexual health among people with intersecting identities are discussed.
Collapse
Affiliation(s)
- Hui Xie
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Yannan Li
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Cailtin Turner
- San Francisco Department of Public Health, San Francisco, CA, USA
| |
Collapse
|
46
|
Mahon CP, Pachankis JE, Kiernan G, Gallagher P. Risk and Protective Factors for Social Anxiety Among Sexual Minority Individuals. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1015-1032. [PMID: 33398699 DOI: 10.1007/s10508-020-01845-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/10/2020] [Accepted: 09/19/2020] [Indexed: 06/12/2023]
Abstract
Minority stress processes represent clear determinants of social anxiety among sexual minority populations. Yet sources of resilience to social anxiety are less explored as are stressors experienced from within sexual minority communities (i.e., intraminority stress). Based on minority stress theory and the psychological mediation framework, we hypothesized that experiences of discrimination and intraminority stress would predict proximal minority stress processes, including internalized homonegativity, sexual concealment behavior, and rejection sensitivity, as well as two resilience factors-sense of coherence and LGBTQ community connectedness-to explain social anxiety among sexual minority individuals. Self-identified cisgender sexual minority women (n = 245) and men (n = 256) residing in the Republic of Ireland completed an online survey. Results from a structural equation modeling analysis indicated that the data fit the hypothesized model well for both women and men. For both sexual minority women and men, experiences of discrimination and intraminority stress were indirectly associated with social anxiety via two paths (1) increased rejection sensitivity and (2) reduced sense of coherence. Intraminority stress was indirectly associated with social anxiety via increased concealment behavior for sexual minority men only. Experiences of discrimination were indirectly associated with social anxiety via a sequential pathway through increased proximal minority stress (i.e., concealment behavior and internalized homonegativity), and reduced LGBTQ community connectedness solely among sexual minority women. Findings are discussed in terms of implications for future research and clinical practice with sexual minority individuals who suffer from social anxiety.
Collapse
Affiliation(s)
- Conor P Mahon
- School of Psychology, Dublin City University, 620 Collins Ave Ext, Glasnevin, Dublin 9, D09 X984, Ireland.
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Gemma Kiernan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Pamela Gallagher
- School of Psychology, Dublin City University, 620 Collins Ave Ext, Glasnevin, Dublin 9, D09 X984, Ireland
| |
Collapse
|
47
|
Klibert JJ, Choudhury S, Yancey CT. A sexual minority model of flourishing: Examining the interactions among negative emotions, positive emotions, and sexual orientation identity status. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2021.1883495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
48
|
Baumel K, Hamlett M, Wheeler B, Hall D, Randall AK, Mickelson K. Living Through COVID-19: Social Distancing, Computer-Mediated Communication, and Well-Being in Sexual Minority and Heterosexual Adults. JOURNAL OF HOMOSEXUALITY 2021; 68:673-691. [PMID: 33523776 DOI: 10.1080/00918369.2020.1868190] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
COVID-19 has had far-reaching effects on people's lives, with evidence of a disproportionate impact on marginalized groups. Given existing health disparities and research on minority stress, COVID-19 may have uniquely impacted psychological well-being among sexual minorities. In an online survey of adults in the U.S. (N = 1,007) conducted in April 2020, we examined differences between sexual minority and heterosexual participants in psychological well-being, social distancing, computer-mediated communication, and COVID-19-related worry and experiences. Sexual minorities reported lower thriving and greater psychological distress, social distancing, computer-mediated communication, and COVID-19 worry and experiences than heterosexual participants. Social distancing and distress were positively correlated among sexual minorities and more frequent computer-mediated communication predicted greater thriving across groups. Path analyses showed sexual minorities' poorer psychological well-being was mediated by their greater COVID-19 worry and social distancing, in particular. These findings shed light on the distinct impact of COVID-19 on sexual minorities.
Collapse
Affiliation(s)
- Katie Baumel
- School of Social and Behavioral Sciences, Arizona State University , Glendale, Arizona, USA
| | - Mara Hamlett
- School of Social and Behavioral Sciences, Arizona State University , Glendale, Arizona, USA
| | - Brittany Wheeler
- School of Social and Behavioral Sciences, Arizona State University , Glendale, Arizona, USA
| | - Deborah Hall
- School of Social and Behavioral Sciences, Arizona State University , Glendale, Arizona, USA
| | - Ashley K Randall
- Counseling and Counseling Psychology, Arizona State University , Tempe, Arizona, USA
| | - Kristin Mickelson
- School of Social and Behavioral Sciences, Arizona State University , Glendale, Arizona, USA
| |
Collapse
|
49
|
Psychological maltreatment predicts decreases in social wellbeing through resilience in college students: A conditional process approach of positive emotions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01583-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
50
|
Chan RCH, Huang YT. A Minority Stress Response Model of Health Behaviors in Gay and Bisexual Men: Results from a Taiwanese Sample. LGBT Health 2021; 8:209-221. [PMID: 33625267 DOI: 10.1089/lgbt.2020.0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Health disparities among sexual minority men remain and continue to demand novel interventions. Other than risk reduction, a promising approach is to identify pathways to health-promoting behaviors. In this study, depressive symptoms, internalized homophobia, and sense of community connectedness were hypothesized to result from the experience of harassment and rejection, and in turn either promote or inhibit an individual's tendency toward health-promoting behaviors. We accounted for subgroup differences by examining the hypothesized model in gay and bisexual men separately. Methods: This was a cross-sectional survey study. One thousand three hundred eighty-one gay (81.5%) and bisexual (18.5%) Taiwanese men 18-49 years of age (mean = 26.56, standard deviation = 6) were recruited through a social media advertisement and completed an online survey. Structural equation modeling was employed to simultaneously examine multiple hypothesized paths. Results: Harassment and rejection were associated with greater depressive symptoms, internalized homophobia, and sense of community connectedness, which in turn yielded direct or indirect associations with health-promoting behavior among gay men. For bisexual men, depressive symptoms remained an important mechanism linking harassment and rejection and health-promoting behavior, whereas the roles of internalized homophobia and sense of community connectedness appeared less obvious. Conclusion: These findings cast new light on the behavioral implications of minority stress and elucidate the possible underlying mechanisms. The study suggests that more effort should be invested to understand and promote the drivers of health-promoting behavior to reduce health disparities in this population.
Collapse
Affiliation(s)
- Randolph Chun Ho Chan
- Department of Special Education and Counseling, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|