The Role of Minority Stressors in Lesbian Relationship Commitment and Persistence over Time

Disparities in Mortality by Sexual Orientation in a Large, Prospective Cohort of Female Nurses

Importance

Extensive evidence documents health disparities for lesbian, gay, and bisexual (LGB) women, including worse physical, mental, and behavioral health than heterosexual women. These factors have been linked to premature mortality, yet few studies have investigated premature mortality disparities among LGB women and whether they differ by lesbian or bisexual identity.

Objective

To examine differences in mortality by sexual orientation.

Design, Setting, and Participants

This prospective cohort study examined differences in time to mortality across sexual orientation, adjusting for birth cohort. Participants were female nurses born between 1945 and 1964, initially recruited in the US in 1989 for the Nurses' Health Study II, and followed up through April 2022.

Exposures

Sexual orientation (lesbian, bisexual, or heterosexual) assessed in 1995.

Main Outcome and Measure

Time to all-cause mortality from assessment of exposure analyzed using accelerated failure time models.

Results

Among 116 149 eligible participants, 90 833 (78%) had valid sexual orientation data. Of these 90 833 participants, 89 821 (98.9%) identified as heterosexual, 694 (0.8%) identified as lesbian, and 318 (0.4%) identified as bisexual. Of the 4227 deaths reported, the majority were among heterosexual participants (n = 4146; cumulative mortality of 4.6%), followed by lesbian participants (n = 49; cumulative mortality of 7.0%) and bisexual participants (n = 32; cumulative mortality of 10.1%). Compared with heterosexual participants, LGB participants had earlier mortality (adjusted acceleration factor, 0.74 [95% CI, 0.64-0.84]). These differences were greatest among bisexual participants (adjusted acceleration factor, 0.63 [95% CI, 0.51-0.78]) followed by lesbian participants (adjusted acceleration factor, 0.80 [95% CI, 0.68-0.95]).

Conclusions and Relevance

In an otherwise largely homogeneous sample of female nurses, participants identifying as lesbian or bisexual had markedly earlier mortality during the study period compared with heterosexual women. These differences in mortality timing highlight the urgency of addressing modifiable risks and upstream social forces that propagate and perpetuate disparities.

Sexual Orientation and Infidelity-Related Behaviors on Social Media Sites

Little research has been focused on offline or online infidelity in GL dating relationships, especially in a post-communist socio-cultural context. Infidelity-related (IR) behaviors on social media sites might be as hurtful to relationships as offline infidelity, both in gay, lesbian (GL) and heterosexual romantic monogamous relationships. In this cross-sectional study, we aimed to examine the associations between dyadic satisfaction, attitudes toward infidelity, and problematic internet usage, with IR behaviors on social media sites among GL and heterosexual unmarried individuals in Romanian sexual minority communities. Results showed that GL respondents did not significantly differ from heterosexual participants regarding IR behaviors. Furthermore, we found the main effect of attitudes toward infidelity and problematic internet use on IR behaviors. Sexual orientation highlights the main effect of IR behaviors when analyzed with dyadic satisfaction. The current study may be a precursor to further research investigating correlations in online IR behavior among lesbian and gay individuals engaging in consensual nonmonogamy. Implications of the findings are discussed in the social context of a post-communist country where GL individuals may face discrimination and stigma because of their sexual orientation.

A test of the investment model among asexual individuals: The moderating role of attachment orientation

Many asexual individuals are in long-term satisfying romantic relationships. However, the contributors to relational commitment among asexual individuals have received little attention. How do investment model characteristics and attachment orientations predict relationship commitment among asexual individuals? Our study looked at a sample of 485 self-identified asexual individuals currently in a romantic relationship (M_age = 25.61, SD = 6.24; M_{RelationshipLength} = 4.42 years, SD = 4.74). Individuals reported on Investment Model characteristics (i.e., their relationship satisfaction, investment, alternatives, and commitment) and their attachment orientations. Satisfaction, investment, and fewer alternatives were associated with greater commitment. Attachment orientations only occasionally moderated the results: for people low in anxiety, satisfaction and investment were more strongly related to commitment compared to people high in anxiety. The current study provided an extension of the Investment Model to describe romantic relationships among asexual individuals.

Associations between body dissatisfaction and relationship functioning among same-sex female couples: An actor-partner interdependence model

Nearly all past research about body dissatisfaction and romantic relationship factors is among heterosexual couples; little is known about these associations in sexual minority couples. The present study aimed to fill gaps in the current literature by using actor-partner interdependence models (APIMs) to examine dyadic patterns of association between body dissatisfaction and different aspects of relationship functioning among same-sex female couples. Participants were 163 same-sex female romantic dyads (326 women) between the ages of 18-35 years who completed measures of body dissatisfaction and relationship factors. Results from significance testing of actor and partner effects indicated higher levels of women's own body dissatisfaction were associated with lower levels of their own, but not their partner's, relationship satisfaction, closeness, sexual satisfaction, and intimacy/connectedness. Significance testing alone indicated that the association between one's own body dissatisfaction and their partner's relationship satisfaction was not significant. However, dyadic pattern testing identified a partner pattern for this effect, which suggests that the association between one's own body dissatisfaction and one's own relationship satisfaction is similar in magnitude and direction as that between an individuals' own body dissatisfaction and their partner's relationship satisfaction. In this study, women's own body dissatisfaction was found to be negatively associated with their own relationship functioning, which is consistent with findings of women in male-female couples. Thus, these findings highlight the important role that body dissatisfaction plays in women's relationship experiences. More research is needed to better understand potential cross-partner effects of body dissatisfaction and relationship factors in same-sex female couples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sexual Minority Stressors and Intimate Partner Violence Among Same-Sex Couples: Commitment as a Resource

Accumulating evidence has been found for the associations from sexual minority stressors to intimate partner violence (IPV) among same-sex couples. Yet key gaps still exist, including the rare utilization of couple dyadic data, the understudied moderating and mediating mechanisms, and the few studies conducted during the transitional period of same-sex marriage legalization. To address these gaps, we used cross-sectional, dyadic data collected from 144 US same-sex couples during the 2014-2015 national campaign for the legalization of same-sex marriage. Guided by the systemic transactional model (STM), we examined associations from sexual minority stressors (including both internalized homophobia and discrimination) to same-sex IPV and tested whether commitment moderated or mediated these associations. Overall, we found evidence supporting the STM: (1) High internalized homophobia and discrimination were related to high prevalence and/or frequency of IPV perpetration; (2) high commitment attenuated positive associations between high discrimination and high prevalence and/or frequency of IPV perpetration; and (3) high internalized homophobia was related to low commitment, which in turn was related to high prevalence and/or frequency of IPV perpetration. Collectively, our study identified commitment as both a moderator and mediator in associations from sexual minority stressors to same-sex IPV. Further, the roles of commitment (i.e., moderator or mediator) depend on whether the focal sexual minority stressors are distal and more intermittent (i.e., heterosexist discrimination) or proximal and more constant (i.e., internalized homophobia).

"Our feelings are valid" - reviewing the lesbian, gay, and bisexual affirmative approaches in a mental health setting

In recent years, although research into support mechanisms for managing distress experienced by Lesbian Gay and Bisexual (LGB) communities has increased. Stigma-related discrimination related to sexual minority status remains. This is further compounded by stigma against mental illnesses thus creating double jeopardy. This review will outline recent discoveries by exploring existing theories highlighting factors that explain health disparities for cisgender LGB people. It appears that the experience of the LGB population and the use of psychological therapies is varied across the spectrum. Some focus upon symptom reduction as part of the experience, but others talk about not being validated. Some mention minority stress constructs, alongside the psychological mediation framework, which offers a potential theoretical understanding of the experiences of the LGB population who receive psychological therapies.

Effectiveness of an Intervention based on Peplau’s Model on Health Literacy among Nurses Who Smoke: A Quasi-Experimental Study

Introduction: : Lack of health literacy for smoking nurses has worsened image of nursing services. The role of leader can be a support in increasing behavior change of nurses who smoke. The aimed to find out health literacy of smokers in nursing staff through interpersonal role of the head of the room by intervention based on Peplau’s model.Methods: A quasi-experimental research with a pre-and post-control group design, using modification questionnaire of knowledge and behavior. The target population was nurses living in Singkawang who smoke in a hospital. Sample was 35 respondents for each group (controlling group and intervention group) using purposive sampling. Dependent variable is health literacy among nurses who smoke and independent variable is intervention based on Peplau’s model. Intervention is in the form of a guide module consisting of strengthening health literacy (health awareness, self-reflection, cognitive competence and behavioral interpersonal relationships in the head of the room) and   will be implemented to nurses who smoke. Analysis data for bivariate used paired t – test and for multivariate used the McNemar test.Results: The research showed that the difference before and after intervention was 2.23 (p = 0.001) and control group was 8.00 with a default value of 0.870 deviation. The results showed a significant increase in health literacy in nurse smokers through the role of interpersonal head nurse (p=0.001).Conclusion:Role of head of room in interpersonal relationship with Peplau’s model affects the health literacy of nursing staff who smoke.

Do relationships provide the same levels of protection against heavy drinking for lesbian and bisexual women? An intersectional approach

PURPOSE

Sexual minority women (SMW; e.g., lesbian, bisexual) are more likely than heterosexual women to be heavy drinkers, with bisexual women showing the highest risk. There is ample literature demonstrating that intimate relationships protect against stress-related health risk behaviors in the general population. However, very little research has focused on SMW's relationships and far less is known about the relationships of SMW of color. Using intersectionality theory as our framework, we tested two competing models to determine whether the effects of minority sexual identity (lesbian, bisexual) and race/ethnicity (African American, Latinx, White) are: 1) additive, or 2) multiplicative in the associations between relationship status and heavy drinking.

METHODS

Data are from a diverse sample of cisgender sexual minority women (N = 641) interviewed in Wave 3 of the CHLEW study, a 20-year longitudinal study of SMW's health.

RESULTS

Findings from two- and three-way interactions provide mixed evidence for both the additive and multiplicative hypotheses; support for each varied by sexual identity and race/ethnicity. Overall, we found that Latinx SMW, particularly single and bisexual Latinx SMW report the highest rates of heavy drinking compared to their cohabiting and lesbian counterparts, respectively. African American single SMW reported significantly higher rates of heavy drinking compared to their cohabiting counterparts.

CONCLUSION

Our findings suggest that the protective qualities of SMW's intimate relationships vary based on sexual identity and race/ethnicity-and the intersections between them. These results highlight that research among SMW that does not take into account multiple marginalized identities may obscure differences.

PUBLIC SIGNIFICANCE

Little research has focused on health within sexual minority women's relationships, particularly among sexual minority women of color. Given the potential additive or multiplicative effects of multiple sources of oppression such as heterosexism, racism, and sexism, understanding the potential protective effects of relationships is important. Our findings demonstrate that the protective qualities of intimate relationships among SMW vary based on sexual identity and race/ethnicity - and the intersections between them.

Sexual orientation-related stigma and relationship functioning among female same-sex couples

This article discusses how sexual orientation-based stigma serves to undermine functioning in female same-sex relationships. We particularly focus on the unique roles of interpersonal stigma (e.g., victimization, microaggressions) and structural stigma (e.g., institutional forms of discrimination), highlighting critical limitations and gaps in this literature and offering suggestions for future studies. We also discuss the need for future work on sexual orientation-related stigma and relationship functioning to consider the unique experiences of bisexual women, intersecting identities, and couple-level perspectives on stigma.