Perceptions of Safety Among LGBTQ People Following the 2016 Pulse Nightclub Shooting

Standing Together: An Investigation of the Social Support Deterioration Deterrence Model 1 Year After the Club Q Shooting

Both mass shootings and acts of bias-motivated violence have significant psychological consequences, as survivors commonly experience psychological distress in the form of depression symptoms, anxiety symptoms, and posttraumatic stress symptoms (PTSS) following the event. Moreover, increases in psychological distress are common near the year mark of a traumatic event. However, little is currently known about how communities affected by the intersection of bias-motivated violence and mass shootings are affected by these events in the longer term. The present study therefore investigated survivors' psychological reactions around the 1-year mark of the Club Q shooting, which targeted members of the Colorado Springs lesbian, gay, bisexual, trans, queer and questioning (LGBTQ+) community. Specifically, informed by the social support deterioration deterrence model, this study used path analysis to explore how exposure to the shooting, community solidarity, and receiving social support were associated with psychological distress among N = 64 LGBTQ+ individuals in Colorado Springs. Results indicated that higher community solidarity was associated with more severe psychological distress, a latent variable comprised of depression symptoms, anxiety symptoms, and PTSS, β = .39, p = .001, but no other predictors were statistically significant. These results suggest that community solidarity may increase vulnerability to psychological distress, perhaps because these individuals are more personally affected when their community is targeted and harmed. This study also highlights the need for ongoing community support and healing efforts around the 1-year mark of a bias-motivated mass shooting.

A scoping review of empirical research on firearms and firearm violence among sexual and gender minority populations in the United States

BACKGROUND

Firearms-related health sciences research has documented disparities in fatal and nonfatal firearm injury impacting populations in the United States defined by race and ethnicity, age, gender, and geography. Recent reports from research and advocacy organizations have highlighted a need for this research to include sexual and gender minority (ie, lesbian, gay, bisexual, transgender, and queer [LGBTQ+]) populations to guide public health efforts to prevent homicide, suicide, and injury.

PURPOSE

The current review examines and summarizes existing research related to firearms and LGBTQ+ populations in the United States.

METHODS

A search of PubMed, Embase, CINAHL, PsycInfo, LGBT Life, and Scopus was conducted in May 2024 using search strings related to LGBTQ+ populations, firearms, and suicide. Articles were included in this review if they were peer-reviewed, empirical studies assessing any construct related to firearms among LGBTQ+ people in the United States.

RESULTS

Ultimately, 35 studies were included. Constructs examined in included studies were suicide (n = 6), homicide (n = 4), responses to the Pulse nightclub shooting (n = 9), nonfatal interpersonal violence (n = 4), and firearm access and ownership (n = 12).

CONCLUSIONS

Findings identified substantial gaps in the literature, underscoring an urgent need for LGBTQ+ health researchers and firearm injury prevention researchers to collaboratively extend and improve the evidence base on firearms among LGBTQ+ populations. Key recommendations include improving Sexual Orientation and Gender Identity data collection in firearms research, collecting original data to address LGBTQ+-specific and LGBTQ+-inclusive research questions regarding firearms, broadening the scope of firearms constructs assessed among LGTBQ+ populations, and using intersectionality to guide future research.

Discrimination on Grounds of Sexual Orientation and Gender Identity: The Limits of Human Rights in Africa

The right to sexual orientation and gender identity (SOGI) are integral to and manifest in LGBTIQ rights including homosexuality and same-sex marriage. International law promotes these rights and prohibits discrimination on these grounds. Many western countries endorse these rights and prohibitions in parliamentary legislation or judicial fiat. In comparison with all other jurisdictions worldwide, and within the African sub-region, only South Africa specifically prohibits unfair direct or indirect discrimination based on "sexual orientation" in its national constitution. This paper explores African approach to SOGI and LGBTIQ rights including homosexuality and same-sex marriage. It argues that despite the threat of homocapitalism, prevalent Afrocentrism and religions reject these form of "new rights" for being immoral, ungodly, unnatural and un-African, thereby underlining the limits of human rights in the sub-region.

Loneliness in Sexual Minority Individuals in the Southeastern United States: The Role of Minority Stress and Resilience

Health disparities in the sexual minority population may be exacerbated by the loneliness experienced due to minority stress. Using a minority stress framework, this study examined minority stress, protective variables, and mental health as correlates of loneliness in sexual minority individuals in a small metropolitan area in the southeastern United States. Participants (n = 273) were a subsample of sexual minority individuals from a broader sample of LGBTQ adults in the Central Savannah River area who completed a health needs assessment. Bivariate correlations were calculated to assess for degree of significant relationships between loneliness and barriers to health care, minority stress, and mental health. Hierarchical linear regression was conducted to examine the relative importance of the study variables' associations with loneliness. A multiple regression model found household income, assault victimization, depressive symptoms, and sense of community to be significant correlates of loneliness. Interventions to decrease loneliness in this population will need to consider these interconnected, multi-level influences.

The rainbow connection: Disrupting background affect, overcoming barriers and emergent emotional collectives at "Pride in London"

This article focuses on a large-scale parade in the UK that is often overlooked in research concerned with the sociology of political emotions and group dynamics; "Pride in London". This is an annual parade celebrating, and raising awareness about, the LGBTQ+ community and commemorating the Stonewall riots. Following a brief description of the study context, participants and methods, the article illustrates the use of reflexive thematic analysis of 23 interviewee accounts of the parade. Analysis of emotional habitus and affective practices preceding, and on the day of, the parade offer an insight into the manifestation of collective emotion. Three themes are developed exploring the use of recognizable and emotive symbols, physicality of embodied emotion and spatial arrangement and the encompassing nature of group emotion. Finally, the interplay between background and foreground emotion is explored as a way of understanding and demonstrating the fluidity and temporality of affective experience and expression when people are engaged in collective action at a social justice event.

Adrenocortical responses of emerging adults in California in the two months following the Pulse night club massacre: Evidence for distal stress responses

This study examined adrenocortical responses in the days following the Pulse nightclub massacre on June 12, 2016, among emerging adults in Northern California (N = 202; M = 23.18 years, SD = 2.56; 25% LGBQ-Latinx, 25% LGBQ-White, 25% Straight-Latinx, and 25% Straight-White) between June 13-August 12, 2016. As predicted, participants tested more proximally to the massacre had higher waking cortisol (intercepts) and flatter diurnal cortisol output (slopes), indicative of time-dependent adrenocortical arousal across the day. The effect of days post-massacre on waking cortisol was moderated by daily distress, with days since the Pulse massacre predicting waking cortisol significant only for participants reporting lower distress; participants who reported feeling higher daily distress had elevated waking cortisol across the testing period. These findings were independent of weekly personal stressors, and consistent across participants' demographic and identity characteristics. The violent attack at the Pulse nightclub was connected to increased waking cortisol and diurnal cortisol production for several days after the massacre, in a distal population exposed to the massacre vicariously, and especially for individuals not experiencing other, personal stressors. Heightened physiological responses to violent crimes support policy efforts to protect vulnerable communities, including violence prevention, gun control, and community-based trauma response services for those directly and indirectly affected by gun violence.

Ensuring survey research data integrity in the era of internet bots

We used an internet-based survey platform to conduct a cross-sectional survey regarding the impact of COVID-19 on the LGBTQ + population in the United States. While this method of data collection was quick and inexpensive, the data collected required extensive cleaning due to the infiltration of bots. Based on this experience, we provide recommendations for ensuring data integrity. Recruitment conducted between May 7 and 8, 2020 resulted in an initial sample of 1251 responses. The Qualtrics survey was disseminated via social media and professional association listservs. After noticing data discrepancies, research staff developed a rigorous data cleaning protocol. A second wave of recruitment was conducted on June 11–12, 2020 using the original recruitment methods. The five-step data cleaning protocol led to the removal of 773 (61.8%) surveys from the initial dataset, resulting in a sample of 478 participants in the first wave of data collection. The protocol led to the removal of 46 (31.9%) surveys from the second two-day wave of data collection, resulting in a sample of 98 participants in the second wave of data collection. After verifying the two-day pilot process was effective at screening for bots, the survey was reopened for a third wave of data collection resulting in a total of 709 responses, which were identified as an additional 514 (72.5%) valid participants and led to the removal of an additional 194 (27.4%) possible bots. The final analytic sample consists of 1090 participants. Although a useful and efficient research tool, especially among hard-to-reach populations, internet-based research is vulnerable to bots and mischievous responders, despite survey platforms’ built-in protections. Beyond the depletion of research funds, bot infiltration threatens data integrity and may disproportionately harm research with marginalized populations. Based on our experience, we recommend the use of strategies such as qualitative questions, duplicate demographic questions, and incentive raffles to reduce likelihood of mischievous respondents. These protections can be undertaken to ensure data integrity and facilitate research on vulnerable populations.

Determinants of Intimate Partner Violence Among Young Men Who Have Sex With Men: The P18 Cohort Study

Intimate Partner Violence (IPV) is an understudied health problem among young gay, bisexual, and other non-identified young men who have sex with men (YMSM). According to cross-sectional studies, IPV is associated with psychosocial and mental health problems, such as stigma and depression, among YMSM. IPV is also associated with health-risk behaviors, such as substance use, among this population. Yet, to date, no studies have used longitudinal data to examine determinants of IPV among YMSM. This gap in the extant literature is problematic, as it limits our understanding of how to intervene to interrupt cycles of violence. The aim of the present study was to examine longitudinal determinants of IPV among a sample of (N = 526) YMSM living in the New York City area. Longitudinal analyses using Generalized Estimating Equations (GEE) were used to examine individual, relationship, mental health, psychosocial, and substance use factors in relation to IPV victimization and perpetration. Most notably, early experiences of IPV were a robust predictor of later experiences of IPV victimization and perpetration. Relationship status, depression, public gay-related stigma, and illicit substance use were associated with IPV victimization over time. Similarly, relationship status, depression, public gay-related stigma, marijuana, and other illicit substance were associated with IPV perpetration. These findings suggest that prevention programs and awareness campaigns should aim to reach YMSM before their first experiences of relationship violence, as these early experiences of violence are strongly linked to later experiences of violence. Also, IPV interventions should be tailored to the needs of YMSM and should target depressive symptoms, gay-related stigma, and substance use behaviors. Additionally, substance use interventions may be improved by addressing IPV. Finally, policymakers should support policies that improve the social climate for LGBTQ people, thereby reducing gay-related stigma, and potentially stemming violence against and among YMSM.

Three case studies of community behavioral health support from the US Department of Veterans Affairs after disasters

Background

Community disaster resilience is comprised of a multitude of factors, including the capacity of citizens to psychologically recover. There is growing recognition of the need for public health departments to prioritize a communitywide mental health response strategy to facilitate access to behavioral health services and reduce potential psychological impacts. Due to the US Department of Veterans Affairs’ (VA) extensive experience providing trauma-informed behavioral healthcare to its Veterans, and the fact that VA Medical Centers (VAMCs) are located throughout the United States, the VA is well situated to be a key partner in local communities’ response plans. In this study we examined the role the VA can play in a community’s behavioral health response using case studies from three disasters.

Methods

This study investigated experiences of VA employees in critical emergency response positions (N = 17) in communities where disasters occurred between 2017 and 2019. All respondents were interviewed March–July 2019. Data were collected via semi-structured interviews exploring participants’ experiences and knowledge about VA activities provided to communities following the regional disasters. Data were analyzed using thematic and grounded theory coding methods.

Results

Respondents underscored VA’s primary mission after a disaster was to maintain continuity of care to Veterans. The majority also described the VA supporting community recovery. Specifically, three recent events provided key examples of VA’s involvement in disaster behavioral health response. Each event showed VA’s integration into local response structures was facilitated by pre-existing emergency management and clinical relationships as well as prioritization from VA leadership to engage in humanitarian missions. The behavioral health interventions were provided by behavioral health teams integrated into disaster assistance centers and non-VA hospitals, VA mobile units deployed into the community, and VA telehealth services.

Conclusions

Recent disasters have revealed that coordinated efforts between multidisciplinary agencies can strengthen communities’ capacity to respond to mental health needs, thereby fostering resilience. Building relationships with local VAMCs can help expedite how VA can be incorporated into emergency management strategies. In considering the strengths community partners can bring to bear, a coordinated disaster mental health response would benefit from involving VA as a partner during planning.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10650-x.

An Intersectional Analysis of LGBTQ Online Media Coverage of the Pulse Nightclub Shooting Victims

This study illustrates the radical potential of intersectionality to offer a more deeply critical analysis of hierarchies in lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. The author examines how 377 reports from the five most-trafficked LGBTQ Web sites represented victims of the Pulse nightclub shooting in Orlando, FL. Findings support previous scholarship that has emphasized Latinx exclusion, as the articles generally failed to present the victims in an intersectional way, focusing on their LGBTQ status and excluding their Latinx identities. At the same time, a significant minority of the reports emphasized Latinx queer people, most frequently in a way that continued to prioritize LGBTQ identification, sometimes even advancing stereotypical representations of Latinx communities as extraordinarily focused on faith, family, or "machismo." Moreover, none of the articles considered xenophobia as a potential motivating factor in the shooting, and the reports typically presented policing agencies in a neutral, and sometimes even positive, way.

The Health Challenges of Emerging Adult Gay Men: Effecting Change in Health Care

This article focuses on the health and health care challenges experienced by young and emerging adult gay men. Evidence is provided on the extent to which young and emerging adult gay men are disproportionally burdened by multidimensional health disparities, barriers to health care access, and inadequate provider-patient interactions. Recommendations are provided for health care providers and public health officials working with populations of emerging adult gay men that might have the greatest overall impact on improving this population's well-being and access to competent health care by increasing providers' awareness of the unique needs of young and emerging adult gay men.

LGBTQ-Related Individual Differences Predict Emotional Reactions to the Pulse Nightclub Shootings

This study examined, among 232 lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) participants, the association of identity centrality and public regard with negative affect about the Pulse nightclub shootings in Orlando, Florida. Identification with victims and perceived threat to personal safety were sequential mediators. Identity centrality was associated with greater identification with the shooting victims. In turn, identification with the victims was associated with greater perceived threat, followed by more negative affect. Low public regard was associated with greater perceived threat that, in turn, was associated with more negative affect. The results support the notion that LGBTQ-related individual differences increase distress about anti-sexual/gender minority hate crimes, especially for individuals with a strong LGBTQ identity and who believe that the majority, heterosexual society devalues sexual/gender minority persons.

Exposure to Stigma Elicits Negative Affect and Alcohol Craving Among Young Adult Sexual Minority Heavy Drinkers

BACKGROUND

Sexual orientation disparities in alcohol use disorder (AUD) are thought to be explained by stigma specific to sexual minorities. Despite the importance of negative affect and craving in addiction, research has yet to test the effects of stigma on affect and alcohol craving among sexual minorities. This laboratory study examined the effects of 3 novel mood inductions (stigma, general unpleasant, and neutral) on affect and alcohol craving among heavy-drinking sexual minority young adults. We also paired these mood inductions with an established alcohol cue reactivity paradigm to explore the effects of stigma on cue-elicited craving.

METHODS

Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, standard deviation = 2.65), were recruited from the community. Participants completed 3 mood induction and cue reactivity trials counterbalanced over 3 visits on different days: stigma, general unpleasant, and neutral mood inductions. A structured interview assessed criteria for DSM-5 AUD, and self-report measures assessed lifetime adverse experiences.

RESULTS

Most participants met criteria for past-year AUD (75%). Exposure to stigma produced more negative affect and greater alcohol craving than the neutral and general unpleasant mood induction conditions. The general unpleasant mood induction did not predict greater alcohol craving than the neutral mood induction. Stigma enhanced alcohol cue reactivity effects, as measured with a single-item craving measure, compared to the general unpleasant mood condition, and this effect remained significant while controlling for covariates.

CONCLUSIONS

Findings are the first to demonstrate how stigma uniquely predicts negative affect and alcohol craving among sexual minorities. This study suggests that being exposed to stigma, specifically heterosexism, elicits negative mood and alcohol craving among sexual minority young adults who are heavy drinkers.