It's complicated: The impact of marriage legalization among sexual minority women and gender diverse individuals in the United States

"A Tremendous Outpouring of Love and Affection": A Template Analysis of Positive Experiences During a Major LGBTQ Rights Campaign

Human rights for lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people have frequently been decided via popular vote. Australia conducted one such vote on the topic of marriage equality in 2017. Research has tended to focus on the negative experiences reported by LGBTQ people during such votes, with little attention paid to any positive experiences identified. This paper seeks to redress that imbalance, reporting the findings of two qualitative studies asking LGBTQ Australians about positive experiences during the marriage equality vote. The first study analyzed 673 typed responses collected during the two-month voting period, while the second analyzed interview data from 19 LGBTQ Australians collected two-and-a-half years after the vote. Both were analyzed using template analysis. Results identified sources of support, types of support, empowerment through activism, changes in general and LGBTQ communities, and positive personal changes. As public votes continue to be used to determine LGBTQ human rights, the findings may guide interventions to help LGBTQ people and their allies cope with such campaigns.

Associations Between Latent Classes of Trauma Exposure and Minority Stressors and Substance Use Among Cisgender Sexual Minority Women

Psychosocial stressors (e.g., minority stressors, trauma exposure) profoundly impact sexual minority women's (SMW's) risk of alcohol and other drug (AOD) use. However, research has not examined whether there are distinct typologies (i.e., patterns) of psychosocial stressors and whether these vary based on sociodemographic characteristics or are differentially associated with AOD outcomes (e.g., alcohol dependence) among SMW. This study aimed to identify latent classes of SMW reporting distinct typologies of psychosocial stressors and examine predictors and outcomes of latent classes of psychosocial stressors among SMW. Participants included a community sample of 602 SMW (M_age = 39.9, SD = 14.0; 74.0% lesbian; 37.4% White, 36.6% Black, 22.3% Latinx; 26.6% annual income ≤$14,999). Latent class analysis was used to identify typologies of psychosocial stressors. Regression analyses were employed to examine sociodemographic predictors and AOD outcomes of class membership. Three classes of psychosocial stressors emerged. Participants in Class 1 were likely to report relatively low adversity. SMW in Class 2, who reported childhood physical abuse (CPA), severe childhood sexual abuse, and adult physical assault, were vulnerable to discrimination and stigma consciousness. A distinct subgroup of SMW (Class 3) was at heightened risk of CPA, adult sexual assault (ASA), and stigma consciousness. Older SMW, Black SMW, and SMW with lower social support were more likely to be in classes characterized by higher adversity. Older SMW were at disproportionate risk of CPA and ASA. Different combinations of psychosocial stressors were uniquely associated with AOD outcomes. Findings underscore the importance of considering within-group heterogeneity in SMW's differential risk of psychosocial stressors and AOD outcomes. Routine screening of psychosocial stressors across several dimensions, brief interventions targeting AOD outcomes, and policies mitigating structural drivers of SMW's increased risk of trauma and minority stressors may be especially important for older SMW, Black SMW, and SMW who lack social support.

Associations of adult roles and minority stressors with trajectories of alcohol dependence symptoms throughout adulthood among sexual minority women

OBJECTIVE

In the present study, we sought to identify trajectories of symptoms of potential alcohol dependence (AD) among adult sexual minority women (SMW). Theoretical correlates were examined in relation to the empirically identified trajectories.

METHOD

Data were collected at three time points between 2000 and 2012 from SMW drinkers (n = 434) enrolled in a longitudinal study (M Age = 37.49 at baseline, SD = 11.55). Using an accelerated-cohort longitudinal design, latent growth curve mixture models identified homogeneous patterns of any past-year symptoms of potential AD. Correlates of trajectories included alcohol-related developmental risk factors, adult roles, and exposure to minority stressors.

RESULTS

Three trajectories were identified that captured risk of symptoms of potential AD over time, reflecting: (a) relatively consistent, low risk over time; (b) deceleration in risk throughout adulthood; (c) relatively persistent, high risk over time. Consistent with prior work, SMW drinkers who reported higher levels of perceived stigma or masculinity showed persistently high risk of reporting at least one past-year symptom of potential AD.

CONCLUSIONS

Most SMW drinkers report deceleration in risk of AD symptoms over time. Findings have implications for prevention and intervention efforts tailored to SMW drinkers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Probable PTSD, PTSD symptom severity, and comorbid PTSD and hazardous drinking among sexual minority women compared to heterosexual women: A meta-analysis

Posttraumatic stress disorder (PTSD) is more prevalent among sexual minority women (SMW) than among heterosexual women. PTSD risk varies among SMW, but no meta-analysis has clarified sexual identity-related disparities in probable PTSD among women or SMW's heterogeneity in PTSD risk. SMW are also at pronounced risk of comorbid PTSD and hazardous drinking (HD). However, the difference in comorbid PTSD/HD between SMW and heterosexual women is understudied. This meta-analysis aimed to provide a comprehensive understanding of differences between SMW and heterosexual women and among SMW across demographic characteristics. Peer-reviewed publications that were written in English and reported quantitative data on PTSD specific to SMW were included. Eligible publications (n = 45) were identified through a systematic search of 11 electronic databases, supplemented by a search of reference lists of relevant papers. We found that probable PTSD, PTSD symptom severity, and probable comorbid PTSD/HD are highly prevalent among SMW, with SMW of color, transgender and gender diverse people, and bi+ women (e.g., bisexual, pansexual, queer) being at greatest risk. These results emphasize the need to improve accurate assessment of trauma-related sequelae among SMW and to develop, disseminate, and implement culturally sensitive treatments to reduce PTSD and comorbid PTSD/HD among at-risk SMW.

Cohabitation and Marriage Among Same-Sex Couples in the 2019 ACS and CPS: A Research Note

Since the 2015 U.S. Supreme Court ruling that marriages of same-sex couples are legal in all states in the union, federal surveys have adapted to the shifting legal climate and included new measures that more directly identify same-sex and different-sex cohabiting and married couples. In this research note comparing the largest and most recent federal surveys-the 2019 American Community Survey and Current Population Survey-we find consistent levels of cohabitation and marriage across surveys. While the vast majority (90%) of different-sex couples were married, we report a more even split in cohabitation and marriage among same-sex couples. Our evaluation of sociodemographic characteristics of married and cohabiting couples indicates that differences were less prominent among same-sex couples than among different-sex couples, suggesting weaker sociodemographic selection into marriage among the former. However, factors affecting same-sex and different-sex couples' decisions to live together and marry may differ because of legal and social climates that still present unique obstacles for same-sex couples. Researchers need to acknowledge these differences in assessments of the implications of marriage for health and well-being.

Examining perceived effects of same-sex marriage legalization among sexual minority women: Identifying demographic differences and factors related to alcohol use disorder, depression, and self-perceived health

Background

Reductions in structural stigma, such as gaining access to legalized same-sex marriage, is associated with positive psychological and physical health outcomes among sexual minorities. However, these positive outcomes may be less robust among sexual minority women (SMW).

Methods

This study examined how perceptions of the impact of legalized same-sex marriage among SMW may 1) differ by demographic characteristics and 2) predict alcohol use disorder, depression, and self-perceived health. A diverse sample of SMW (N=446) completed an online survey in 2020 assessing the perceived impact of legalized same-sex marriage across six social-ecological domains: 1) personal impact, 2) stigma-related concerns, 3) couple impact, 4) family support, 5) work/school impact, and 6) local social climate towards LGBTQ people.

Results

Perceived impact across multiple domains differed by relationship status and sexual identity (e.g., lesbian compared to bisexual identity); only family support differed by race/ethnicity. Stigma-related concerns (e.g., experiencing or witnessing hostility or discrimination because of sexual identity, despite legalized same-sex marriage) were associated with greater odds of depression and lower odds of reporting excellent, very good, or good health. Odds of depression were lower among participants who reported higher personal impact, a greater number of family members supportive of same-sex marriage, and a more positive local social climate. Family support also predicted self-perceived health. However, participants who perceived increased support in work/school contexts after legalized same-sex marriage had higher odds of alcohol use disorder.

Conclusions

Overall, findings underscore the importance of policy in improving health outcomes through reducing stigma-related concerns and improving social acceptance.

Measuring the impact of legal recognition of same-sex marriage among sexual minority women

Reductions in structural stigma, such as gaining access to legalized same-sex marriage, is associated with positive psychological and physical health outcomes among sexual minority adults. However, these positive outcomes may be less robust among sexual minority women (SMW; e.g., lesbian, bisexual, queer) than sexual minority men and new measures are needed to develop a more nuanced understanding of the impact of affirming policies on the health and well-being of SMW. This study assessed the psychometric properties of measures developed to assess the psychosocial impacts of legalized same-sex marriage on the lives of SMW. Participants (N=446) completed an online survey assessing the psychosocial impact of legalized same-sex marriage in five domains: 1) personal impact, 2) stigma-related concerns, 3) couple impact, 4) LGBTQ community impact, and 5) political/social environment. Psychometric properties of the scales were examined using traditional and Rasch analyses. Personal, concerns, couple, and political/social environment scales demonstrated high internal consistency (α > 0.80), and acceptable levels of reliability even when scales reduced to five items each. The LGBTQ community scale demonstrated adequate internal consistency (α = 0.79) and could only be reduced to 9 items. These scales may be useful in future studies of SMW health and well-being.

Perceived psychosocial impacts of legalized same-sex marriage: A scoping review of sexual minority adults' experiences

A growing body of literature provides important insights into the meaning and impact of the right to marry a same-sex partner among sexual minority people. We conducted a scoping review to 1) identify and describe the psychosocial impacts of equal marriage rights among sexual minority adults, and 2) explore sexual minority women (SMW) perceptions of equal marriage rights and whether psychosocial impacts differ by sex. Using Arksey and O’Malley’s framework we reviewed peer-reviewed English-language publications from 2000 through 2019. We searched six databases (PubMed, PsycINFO, CINAHL, Web of Science, JSTOR, and Sociological Abstracts) to identify English language, peer-reviewed journal articles reporting findings from empirical studies with an explicit focus on the experiences and perceived impact of equal marriage rights among sexual minority adults. We found 59 studies that met our inclusion criteria. Studies identified positive psychosocial impacts of same-sex marriage (e.g., increased social acceptance, reduced stigma) across individual, interpersonal (dyad, family), community (sexual minority), and broader societal levels. Studies also found that, despite equal marriage rights, sexual minority stigma persists across these levels. Only a few studies examined differences by sex, and findings were mixed. Research to date has several limitations; for example, it disproportionately represents samples from the U.S. and White populations, and rarely examines differences by sexual or gender identity or other demographic characteristics. There is a need for additional research on the impact of equal marriage rights and same-sex marriage on the health and well-being of diverse sexual minorities across the globe.

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.