Out of the Closet, but Not Out of the Woods: The Longitudinal Associations Between Identity Disclosure, Discrimination, and Nonsuicidal Self-Injury Among Sexual Minoritized Young Adults

An Intersectional Exploration of Outness, Encountered Discrimination and Violence, and Non-Suicidal Self-Injury among Asexual Youth across Gender Identities

Current research on asexual youth is limited, especially in understanding the impact of their outness and the intersection of sexual orientation with gender minority identities. This study investigates the influence of outness on experiences of harassment, discrimination, violence, and the risk of non-suicidal self-injury (NSSI) among asexual youth, with a focus on those with transgender and non-binary identities. Data for this study were obtained from the 2021 Ace Community Survey, an international online survey designed to assess the needs and health status of the Ace community, targeting respondents aged 13 and older. The analysis involved a subsample of 5574 respondents aged 13 to 24 (mean age = 19.28), including 2361 cisgender (mean age = 19.65), 1,195 transgender (mean age = 18.80), and 2,018 non-binary individuals (mean age = 19.13). The results revealed that experienceds of sexual violence, verbal aggression, and physical harassment and bullying not only correlated with but also completely mediated the relationship between outness and NSSI. Asexual transgender youth experienced heightened levels of discrimination and NSSI but demonstrated notable resilience against the negative effects of identity disclosure, highlighting complex dynamics of vulnerability and protection within these communities.

Everyday Sexual and Gender Minority Stress and Health: A Systematic Review of Experience Sampling Studies

Sexual and gender minority stress is associated with negative physical and mental health outcomes, such as hypertension and depression. Expanding on previous reviews of the literature on cross-sectional and long-term prospective associations between sexual and gender minority stress and health outcomes, the current systematic review synthesizes the evidence on how everyday sexual and gender minority stress relates to momentary changes in health. The findings of 53 experience sampling studies published between 2007 and 2022 suggest that daily and momentary within-persons fluctuations in minority stressors are associated with cognitive-emotional (e.g., affect, suicidality), behavioral (e.g., substance use), social (e.g., relationship satisfaction), and physical health outcomes (e.g., somatic symptoms). These findings suggest that sexual and gender minority stress is a dynamic process that can vary within individuals over time and significantly impact everyday mental and physical health. We discuss the implications of these findings for minority stress theory, LGBTQ+ health research, LGBTQ+ affirming therapy, and prevention initiatives. The current experience sampling literature is limited by a lack of attention to gender minority stress and a focus on a limited range of health outcomes. Methodological and theoretical considerations for future experience sampling research are discussed in light of these limitations.

Latent Heterogeneity of Online Sexual Experiences and Associations With Sexual Risk Behaviors and Behavioral Health Outcomes in Chinese Young Adults: Cross-Sectional Study

BACKGROUND

Online sexual experiences (OSEs) are becoming increasingly common in young adults, but existing papers have reported only on specific types of OSEs and have not shown the heterogeneous nature of the repertoire of OSEs. The use patterns of OSEs remain unclear, and the relationships of OSEs with sexual risk behaviors and behavioral health outcomes have not been evaluated.

OBJECTIVE

This study aimed to examine the latent heterogeneity of OSEs in young adults and the associations with sexual risk behaviors and behavioral health outcomes.

METHODS

The 2021 Youth Sexuality Study of the Hong Kong Family Planning Association phone interviewed a random sample of 1205 young adults in Hong Kong in 2022 (male sex: 613/1205, 50.9%; mean age 23.0 years, SD 2.86 years) on lifetime OSEs, demographic and family characteristics, Patient Health Questionnaire-4 (PHQ-4) scores, sex-related factors (sexual orientation, sex knowledge, and sexual risk behaviors), and behavioral health outcomes (sexually transmitted infections [STIs], drug use, and suicidal ideation) in the past year. Sample heterogeneity of OSEs was analyzed via latent class analysis with substantive checking of the class profiles. Structural equation modeling was used to examine the direct and indirect associations between the OSE class and behavioral health outcomes via sexual risk behaviors and PHQ-4 scores.

RESULTS

The data supported 3 latent classes of OSEs with measurement invariance by sex. In this study, 33.1% (398/1205), 56.0% (675/1205), and 10.9% (132/1205) of the sample were in the abstinent class (minimal OSEs), normative class (occasional OSEs), and active class (substantive OSEs), respectively. Male participants showed a lower prevalence of the abstinent class (131/613, 21.4% versus 263/592, 44.4%) and a higher prevalence of the active class (104/613, 17.0% versus 28/592, 4.7%) than female participants. The normative class showed significantly higher sex knowledge than the other 2 classes. The active class was associated with male sex, nonheterosexual status, higher sex desire and PHQ-4 scores, and more sexual risk behaviors than the other 2 classes. Compared with the nonactive (abstinent and normative) classes, the active class was indirectly associated with higher rates of STIs (absolute difference in percentage points [Δ]=4.8%; P=.03) and drug use (Δ=7.6%; P=.001) via sexual risk behaviors, and with higher rates of suicidal ideation (Δ=2.5%; P=.007) via PHQ-4 scores.

CONCLUSIONS

This study provided the first results on the 3 (abstinent, normative, and active) latent classes of OSEs with distinct profiles in OSEs, demographic and family characteristics, PHQ-4 scores, sex-related factors, and behavioral health outcomes. The active class showed indirect associations with higher rates of STIs and drug use via sexual risk behaviors and higher rates of suicidal ideation via PHQ-4 scores than the other 2 classes. These results have implications for the formulation and evaluation of targeted interventions to help young adults.

Development and Validation of the Gay-Specific Intraminority Stigma Inventory (G-SISI): Initial Evidence Underpinned by Intraminority Stress Theory

There is currently a lack of measures testing intraminority stress within gay men. Therefore, the current study sought to develop and psychometrically test the Gay-Specific Intraminority Stigma Inventory (G-SISI). Based on a content review of the literature and a panel of experts, a pool of items assessing gay men's perceived exposure to a range of discriminatory attitudes from other gay men was generated. Utilizing a randomly split sample of 1723 gay men between the ages of 19 and 79 years, an exploratory factor analysis was first performed (n = 861). The remaining unexamined data were then used to conduct a confirmatory factor analysis (n = 862). The results support a six-factor model: (1) Age Stigma, (2) Socioeconomic Stigma, (3) Gay Non-Conformity Stigma, (4) Racial Stigma, (5) Gender Expression Stigma, and (6) Body Stigma. Cronbach's alpha for the total scale was 0.90 and for the subscales ranged from 0.60 to 0.85. Sociodemographic factors and measures of community involvement were differentially associated with the G-SISI subscales, providing evidence of construct validity. The findings demonstrate initial support for the dimensionality and validity of the G-SISI, which targets modifiable factors (e.g., identity-based stigma) that may increase stress and reduce community coping resources among gay men with diverse identities.

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities

Social marginalization increases the risk of suicidal ideation (SI) among individuals with diverse identities, yet research examining the effects of marginalization has focused on one identity. Emerging adulthood is a critical period of identity development and the age group with the highest rates of SI. Considering the challenges of living in potentially heterosexist, cissexist, racist, and sizeist environments, we tested whether possessing multiple marginalized identities was associated with severity of SI through factors proposed in the interpersonal-psychological theory (IPT) and the three-step theory (3ST) of suicide and if mediation paths were moderated by sex. A sample of 265 college students completed a cross-sectional online survey assessing SI and constructs related to IPT and 3ST. The number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index >25 kg/m2, sexual attraction to same sex but identified as heterosexual, and gender-fluid identity. In IPT multiple mediation analyses, possessing more marginalized identities was associated with SI severity through burdensomeness and hopelessness, but not belonging. Indirect paths through burdensomeness and belonging were moderated by sex. For 3ST, possessing more marginalized identities was associated with SI severity through hopelessness and psychological pain, but not social connection or meaning in life. Future research should consider intersecting social identities and test mechanisms by which multiply marginalized college students develop resilience to SI risk factors, such as support within their marginalized groups, to inform suicide assessment and intervention efforts on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).