Internalized Sexual Stigma in Italian Lesbians and Gay Men: The Roles of Outness, Connectedness to the LGBT Community, and Relationship Satisfaction

Differential effects of community involvement on eating disorder prevention outcomes in sexual minority men

Prior research has been conflicted on whether gay community involvement serves as a risk or protective factor for body image and eating disorders (EDs) in sexual minority men (SMM), perhaps given that prior research has examined community involvement unidimensionally. The present study examined whether non-appearance-based ("social activism") and appearance-based ("going out/nightlife") community involvement differentially predicted ED prevention outcomes in SMM. SMM (N = 73) enrolled in a randomized controlled trial of an ED prevention program completed measures of community involvement, drive for muscularity, body dissatisfaction, and bulimic symptoms at pre-intervention, post-intervention, and 1-month follow-up. "Social activism" community involvement moderated intervention effects for drive for muscularity and body dissatisfaction scores, but not bulimic symptoms, such that those who placed higher importance on social activism demonstrated expected improvements, while those who placed lower importance on social activism did not exhibit expected improvements. "Going out/nightlife" community involvement did not moderate intervention outcomes; however, greater importance of going out/nightlife was associated with increased body dissatisfaction. Findings support that the impact of community involvement on body image and ED risk for SMM may be nuanced. Encouraging community involvement through activism could help enhance ED prevention efforts for SMM.

Identity Processes and Psychological Wellbeing Upon Recall of a Significant "Coming Out" Experience in Lesbian, Gay and Bisexual People

This study focuses on the relations between minority stressors, protective factors and psychological wellbeing among lesbian, gay and bisexual (LGB) people. Experimental data based on a sample of 156 showed that participants asked to recall a negative coming out experience to somebody significant reported more identity threat and distress and less positive affect compared to those recalling a neutral coming out experience. In the negative recall condition, the effects of the stressors of discrimination and rejection on the variance of distress through the mediation of identity threat were statistically significant but not in the neutral recall condition and the two conditions statistically significantly differed in regards to the relationship between discrimination and distress. Identity resilience-continuity was associated with less identity threat and distress in the negative recall condition only, while social support was negatively associated and LGB stigma sensitivity was positively associated with distress in both conditions. Degree of outness (operating as a coping strategy) was associated with increased positive affect in both the neutral and negative recall conditions. When recalling a negative coming out experience, LGB people may be more susceptible to distress associated with minority stressors but also capitalize on available coping strategies.

Social Media and Online Dating Safety Practices by Adolescent Sexual and Gender Diverse Men: Mixed-Methods Findings From the SMART Study

PURPOSE

Sexual and gender diverse youth (SGDY) develop and employ safety strategies on their own to manage risks while using dating apps. This study aimed to describe the online dating safety practices of SGDY and determine the effectiveness of an eHealth HIV-prevention educational intervention with dating safety content to promote future safety behaviors.

METHODS

SGDY aged 13-18 from across the United States (N = 1087) were assigned to increasingly intensive HIV-prevention educational programs using a sequential multiple-assignment randomized trial design. Data were collected at three time points, each three months apart. Participants were asked multiple-choice and open-ended questions about the safety practices they used online and in person; mixed-methods described the safety behaviors of SGDY. Logistic regressions were used to determine psychosocial predictors of safety behaviors and the effectiveness of the intervention in promoting future safety practices.

RESULTS

60% (n = 662) of participants used dating apps, most of whom reported using online (96.4%, n = 638) and in-person (92.9%, n = 615) safety strategies, such as limiting the disclosure of personal information or meeting other users in public. Outness and previous victimization were important psychosocial predictors of engaging in safety behaviors. Additionally, participants who received the online safety education were over 50% more likely to employ certain safety behaviors than SGDY who did not.

DISCUSSION

While most SGDY reported at least 1 type of safety strategy when dating online, safety practices differed across psychosocial variables, such as outness. This study provides evidence for the effectiveness of an eHealth educational intervention tailored to SGDY to promote additional safety behaviors.

Romantic Attachment, Relationship Satisfaction, Internalized Sexual Stigma, and Motives for Parenthood in Italian Lesbian Women and Gay Men

This study examines romantic attachment, internalized sexual stigma, relationship satisfaction, and motives for parenthood in a sample of 313 Italian lesbian women (47.9%) and gay men (52.1%) aged 18-71 years (M = 36.2; SD = 11.9) and in same-sex relationships. The following hypotheses were tested: that romantic attachment is positively correlated with internalized stigma and motives to not have children, while it is negatively correlated with relationship satisfaction; that relationship satisfaction is negatively correlated with internalized stigma and motives for parenthood; that internalized stigma is negatively correlated with motives for parenthood; and that relationship satisfaction mediates the relationships between romantic attachment and motives for parenthood and between internalized stigma and motives for parenthood. The results strongly support the hypotheses. Furthermore, the results indicate that the lesbian participants reported lower levels of avoidance and internalized stigma and higher levels of relationship satisfaction and motives to not have children, and the participants in civil unions reported lower levels of anxiety and internalized stigma and higher levels of relationship satisfaction and motives to not have children. Taken together, our findings contribute to the growing body of research on LG parenthood and may inform social policy and psychological support for LG individuals pursuing parenthood.

Kept in the Closet: Structural Stigma and the Timing of Sexual Minority Developmental Milestones Across 28 European Countries

Structural stigma's role in lesbian, gay, and bisexual (LGB) people's attainment of identity development milestones remains unknown. In a sample of 111,498 LGB people (ages 15 to 65+) living across 28 European countries, associations were investigated between structural stigma measured using an objective index of discriminatory country-level laws and policies affecting LGB people and the timing and pacing of LGB self-awareness, coming out, and closet duration, and subgroup differences in these associations. On average, self-awareness occurred at age 14.8 years old (SD = 5.1), coming out occurred at 18.5 years old (SD = 5.7), and the closet was 3.9 years long (SD = 4.9); thereby highlighting adolescence as a key period for sexual identity development and disclosure. Greater structural stigma was associated with higher odds of never coming out, later age of coming out, and longer closet duration. Gender identity, transgender identity, and sexual identity moderated associations between structural stigma and these developmental milestones. Reducing structural stigma can plausibly promote sexual identity development among LGB populations, especially during adolescence when identity related milestones are often attained.

Effects of psychological distress and life satisfaction on COVID-related traumatic stress: An international, cross-sectional study

BACKGROUND

This study examines the individual impacts of psychological distress (i.e., depression and anxiety) and life satisfaction on COVID-related traumatic stress in an international sample of heterosexual versus LGBQ+ adults.

METHOD

Between July and August 2020, a cross-sectional electronic survey (n = 2482) was launched in five countries (India, Italy, Saudi Arabia, Spain, and United States) assessing sociodemographic characteristics as well as psychological, behavioral, and social factors related to health outcomes during the COVID-19 pandemic.

RESULTS

Significant differences between LGBQ+ participants and heterosexual participants were found for depression (p < .001) and anxiety (p < .001). Depression was associated with COVID-related traumatic stress among heterosexual participants (p < .001) but not LGBQ+ participants. Both anxiety (p < .001) and life satisfaction (p = .003) were also associated with COVID-related traumatic stress in both groups. Hierarchical regression models demonstrated significant effects of COVID-related traumatic stress for adults outside the United States (p < .001); less than full-time employment (p = .012); and for greater levels of anxiety, depression, and life satisfaction, respectively (all ps < .001).

LIMITATIONS

Given the stigma of being LGBQ+ that remains in many countries, participants in may have been reluctant to identify as a sexual minority and therefore indicated a heterosexual sexual orientation.

CONCLUSION

The impact of sexual minority stress among LGBQ+ may play a role in COVID-related post-traumatic stress. Large-scale global disasters such as pandemics, contribute to disparities in psychological distress among LGBQ+ individual, however, sociodemographic factors such as country and urbanicity may play mediating or moderating roles.

Gay, Lesbian, and Bisexual (LGB) peoples' leadership self-effectiveness: The roles of internalized sexual stigma, LGB positive identity, and traditional masculinity

Grounded in the theoretical frameworks of the minority stress model and the model of positive identity in sexual minority people, the current research contributes to fill a gap in the previous literature, investigating the relationships among leadership self-effectiveness, internalized sexual stigma, positive identity, and adherence to traditional masculinity of gay, lesbian, and bisexual (LGB) individuals. Through a correlational study (N = 449), we collected data from 229 gay/bisexual men (51%) and 220 lesbian/bisexual women (49%). We hypothesized that lower internalized sexual stigma, higher LGB positive identity, and higher adherence to traditional masculinity were associated to higher self-perceived effectiveness. The interactive relationships among the variables, including participants' gender, were investigated from an exploratory perspective. The hypotheses were tested through two moderated regression models and the results confirmed that participants with lower internalized sexual stigma and higher LGB positive identity were more likely to perceive themselves as potential effective leaders. Also, the results showed a significant interaction between participants' gender and traditional masculinity score suggesting that high adherence to traditional masculinity was a significant predictor of self-perceived effectiveness only for gay/bisexual men, but not for lesbian/bisexual women. This research contributes to provide both confirmation and novel insights into the key role of relevant factors impacting on LGB people's leadership self-effectiveness, which might contribute to preserve the gay glass ceiling effect. The presence of antidiscrimination policies in organizations not only might reduce reports of discrimination but also enhance LGB employees' positive sense of self, which is a critical aspect to emerge as a leader.

Feeling safe and content: Relationship to internalized sexual stigma, self-awareness, and identity uncertainty in Italian lesbian and bisexual women

Research has linked feelings of safety and contentment to lower adverse mental health outcomes (e.g., stress, anxiety, depression) in the general population. The current study aimed at exploring the relationship between safe/content positive affect and minority stress (e.g., internalized sexual stigma) in lesbian and bisexual women, considering the effect of potential mediators such as identity self-awareness and identity uncertainty. An online survey was administered to 400 Italian women (220 lesbian and 180 bisexual women), aged 18-40 years (M = 25.98, SD = 6.07). The results showed that lesbian women reported lower internalized sexual stigma and identity uncertainty and higher safe/content positive affect and identity self-awareness, relative to bisexual women. Higher internalized sexual stigma predicted lower safe/content positive affect, regardless of sexual orientation. Furthermore, identity self-awareness and identity uncertainty significantly mediated the relationship between internalized sexual stigma and safe/content feelings, thus confirming the protective role of sexual identity variables on lesbian and bisexual women's positive affectivity. Finally, univariate analyses suggested that lesbian women were more resilient than bisexual women in the face of minority stressors. The results contribute to the understanding of the differences between lesbian and bisexual women in their perception of salient identity categories. In addition, the findings highlight the relevance of protective factors (e.g., identity certainty, lesbian and bisexual positive identity) in ameliorating the adverse effects of minority stress and promoting positive affect and social adjustment in lesbian and bisexual women. Research and clinical implications and directions are discussed.

Do Spirituality, Rurality, and LGBTQ Support Increase Outness and Quality of Health in Gay and Bisexual Men?

Although the existing research suggests that spirituality may positively affect health outcomes for gay and bisexual men, it is unclear to what extent it improves the quality of health over and above sociodemographic factors. Furthermore, there remains conflicting evidence regarding the role of residential location on levels of outness for gay and bisexual men. To that end, the present study used hierarchical linear regression analyses to examine the role of spirituality, rurality, and LGBTQ connectedness in outness and quality of health. The sample comprised 2,202 self-identified gay and bisexual men aged 18 and older who responded to the Social Justice Sexuality Project survey; participants represented all 50 states and Puerto Rico. The results indicate that whereas spirituality was positively associated with a greater quality of life, there was no significant difference in outness between rural versus nonrural participants. Moreover, bisexual men endorsed significantly lower levels of outness compared to their gay counterparts. Implications for future research regarding the role of spirituality and rurality in sexual minority health are discussed.

Self-Compassion and Mental Health in Sexual and Gender Minority People: A Systematic Review and Meta-Analysis

Purpose: Literature shows that sexual and gender minority (SGM) individuals are at higher risk of developing minority stress-related mental health problems. Recently, it has been suggested that promoting self-compassion through affirmative mental health care for SGM people can be beneficial. However, no systematic analysis has been published exploring the relationship between self-compassion and mental health indicators in SGM individuals. We aim to fill this gap by synthesizing and meta-analyzing studies that focus on the relationship between self-compassion and mental health in SGM people. Methods: After registering in PROSPERO (CRD42021254774), PubMed, PsycINFO, CENTRAL, and Web of Knowledge were systematically searched to identify studies assessing the association between self-compassion and mental health and/or minority stress indicators in SGM individuals. All screening steps and data extraction were performed independently by the two researchers. The quality of each study was assessed with the National Heart, Lung and Blood Institute tool, and meta-analysis was performed on R software. Results: Twenty-one studies were included in the meta-analysis, corresponding to a total of 6573 nonheterosexual and/or noncisgender participants. All meta-analytic models were significant: higher levels of self-compassion were associated with less depression, anxiety, psychological distress, suicidal ideation, internalized homophobia/transphobia, and stigma, and with more well-being, outness, and social support. Conclusion: This meta-analysis suggests that self-compassion is significantly associated with mental health indicators in SGM people, and this relationship is especially strong with internalized homophobia/transphobia in older SGM adults, and with suicidal ideation in younger SGM individuals. Results suggest that affirmative mental health care may benefit from promoting self-compassion.

Psychophysical Impact of COVID-19 Pandemic and Same-Sex Couples' Conflict: The Mediating Effect of Internalized Sexual Stigma

Research on the effects of the COVID-19 pandemic on same-sex relationships is limited. The present study aimed at analyzing the association between the psychophysical impact of the COVID-19 pandemic and same-sex couples' conflict, also considering the potential mediating effect of internalized sexual stigma (ISS). For this purpose, psychophysical challenges and couples' conflict during the COVID-19 pandemic, ISS, age, biological sex, sexual orientation, relationship duration, religiosity, involvement in lesbian, gay, and bisexual (LGB) associations, sexual satisfaction, and interpersonal partner violence were assessed in an Italian sample of 232 LGB people engaged in a same-sex relationship (aged 18-45 years; M age = 28.68, SD = 6.91). The results indicated that the psychophysical impact of the COVID-19 pandemic was significantly associated with couples' conflict, and ISS mediated this relationship. Among the covariates considered, only sexual satisfaction was associated with couples' conflict. The findings suggest that ISS, over and above the adverse effects of the COVID-19 pandemic on psychophysical health, triggered conflict within same-sex relationships. Studying the role of ISS in various relational and social contexts is important, as ISS may have an adverse effect on the mental health of sexual minority people. We recommend that more efforts be made to improve research on the LGB population during the public health response to the COVID-19 emergency, because the paucity of studies underlines the invisibility of this population in many domains, including the domain of romantic relationships. Implications and directions for future research are discussed.

Sex Differences in the Romantic Relationships of Same-Gender Couples: The Role of Visibility Management

Although internalized homonegativity (IH) in lesbian, gay, or bisexual people (LGBs) predicts adverse relationship satisfaction, this association has typically only been examined on an individual level. Moreover, studies often ignore potential mechanisms that underlie sex differences. One of these mechanisms is related to visibility management (i.e., the careful, planned decisions about whether or not to disclose one's sexual orientation). Therefore, in this study we investigate dyadic sex-specific associations between IH, visibility management, and relationship satisfaction. Our sample includes 254 LGB couples (139 female and 115 male same-gender dyads) in Flanders, Belgium. Data were analyzed with the Actor-Partner Interdependence Mediation Model (APIMeM). Results indicated that there were small to medium significant correlations among IH, visibility management, and relationship satisfaction. We also found support for mediated actor effects: individuals low in IH maintain less restrictive visibility management strategies. These in turn lead to higher relationship satisfaction, but only in female same-gender couples. Our findings contribute to the understanding of mechanisms that underlie the harmful effects of sexual minority stressors for same-gender relationship satisfaction.

Adult Attachment, Differentiation of Self, and Relationship Satisfaction in Lesbians and Gay Men

We examined adult attachment styles, differentiation of self, and relationship satisfaction in a sample of 298 Italian lesbians (48%) and gay men (52%), all of whom were ages 19–71 years (M = 36.1; SD = 11.8) and in a couple relationship for at least six months. Participants were recruited via the Internet and completed a web-based survey. We tested the hypotheses that attachment insecurity and differentiation of self would predict relationship satisfaction, as well as that differentiation of self would mediate the relationship between adult attachment and relationship satisfaction. Results supported the hypotheses, thus indicating that attachment insecurity and differentiation of self were correlated with and predicted relationship satisfaction. Furthermore, results supported the hypothesized mediating role of differentiation of self. Finally, results indicated that younger participants, lesbians, and participants in civil unions reported higher levels of relationship satisfaction. Implications for counselors and therapists working with LG populations are discussed.

Lesbian and Gay Relationship Satisfaction Among Italians: Adult Attachment, Social Support, and Internalized Stigma

We examined adult attachment styles, perceived social support, internalized stigma, and relationship satisfaction in a sample of 305 lesbians (48.2%) and gay men (51.8%), ages 19-72 years (M = 36.4; SD = 11.8), and in a same-sex relationship for at least 6 months. Participants were recruited via the Internet and completed a web-based survey. We tested the hypotheses that attachment styles, perceived social support, and internalized stigma predicted relationship satisfaction, as well as that perceived social support would be correlated with internalized stigma. Results strongly supported the hypotheses, thus indicating that attachment styles, perceived support, and internalized stigma were negatively correlated with and predicted relationship satisfaction and that perceived social support was negatively correlated with internalized stigma. Furthermore, results indicated that lesbian participants had lower levels of anxious attachment style and reported higher levels of relationship satisfaction and lower levels of internalized stigma. Finally, results indicated that in the lesbian subsample, conservative political orientation and religious beliefs were correlated with higher levels of internalized stigma; participants coming from central Italy reported higher levels of perceived social support; and participants in civil unions reported higher levels of perceived social support and relationship satisfaction, and lower levels of internalized stigma. Implications for counselors and therapists working with lesbian and gay populations are discussed.