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Li M, Chau K, Calabresi K, Wang Y, Wang J, Fritz J, Tseng TS. The Effect of Minority Stress Processes on Smoking for Lesbian, Gay, Bisexual, Transgender, and Queer Individuals: A Systematic Review. LGBT Health 2024. [PMID: 38557209 DOI: 10.1089/lgbt.2022.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Purpose: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are more likely to smoke than non-LGBTQ individuals. Smoking has been posited as a coping mechanism for LGBTQ individuals facing minority stress. However, the exact relationship between minority stress and smoking behaviors among LGBTQ individuals is unclear. Therefore, the purpose of this systematic review was to examine how minority stress processes are associated with smoking behaviors for LGBTQ individuals. Methods: Searches of the PubMed and PsycINFO databases were conducted for smoking-, LGBTQ-, and minority stress-related terms. No date, geographic, or language limits were used. For inclusion, the study must have (1) been written in English, (2) had an LGBTQ group as the study population or a component of the study population, (3) assessed the cigarette smoking status of patients, and (4) assessed at least one minority stress-related process (internalized stigma, perceived stigma, or prejudice events). Results: The final review included 44 articles. Aside from two outlier studies, all of the reviewed studies exhibited that increased levels of minority stress processes (internalized queerphobia, perceived stigma, and prejudice events) were associated with increased probability of cigarette use in LGBTQ individuals. Increased minority stress was also associated with greater psychological distress/mental health decline. Conclusion: The findings of this review suggest that minority stress processes represent a contributing factor to smoking health disparities in LGBTQ populations. These results highlight the need for smoking cessation and prevention programs to address minority stress and improve smoking disparities in these populations.
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Affiliation(s)
- Mirandy Li
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Kelly Chau
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Kaitlyn Calabresi
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Yuzhi Wang
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Jack Wang
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Jackson Fritz
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Tung Sung Tseng
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
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Xu Y, Zheng L. Self-Objectification and Self-Sexualizing Appearance Behaviors in Chinese Lesbian and Bisexual Females: Moderating Effect of Femme/Butch/Androgyne Identity. JOURNAL OF HOMOSEXUALITY 2024:1-22. [PMID: 38319638 DOI: 10.1080/00918369.2024.2310758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
In heterosexual populations, self-objectification is associated with self-sexualizing appearance behaviors. This study examined the relationship between self-objectification and self-sexualizing appearance behaviors and the moderating effect of butch/androgynous/femme sexual self-label identification in Chinese bisexual and lesbian females. We recruited 637 bisexual and lesbian females to complete an online questionnaire that asked about demographic information and feminine and masculine self-sexualizing appearance behaviors and measured the Objectified Body Consciousness Scale. Feminine self-sexualizing appearance behaviors include wearing high heels, short skirts, low-cut outfits, skinny clothes and makeup. Masculine self-sexualizing appearance behaviors include wearing short hair and binding breasts. Femme-identified females scored higher on body surveillance than did butch- and androgynous-identified females. Butch-identified females reported having more masculine self-sexualizing behaviors, whereas femme-identified females reported having more feminine self-sexualizing appearance behaviors. Sexual self-label identification moderated the relationship between self-objectification and feminine self-sexualizing behaviors. Body surveillance was significantly associated with feminine self-sexualizing behaviors in femme- and androgynous-identified females but not in butch-identified females. Body shame was negatively associated with feminine self-sexualizing appearance behaviors in androgynous-identified females. The current findings highlight the role of sexual self-label identification in self-objectification among Chinese bisexual and lesbian females. The findings imply the heterogeneousness of self-objectification among Chinese bisexual and lesbian females.
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Affiliation(s)
- Yue Xu
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Lijun Zheng
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
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Kuhlemeier A. Measurement Invariance of Psychological Distress, Substance Use, and Adult Social Support across Race/Ethnicity and Sex among Sexual Minority Youth. JOURNAL OF SEX RESEARCH 2023; 60:674-688. [PMID: 35200066 PMCID: PMC9399311 DOI: 10.1080/00224499.2022.2038059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Research on intersectional differences among sexual minority youth (SMY) relies on population-level datasets to ensure sufficiently large samples to explore between-group differences and assess the influence of axes of oppression/privilege. I argue that a structural equation modeling framework for investigating intersectional differences among SMY increases the nuance with which we understand heterogeneity and provides tools for ensuring that variables measure comparable constructs across diverse populations - an assumption of traditional univariate methods that is rarely empirically verified. Using a subset of SMY that identified as either White or Hispanic/Latino and male or female from the New Mexico Youth Risk and Resiliency Survey (N = 3,654), this study tested invariance of three latent constructs: psychological distress, substance use, and adult support across sexual orientation, race/ethnicity, sex, and three-way intersections of those identities. Analyses established invariance across race/ethnicity and sex of all constructs among gay/lesbian youth. Partial invariance models were required to account for intersectional differences in substance use among bisexual youth and in psychological distress among questioning youth. This study models a novel strategy for examining how social location at the intersection of multiple axes of oppression/privilege shape behavioral health and social support and paves the way for significant advances in research on SMY.
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Affiliation(s)
- Alena Kuhlemeier
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM 87131
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Batchelder AW, Foley JD, Stanton AM, Gorman KR, Morris JC, Scheer JR. Facets of Gender Expression and Discrimination in Relation to Alcohol and Other Drug Use Severity Among Sexual Minority Women and Gender Diverse Individuals Assigned Female at Birth. LGBT Health 2022; 10:191-201. [PMID: 36367714 PMCID: PMC10079249 DOI: 10.1089/lgbt.2022.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sexual minority women and gender diverse individuals assigned female at birth (SMW+) consistently report more alcohol and other drug (AOD) use severity than heterosexual women, with greater disparities reported among bisexual plus (bi+) SMW (including bisexual, pansexual, queer, and those with attractions to more than one gender regardless of identity). Furthermore, emerging evidence suggests that SMW with masculine gender expression (e.g., SMW with masculine gender appearance) disproportionately experience problematic AOD use compared to those with feminine gender expression. The minority stress model, which has predominantly been investigated in relation to internalized homonegativity and sexuality-based discrimination, may also account for these AOD use disparities. This study examined gender expression, related discrimination, and AOD use severity among SMW+. Methods: In a 2020 sample of SMW+ (n = 236), we investigated AOD use severity in relation to gender expression (appearance, emotional expression, and gender roles) and gender expression-based discrimination after controlling for internalized homonegativity and sexuality-based discrimination through an online survey. Results: Masculine gender roles were associated with AOD use severity, whereas masculine appearance and emotional expression were not. In multivariable models, gender identity was inconsistently associated with alcohol use severity, sexuality-based discrimination was consistently associated with alcohol use severity and inconsistently associated with other drug use severity, and gender expression-based discrimination was associated with neither. Conclusion: This study emphasizes the importance of examining intersecting aspects of minority identity among SMW+, including facets of gender expression, in relation to AOD use severity.
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Affiliation(s)
- Abigail W. Batchelder
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Jacklyn D. Foley
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Amelia M. Stanton
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | | | - Jenna C. Morris
- Department of Internal Medicine, University of Rochester, Rochester, New York, USA
| | - Jillian R. Scheer
- Department of Psychology, Syracuse University, Syracuse, New York, USA
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Amos N, Bourne A, Hill AO, Power J, McNair R, Mooney-Somers J, Pennay A, Carman M, Lyons A. Alcohol and tobacco consumption among Australian sexual minority women: Patterns of use and service engagement. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103516. [PMID: 34753044 DOI: 10.1016/j.drugpo.2021.103516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sexual minority women consume both alcohol and tobacco at higher rates than heterosexual women. However, various sociodemographic and cultural factors associated with these practices among sexual minority women in Australia are not well understood, nor are the factors associated with seeking alcohol-related support. METHODS This study utilised data from cisgender sexual minority women respondents of Private Lives 3: a national, online, cross-sectional survey of the health and wellbeing of LGBTIQ adults in Australia aged 18+ conducted in 2019. Multivariable analyses were performed to identify co-existing smoking and alcohol use, sociodemographic factors associated with smoking, alcohol consumption and seeking alcohol-related support. RESULTS Of 2,647 sexual minority women respondents, 16.90% were currently smoking tobacco, 7.67% smoking tobacco daily and 60.50% reported potentially risky patterns of alcohol consumption. Tobacco and potentially risky alcohol consumption were found to frequently co-occur. Women who identified as queer were more likely than lesbian identifying women to currently smoke tobacco and to smoke tobacco daily. Tobacco consumption was associated with increased age, unemployment, low-mid range income and secondary-school education, while potential risky drinking was associated with living in outer urban or rural areas and being Australian born . Self-reporting having struggled with alcohol in the past twelve months was associated with residential location. Less than 3% of the sample has sought help for alcohol use. Seeking support was more likely as women aged, and with potentially risky drinking, and much more likely with self-perceived struggles with alcohol. CONCLUSIONS The findings highlight the need for future alcohol and tobacco use health promotion strategies focussing on sexual minority women to attend to within group differences that relate to risk of higher consumption. They also highlight the need for approaches that empower sexual minority women to self-identify when they are struggling with alcohol use and encourage seeking support with organisations that are affirming of sexual minority women.
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Affiliation(s)
- Natalie Amos
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia.
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Adam O Hill
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Level 3, 780 Elizabeth St, Melbourne, Victoria, 3004, Australia
| | - Julie Mooney-Somers
- University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics, Level 1 Medical Foundation Building, 91-97 Parramatta Road, Camperdown, NSW, 2050, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Building NR1, Bundoora, Victoria, 3086, Australia
| | - Marina Carman
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
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Johnson EEH, Wilder SMJ, Andersen CVS, Horvath SA, Kolp HM, Gidycz CA, Shorey RC. Trauma and Alcohol Use Among Transgender and Gender Diverse Women: An Examination of the Stress-Buffering Hypothesis of Social Support. J Prim Prev 2021; 42:567-581. [PMID: 34546505 DOI: 10.1007/s10935-021-00646-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Transgender and gender diverse (TGD) women (i.e., individuals who were assigned male at birth and identify as women or trans women) experience trauma at disproportionate rates compared to cisgender populations. While trauma is associated with increased alcohol use among TGD women, research regarding factors that are protective of this association is scant. The stress-buffering hypothesis of social support suggests that perceived social support, defined as the judgment that social network members will be helpful when individuals experience stress, may buffer and reduce the association between trauma symptoms and alcohol use. However, this relationship has not been examined among TGD women. We examined whether perceived social support moderates the association between trauma and alcohol use among 89 TGD women. Exploratory multiple regression analyses provided support for this hypothesis, insofar as trauma symptoms were related to alcohol use by individuals with low, relative to high levels of perceived social support. Exploratory analyses demonstrated that this finding was driven by perceived social support from friends and family. Our results are the first to suggest that social support reduces alcohol use among TGD women and add to the literature on their trauma and alcohol use.
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Affiliation(s)
| | | | | | | | - Haley M Kolp
- Department of Psychology, University of Wisconsin-Milwaukee, 238B Garland Hall, Milwaukee, WI, USA
| | | | - Ryan C Shorey
- Department of Psychology, University of Wisconsin-Milwaukee, 238B Garland Hall, Milwaukee, WI, USA.
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7
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Matheson L, Ortiz DL, Hoskin RA, Holmberg D, Blair KL. The feminine target: Gender expression in same-sex relationships as a predictor of experiences with public displays of affection. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2021. [DOI: 10.3138/cjhs.2021-0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The extent to which sexual minority individuals present publicly as masculine, feminine, or both has been associated with their perceptions of threat and safety in public spaces. The current study investigates the role of gender expression in men and women’s experiences of public displays of affection (PDAs) in same-sex relationships. Participants (N = 528) reported their own gender expression as well as that of their partner, perceptions of support for PDAs, PDA-related vigilance, general vigilance and overall PDA frequency. Men in same-sex relationships reported less frequent PDAs and greater PDA-related vigilance than women, while women reported greater overall variability in their gender expression than men. Multiple regression analyses show femininity within the participant (for men) or their partner (for both men and women) was associated with greater general and PDA-related vigilance. These findings align with previous research on femmephobia, in which femininity is described as making individuals feel ‘targeted’ for other forms of oppression (e.g., homophobia, sexism, transphobia; Hoskin, 2019 ). Although femininity was associated with greater vigilance, the association between masculinity within a same-sex relationship and vigilance was more tenuous, demonstrating evidence of masculinity serving as both a potential target for homophobic violence as well as a source of protection. The dual nature of masculinity was particularly salient among women in same-sex relationships, where masculinity tempered by femininity was associated with greater perceived support for PDAs but for women with partners low in femininity, the more masculine their partner, the greater their reported levels of vigilance.
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Affiliation(s)
- Lauren Matheson
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Drexler L. Ortiz
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Rhea Ashley Hoskin
- Departments of Sociology & Legal Studies; Sexuality Marriage & Family Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Diane Holmberg
- Department of Psychology, Acadia University, Wolfville, Nova Scotia, Canada
| | - Karen L. Blair
- Department of Psychology, Trent University, Peterborough, Ontario, Canada
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Gardella JM, Parnes MF, Hirst W, Brown AD. Knowledge of Chosen Family History and Depressive Symptoms in Sexual Minority Women. Front Psychol 2021; 12:624641. [PMID: 34211416 PMCID: PMC8239219 DOI: 10.3389/fpsyg.2021.624641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
Recent work on intergenerational memory has revealed a positive association between family of origin knowledge and wellbeing in adolescents. However, little is known about the generalizability of these data, as significantly less attention has focused on autobiographical memory sharing and wellbeing in historically marginalized communities. Given the high incidence of familial rejection and abandonment within the LGBTQIA + community, close relationships with individuals outside of one’s family of origin, chosen families, often serve as an important source of social support. This study sought to examine the relationship between knowledge of a close non-family member and wellbeing among emerging adult sexual minority women (SMW) according to their gender presentation. A community sample from New York City comprised of heterosexual women (n = 50), masculine-presenting SMW (n = 50), and feminine presenting SMW (n = 50) completed measures associated with their knowledge of their family of origin, knowledge of a close non-family member, as well as self-reported measures of depression, emotion regulation, and socio-demographic questions. Family of origin knowledge was associated with lower levels of depression only among heterosexual women. However, heterosexual and SMW who knew more about their close non-family member reported lower levels of depression. Additionally, emotion regulation (cognitive reappraisals) mediated the relationship between knowing more about one’s chosen family and lower depressive symptom severity among heterosexual women, but this relationship was only significant for SMW who were at least moderately open about their sexuality. These findings extend the literature on the benefits of memory sharing to historically marginalized communities by showing that memory sources outside of one’s family of origin may be particularly important. Additionally, these data begin to shed light on potential mediating factors, such as emotion regulation and openness about one’s sexual identity, that underlie the links between memory sharing and metrics of wellbeing. Taken together, in contexts in which there may not be opportunities to learn about family history from one’s family of origin, it appears that access to stories from someone close outside of one’s family is also associated with lower levels of depression.
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Affiliation(s)
- Jamie M Gardella
- Department of Psychology, The New School for Social Research, New York, NY, United States
| | - McKenna F Parnes
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - William Hirst
- Department of Psychology, The New School for Social Research, New York, NY, United States
| | - Adam D Brown
- Department of Psychology, The New School for Social Research, New York, NY, United States.,Department of Psychiatry, New York University School of Medicine, New York, NY, United States
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Holloway IW, Green D, Pickering C, Wu E, Tzen M, Goldbach JT, Castro CA. Mental Health and Health Risk Behaviors of Active Duty Sexual Minority and Transgender Service Members in the United States Military. LGBT Health 2021; 8:152-161. [PMID: 33538639 PMCID: PMC8336224 DOI: 10.1089/lgbt.2020.0031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The aim of this study was to examine health risk behaviors and mental health outcomes among sexual minority and transgender active duty military service members and their heterosexual and cisgender counterparts. Methods: Participants (N = 544) were recruited by using respondent-driven sampling between August 2017 and March 2018 and completed an online survey by using validated measures of cigarette smoking, alcohol use, anxiety, depression, post-traumatic stress disorder (PTSD), and suicidality. Bayesian random intercept multiple logistic regressions were used to understand differences between sexual minority participants and heterosexual participants as well as between transgender participants and both their cisgender sexual minority and cisgender heterosexual peers. Results: Cisgender sexual minority women service members were more likely to meet criteria for problematic alcohol use (adjusted odds ratio [aOR] = 10.11) and cigarette smoking (aOR = 7.12) than cisgender heterosexual women. Cisgender sexual minority men had greater odds of suicidality (aOR = 4.73) than their cisgender heterosexual counterparts. Transgender service members had greater odds of anxiety, PTSD, depression, and suicidality than their cisgender peers. Conclusion: Military researchers and policymakers who seek to improve the overall health and well-being of sexual minority and transgender service members should consider programs and policies that are tailored to specific health outcomes and unique sexual minority and transgender subgroups.
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Affiliation(s)
- Ian W. Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel Green
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Chad Pickering
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
- California Center for Population Research, University of California, Los Angeles, Los Angeles, California, USA
| | - Elizabeth Wu
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Michael Tzen
- California Center for Population Research, University of California, Los Angeles, Los Angeles, California, USA
| | - Jeremy T. Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Carl A. Castro
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
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Mantey DS, Yockey RA, Lee JGL. Sexual Minority Status and Marijuana Initiation during Adulthood: A Longitudinal Study Using Nationally Representative Data. Subst Use Misuse 2021; 56:1054-1061. [PMID: 33855928 PMCID: PMC8170695 DOI: 10.1080/10826084.2021.1906704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sexual minorities (i.e. individuals who identify as lesbian, gay, and bisexual) are at increased risk for marijuana use. However, little is known about initiation during adulthood. This study examines: (1) sexual minority status as a risk factor for marijuana initiation, and (2) the modifying effect of sex (labeled at birth) on this relationship. Methods: We analyzed Wave 1 (2013-2014) and Wave 2 (2014-2015) of the Population Assessment of Tobacco and Health, a nationally representative survey. Participants were n = 10,756 adult never marijuana users. A multivariable logistic regression examined the relationship between sexual minority status and initiation of marijuana use at Wave 2. Multivariable logistic regressions, stratified by sex, were used to assess for effect modification. Covariates were sex, age, race/ethnicity, income, currently attending college, and mental health well-being. Results: Approximately 1.1% of adults initiated marijuana use from Wave 1 to Wave 2. Sexual minority status was associated with 1.57 (95% CI: 1.00-2.46) greater odds of marijuana initiation. In stratified analyses, sexual minority status was associated with greater odds of marijuana initiation for females (Adj OR: 1.97; 95% CI: 1.19-3.26) but not males (Adj OR: 0.84: 95% CI: 0.33-2.16). Conclusions: Sexual minority status is a risk factor for marijuana initiation during adulthood. This relationship was only consistent for females, suggesting that sex may be an effect modifier. However, research designed and powered to directly detect this effect is needed. Findings highlight a need for public health interventions that reduce disparities in marijuana use among sexual minorities.
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Affiliation(s)
- Dale S Mantey
- School of Public Health, University of Texas, Austin, Texas, USA
| | - R Andrew Yockey
- Department of Health Promotion and Education, University of Cincinnati, Cincinnati, Ohio, USA
| | - Joseph G L Lee
- Department of Maternal & Child Health, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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11
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Prevalence and correlates of substance use among transgender adults: A systematic review. Addict Behav 2020; 111:106544. [PMID: 32717497 DOI: 10.1016/j.addbeh.2020.106544] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 06/23/2020] [Accepted: 07/05/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Minority stress theories suggest that high rates of discrimination experienced by transgender people are precipitants of substance use. This risk is likely exacerbated by an inadequate provision of trans-inclusive substance misuse services. However, the exclusion of transgender people from the general substance misuse literature makes it difficult to determine the extent to which transgender status influences substance use. A systematic review was undertaken to better understand the prevalence, patterns and correlates of substance use among this group. METHODS In accordance with the PRISMA guidance, a literature search was conducted to 29th May 2019 on PubMed, PsycINFO, Embase and Global Health databases. Primary quantitative studies, published in English, that reported the prevalence, patterns or correlates of substance use by transgender people were included, with no restriction on methodological design. RESULTS 653 unique records were identified, and 41 studies were included. Half the studies reported on both transgender men and transgender women and half transgender women only. There was high and excess prevalence of substance use among transgender compared with cisgender people, but insufficient evidence to estimate prevalence or quantify the risk for substance use. Correlates of substance use included transphobic discrimination or violence, unemployment and sex work, gender dysphoria, high visual gender non-conformity and intersectional sexual minority status. CONCLUSIONS The sparse findings lend support to the minority stress model. However, the overreliance of the literature on disproportionate investigation of transgender women with multiple intersectional disadvantages, means there are significant gaps regarding the wider transgender community. To ensure substance use treatment services are inclusive, gender identity should be recorded and targeted interventions available. Clinicians should be aware of the multiple, complex drivers of substance use and be prepared to ask about substance use and offer support. Given the high prevalence of trauma experienced by transgender people, trauma-informed psychosocial interventions may be useful in the management of problematic substance use in transgender adults.
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12
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Bryson MK, Taylor ET, Boschman L, Hart TL, Gahagan J, Rail G, Ristock J. Awkward Choreographies from Cancer's Margins: Incommensurabilities of Biographical and Biomedical Knowledge in Sexual and/or Gender Minority Cancer Patients' Treatment. THE JOURNAL OF MEDICAL HUMANITIES 2020; 41:341-361. [PMID: 30488328 PMCID: PMC7343748 DOI: 10.1007/s10912-018-9542-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were conducted with a diverse group (n=81) of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge.
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Affiliation(s)
- Mary K Bryson
- Department of Language and Literacy Education, Faculty of Education, University of British Columbia, Vancouver, BC, Canada.
| | - Evan T Taylor
- Department of Language and Literacy Education, UBC, Vancouver, BC, Canada
| | - Lorna Boschman
- Department of Language and Literacy Education, UBC, Vancouver, BC, Canada
| | - Tae L Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Jacqueline Gahagan
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Genevieve Rail
- Simone de Beauvoir Institute, Concordia University, Montréal, QC, Canada
| | - Janice Ristock
- Women's and Gender Studies, University of Manitoba, Winnipeg, MB, Canada
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13
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Drug use, sexual risk, and structural vulnerability among female sex workers in two urban centers of the Dominican Republic: The EPIC study. Drug Alcohol Depend 2020; 212:108039. [PMID: 32428789 DOI: 10.1016/j.drugalcdep.2020.108039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Evidence in different countries suggest an association between sex work and drug use. In the Dominican Republic an estimated 60,000-100,000 women work in the sex industry. However, little is known about their drug use behaviors. OBJECTIVE To characterize the burden of drug use and examine correlates of these behaviors among female sex workers in the Dominican Republic. METHODS Data for this analysis comes from a cross-sectional study among key populations at risk for HIV. A community sample of female sex workers (N = 389) was recruited using passive and active recruitment strategies. Participants completed a behavioral survey between 2015 and 2016. Logistic regression models were constructed to examine predictors of drug use. RESULTS Protective factors against marijuana and crack or cocaine use included being heterosexual, having a higher level of education, regular employment, and fewer male sexual partners. Increased odds of crack or cocaine use were associated with incarceration, having slept in a place not meant for human habitation in the last six months, and having ever lived in a batey (a community around a sugar mill where workers and their families live). Participants that used marijuana were generally younger, while those that used crack or cocaine were older. CONCLUSIONS Our findings highlight characteristics of the social and economic environment that require further research to optimize prevention and care strategies for this population. Public health interventions are needed that address drug use, sexual risk-taking, and helping female sex workers and their families achieve a healthy life.
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14
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Health and socio-economic inequalities by sexual orientation among older women in the United Kingdom: findings from the UK Household Longitudinal Study. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractLesbian, gay, bisexual and queer (LGBQ) women living in the United Kingdom (UK) experience worse health than their heterosexual peers throughout their lives, but less is known about health inequalities in older age. This study uses population-level data to examine inequalities among LGBQ older women and women who prefer not to disclose their sexuality, compared to heterosexual women. Analyses use data from women aged 50 and older who were active in Waves 3 and 7 of the UK Household Longitudinal Study (also known as Understanding Society) (N = 8,209) to examine inequalities in socio-economic conditions, health and alcohol consumption across sexual orientation groups. LGBQ older women are on average younger and have higher socio-economic resources than their heterosexual peers. In contrast, women who prefer not to disclose their sexual orientation are older and have the lowest income and educational qualifications. Results of the health inequalities analyses show that LGBQ older women are almost twice as likely as heterosexual older women to engage in harmful alcohol consumption. Older women who prefer not to disclose their sexuality have worse physical and mental health than heterosexual older women. The health of LGBQ older women and women who prefer not to disclose their sexual orientation is one of the most neglected research areas in UK gerontology. Findings of this study contribute to our understanding of their social and health circumstances, and illuminate methodological limitations in existing data.
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15
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Jensen MB, Herold MD, Frank VA, Hunt G. Playing with gender borders: flirting and alcohol consumption among young adults in Denmark. NORDIC STUDIES ON ALCOHOL AND DRUGS 2019; 36:357-372. [PMID: 31827373 PMCID: PMC6905436 DOI: 10.1177/1455072518807794] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/20/2018] [Indexed: 11/16/2022] Open
Abstract
In the present article we explore and discuss the gendered aspects of how flirting among young people is an integrated part of a night out among young adults in Denmark, specifically a night out in mainstream bars and clubs. Empirically, we base our analysis on 140 qualitative interviews with regular alcohol users between 18 - 25 years of age. Drawing on Ahmed's (2006) notion on orientation in combination with Thorne's (1993) notions on gender play and borderwork, our aim is to explore and discuss how flirting - for these young people - become an unavoidable interactional practice in Night Time Economy (NTE) contexts, which, in some cases is experienced as easy and enjoyable, and in others as uncomfortable and challenging. In the analysis we specifically focus on how gender norms related to the NTE is navigated and/or challenged by our participants, in relation to flirting. On this basis, we show how the gendered structures of the mainstream NTE are, in some instances, supportive of its participants flirting practices and experiences, and challenging in other cases. In conclusion, we emphasize that the young people relate challenges to queer flirting as well as heterosexual flirting, and that notions of risks in this context relate to risks of marginalization, rather than health risks.
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Affiliation(s)
- Mie Birk Jensen
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | | | | | - Geoffrey Hunt
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
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16
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Lo IPY, Kim YK, Small E, Chan CHY. The Gendered Self of Chinese Lesbians: Self-Esteem as a Mediator Between Gender Roles and Depression. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1543-1554. [PMID: 31123949 DOI: 10.1007/s10508-019-1402-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
Sexual minority women are at an elevated risk for depression compared to heterosexual women, yet less is known about how gender roles affect the mental health of sexual minority women. Existing studies examining the role of self-esteem in the relationship between gender roles and depression are scarce and have predominantly focused on heterosexual populations. Using a cross-sectional survey of Chinese lesbians in Hong Kong (N = 438), the study tested the direct and indirect effects of different types of gender roles (masculine, feminine, and androgynous) on depression through the mediating factor of self-esteem. We found that masculinity and androgyny were positively associated with self-esteem, while femininity was negatively associated with self-esteem. More importantly, self-esteem fully mediated the inverse relationship between masculinity and depression and that between androgyny and depression. The positive relationship between femininity and depression was also fully mediated by self-esteem. By examining different types of gender roles and incorporating gender roles, self-esteem, and depression into a unified framework, the research highlighted the particularly protective effect of androgyny, which had the strongest positive direct effect on self-esteem and indirect effect on depression through the mediation of self-esteem compared to the effects of other types of gender roles. Our results illuminate the importance of understanding how individual differences in gender roles relate to the mental health of sexual minority women in future research and interventions. Implications for interventions that help Chinese lesbians cope with gender expectations and improve their mental health are discussed.
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Affiliation(s)
- Iris Po Yee Lo
- Department of Sociology, University of Oxford, Manor Road, Oxford, OX1 3UQ, UK
| | - Youn Kyoung Kim
- School of Social Work, Louisiana State University, Baton Rouge, LA, USA
| | - Eusebius Small
- School of Social Work, University of Texas, Arlington, TX, USA
| | - Celia Hoi Yan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong S. A. R., China.
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17
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Luoto S, Krams I, Rantala MJ. A Life History Approach to the Female Sexual Orientation Spectrum: Evolution, Development, Causal Mechanisms, and Health. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1273-1308. [PMID: 30229521 DOI: 10.1007/s10508-018-1261-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/29/2018] [Accepted: 06/14/2018] [Indexed: 05/12/2023]
Abstract
Women's capacity for sexual fluidity is at least as interesting a phenomenon from the point of view of evolutionary biology and behavioral endocrinology as exclusively homosexual orientation. Evolutionary hypotheses for female nonheterosexuality have failed to fully account for the existence of these different categories of nonheterosexual women, while also overlooking broader data on the causal mechanisms, physiology, ontogeny, and phylogeny of female nonheterosexuality. We review the evolutionary-developmental origins of various phenotypes in the female sexual orientation spectrum using the synergistic approach of Tinbergen's four questions. We also present femme-specific and butch-specific hypotheses at proximate and ultimate levels of analysis. This review article indicates that various nonheterosexual female phenotypes emerge from and contribute to hormonally mediated fast life history strategies. Life history theory provides a biobehavioral explanatory framework for nonheterosexual women's masculinized body morphology, psychological dispositions, and their elevated likelihood of experiencing violence, substance use, obesity, teenage pregnancy, and lower general health. This pattern of life outcomes can create a feedback loop of environmental unpredictability and harshness which destabilizes intrauterine hormonal conditions in mothers, leading to a greater likelihood of fast life history strategies, global health problems, and nonheterosexual preferences in female offspring. We further explore the potential of female nonheterosexuality to function as an alloparental buffer that enables masculinizing alleles to execute their characteristic fast life history strategies as they appear in the female and the male phenotype. Synthesizing life history theory with the female sexual orientation spectrum enriches existing scientific knowledge on the evolutionary-developmental mechanisms of human sex differences.
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Affiliation(s)
- Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Arts 1, Building 206, Room 616, 14A Symonds St., Auckland, 1010, New Zealand.
- School of Psychology, University of Auckland, Auckland, New Zealand.
| | - Indrikis Krams
- Department of Zoology and Animal Ecology, University of Latvia, Riga, Latvia
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Markus J Rantala
- Department of Biology & Turku Brain and Mind Center, University of Turku, Turku, Finland
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18
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Coulter RWS, Ware D, Fish JN, Plankey MW. Latent Classes of Polysubstance Use Among Adolescents in the United States: Intersections of Sexual Identity with Sex, Age, and Race/Ethnicity. LGBT Health 2019; 6:116-125. [PMID: 30822259 DOI: 10.1089/lgbt.2018.0149] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE We aimed to estimate latent classes of concurrent polysubstance use and test for sexual orientation differences in latent class memberships with representative data from adolescents living in 19 U.S. states. We also tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships. METHODS We analyzed data from 119,437 adolescents from 19 states who participated in the 2015 Youth Risk Behavior Survey. Latent class analysis characterized polysubstance use patterns based on self-reported frequency of lifetime and past-month use of alcohol (including heavy episodic drinking), tobacco (cigarettes, cigars, and smokeless tobacco), and marijuana. Multinomial logistic regression models tested differences in latent class memberships by sexual identity. Interaction terms tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships. RESULTS A six-class model of polysubstance use fit the data best and included nonusers (61.5%), experimental users (12.2%), marijuana-alcohol users (14.8%), tobacco-alcohol users (3.8%), medium-frequency three-substance users (3.6%), and high-frequency three-substance users (4.1%). Gay/lesbian- and bisexual-identified adolescents had significantly higher odds than heterosexual-identified adolescents of being in all of the user classes compared with the nonuser class. These sexual identity differences in latent polysubstance use class memberships were generally larger for females than for males, varied occasionally by race/ethnicity, and were sometimes larger for younger ages. CONCLUSION Compared with their heterosexual peers, gay/lesbian and bisexual adolescents-especially females-are at heightened risk of engaging in multiple types of polysubstance use. Designing, implementing, and evaluating interventions will likely reduce these sexual orientation disparities.
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Affiliation(s)
- Robert W S Coulter
- 1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,2 Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,3 Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,4 Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Deanna Ware
- 5 Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia
| | - Jessica N Fish
- 6 Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland
| | - Michael W Plankey
- 5 Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia
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19
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Parent MC, Arriaga AS, Gobble T, Wille L. Stress and substance use among sexual and gender minority individuals across the lifespan. Neurobiol Stress 2019; 10:100146. [PMID: 30937352 PMCID: PMC6430403 DOI: 10.1016/j.ynstr.2018.100146] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/23/2018] [Accepted: 12/26/2018] [Indexed: 11/25/2022] Open
Abstract
Sexual and gender minority (SGM) individuals face marked disparities in substance use. The present narrative review explores research on substance use in SGM communities using a minority stress theory lens. We define the SGM population and minority stress, and explore stresses and substance use disparities in adolescence, adulthood, and older age. Though research on this topic is beginning to highlight the relationship between stress and substance use for SGM individuals, more work is needed on older SGM populations and in translating research findings to effective interventions.
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Affiliation(s)
- Mike C. Parent
- University of Texas at Austin, Department of Educational Psychology, Sanchez 262H, Austin, TX, 78749, USA
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20
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Matthews AK, Steffen A, Hughes T, Aranda F, Martin K. Demographic, Healthcare, and Contextual Factors Associated with Smoking Status Among Sexual Minority Women. LGBT Health 2018; 4:17-23. [PMID: 28113006 DOI: 10.1089/lgbt.2016.0039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The study purpose was to examine demographic, healthcare, and contextual correlates of smoking among sexual minority women (SMW). METHODS Data were from the Chicago Health and Life Experiences of Women study (2010-2012, N = 726). RESULTS The rate of current smoking was 29.6%, with 29.5% and 40.9% former or nonsmokers, respectively. A history of ever smoking was associated with lower educational levels, having a partner who smokes, heavy drinking, illicit drug use, and a bisexual identity. Statistically significant correlates of former versus current smoker included higher education, having a nonsmoking partner, being from the newest recruited cohort, and less illicit drug use. A past-year quit attempt among current smokers was associated with higher levels of illicit drug use, longer time until first cigarette, and being from the original cohort. CONCLUSION The study results highlight key correlates of smoking behaviors among SMW and make an important contribution to the literature on smoking disparities. Additional research is needed to inform smoking cessation prevention and control efforts to reduce known and persistent smoking disparities among SMW.
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Affiliation(s)
- Alicia K Matthews
- 1 Department of Health Systems Science, College of Nursing, University of Illinois at Chicago , Chicago, Illinois
| | - Alana Steffen
- 1 Department of Health Systems Science, College of Nursing, University of Illinois at Chicago , Chicago, Illinois
| | - Tonda Hughes
- 1 Department of Health Systems Science, College of Nursing, University of Illinois at Chicago , Chicago, Illinois
| | - Frances Aranda
- 2 Department of Behavioral Sciences, Rush University Medical Center , Chicago, Illinois
| | - Kelly Martin
- 1 Department of Health Systems Science, College of Nursing, University of Illinois at Chicago , Chicago, Illinois
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21
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Zheng L, Wen G, Zheng Y. Butch-Femme Identity and Visuospatial Performance Among Lesbian and Bisexual Women in China. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1015-1024. [PMID: 29230602 DOI: 10.1007/s10508-017-1128-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 06/07/2023]
Abstract
Lesbian and bisexual women who self-identify as "butch" show a masculine profile with regard to gender roles, gender nonconformity, and systemizing cognitive style, whereas lesbian and bisexual women who self-identify as "femme" show a corresponding feminine profile and those who self-identify as "androgynes" show an intermediate profile. This study examined the association between butch or femme lesbian or bisexual identity and visuospatial ability among 323 lesbian and bisexual women, compared to heterosexual women (n = 207) and men (n = 125), from multiple cities in China. Visuospatial ability was assessed using a Shepard and Metzler-type mental rotation task and Judgment of Line Angle and Position (JLAP) test on the Internet. Heterosexual men outperformed heterosexual women on both mental rotation and JLAP tasks. Lesbian and bisexual women outperformed heterosexual women on mental rotation, but not on JLAP. There were significant differences in mental rotation performance among women, with butch- and androgyne-identified lesbian/bisexual women outperforming femme-identified and heterosexual women. There were also significant differences in JLAP performance among women, with butch- and androgyne-identified lesbian/bisexual women and heterosexual women outperforming femme-identified lesbian/bisexual women. The butch-femme differences in visuospatial ability indicated an association between cognitive ability and butch-femme identity and suggest that neurobiological underpinnings may contribute to butch-femme identity although alternative explanations exist.
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Affiliation(s)
- Lijun Zheng
- Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China.
- Faculty of Psychology, Southwest University, Chongqing, 400715, China.
| | - Guangju Wen
- Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Yong Zheng
- Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
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22
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Staples JM, Neilson EC, George WH, Flaherty BP, Davis KC. A descriptive analysis of alcohol behaviors across gender subgroups within a sample of transgender adults. Addict Behav 2018; 76:355-362. [PMID: 28903090 DOI: 10.1016/j.addbeh.2017.08.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 06/10/2017] [Accepted: 08/17/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Transgender (trans) adults are identified as an at-risk group for problem alcohol use. Descriptive empirical data examining alcohol behaviors among trans adults is limited. The present study investigates alcohol behaviors - quantity, frequency, alcohol-related problems, and drinking to cope motives - across sex assigned at birth, gender expression, and gender identity subgroups within a sample of trans adults. METHOD A total of 317 trans participants were recruited to complete a cross-sectional battery of online measures assessing alcohol use behaviors, alcohol-related problems, and drinking to cope. Gender identity was assessed through two methods: (1) an open-ended question in which participants wrote-in their primary gender identity; and (2) participants rated the extent to which they identified with 14 gender identity categories. RESULTS This sample had high rates of alcohol use, alcohol-related problems, and drinking to cope motives relative to the general population. Significant and meaningful differences in drinking frequency, alcohol-related problems and drinking motives were found according to gender expression, but not sex assigned at birth or gender identity. CONCLUSIONS Future work should examine alcohol behaviors among trans individuals, including investigation of predictors and causal pathways, to inform prevention and intervention work aimed at reducing trans people's risk for alcohol-related problems.
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Affiliation(s)
- Jennifer M Staples
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - Elizabeth C Neilson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - William H George
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - Brian P Flaherty
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195, United States.
| | - Kelly Cue Davis
- College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ 85004, United States.
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23
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Arayasirikul S, Pomart WA, Raymond HF, Wilson EC. Unevenness in Health at the Intersection of Gender and Sexuality: Sexual Minority Disparities in Alcohol and Drug Use Among Transwomen in the San Francisco Bay Area. JOURNAL OF HOMOSEXUALITY 2018; 65:66-79. [PMID: 28332945 PMCID: PMC5683394 DOI: 10.1080/00918369.2017.1310552] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Research on the health of transwomen is largely focused on heterosexual HIV risk. Little is known about the health of sexual minority transwomen. We conducted a secondary cross-sectional analysis of data from a HIV risk and resilience study of transwomen aged 16 to 24 years in the San Francisco Bay Area (N = 259). Prevalence and demographic characteristics of sexual minority transwomen was assessed and logistic regression models were used to examine the relationship between sexual minority status and alcohol and drug use. In logistic regression models, sexual minority transwomen had greater fold odds of heavy episodic drinking and illicit prescription drug use compared to their heterosexual counterparts, controlling for race/ethnicity, age, income, nativity, hormone status, and history of feminization procedures. These results suggest that sexual minority status may be an important social determinant of health among gender minorities. Populations of transwomen are heterogeneous; effective interventions must consider sexual minority status.
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Affiliation(s)
- Sean Arayasirikul
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States
- Medical Sociology, Department of Social and Behavioral Sciences, University of California San Francisco, 3333 California Street Suite #455, San Francisco, CA 94118, United States
| | | | - H. Fisher Raymond
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street 2 Floor, San Francisco, CA 94158, United States
| | - Erin C. Wilson
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street 2 Floor, San Francisco, CA 94158, United States
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24
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Shahab L, Brown J, Hagger-Johnson G, Michie S, Semlyen J, West R, Meads C. Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey. BMJ Open 2017; 7:e015058. [PMID: 29074508 PMCID: PMC5665254 DOI: 10.1136/bmjopen-2016-015058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 06/09/2017] [Accepted: 06/30/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics. DESIGN Cross-sectional household survey conducted in 2014-2016. SETTING England, UK. PARTICIPANTS Representative English population sample (pooled n=43 866). MAIN OUTCOMES Sexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ≥8). All outcomes were self-reported. RESULTS Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95% CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95% CI 25.9% to 39.6%; men: 30.7%, 95% CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95% CI 13.5% to 17.8%) but not men (22.7%, 95% CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95% CI 17.0% to 18.0%; men: 20.4%, 95% CI 19.9% to 21.0%; p<0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian/gay (women: 19.0%, 95% CI 14.0% to 25.3%; men: 30.0%, 25.2%-35.3%) and bisexual participants (women: 24.4%, 95% CI 18.7% to 31.3%; men: 24.3%, 95% CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95% CI 3.0% to 5.4%; men: 13.7%; 95% CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95% CI 7.9% to 8.7%; men: 18.4%, 95% CI 17.9% to 18.9%; p<0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men. CONCLUSIONS In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women.
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Affiliation(s)
- Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Gareth Hagger-Johnson
- Administrative Data Research Centre for England (ADRC-E), Farr Institute, University College London, London, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joanna Semlyen
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Catherine Meads
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK
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25
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Hunt G, Antin T. Gender and Intoxication: From Masculinity to Intersectionality. DRUGS-EDUCATION PREVENTION AND POLICY 2017; 26:70-78. [PMID: 30692716 DOI: 10.1080/09687637.2017.1349733] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Geoffrey Hunt
- Centre for Alcohol and Drug Research, Aarhus University, Denmark.,Institute for Scientific Analysis, San Francisco
| | - Tamar Antin
- Institute for Scientific Analysis, San Francisco
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26
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Wintemberg J, McElroy JA, Ge B, Everett KD. Can Smoke-Free Policies Reduce Tobacco Use Disparities of Sexual and Gender Minorities in Missouri? Nicotine Tob Res 2017; 19:1308-1314. [DOI: 10.1093/ntr/ntx078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/03/2017] [Indexed: 11/14/2022]
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27
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Kecojevic A, Jun HJ, Reisner SL, Corliss HL. Concurrent polysubstance use in a longitudinal study of US youth: associations with sexual orientation. Addiction 2017; 112:614-624. [PMID: 27790758 PMCID: PMC5339035 DOI: 10.1111/add.13681] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/29/2016] [Accepted: 10/26/2016] [Indexed: 01/08/2023]
Abstract
AIMS To estimate longitudinal associations between self-reported sexual orientation and past-year polysubstance use among youth, and test how gender, age and early onset of tobacco and alcohol use contributed to variation in polysubstance use. DESIGN Longitudinal community-based cohort of US adolescents from the Growing Up Today Study (GUTS 1) (n = 16 873) followed from ages 12-29 years. SETTING United States of America. PARTICIPANTS A total of 13 519 individuals (7839 females; 5680 males) who responded to at least one of five self-administered questionnaires from 1999 to 2010. Ninety-three per cent reported their race/ethnicity as non-Hispanic white. MEASUREMENTS Multivariable repeated measures generalized estimating equations estimated relative risks (RRs) of concurrent polysubstance use (i.e. past 12-month use of three or more substances) comparing sexual orientation minority youth [i.e. mostly heterosexual (MH), bisexual (BI), gay/lesbian (GL)] to their same-gender, completely heterosexual (CH) counterparts. Mediation analyses tested whether early onset of tobacco and/or alcohol use explained relationships between sexual orientation and concurrent polysubstance use. FINDINGS Compared with their same-gender CH peers, sexual minorities evidenced higher risk for concurrent polysubstance use over all repeated measures [risk ratios (RRs) for sexual minority subgroups: from 1.63-2.91, P-values: <0.001] and for all age groups (RRs: from 1.50-4.04, P-values: < 0.05-< 0.001), except GL males aged 18-20 years. Differences between sexual minorities and CHs were larger among females than males (P-values for sexual orientation × gender interactions were < 0.05 for MHs and BIs), and among younger versus older ages (P-values for sexual orientation × age interactions were < 0.05, except for BI males). Sexual minorities' younger age of smoking and/or drinking initiation contributed to their elevated polysubstance use (% of effect explained was between 9.4-24.3, P-values: 0.04-< 0.001), except among GL males. CONCLUSIONS Sexual minority youth in the United States, and in particular younger females, appear to be at disproportionate risk for concurrent past-year polysubstance use. Early onset of smoking and drinking may contribute to elevated risk of polysubstance use among sexual minorities.
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Affiliation(s)
- Aleksandar Kecojevic
- William Paterson University New Jersey, Department of Public Health, University Hall 369, 300 Pompton Rd, Wayne, NJ 07470
| | - Hee-Jin Jun
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 9245 Sky Park Court, Suite 100, San Diego, CA 92123
| | - Sari L Reisner
- Boston Children’s Hospital/Harvard Medical School, Division of General Pediatrics, 300 Longwood Ave, BCH3201, Boston, MA 02115,Harvard T.H. Chan School of Public Health, Department of Epidemiology, 677 Huntington Ave, Kresge Room 911, Boston, MA 02115,Fenway Health, The Fenway Institute, 1340 Boylston St, Ansin Building 8 Floor, Boston, MA 02115
| | - Heather L Corliss
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, 9245 Sky Park Court, Suite 100, San Diego, CA 92123,Channing Division of Network Medicine, Brigham and Women’s Hospital, 181 Longwood Avenue, Boston, MA 02115
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Wilson SM, Gilmore AK, Rhew IC, Hodge KA, Kaysen DL. Minority stress is longitudinally associated with alcohol-related problems among sexual minority women. Addict Behav 2016; 61:80-3. [PMID: 27249806 PMCID: PMC4915988 DOI: 10.1016/j.addbeh.2016.05.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/28/2016] [Accepted: 05/19/2016] [Indexed: 11/22/2022]
Abstract
Compared to sexual minority men and heterosexual women, sexual minority women report elevated alcohol use in young adulthood. Heavy alcohol use and alcohol use disorders disproportionately affect sexual minority women across the lifespan, yet there is limited research investigating reasons for such associations. The present study investigates longitudinal associations between minority stress and both alcohol use as well as self-rated drinking consequences. Participants (N=1057) were self-identified lesbian (40.5%) and bisexual (59.5%) women between the ages of 18 to 25 recruited from across the U.S. using online advertisements. Participants completed four annual surveys. Hurdle mixed effects models were used to assess associations between minority stress and typical weekly drinking and drinking consequences one year later. Minority stress was not significantly associated with subsequent typical drinking. However, minority stress was significantly associated with having any alcohol consequences as well as the count of alcohol consequences one year later after controlling for covariates. Consistent with extant literature, this study provides evidence for a prospective association between minority stress experienced by sexual minority women and drinking consequences. This study also provides support for the potential impact of efforts to reduce minority stress faced by sexual minority women.
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Affiliation(s)
- Sarah M Wilson
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, United States.
| | - Amanda K Gilmore
- Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, National Crime Victims Research and Treatment Center, United States
| | - Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States
| | - Kimberley A Hodge
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States
| | - Debra L Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States
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Gilbert PA, Zemore SE. Discrimination and drinking: A systematic review of the evidence. Soc Sci Med 2016; 161:178-94. [PMID: 27315370 PMCID: PMC4921286 DOI: 10.1016/j.socscimed.2016.06.009] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022]
Abstract
Although it is widely accepted that discrimination is associated with heavy and hazardous drinking, particularly within stress and coping frameworks, there has been no comprehensive review of the evidence. In response, we conducted a systematic review of the English language peer-reviewed literature to summarize studies of discrimination and alcohol-related outcomes, broadly defined. Searching six online data bases, we identified 938 non-duplicative titles published between 1980 and 2015, of which 97 met all inclusion criteria for our review and reported quantitative tests of associations between discrimination and alcohol use. We extracted key study characteristics and assessed quality based on reported methodological details. Papers generally supported a positive association; however, the quantity and quality of evidence varied considerably. The largest number of studies was of racial/ethnic discrimination among African Americans in the United States, followed by sexual orientation and gender discrimination. Studies of racial/ethnic discrimination were notable for their frequent use of complex modeling (i.e., mediation, moderation) but focused nearly exclusively on interpersonal discrimination. In contrast, studies of sexual orientation discrimination (i.e., heterosexism, homophobia) examined both internalized and interpersonal aspects; however, the literature largely relied on global tests of association using cross-sectional data. Some populations (e.g., Native Americans, Asian and Pacific Islanders) and types of discrimination (e.g., systemic/structural racism; ageism) received scant attention. This review extends our knowledge of a key social determinant of health through alcohol use. We identified gaps in the evidence base and suggest directions for future research related to discrimination and alcohol misuse.
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Affiliation(s)
- Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145N. Riverside Drive, N414 CPHB, Iowa City, IA 52242, USA; Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA
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Coulter RWS, Marzell M, Saltz R, Stall R, Mair C. Sexual-orientation differences in drinking patterns and use of drinking contexts among college students. Drug Alcohol Depend 2016; 160:197-204. [PMID: 26827292 PMCID: PMC4767549 DOI: 10.1016/j.drugalcdep.2016.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/08/2016] [Accepted: 01/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Evidence suggests there are important sexual-orientation differences in alcohol consumption, particularly among women. Little is known about where gay/lesbian and bisexual college students drink or differences in drinking patterns derived from graduated frequency measures between heterosexual, gay/lesbian, and bisexual students. The goal of this analysis was to examine patterns of alcohol consumption-including drinking prevalence, quantity, frequency, and contexts of use-by sexual orientation. METHODS Data on sexual identity, gender, drinking behaviors, and drinking contexts were examined from repeated cross-sectional samples of undergraduate students attending 14 public California universities from 2003-2011 (n=58,903). Multivariable statistical techniques were employed to examine sexual-orientation differences stratified by gender. RESULTS Gay males, lesbians, and bisexual females were significantly more likely to report drinking alcohol in the current semester than their same-gender heterosexual peers (relative risks ranged from 1.07 to 1.10, p-values <0.01). Among current drinkers, bisexual females consumed 7 or more drinks and lesbians consumed 10 or more drinks on significantly more days than heterosexual females. On the other hand, gay male drinkers consumed 8 or more drinks on significantly fewer days than heterosexual male drinkers. Compared to their same-gender heterosexual peers: lesbian/gay and bisexual students drank less frequently at Greek parties (incidence rate ratios [IRRs] ranged from 0.52 to 0.73, p-values <0.01); lesbians (IRR=0.84, p=0.043) and bisexual males (IRR=0.82, p=0.009) drank less frequently at off-campus parties; and gay males drank more frequently outdoors (IRR=1.63, p<0.001) and at bars/restaurants (IRR=1.21, p=0.013). CONCLUSIONS Alcohol prevention programs and future research should consider sexual-orientation differences in drinking patterns and use of drinking contexts.
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Affiliation(s)
- Robert W S Coulter
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States.
| | - Miesha Marzell
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa,145 N. Riverside Drive, Iowa City, IA 52242, United States
| | - Robert Saltz
- Prevention Research Center, Pacific Institute for Research & Evaluation, 180 Grand Avenue, Oakland, CA 94612, United States
| | - Ron Stall
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States
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Zheng L, Zheng Y. Gender Nonconformity and Butch-Femme Identity Among Lesbians in China. JOURNAL OF SEX RESEARCH 2016; 53:186-93. [PMID: 26457847 DOI: 10.1080/00224499.2015.1058890] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Previous studies have indicated that the butch-femme identities of lesbian women are related to gender roles (e.g., instrumentality and expressiveness). This study examined the association between butch and femme lesbian identities and gender nonconformity in both childhood (Study 1: 434 lesbian women and 230 heterosexual women) and adulthood (Study 2: 207 lesbian women and 342 heterosexual women) among women in China. In Study 1 (97 femmes, 76 androgynous women, and 264 butches), butches recalled more childhood gender nonconformity (CGN) than did femmes, androgynous, and heterosexual women, and androgynous women recalled more CGN than did heterosexual women. In Study 2 (43 femmes, 44 androgynous women, and 120 butches), butches reported more adulthood gender nonconformity (AGN) based on a "people-thing" dimension of interests than did femmes and heterosexual women, and androgynous women reported preferring more masculine hobbies than did femmes or heterosexual women. There was no significant difference in CGN and AGN between femmes and heterosexual women. These results indicate that femmes are quite similar to heterosexual women with regard to CGN and AGN, thus providing an important extension of previous studies based on a Chinese sample.
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Affiliation(s)
- Lijun Zheng
- a Key Laboratory of Cognition and Personality, Southwest University , Ministry of Education , Chongqing , China
- b Faculty of Psychology , Southwest University , Chongqing , China
| | - Yong Zheng
- a Key Laboratory of Cognition and Personality, Southwest University , Ministry of Education , Chongqing , China
- b Faculty of Psychology , Southwest University , Chongqing , China
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Martin-Storey A, August EG. Harassment Due to Gender Nonconformity Mediates the Association Between Sexual Minority Identity and Depressive Symptoms. JOURNAL OF SEX RESEARCH 2016; 53:85-97. [PMID: 25621903 DOI: 10.1080/00224499.2014.980497] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The visibility of a stigmatized identity is central in determining how individuals experience that identity. Sexual minority status (e.g., identifying as gay, lesbian, or bisexual) has traditionally been identified as a concealable stigma, compared with race/ethnicity or physical disability status. This conceptualization fails to recognize, however, the strong link between sexual minority status and a visible stigma: gender nonconformity. Gender nonconformity, or the perception that an individual fails to conform to gendered norms of behavior and appearance, is strongly stigmatized, and is popularly associated with sexual minority status. The hypothesis that harassment due to gender nonconformity mediates the association between sexual minority status and depressive symptoms was tested. Heterosexual and sexual minority-identified college and university students (N = 251) completed questionnaires regarding their sexual minority identity, experiences of harassment due to gender nonconformity, harassment due to sexual minority status, and depressive symptoms. A mediational model was supported, in which the association between sexual minority identity and depressive symptoms occurred via harassment due to gender nonconformity. Findings highlight harassment due to gender nonconformity as a possible mechanism for exploring variability in depressive symptoms among sexual minorities.
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Affiliation(s)
| | - Elana G August
- b Department of Psychology and Center for Research in Human Development , Concordia University
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Wandrey RL, Qualls WD, Mosack KE. Rejection of Breast Reconstruction Among Lesbian Breast Cancer Patients. LGBT Health 2015; 3:74-78. [PMID: 26669679 DOI: 10.1089/lgbt.2015.0091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE After having breast cancer (BC) and being treated by mastectomy, patients typically struggle with decisions about reconstruction. It is unclear how lesbian-identified women think about breast reconstruction. The purpose of this study was to explore lesbian BC survivors' attitudes toward breast reconstruction. This study represents the first published study to analyze data from a lesbian-specific BC forum to evaluate such attitudes. METHODS We conducted an inductive thematic analysis of breast reconstruction discussions among individuals who posted to a lesbian-specific online support forum found on breastcancer.org , the largest online support venue for BC survivors. Two hundred fifty-five users posted to the lesbian-specific forum; 53 of these users discussed breast reconstruction and were included in the present analysis. We analyzed a total of 168 posts. RESULTS Our analysis revealed five important themes related to breast reconstruction attitudes as follows: (1) rejecting being defined by their body image, (2) privileging sensation over appearance, (3) believing that being breastless is protective, (4) perceiving their social context as supportive of nonreconstruction, and (5) feeling pressured by social norms to undergo reconstructive surgery. CONCLUSIONS Among postings in the lesbian-specific online support forum, attitudes related to the rejection of breast reconstruction were pervasive. Provider communication should be evaluated for heterosexist biases, such as the implication that breast reconstruction should be a part of a normal course of treatment. In addition, providers must acknowledge that breast reconstruction is value laden and the range of viable treatment and construction options, including the decision not to reconstruct, should be presented in a nonbiased neutral way.
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Affiliation(s)
- Rachael L Wandrey
- Department of Psychology, University of Wisconsin-Milwaukee , Milwaukee, Wisconsin
| | - Whitney D Qualls
- Department of Psychology, University of Wisconsin-Milwaukee , Milwaukee, Wisconsin
| | - Katie E Mosack
- Department of Psychology, University of Wisconsin-Milwaukee , Milwaukee, Wisconsin
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Kerr D, Ding K, Burke A, Ott-Walter K. An alcohol, tobacco, and other drug use comparison of lesbian, bisexual, and heterosexual undergraduate women. Subst Use Misuse 2015; 50:340-9. [PMID: 25488100 DOI: 10.3109/10826084.2014.980954] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Little research has focused specifically on alcohol, tobacco, and other drug (ATOD) use of lesbian and bisexual women in general or the college subgroup specifically. Previous research shows sexual minority women at increased risk when compared to their heterosexual counterparts. OBJECTIVES The purpose of the current study was to compare ATOD use of lesbian, bisexual, and heterosexual undergraduate college women. METHODS A secondary analysis of three fall semesters (2009-2011) of American College Health Association-National College Health Assessment (ACHA-NCHA-II) data was conducted. Women who self-identified as gay/lesbian (N = 538), bisexual (N = 1579), and heterosexual (N = 40,869) were compared on ATOD use. Chi-square Tests were used to analyze differences between the groups and logistic regression determined odds ratios of ATOD use. RESULTS Bisexual women had greater odds of using alcohol, tobacco, and marijuana than heterosexual women and lesbians. They also had greater odds of using all illicit drugs (except steroids) and misusing prescription drugs than heterosexual women and greater odds of using amphetamines other than meth, sedatives, and ecstasy when compared to lesbians. Lesbians had greater odds of using tobacco, marijuana, sedatives, hallucinogens, other illegal drugs and misusing prescription drugs than heterosexual women. Conclusions/Importance: The study confirms increased ATOD use among sexual minority women as compared to their heterosexual counterparts with bisexual women having the highest use. This is the first study to examine misuse of prescription drugs among a large number of lesbian and bisexual college women, and contributes to the scant literature addressing college women's ATOD use by sexual orientation.
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Affiliation(s)
- Dianne Kerr
- 1Health Education & Promotion, Kent State University, Kent State University, Kent, Ohio, USA
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Rosario M, Reisner SL, Corliss HL, Wypij D, Frazier AL, Austin SB. Disparities in depressive distress by sexual orientation in emerging adults: the roles of attachment and stress paradigms. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:901-16. [PMID: 23780518 PMCID: PMC4184030 DOI: 10.1007/s10508-013-0129-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 02/07/2013] [Accepted: 03/10/2013] [Indexed: 05/03/2023]
Abstract
Lesbian, gay, and bisexual (BI) youth have elevated rates of depression compared to heterosexuals. We proposed and examined a theoretical model to understand whether attachment and stress paradigms explain disparities in depressive distress by sexual orientation, using the longitudinal Growing Up Today Study (GUTS) and Nurses' Health Study II (NHSII). GUTS participants eligible for this analysis reported sexual orientation, childhood gender nonconforming behaviors (GNBs), attachment to mother (all in 2005), and depressive symptoms (in 2007). Mothers of the GUTS participants who are the NHSII participants reported attitudes toward homosexuality (in 2004) and maternal affection (in 2006). The sample had 6,122 participants. Of GUTS youth (M = 20.6 years old in 2005; 64.4 % female), 1.7 % were lesbian/gay (LG), 1.7 % bisexual (BI), 10.0 % mostly heterosexual (MH), and 86.7 % completely heterosexual (CH). After adjusting for demographic characteristics and sibling clustering, LGs, BIs, and MHs reported more depressive distress than CHs. This relation was partially mediated (i.e., explained) for LGs, BIs, and MHs relative to CHs by less secure attachment. A conditional relation (i.e., interaction) indicated that BIs reported more distress than CHs as GNBs increased for BIs; no comparable relation was found for LGs versus CHs. Sibling comparisons found that sexual minorities (LGs, BIs, and MHs) reported more depressive distress, less secure attachment, and more childhood GNBs than CH siblings; the mothers reported less affection for their sexual-minority than CH offspring. The findings suggest that attachment and childhood gender nonconformity differentially pattern depressive distress by sexual orientation. Attachment and related experiences are more problematic for sexual minorities than for their CH siblings.
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Affiliation(s)
- Margaret Rosario
- Department of Psychology, The City University of New York-The City College and Graduate Center, Convent Avenue and 138th Street, NAC 7-120, New York, NY, 10031, USA,
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Lyons T, Kerr T, Duff P, Feng C, Shannon K. Youth, violence and non-injection drug use: nexus of vulnerabilities among lesbian and bisexual sex workers. AIDS Care 2014; 26:1090-4. [PMID: 24382155 DOI: 10.1080/09540121.2013.869542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite increasing evidence of enhanced HIV risk among sexual minority populations, and sex workers (SWs) in particular, there remains a paucity of epidemiological data on the risk environments of SWs who identify as lesbian or bisexual. Therefore, this short report describes a study that examined the individual, interpersonal and structural associations with lesbian or bisexual identity among SWs in Vancouver, Canada. Analysis drew on data from an open prospective cohort of street and hidden off-street SWs in Vancouver. Bivariate and multivariable logistic regressions were used to examine the independent relationships between individual, interpersonal, work environment and structural factors and lesbian or bisexual identity. Of the 510 individuals in our sample, 95 (18.6%) identified as lesbian or bisexual. In multivariable analysis, reporting non-injection drug use in the last six months (adjusted odds ratio [AOR] = 2.89; 95% confidence intervals [CI] = 1.42, 5.75), youth ≤24 years of age (AOR = 2.43; 95% CI = 1.24, 4.73) and experiencing client-perpetrated verbal, physical and/or sexual violence in the last six months (AOR = 1.85; 95% CI = 1.15, 2.98) remained independently associated with lesbian/bisexual identity, after adjusting for potential confounders. The findings demonstrate an urgent need for evidence-based social and structural HIV prevention interventions. In particular, policies and programmes tailored to lesbian and bisexual youth and women working in sex work, including those that prevent violence and address issues of non-injection stimulant use are required.
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Affiliation(s)
- Tara Lyons
- a British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , BC , Canada
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Rosario M, Corliss HL, Everett BG, Reisner SL, Austin SB, Buchting FO, Birkett M. Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys. Am J Public Health 2013; 104:245-54. [PMID: 24328632 DOI: 10.2105/ajph.2013.301506] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES We examined sexual orientation disparities in cancer-related risk behaviors among adolescents. METHODS We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex orientation as sexual minority and the remainder as heterosexual. We compared the groups on risk behaviors and stratified by gender, age (< 15 years and > 14 years), and race/ethnicity. RESULTS Sexual minorities (7.6% of the sample) reported more risk behaviors than heterosexuals for all 12 behaviors (mean = 5.3 vs 3.8; P < .001) and for each risk behavior: odds ratios (ORs) ranged from 1.3 (95% confidence interval [CI] = 1.2, 1.4) to 4.0 (95% CI = 3.6, 4.7), except for a diet low in fruit and vegetables (OR = 0.7; 95% CI = 0.5, 0.8). We found sexual orientation disparities in analyses by gender, followed by age, and then race/ethnicity; they persisted in analyses by gender, age, and race/ethnicity, although findings were nuanced. CONCLUSIONS Data on cancer risk, morbidity, and mortality by sexual orientation are needed to track the potential but unknown burden of cancer among sexual minorities.
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Affiliation(s)
- Margaret Rosario
- Margaret Rosario is with the Department of Psychology, City College and Graduate Center, City University of New York. Heather L. Corliss and S. Bryn Austin are with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Bethany G. Everett is with the Department of Sociology, University of Illinois at Chicago. Sari L. Reisner is with the Fenway Institute, Boston. Francisco O. Buchting is with Buchting Consulting, Oakland, CA. Michelle Birkett is with the Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago
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Acier D. La consommation de substances psychoactives chez les personnes gaies, lesbiennes et bisexuelles : état de la littérature. EVOLUTION PSYCHIATRIQUE 2013. [DOI: 10.1016/j.evopsy.2013.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zheng L, Zheng Y. Butch–femme identity and empathizing–systemizing cognitive traits in Chinese lesbians and bisexual women. PERSONALITY AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.paid.2013.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Goldbach JT, Tanner-Smith EE, Bagwell M, Dunlap S. Minority Stress and Substance Use in Sexual Minority Adolescents: A Meta-analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2013; 15:350-63. [DOI: 10.1007/s11121-013-0393-7] [Citation(s) in RCA: 267] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ott MQ, Wypij D, Corliss HL, Rosario M, Reisner SL, Gordon AR, Austin SB. Repeated changes in reported sexual orientation identity linked to substance use behaviors in youth. J Adolesc Health 2013; 52:465-72. [PMID: 23298999 PMCID: PMC3608814 DOI: 10.1016/j.jadohealth.2012.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 08/09/2012] [Accepted: 08/15/2012] [Indexed: 11/16/2022]
Abstract
PURPOSE Previous studies have found that sexual minority (e.g., lesbian, gay, bisexual) adolescents are at higher risk of substance use than heterosexuals, but few have examined how changes in sexual orientation over time may relate to substance use. We examined the associations between change in sexual orientation identity and marijuana use, tobacco use, and binge drinking in U.S. youth. METHODS Prospective data from 10,515 U.S. youth ages 12-27 years in a longitudinal cohort study were analyzed using sexual orientation identity mobility measure M (frequency of change from 0 [no change] to 1 [change at every wave]) in up to five waves of data. Generalized estimating equations were used to estimate substance use risk ratios and 95% confidence intervals; interactions by sex and age group were assessed. RESULTS All substance use behaviors varied significantly by sexual orientation. Sexual minorities were at higher risk for all outcomes, excluding binge drinking in males, and mobility score was positively associated with substance use in most cases (p < .05). The association between mobility and substance use remained significant after adjusting for current sexual orientation and varied by sex and age for selected substance use behaviors. This association had a higher positive magnitude in females than males and in adolescents than young adults. CONCLUSIONS In both clinical and research settings it is important to assess history of sexual orientation changes. Changes in reported sexual orientation over time may be as important as current sexual orientation for understanding adolescent substance use risk.
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Affiliation(s)
- Miles Q. Ott
- Center for Statistical Sciences, Brown University, Providence, RI
| | - David Wypij
- Department of Cardiology, Boston Children’s Hospital, Boston, MA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Heather L. Corliss
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Margaret Rosario
- City University of New York, City College and Graduate Center, New York, NY
| | - Sari L. Reisner
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
- Fenway Institute, Boston, MA
| | - Allegra R. Gordon
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
| | - S. Bryn Austin
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
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Drabble L, Trocki KF, Hughes TL, Korcha RA, Lown AE. Sexual orientation differences in the relationship between victimization and hazardous drinking among women in the National Alcohol Survey. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:639-48. [PMID: 23438246 DOI: 10.1037/a0031486] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n = 3,880), 2005 (n = 3,464), and 2010 (n = 3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms, and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared with three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3%). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (ORadj = 2.0, CI = 1.1-3.9, p < .01; bisexual (ORadj = 1.8, CI = 1.0-3.3, p < .05; heterosexual with same-sex partners (ORadj = 2.7; CI = 1.7-4.3, p < .001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women.
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Reisner SL, Falb KL, Wagenen AV, Grasso C, Bradford J. Sexual orientation disparities in substance misuse: the role of childhood abuse and intimate partner violence among patients in care at an urban community health center. Subst Use Misuse 2013; 48:274-89. [PMID: 23368669 PMCID: PMC3918899 DOI: 10.3109/10826084.2012.755702] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined disparities in lifetime substance misuse by sexual orientation among 2,653 patients engaged in care at an urban community health center in Boston, MA, as well as the potential mediating roles of childhood abuse <age 15 (CA) and intimate partner violence (IPV). Violence indicators were highly associated with substance misuse, as was identifying as a sexual minority compared to heterosexual. CA and IPV experiences partly explained disparities in substance abuse by sexual orientation with differences seen by sex. Clinicians should assess history of CA and IPV among sexual minorities presenting with a history of substance abuse disorders. The study's limitations are noted.
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Affiliation(s)
- Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
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Talley AE, Sher KJ, Steinley D, Wood PK, Littlefield AK. Patterns of alcohol use and consequences among empirically derived sexual minority subgroups. J Stud Alcohol Drugs 2012; 73:290-302. [PMID: 22333337 DOI: 10.15288/jsad.2012.73.290] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The current study develops an empirically determined classification of sexual orientation developmental patterns based on participants' annual reports of self-identifications, sexual attractions, and sexual behaviors during the first 4 years of college. A secondary aim of the current work was to examine trajectories of alcohol involvement among identified subgroups. METHOD Data were drawn from a subsample of a longitudinal study of incoming first-time college students at a large, public university (n = 2,068). Longitudinal latent class analysis was used to classify sexual minority participants into empirically derived subgroups based on three self-reported facets of sexual orientation. Multivariate repeated-measures analyses were conducted to examine how trajectories of alcohol involvement varied by sexual orientation class membership. RESULTS Four unique subclasses of sexual orientation developmental patterns were identified for males and females: one consistently exclusively heterosexual group and three sexual minority groups. Despite generally similar alcohol use patterns among subclasses, certain sexual minority subgroups reported elevated levels of alcohol-related negative consequences and maladaptive motivations for use throughout college compared with their exclusively heterosexual counterparts. CONCLUSIONS Elevations in coping and conformity motivations for alcohol use were seen among those subgroups that also evidenced heightened negative alcohol-related consequences. Implications and limitations of the current work are discussed.
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Affiliation(s)
- Amelia E Talley
- University of Missouri and the Midwest Alcoholism Research Center, Columbia, Missouri 65211, USA.
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Childhood Trauma, Adult Sexual Assault, and Adult Gender Expression among Lesbian and Bisexual Women. SEX ROLES 2012; 67:272-284. [PMID: 24003263 DOI: 10.1007/s11199-012-0171-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Several studies have demonstrated that lesbian and bisexual women are more likely than heterosexual women to report childhood abuse and adult sexual assault. It is unknown, however, which sexual minority women are most likely to experience such abuse. We recruited adult sexual minority women living in the US through electronic fliers sent to listservs and website groups inviting them to complete an online survey (N=1,243). We examined differences in both childhood abuse and adult sexual assault by women's current gender identity (i.e., butch, femme, androgynous, or other) and a continuous measure of gender expression (from butch/masculine to femme/feminine), adjusting for sexual orientation identity, age, education, and income. Results indicated that a more butch/masculine current self-assessment of gender expression, but not gender identity, was associated with more overall reported childhood trauma. Although one aspect of gender expression, a more butch/masculine gender role, was associated with adult sexual assault, feminine appearance and a femme gender identity also significantly predicted adult sexual assault. These findings highlight the significance of gender identity and expression in identifying women at greater risk for various abuse experiences.
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Corliss HL, Wadler BM, Jun HJ, Rosario M, Wypij D, Frazier AL, Austin SB. Sexual-orientation disparities in cigarette smoking in a longitudinal cohort study of adolescents. Nicotine Tob Res 2012; 15:213-22. [PMID: 22581940 DOI: 10.1093/ntr/nts114] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Youths with a minority sexual orientation (i.e., gay, lesbian, bisexual, and mostly heterosexual) are at high risk for cigarette smoking. We examined sexual-orientation disparities in smoking during adolescence and emerging adulthood and investigated the role of age at first smoking in contributing to smoking disparities. METHODS We used data from the Growing Up Today Study, a large longitudinal cohort of adolescents followed from ages 12 to 24 years (N = 13,913). Self-administered questionnaires filled out annually or biennially assessed age at first smoking, current smoking, frequency of smoking, number of cigarettes smoked daily, and nicotine dependence. Proportional hazards survival analysis and repeated measures regression estimated sexual-orientation differences in smoking. RESULTS Compared with completely heterosexuals, lesbian/gay, bisexual, and mostly heterosexual youths smoked their first cigarette at younger ages, were more likely to be current smokers, and had higher frequency of smoking. Among past-year smokers, sexual-minority females smoked more cigarettes daily and scored higher on nicotine dependence than completely heterosexual females. In some instances, gender and age modified relationships between sexual orientation and smoking, with relative risk accentuated in female sexual minorities and in sexual minorities during younger ages. Younger age of smoking onset contributed to elevated smoking in mostly heterosexuals and bisexuals, and to a lesser extent in lesbians, but not in gay males. CONCLUSIONS Sexual-orientation minorities are at greater risk for smoking during adolescence and emerging adulthood than heterosexuals. Disparities are larger in females and evident in early adolescence. Prevention and cessation efforts should target this population, preferably beginning in early adolescence.
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Affiliation(s)
- Heather L Corliss
- Division of Adolescent and Young Adult Medicine, Children's Hospital, Boston, MA 02115, USA.
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Levitt HM, Puckett JA, Ippolito MR, Horne SG. Sexual minority women's gender identity and expression: challenges and supports. JOURNAL OF LESBIAN STUDIES 2012; 16:153-176. [PMID: 22455340 DOI: 10.1080/10894160.2011.605009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual minority women were divided into four groups to study their gender identities (butch and femme), and gender expression (traditionally gendered and non-traditionally gendered women who do not identify as butch or femme). Experiences of heterosexist events (discrimination, harassment, threats of violence, victimization, negative emotions associated with these events), mental health (self esteem, stress, depression), and supports for a sexual minority identity (social support, outness, internalized homophobia) were examined across these groups. Findings suggested that butch-identified women experienced more heterosexist events than femme women or women with non-traditional gender expressions. There were no differences in mental health variables.
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Affiliation(s)
- Heidi M Levitt
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts 02125, USA.
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Blosnich J, Lee JGL, Horn K. A systematic review of the aetiology of tobacco disparities for sexual minorities. Tob Control 2011; 22:66-73. [PMID: 22170335 DOI: 10.1136/tobaccocontrol-2011-050181] [Citation(s) in RCA: 184] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To conduct a systematic review of the literature examining risk factors/correlates of cigarette smoking among lesbian, gay and bisexual (ie, sexual minority) populations. METHODS Sets of terms relevant to sexual minority populations and cigarette smoking were used in a simultaneous search of 10 databases through EBSCOhost. The search was limited to the peer-reviewed literature up to January 2011, using no geographic or language limits. For inclusion, the paper was required to: (1) have been written in English, (2) have sexual minorities (defined by either attraction, behaviour, or identity) included in the study population and (3) have examined some form of magnitude of association for risk factors/correlates of any definition of cigarette smoking. A total of 386 abstracts were reviewed independently, with 26 papers meeting all inclusion criteria. Abstracts were reviewed and coded independently by authors JB and JGLL using nine codes derived from the inclusion/exclusion criteria. RESULTS Studies used various measures of sexual orientation and of smoking. Risk factors that could be considered unique to sexual minorities included internalised homophobia and reactions to disclosure of sexual orientation. Some studies also indicated common smoking risk factors experienced at higher rates among sexual minorities, including stress, depression, alcohol use and victimisation. CONCLUSIONS This review identified risks that were associated with sexual minority status and common to the general population but experienced at potentially higher rates by sexual minorities. Government and foundation funds should be directed towards research on the origins of this disparity.
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Affiliation(s)
- John Blosnich
- Department of Psychiatry, University of Rochester, 300 Crittenden Blvd. Rochester, NY 14642, USA.
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Blosnich JR, Horn K. Associations of discrimination and violence with smoking among emerging adults: differences by gender and sexual orientation. Nicotine Tob Res 2011; 13:1284-95. [PMID: 21994344 PMCID: PMC3223581 DOI: 10.1093/ntr/ntr183] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 07/18/2011] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Lesbian, gay, and bisexual (i.e., sexual minority) populations have higher smoking prevalence than their heterosexual peers, but there is a lack of empirical study into why such disparities exist. This secondary analysis of data sought to examine associations of discrimination and violence victimization with cigarette smoking within sexual orientation groups. METHODS Data from the Fall 2008 and Spring 2009 National College Health Assessments were truncated to respondents of 18-24 years of age (n = 92,470). Since heterosexuals comprised over 90% of respondents, a random 5% subsample of heterosexuals was drawn, creating a total analytic sample of 11,046. Smoking status (i.e., never-, ever-, and current smoker) was regressed on general (e.g., not sexual orientation-specific) measures of past-year victimization and discrimination. To examine within-group differences, two sets of multivariate ordered logistic regression analyses were conducted: one set of models stratified by sexual orientation and another set stratified by gender-by-sexual-orientation groups. RESULTS Sexual minorities indicated more experiences of violence victimization and discrimination when compared with their heterosexual counterparts and had nearly twice the current smoking prevalence of heterosexuals. After adjusting for age and race, lesbians/gays who were in physical fights or were physically assaulted had higher proportional odds of being current smokers when compared with their lesbian/gay counterparts who did not experience those stressors. CONCLUSIONS When possible, lesbian/gay and bisexual groups should be analyzed separately, as analyses revealed that bisexuals had a higher risk profile than lesbians/gays. Further research is needed with more nuanced measures of smoking (e.g., intensity), as well as examining if victimization may interact with smoking cessation.
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Affiliation(s)
- John R Blosnich
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, WV 26506, USA.
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Abstract
In this article I describe the historical context for research on sexual minority women's drinking, including the age-old tendency to link homosexuality and alcoholism; I summarize gaps and limitations that characterized much of the research on sexual minority women's drinking over the past several decades; and I review recent literature to highlight progress in the field-with a particular focus on my own research related to risk and protective factors for heavy drinking and drinking-related problems among sexual minority women. I conclude with a discussion of barriers to treatment for sexual minority women and recommendations for substance abuse treatment providers.
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Affiliation(s)
- Tonda Hughes
- University of Illinois at Chicago, College of Nursing, Department of Health Systems Sciences, Chicago, Illinois USA
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