Minority Stress and Same-Sex Relationship Satisfaction: The Role of Concealment Motivation

Romantic relationships buffer minority stress in transgender and non-binary adults: Effects on depressive symptoms and suicidality

BACKGROUND

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation.

METHODS

A large international sample (n = 1156) of TNB adults (n = 654 partnered; n = 502 single) reported on minority stress experiences, relationship status and quality, and mental health outcomes (i.e., depressive symptoms and suicidal ideation).

RESULTS

The effects of victimization and rejection on depressive symptoms and suicidal ideation were attenuated among partnered individuals. However, once relationship quality was considered, the buffering effects of relationship involvement applied only to those in more satisfying relationships; the stress-buffering effects were not observed among those in distressed relationships. Of particular importance, general interpersonal satisfaction did not act as a minority stress buffer, suggesting there may be unique stress-buffering effects of being in a satisfying romantic relationship on depressive symptoms and suicidal ideation.

LIMITATIONS

The cross-sectional nature of the current study precludes definitive conclusions regarding causation.

CONCLUSIONS

These findings suggest that romantic involvement may serve a stress-buffering role for TNB adults, but only when these relationships are satisfying. Our results have important theoretical and clinical implications, and further research is needed to investigate the utility of relationship interventions to buffer the effects of TNB minority stress on depressive symptoms and suicidality.

"I didn't come here for your judgement" alongside "they understand you and encourage you": Exploring the narratives of young black and mixed-race LGBTQ+ people who have a physical health condition and their experiences within physical health services

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals experience health inequalities. Young people living with a health condition are also more likely to experience adverse mental health outcomes. Developing positive identity can help to mitigate the impact of this. Young black LGBTQ+ people have additional barriers to developing positive identity. Current research rarely considers the intersection of these identities for young people despite the discrimination they may face, and the impact this may have on their health. A narrative approach allows these voices to be heard in research. Eight participants were interviewed using a narrative approach. Interviews were analysed using content and thematic narrative analysis. Global summaries of each interview were developed and 'plot lines' emerged from these. A central plot related to identity development, with two plots embedded in these exploring experiences of illness and of healthcare. Participants had positive experiences of healthcare despite encountering stigma. Access to positive role models and being able link in with various communities allowed participants to integrate and accept their identities. A key discussion point in this study is the ways in which healthcare staff could become role models for young LGBTQ+ people and help them to integrate and accept their identities.

Age and Gender Identity in the Relationship Between Minority Stress and Loneliness: A Global Sample of Sexual and Gender Minority Adults

Loneliness is prevalent among sexual minority adults and is associated with minority stress. Yet there is limited understanding of how loneliness and minority stress vary across key demographic variables. This cross-sectional study explored age and gender differences in a minority stress model linking sexual orientation marginalization to social and emotional loneliness via proximal stress (internalized homonegativity, concealment, and stigma preoccupation) and via social anxiety and inhibition. The study also assessed age and gender differences in the protective influence of LGBTQ community involvement. 7,856 sexual minority adults from 85 countries completed an online survey. They were categorized as emerging adults (18-24, n = 3,056), young adults (25-34, n = 2,193), midlife adults (35-49, n = 1,243), and older adults (50-88, n = 1,364). Gender identity groups were cisgender men (n = 4,073), cisgender women (n = 3,017), and transgender individuals (n = 766). With each successive age group, there was a lower prevalence of sexual orientation marginalization, proximal stress, social anxiety, inhibition, and emotional loneliness, along with more community involvement. Sexual orientation marginalization was more pronounced among cisgender women and, especially, transgender individuals. The latter also exhibited the most social anxiety, inhibition, loneliness, and community involvement. Proximal stress was more prevalent among cisgender men than cisgender women and transgender individuals. Multiple group structural equation modeling supported the applicability of the loneliness model across age and gender groups, with only a few variations; these mainly related to how strongly community involvement was linked to marginalization, internalized homonegativity, and social loneliness.

The Role of Attachment Anxiety and Avoidance in Predicting Proximal Minority Stressors among Gay and Lesbian People in Italy

As has been widely documented, minority stress affects the psychosocial well-being of gay and lesbian people. Recently, researchers have turned their attention to psychological factors that may influence the level of minority stress experienced, in order to explain individual differences in perceptions of proximal minority stressors. The present research aimed at assessing the effect of attachment avoidance and anxiety on levels of perceived stigma and internalized homonegativity. A total of 163 participants who self-identified as lesbian or gay (Mage = 32.56, SD = 10.87) were recruited and responded to the self-report questionnaires. Two multiple regression models were applied to assess the association between adult attachment and perceived stigma and internalized homonegativity. Results showed a positive association between attachment anxiety and avoidance and internalized homonegativity, as well as between attachment avoidance and perceived stigma. The emerging results demonstrate the impact of attachment anxiety and avoidance on proximal minority stressors and provide useful data for interventions addressing lesbian and gay people aimed at promoting security-based strategies of affect regulation and positive representations of self and others, which in turn may reduce the level of proximal minority stressors experienced and promote psychosocial well-being.

Effects of Subjective Orgasm Experience in Sexual Satisfaction: A Dyadic Analysis in Same-Sex Hispanic Couples

Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.

The interplay of self-acceptance, social comparison and attributional style in adolescent mental health: cross-sectional study

BACKGROUND

Adolescence is a pivotal stage vulnerable to mental health problems such as anxiety and depression. Although self-acceptance and social comparison are known to affect adolescent mental health, their interactive and moderating roles are not fully understood.

AIMS

To explore the role of self-acceptance, social comparison and attributional style in predicting these mental health outcomes among adolescents in clinical settings.

METHOD

A cross-sectional study was conducted on a sample of 242 adolescents. Participants completed measures assessing self-acceptance, social comparison, attributional style and mental health outcomes (depression and anxiety). Mediation models and multi-group analysis were used to examine the relationships among these variables.

RESULTS

Our findings demonstrated a significant relationship between self-acceptance, social comparison, depression and anxiety (rs = 0.32-0.88). Specifically, lower self-acceptance and higher social comparison were associated with higher levels of depression and anxiety. Additionally, individuals with external attributional tendencies reported higher depression (Cohen's d = 0.61) and anxiety (d = 0.58) compared with those with internal tendencies. Mediation modelling showed that social comparison is a mediator between self-acceptance and depression (effect size -0.04, 95% CI -0.08 to -0.01) and anxiety (effect size -0.06, 95% CI -0.10 to -0.02). Crucially, multi-group analysis showed that the impact of social comparison on mental health outcomes varied significantly based on attributional style.

CONCLUSIONS

These findings underscore the importance of considering self-acceptance, social comparison and attributional style in understanding and addressing mental health challenges during adolescence. This could inform the development of targeted interventions to promote mental health and well-being among adolescents. However, further research is needed to confirm these findings in diverse populations and to explore the underlying mechanisms in greater detail.

Family and Relationship Quality among Young Adults with Different Sexual Orientations in Urban China: The Mediating Effects of Life Satisfaction and Self-Esteem

This study explored the ambivalent effects of family on the close relationship quality of Chinese young adults. From a national estimate of the urban population across mainland China, 5,089 participants aged 20-39 were recruited for this study. A three-dimensional conceptualization was applied to identify three groups with different sexual orientations in this study. Group A comprised participants who identified as sexual minority people; Group B comprised participants who identified as heterosexuals but were not exclusively attracted to one sex and/or individuals who had had same-sex sexual experiences; Group C comprised participants who identified as heterosexuals. Groups A and B reported lower close relationship satisfaction and psychological well-being than Group C. Life satisfaction and self-esteem partially mediated the association between family and close relationship satisfaction for all groups. However, this relationship was weaker for Group B, and closeness to family benefitted Group B's life satisfaction to a lesser extent, indicating that the nuanced relationship with family influenced the sexual minority people with heterosexual identities. We recommend future directions and practices in local research and policy-making.

Internalized homonegativity moderates the association between attachment avoidance and emotional intimacy among same-sex male couples

Introduction

The present study aimed to examine dyadic associations between attachment insecurity and emotional intimacy in same-sex male couples, and to investigate whether and how each partner’s internalized homonegativity (IH) moderated these associations.

Methods

The sample included 138 same-sex male couples. Both dyad members completed self-report measures of attachment insecurity, emotional intimacy, and IH. The actor-partner interdependence model with moderation analysis was applied.

Results

Indicated that higher levels of actor’s and partner’s attachment anxiety and attachment avoidance were associated with lower actor’s emotional intimacy. IH moderated the partner effects of attachment avoidance on emotional intimacy. The partner’s higher attachment avoidance was associated with one’s own lower emotional intimacy at low (but not high) levels of one’s own IH and at high (but not low) levels of the partner’s IH.

Discussion

Findings suggest that the partner’s attachment avoidance may differently affect one’s own emotional intimacy depending on the IH levels of both dyad members. Helping partnered sexual minority men decrease attachment insecurity while recognizing their own and their partners’ IH may promote relationship quality.

Intimate Pride: a Tri-Nation Study on Associations between Positive Minority Identity Aspects and Relationship Quality in Sexual Minorities from German-Speaking Countries

Investigations into the intimate relationships of sexual minorities are proliferating, but often adopt a deficit-oriented and US-centered perspective. In this tri-nation online study with sexual minority participants from Austria, Germany, and Switzerland (N = 571), we (i) assessed the construct validity of the German version of a well-known measure for positive minority identity aspects (the Lesbian, Gay, Bisexual Positive Identity Measure; LGB-PIM), and (ii) explored associations between these aspects (self-awareness, authenticity, community, capacity for intimacy, and social justice) and self-reported relationship quality. Model fit of the German version of the LGB-PIM was deemed acceptable. Higher levels of positive minority identity aspects showed small to moderate associations with higher levels of relationship quality in bivariate analyses, but only capacity for intimacy was linked to relationship quality in higher-order models (controlling for country, age, sexual orientation, gender identity, relationship length, and psychological distress). Results remained robust in several sensitivity analyses. Our results highlight the differential role of positive identity aspects for relationship functioning, with capacity for intimacy as a fruitful leverage point for therapeutic work.

Minority Stress and Loneliness in a Global Sample of Sexual Minority Adults: The Roles of Social Anxiety, Social Inhibition, and Community Involvement

Research suggests that loneliness among sexual minority adults is associated with marginalization, but it is unclear which processes may underlie this relationship. This cross-sectional study examined five possibilities: stigma preoccupation, internalized homonegativity, sexual orientation concealment, social anxiety, and social inhibition. The study also examined the possible protective role of LGBTQ community involvement. Respondents were 7856 sexual minority adults aged 18-88 years from 85 countries who completed an online survey. Results of structural equation modeling indicated that marginalization was positively associated with both social and emotional loneliness, and that part of this relationship was indirect via proximal minority stress factors (especially stigma preoccupation) and, in turn, social anxiety and social inhibition. Moreover, while LGBTQ community involvement was associated with greater marginalization, it was also associated with lower levels of proximal stress and both forms of loneliness. Among those who were more involved in the LGBTQ community, the associations between marginalization and proximal stress were somewhat weaker, as were those between stigma preoccupation and social anxiety, and between social inhibition and social loneliness. In contrast, the associations between concealment and social anxiety were somewhat stronger. Model fit and patterns of association were similar after controlling for the possible confounding effect of dispositional negative affectivity, but several coefficients were lower. Findings underscore the continuing need to counter marginalization of sexual minorities, both outside and within the LGBTQ community, and suggest possible avenues for alleviating loneliness at the individual level, such as cognitive-behavioral interventions targeting stigma preoccupation and social anxiety.

Perceived Discrimination and Relationship Satisfaction Among Same-Sex Couples: The Role of Dyadic Stress and Sex

Based on the fact that most research drawn from the minority stress theory on the association between minority stress and relationship satisfaction has focused on an individual perspective rather than a dyadic perspective, and the limited evidence of the systemic transactional model (STM) explore the topics of same-sex couples. This study aims to combine both theories to examine the association between perceived discrimination and relationship satisfaction among lesbian, gay, and bisexual (LGB) people on both partners and test the potential mediating role of dyadic stress and sex difference in this association. Using an actor-partner interdependence mediation model (APIMeM), we analyzed data including a sample of 241 LGB couples (133 female and 108 male same-sex dyads). Results showed that perceived discrimination had no direct actor-partner effects on relationship satisfaction. APIMeM revealed significant indirect partner effects from perceived discrimination on both individuals' and their partners' relationship satisfaction through the partner's dyadic stress. Additionally, the effect of personal dyadic stress on a partner's relationship satisfaction was stronger for women compared to men. These findings demonstrated the utility of the minority stress theory and STM framework for understanding the risk of stressors in damaging LGBs' romantic relationships. Couple interventions should integrate knowledge from a dyadic perspective with attention to sex differences.

Differential Impact of Experienced and Anticipated Discrimination on Sleep and Health Among Sexual Minorities

For many lesbian, gay, and bisexual (LGB) individuals, stigma may represent a psychosocial stressor that can disrupt sleep and impair health. The present study tested a stigma model of sleep health to examine whether experienced and anticipated discrimination, as well as associated primal threat, would affect sleep quality and, in turn, physical and mental health among LGB individuals. A total of 401 LGB individuals (201 women and 200 men; mean age = 27.48 years) from Hong Kong, China, provided cross-sectional questionnaire data on experienced and anticipated discrimination, primal threat, sleep disturbance, and self-rated physical and mental health. Path analyses showed that experienced and anticipated discrimination were associated with higher primal threat, which was, in turn, associated with greater sleep disturbance and then poorer physical and mental health. Bootstrap analyses further revealed that experienced and anticipated discrimination had significant indirect effects on sleep disturbance via primal threat and on physical and mental health via primal threat and sleep disturbance. In addition, multi-group analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, our findings highlighted the importance of considering the differential effects of experienced and anticipated discrimination, as well as the contributive role of primal threat, on the sleep quality and health status of LGB individuals. Practically, our findings pointed to the necessity of developing community-based stigma reduction programs and individual-oriented stigma coping interventions in order to facilitate LGB individuals to reduce discrimination-related primal threat and thereby improve sleep and health.

Prevalence and risk factors associated with perinatal depression in sexual minority women

Perinatal depression is associated with wide-ranging negative outcomes for women and their families, though little research has examined perinatal depression in sexual minority women. We examined depression in sexual minority women in the perinatal period, and whether there were unique minority stress-related risk and protective factors that predicted perinatal depression. One hundred ninety-four perinatal sexual minority women aged 18 years and older were recruited from the US and Australia. Participants completed an online questionnaire incorporating the Edinburgh Postnatal Depression Scale (EPDS) and measures of minority stress and social support. Over one third (35.6%) of the sample scored in the clinical range on the EPDS. Experiences of discrimination were associated with greater depression symptoms via poor social support from family. Higher concealment motivation was associated with greater depression symptoms via poor family and partner support. There were no direct or indirect effects of internalized stigma on depression. Rates of clinically elevated perinatal depression symptoms among sexual minority women are high, extending previous research demonstrating mental health disparities between sexual minorities and their heterosexual counterparts to the perinatal period. The role of social support in mediating the relationships between minority stress and depression suggests that increasing partner and family support might be effective targets for therapeutic interventions during the perinatal period.

Fertility preservation and sperm donation in transgender individuals: the current situation within the French CECOS network

BACKGROUND

Many studies reported that reproductive desire could be high among transgender (TG) individuals. In France, fertility preservation (FP) and sperm donation were very little proposed to TG individuals until recently, mainly because the Bioethics Law allows the use of Assisted Reproductive Technologies (ART) only in infertile couples and prohibits surrogacy.

OBJECTIVES

To evaluate the distribution of care on the French territory concerning fertility preservation and sperm donation in TG individuals.

MATERIALS AND METHODS

A multicentric national survey was carried out between January 2019 and October 2020 in 28 ART centres of the French CECOS (Centres d'Etudes et de Conservation des Oeufs et du Sperme) network. Each centre was questioned to find out how many TG individuals came, were informed and cared for FP and sperm donation.

RESULTS

Concerning FP, 71.4% of centres received TG individuals and performed gamete cryopreservation; 581 TG individuals consulted for FP. TG women were more likely to desire (P<0.0001) and achieve (P<0.0001) FP than TG men. Concerning sperm donation in couples including a TG man, 68% of centres offer the complete course from the first consultation to the completion of the ART cycles; 122 offspring has been conceived with sperm donation in couples including a TG man since 1999.

DISCUSSION

Our results showed that even if all centres do not propose FP or sperm donation in TG individuals, these ART are present throughout the French territory. The major point is that both FP and sperm donation in TG individuals have grown significantly and that the care of these patients is improving year after year.

CONCLUSION

In France, most of CECOS centres can take care of TG individuals for FP and sperm donation. The French Bioethics law allows these latter, and TG individuals can benefit from a financial support of the national health care insurance for FP and sperm donation. This article is protected by copyright. All rights reserved.

How coming out and community involvement affects body image: An in-depth examination of lesbian women's personal experiences

Research on body image commonly focuses on the negative aspects of the construct, and the majority of findings related to body image in general arise from quantitative methods of investigation. Furthermore, little is known about the experiences lesbian women go through as they come out, and what consequence this has on their body image. In this study we examined the experiences of 12 lesbian women and explored how coming out affected their body image. Data were collected via face-to-face interviews and analyzed using thematic analysis. Participants' ages ranged from 20 to 33 (M = 25). The analysis revealed that all participants reported experiencing improved body image after coming out. Other changes related to the presentation of sexual identity in terms of how they dressed, i.e., presenting as either more masculine or feminine. Most participants reported feeling that the sexual and gender minority community was more accepting of different body shapes and sizes compared to the heteronormative society in which they resided. Negative feelings and experiences related to family situations, and occasionally from within themselves. The results are important in understanding how gender and sexual orientation are intertwined to create a distinct experience of body image in lesbian women, and also to illustrate the heterogeneity of body image within subgroups of women.

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

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

LGBQ+ Self-Acceptance and Its Relationship with Minority Stressors and Mental Health: A Systematic Literature Review

Many individuals who identify as lesbian, gay, bisexual, queer, and with other non-heterosexual orientations (LGBQ+) experience stigma, prejudice, and/or discrimination because of their sexuality. According to minority stress and identity development theories, these experiences can contribute to difficulties with self-acceptance of sexuality. Lower self-acceptance is considered a risk factor for adverse mental health outcomes. The current review aims to investigate whether self-acceptance of sexuality is associated with minority stressors or difficulties with mental health in LGBQ+ individuals, as well as whether there are differences in self-acceptance between different sexual orientations. Five bibliographic databases were searched. Thirteen studies were identified which used quantitative methodology to investigate associations between self-acceptance, minority stressors, and/or mental health within LGBQ+ samples, or differences in self-acceptance between different sexual orientations. The results from these cross-sectional studies suggested that lower self-acceptance of sexuality was associated with higher levels of self-reported minority stressors, including a lack of acceptance from friends and family, a lack of disclosure to others, and internalized heterosexism. Lower self-acceptance of sexuality was associated with poorer mental health outcomes, including greater global distress, depression symptoms, and lower psychological well-being. There was no significant relationship with suicidality. Studies also found that LGBQ+ individuals had lower general self-acceptance compared to heterosexual participants, bisexual individuals had lower sexuality self-acceptance compared to lesbian/gay individuals, and lesbian women had lower sexuality self-acceptance compared to gay men. Given the potential importance of self-acceptance for LGBQ+ populations, further research is required with more robust methodology. Self-acceptance could be a potential target in clinical interventions for LGBQ+ individuals.