Adolescent homosexuality and concerns regarding disclosure

Prevalence of Stigma and Discrimination Amongst Men Who have Sex with Men (MSM) and Transgender Women (Waria) in Bali, Indonesia

Men who have sex with men (MSM) and transgender women (waria) in Indonesia experience stigma and discrimination. The prevalence of stigma and discrimination experienced by 416 MSM and waria living in Bali, Indonesia and associations with socio-demographic characteristics are described. High levels of stigma were reported by 50.5% of MSM and 62.7% of waria. Discrimination was reported by 35.5% of MSM and 72.4% of waria. Family rejection, or no family awareness of MSM status, equated to higher levels of stigma compared to those where MSM status was accepted. Homosexual and bisexual waria reported lower odds of experiencing stigma compared to heterosexual waria. MSM who were not single were twice as likely to experience discrimination compared to single participants. Non-Hindu MSM were nearly three times as likely to experience discrimination compared to Hindu participants. Waria who were studying were less likely to experience discrimination compared to those who reported regular employment jobs. Specific policy and practice to reduce experiences of stigma and/or discrimination specific to MSM and waria are needed.

Relations among religiosity, age of self-identification as gay, lesbian, or bisexual, and alcohol use among college students

Research indicates that lesbian, gay, and bisexual (LGB) youth are at increased risk for heavy drinking relative to their heterosexual peers. One possible contributing factor is that religiosity fails to provide the significant protection for LGB youth that it provides in general population samples. Although prior studies provide some support for this hypothesis, there is little research on the reasons that religiosity may fail to protect against heavy drinking among LGB youth. The current study addressed this question by examining relations among religiosity, age of self-identification as LGB, and alcohol use in a sample of 162 young adults self-identified as lesbian, gay, bisexual, or questioning. Age of self-identification was conceptualized as an indicator of stress or internal conflict between religious beliefs and self-identification. We hypothesized that higher levels of religiosity would be associated with a later age of identification as LGB, which, in turn, would contribute to heavier drinking. Path analyses conducted in Mplus provided support for this hypothesis, with higher levels of religiosity indirectly contributing to increased alcohol use through later age of self-identification. Whereas additional studies directly assessing stress associated with the self-identification process are needed, the results of this study suggest that religiosity may serve as a risk, rather than protective, factor among LGB youth. The development of religious support groups specifically for LGB youth may help these individuals reconcile their religious beliefs with their emerging sexual identities, thereby allowing them to derive some of the same benefits that heterosexual youth derive from religious beliefs and practices. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

"It's Almost Like Gay Sex Doesn't Exist:" Parent-Child Sex Communication According to Gay, Bisexual, and Queer Adolescent Sons

Sex communication interventions facilitate positive sexual health outcomes with heterosexual adolescents. The same has yet to be established for male youth with same-sex attractions, behaviors, and identities. Our study describes the experiences of gay, bisexual and queer-identifying adolescent males with parent-child sex communication. We conducted 30 in-depth semi-structured interviews with a diverse group of 15 to 20 year-old gay, bisexual, and queer (GBQ) males. Interview transcripts were coded and themes were identified using thematic and content analysis. Narratives revealed that sex communication with parents occurs rarely, is heteronormative in content prior to adolescent males' disclosure as GBQ, and after disclosure is reactionary and based on stereotypes that associate this population with negative health outcomes. Parents were rated poorly as sex educators by adolescent males and the findings are mixed regarding perception of parents' knowledge about GBQ-specific information. Parents and healthcare providers were identified as preferred sources of sex information by GBQ adolescent males. Sex communication with parents throughout adolescence that excludes GBQ males' same-sex concerns is a missed opportunity for targeted sexual risk reduction. There are multiple ways healthcare providers can assist parents to plan age-appropriate, sexuality-inclusive, home-based discussions about sex for this group.

Waivers of parental consent for sexual minority youth

The Society for Adolescent Health and Medicine emphasizes the need for research to focus on the health outcomes of sexual minority youth (i.e., lesbian, gay, bisexual, transgender, queer). However, sexual minority youth (SMY) are often less willing to participate in research studies where parental consent is required due to potential victimization and discrimination. This is a major concern given that more research is needed to understand the health needs of this population, especially in terms of suicide, substance use, and HIV prevention. The National Suicide Prevention Strategy classifies SMY as a high-risk group, emphasizing the need to explore suicide risks (along with other health outcomes) among this group. However, this high-risk classification also increases the safeguards necessary to conduct research with this population. Many researchers have argued for waivers of parental consent, but such waivers present with several ethical implications. This article discusses ethical principles, risks, benefits, safeguards, and potential alternative approaches to waivers of parental consent for SMY. We conclude by emphasizing the need for policy changes to allow parental consent waivers for research targeting SMY.

Suicidality Among Gay and Bisexual Men in Taiwan: Its Relationships with Sexuality and Gender Role Characteristics, Homophobic Bullying Victimization, and Social Support

This study aimed to examine the associations of suicidality in emerging adulthood with time of coming out, gender role nonconformity, sexual orientation, traditional and cyber homophobic bullying victimization, and family and peer support during childhood in gay and bisexual men in Taiwan. The frequency of "experiencing suicide ideation" and "attempting suicide" in the past year among 500 gay or bisexual men was examined. The participants' time of coming out, level of subjective masculinity, sexual orientation, experiences of traditional and cyber homophobic bullying victimization, and levels of family and peer support during childhood were also evaluated. In total, 31% (n = 155) of participants reported experiencing suicide ideation (n = 82) or attempting suicide (n = 73). Early coming out, traditional homophobic bullying victimization, and low family support during childhood increased the risk of suicidality in emerging adulthood; by contrast, family support did not moderate the association of early coming out or traditional bullying victimization with current suicidality. A high proportion of participants reported experiencing suicide ideation and attempt in emerging adulthood. Hence, effective suicide prevention is required for gay and bisexual men. Suicide prevention programs should consider time of coming out, traditional homophobic bullying victimization, and level of family support.

Quality of life of gay and bisexual men during emerging adulthood in Taiwan: Roles of traditional and cyber harassment victimization

This study examined factors related to the quality of life (QOL) of gay and bisexual men during emerging adulthood in Taiwan. The factors included traditional harassment (e.g., verbal ridicule, relational exclusion, physical aggression, and theft of belongings), cyber harassment, sex- and gender-related factors (e.g., sexual orientation, age at initial identification of sexual orientation, self-reported level of gender nonconformity, and perceived social acceptance toward homosexuality and bisexuality), and demographic characteristics. In total, 305 Taiwanese gay and bisexual men, aged 20-25 years, were recruited. Their QOL, traditional harassment, and cyber harassment data were collected using the World Health Organization Questionnaire on Quality of Life: Short Form, School Bullying Experience Questionnaire, and Cyberbullying Experiences Questionnaire, respectively. In total, 60.3%, 34.4%, 28.2%, and 29.5% of the participants reported experiencing traditional harassment, cyber harassment, traditional harassment across multiple contexts, and harassment in multiple forms, respectively. Both traditional and cyber harassment were significantly associated with lower QOL. Individuals who experienced traditional harassment across multiple contexts and harassment in multiple forms had lower QOL in nearly all domains than did individuals who had experienced traditional harassment in a single context and harassment of a single form. However, the QOL did not significantly differ between individuals who had experienced traditional harassment in a single context and nonvictims nor between individuals who had experienced harassment of a single form and nonvictims. Lower education level, older age at initial identification of sexual orientation, higher perception of gender nonconformity, and lower perceived social acceptance toward homosexuality and bisexuality were significantly associated with lower QOL. Clinical and public health professionals should consider these factors when developing programs to enhance the QOL of gay and bisexual men.

The Significance of Parenting and Parent-Child Relationships for Sexual and Gender Minority Adolescents

Adolescents in 21st century America are experiencing the emergence of their sexual and gender identities in a heteronormative society that is steadily adopting more progressive views and policies related to sexual orientation and gender. However, despite these sociocultural changes, parent-child relationships remain as one of the strongest predictors of LGBT adolescent adjustment. This article reviews the extant literature on this topic from family systems and attachment perspectives while highlighting the significance of family experiences within a minority stress framework. The presentation is oriented around the coming out process, including factors influencing this experience and how postdisclosure parenting affects the health and well-being of LGBT adolescents. We end by discussing future directions and the challenges inherent to this research.

Communicating with School Staff About Sexual Identity, Health and Safety: An Exploratory Study of the Experiences and Preferences of Black and Latino Teen Young Men Who Have Sex with Men

PURPOSE

This exploratory study examined the experiences of black and Latino teen young men who have sex with men (YMSM) and their preferences for communication with school staff about matters related to sexual orientation.

METHODS

Participants for this study were recruited in three urban centers in the United States and by multiple community-based organizations serving black and Latino YMSM. Eligible youth were male, black and Latino, ages 13–19, enrolled in 90 days of school in the previous 18 months, and reported attraction to or sexual behavior with other males, or identified as gay or bisexual. Participants completed web-based questionnaires (n=415) and/or in-depth interviews (n=32).

RESULTS

Questionnaire participants reported willingness to talk to at least one school staff member about: safety, dating and relationships, and feeling attracted to other guys (63.4%, 58.4%, and 55.9%, respectively). About one-third of the sample reported they would not talk with any school staff about these topics. Exploratory analyses revealed youth who experienced feeling unsafe at school and who had higher levels of trust in the information provided by school staff were more likely to be willing to talk with school staff about safety issues, dating, or same sex attraction (adjusted odds ratio [AOR]=2.80 and AOR=4.85, respectively). Interview participants reported being most willing to talk to staff who were able and willing to help them, who would keep discussions confidential, and who expressed genuine care. Preferences for confiding in school staff perceived to be lesbian, gay, bisexual, and transgender (LGBT) and having similar racial/ethnic background were also noted.

CONCLUSION

Findings suggest school staff can serve as points of contact for reaching YMSM and professional development and interventions can be tailored to reach YMSM and connect them to services they need. Additional research is needed to understand how to increase YMSM comfort talking with school staff about sexual health or sexual identity concerns.

Associations of Health-Risk Behaviors and Health Cognition With Sexual Orientation Among Adolescents in School: Analysis of Pooled Data From Korean Nationwide Survey From 2008 to 2012

Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents.Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents and analyzed with multiple logistic regression models.Compared with heterosexual adolescents (n = 127,594), homosexual adolescents (n = 2306) were more likely to engage in various health-risk behaviors and to have poor health cognition. In multiple logistic regression analysis, not living with parents, alcohol experience (adjusted odds ratio, 1.50; 95% confidence interval, 1.26-1.78 for males and 1.66; 1.33-2.07 for females), smoking experience (1.80; 1.54-2.10 for males and 3.15; 2.61-3.79 for females), and drug experience (3.65; 2.81-4.80 for males and 3.23; 2.35-4.46 for females) were associated with homosexual behavior. Homosexual adolescents were more likely to use adult internet content (2.82; 2.27-3.50 for males and 7.42; 4.19-13.15 for females), and to be depressed (1.21; 1.03-1.43 for males and 1.32; 1.06-1.64 for females). In addition, suicide ideation (1.51; 1.26-1.81 for males and 1.47; 1.16-1.86 for females) and attempts (1.67; 1.37-2.05 for males and 1.65; 1.34-2.03 for females) were significantly more prevalent among homosexual adolescents.Homosexual adolescents report disparities in various aspects of health-risk behavior and health cognition, including use of multiple substances, adult internet content and inappropriate weight loss methods, suicide ideation and attempts, and depressive mood. These factors should be addressed relevantly to develop specific interventions regarding sexual minorities.

Physicians Use of Inclusive Sexual Orientation Language During Teenage Annual Visits

PURPOSE

Physicians are encouraged to use inclusive language regarding sexuality in order to help all adolescent patients feel accepted. Non-inclusive language by physicians may influence relationships with adolescent patients, especially those with still-developing sexual identities. The aim of this study was to identify patterns of physicians' use of inclusive and non-inclusive language when discussing sexuality.

METHOD

A total of 393 conversations between 393 adolescents and 49 physicians from 11 clinics located throughout the Raleigh-Durham, North Carolina, area were audio recorded. Conversations were coded for the use of inclusive talk (language use that avoids the use of specific gender, sex, or sexual orientation language), direct non-inclusive talk (language use that assumes the teenager is heterosexual or exclusively engages in heterosexual sexual activity), and indirect non-inclusive talk (language use that frames talk heterosexually but does not pre-identify the adolescent as heterosexual).

RESULTS

Nearly two-thirds (63%, 245) of the visits contained some sexuality talk. Inclusive talk rarely occurred (3.3%) while non-inclusive language was predominant (48.1% direct and 48.6% indirect). There were no significant differences in language use by gender, age, adolescent race, or visit length. These non-significant findings suggest that all adolescents regardless of race, gender, or age are receiving non-inclusive sexuality talk from their providers.

CONCLUSION

Physicians are missing opportunities to create safe environments for teenagers to discuss sexuality. The examples of inclusive talk from this study may provide potentially useful ways to teach providers how to begin sexuality discussions, focusing on sexual attraction or asking about friends' sexual behavior, and maintain these discussions.

Promoting the successful development of sexual and gender minority youths

Because of societal discomfort with atypical expressions of sexual orientation and gender identity, lesbian, gay, bisexual and transgender (LGBT) youths have experienced enhanced developmental challenges compared with their heterosexual peers. A recent special issue of the American Journal of Public Health delineated how social stigma affecting LGBT youths has resulted in a wide range of health disparities, ranging from increased prevalence of depression and substance use to downstream effects, such as an increased risk for cancer and cardiovascular disease when older. We review the clinical significance of these findings for health care professionals, who need to become informed about these associations to provide better care for their sexual and gender minority youth patients, and to be able to educate their parents and other caregivers.

Isolation of lesbian, gay, bisexual and transgender youth: a dimensional concept analysis

AIM

To present the findings of a dimensional analysis of isolation in the context, and from the perspective, of lesbian, gay, bisexual and transgender youth.

BACKGROUND

Lesbian, gay, bisexual and transgender youth are often at greater risk for negative health outcomes compared with heterosexual youth. Isolation is one risk factor cited throughout the literature; however, the concept is complicated and has many uses and thus warrants clarification.

DESIGN

Concept Analysis.

DATA SOURCES

Sources comprise 35 English language research articles retrieved from CINAHL and EBSCOHost (1987-2012).

METHODS

A dimensional concept analysis was undertaken to analyse how the concept, isolation, is socially constructed.

RESULTS

This dimensional analysis revealed five socially constructed dimensions and four sub-dimensions. These findings indicate that there is substantial variability in the concept of isolation. These differences and variations are most notably observed in the 20 articles (57%) that had more than one dimension. Although some of these articles were explicit with the different meanings and use of the concept, most of the papers had wide variability in the use and meaning of the concept.

CONCLUSION

The disproportionately greater physical and mental health disparities between lesbian, gay, bisexual and transgender and heterosexual youth are a signal to conduct more research to clarify the concept of isolation, to develop instrumentation to identify at-risk youth and to explore predictors and consequences of isolation. Nurses and others can lead the way in translating this knowledge into strategies that will improve the health and lives of these young people.

The interplay between online and offline explorations of identity, relationships, and sex: a mixed-methods study with LGBT youth

Although the Internet is commonly used by lesbian, gay, bisexual, and transgender (LGBT) youth to explore aspects of sexual health, little is known about how this usage relates to offline explorations and experiences. This study used a mixed-methods approach to investigate the interplay between online and offline explorations of multiple dimensions of sexual health, which include sexually transmitted infections, sexual identities, romantic relationships, and sexual behaviors. A diverse community sample of 32 LGBT youth (ages 16-24) completed semi-structured interviews, which were transcribed and then qualitatively coded to identify themes. Results indicated that, although many participants evaluated online sexual health resources with caution, they frequently used the Internet to compensate for perceived limitations in offline resources and relationships. Some participants turned to the Internet to find friends and romantic partners, citing the relative difficulty of establishing offline contact with LGBT peers. Further, participants perceived the Internet as an efficient way to discover offline LGBT events and services relevant to sexual health. These results suggest that LGBT youth are motivated to fill gaps in their offline sexual health resources (e.g., books and personal communications) with online information. The Internet is a setting that can be harnessed to provide support for the successful development of sexual health.

The Daily Heterosexist Experiences Questionnaire: Measuring Minority Stress Among Lesbian, Gay, Bisexual, and Transgender Adults

The authors conducted a three-phase, mixed-methods study to develop a self-report measure assessing the unique aspects of minority stress for lesbian, gay, bisexual, and transgender adults. The Daily Heterosexist Experiences Questionnaire has 50 items and nine subscales with acceptable internal reliability, and construct and concurrent validity. Mean sexual orientation and gender differences were found.

Comprehensive clinical care for men who have sex with men: an integrated approach

Men who have sex with men (MSM) have unique health-care needs, not only because of biological factors such as an increased susceptibility to infection with HIV and sexually transmitted infections associated with their sexual behaviour, but also because of internalisation of societal stigma related to homosexuality and gender non-conformity, resulting in depression, anxiety, substance use, and other adverse outcomes. Successful responses to the global HIV/AIDS epidemic will require the development of culturally sensitive clinical care programmes for MSM that address these health disparities and root causes of maladaptive behaviour (eg, societal homophobia). Health-care providers need to become familiar with local outreach agencies, hotlines, and media that can connect MSM with positive role models and social opportunities. Research is needed to understand how many MSM lead resilient and productive lives in the face of discrimination to develop assets-based interventions that build on community support. Optimum clinical care for sexual and gender minorities is a fundamental human right. MSM deserve to be treated with respect, and health-care providers need to interact with them in ways that promote disclosure of actionable health information.

Stress-related growth, coming out, and internalized homonegativity in lesbian, gay, and bisexual youth. An examination of stress-related growth within the minority stress model

This study investigates how young lesbian, gay, and bisexual (LGB) individuals deal with coming out and how perceived personal growth may result from that experience. We considered stress-related growth as a mediator between coming-out experiences and internalized homonegativity (IH). Our sample was taken from an online survey and is comprised of 502 LGBs aged 14-30. The social environment's acceptance of an individual's sexual orientation and the individual's social identification influence stress-related growth. Several coming-out indicators influence internalized homonegativity and, although growth perception does not function as a mediator between coming out and internalized homonegativity, it has a direct effect on IH.

Inside and outcast: multifaceted stigma and redemption in the lives of gay and lesbian Jehovah's Witnesses

Homosexuality has become a divisive issue in many religions and congregations. Like many other fundamentalist denominations, Jehovah's Witnesses condemns homosexual acts, thoughts, and feelings. Consequently, gay and lesbian Witnesses experience not just stigmatization and conflict between their sexual and religious identities in the social world, but also a nearly impossible task in their inner world. This inner task adds a new facet to our understanding of stigma (Goffman, 1963). This study explores the written narratives of a subset of gay and lesbian former Jehovah's Witnesses who were able to comprehend, negotiate, and, in most cases, resolve their multifaceted stigmas and conflicts through struggle, self-determination, and eventually connecting with networks of peers who faced or are facing similar stigmas. This research contributes to other work on the intersection of religion, family, and homosexuality; in particular, the findings have implications for the study of other strict fundamentalist religions.