Sexual identity development: relationship with lifetime suicidal ideation in sexual minority women

Community (dis)connectedness and identity among LGBTQIA+ people during the COVID-19 pandemic: A qualitative cross-sectional and longitudinal trajectory study

The coronavirus disease 2019 (COVID-19) pandemic and associated shelter-in-place ordinances passed in the first year of the pandemic rapidly limited access to in-person social interactions, raising concerns of diminishing social support and community cohesion while psychological stressors increased. For LGBTQIA+ people, connectedness to the LGBTQIA+ community is known to buffer against the harmful effects of stressors and decrease risks for poor psychological and behavioral health outcomes. The current study uses qualitative cross-sectional and trajectory analysis methods to characterize how LGBTQIA+ people's perceptions of community connectedness shifted during the first year of the pandemic. A convenience sample of LGBTQIA+-identified people in the U.S. completed an initial online survey in September 2020 (n = 298 and a follow-up survey in September 2021 (n = 129). The survey included changes in connectedness to the LGBTQIA+ community since the pandemic's beginning. Thus, we used both cross-sectional (between-person analyses) and longitudinal trajectory (within-person analyses) qualitative approaches to understanding changes in LGBTQIA+ people's sense of connection to the LGBTQIA+ community across the first two years of the COVID-19 pandemic. Eight cross-cutting themes (related to identity shifts/exploration, disconnection, online connections, and increased awareness of social justice issues) were identified and then organized within each level of the Social-Ecological Model of LGBTQIA+ wellbeing (i.e., the individual-, couple-, interpersonal-, organizational-, community-, and chronosystem- level). Given the importance of social support for LGBTQIA+ wellbeing, more longitudinal research is needed to determine whether these changes persist after the resolution of the acute phase of the pandemic.

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

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

Sexual Orientation Identity Development Milestones Among Lesbian, Gay, Bisexual, and Queer People: A Systematic Review and Meta-Analysis

This paper is a systematic review and meta-analysis on sexual orientation identity development milestones among people who are lesbian, gay, bisexual, or another sexual minority identity (LGB+). Common milestones measured in the 30 studies reviewed were becoming aware of queer attractions, questioning one's sexual orientation, self-identifying as LGB+, coming out to others, engaging in sexual activity, and initiating a romantic relationship. Milestones occurred in different sequences, although attraction was almost always first, often followed by self-identification and/or sexual activity; coming out and initiating a romantic relationship often followed these milestones. Meta-analysis results showed that the mean effect sizes and 95% confidence intervals varied by milestone: attraction [M _age=12.7 (10.1, 15.3)], questioning one's orientation [M _age=13.2 [12.8, 13.6]), self-identifying [M _age=17.8 (11.6, 24.0)], sexual activity [M _age=18.1 (17.6, 18.6)], coming out [M _age=19.6 (17.2, 22.0)], and romantic relationship [M _age=20.9 (13.2, 28.6)]. Nonetheless, results also showed substantial heterogeneity in the mean effect sizes. Additional meta-analyses showed that milestone timing varied by sex, sexual orientation, race/ethnicity, and birth cohort. Although patterns were found in LGB+ identity development, there was considerable diversity in milestone trajectories.

Ambient Discrimination, Victimization, and Suicidality in a Non-Probability U.S. Sample of LGBTQ Adults

Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at a higher risk for suicidality compared to the general population. A growing body of research has investigated this risk, particularly with attention to systemic factors such as discrimination and harassment. Unfortunately, research has only examined the impact of direct discrimination on suicidality and has neglected to examine how ambient discrimination (i.e., witnessing or being made aware of discriminatory behaviors directed at someone other than yourself in your group) relates to suicidality. Additionally, although some links exist between discrimination and suicidality, the mechanisms by which these are related are understudied. This study aimed to address these gaps by exploring the effect of ambient discrimination on suicidal ideation and examining psychological pain as a mediator in this relationship. Data were collected from a sample of 200 LGBTQ-identified individuals (M age = 35 years; 53.5% female; 86% White). Results of independent t tests and a one-way multivariate ANOVA revealed greater vulnerability for ambient/direct discrimination and psychache among individuals identifying as transgender, queer, and other. Regression and mediation analyses revealed that while both ambient and direct discrimination predicted suicidal ideation, only direct discrimination accounted for unique variance in the outcome; however, both ambient and direct discrimination contributed unique variance to psychological pain, which fully mediated their relationships to suicidal ideation. Results of this study may begin to provide insight into the pathways of risk and points of intervention for suicidality in the LGBTQ community.

Young people's health and risk behaviours in relation to their sexual orientation: A cross-sectional study of Thailand and Sweden

OBJECTIVES

This study examined the associations between sexual orientation of young people and their health and risk behaviours in Thailand and Sweden, and to explore similarities and differences between the countries.

STUDY DESIGN

A cross-sectional study using data from the Life and Health - Young surveys in Thailand and Sweden. Three different statistical analyses were used to examine the associations of the variables.

RESULTS

In total, 3869 students aged 16-18 years old were included: 1488 Thai students and 2381 Swedish students. Significantly more Thai (20%) than Swedish (9%) students identified themselves as bisexual, homosexual or unsure (p < .001). Bivariate analysis showed that, in Thailand, self-harm was more often reported by the homosexual, unsure, and bisexual groups than by the heterosexual group (p = .005). In Sweden, early sexual debut was more often reported by the unsure, bisexual, and homosexual groups than by the heterosexual group (p = .033). Multiple logistic regression analysis showed that homosexual and unsure sexual orientations were significantly associated with self-harm (p < .05) among Thai students. Unsure sexual orientation was significantly associated with early sexual debut (p = .04) among Swedish students. Multiple correspondence analysis indicated that sexual orientation was associated with health and risk behaviours, and varied by different subcategories of students' backgrounds such as country, sexual orientation, family structure and adult support.

CONCLUSIONS

Sexual minority young people reported more risk behaviours and poorer health than their heterosexual counterparts. The findings are useful for policy programmes on sexual and reproductive health and rights of young people.

What's Unique About Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth and Young Adult Suicides? Findings From the National Violent Death Reporting System

PURPOSE

The purpose of the study was to explore variability in circumstances around suicide deaths among youth and young adults by sexual/gender identity category (gay male, lesbian/gay female, bisexual male, bisexual female, transgender male, transgender female, non-LGBT [lesbian, gay, bisexual, and transgender] male, and non-LGBT female).

METHODS

Secondary analysis of National Violent Death Reporting System (NVDRS) data for all 12- to 29-year-olds who died by suicide in NVDRS participating states. Coverage begins in 2013, the year that NVDRS began coding for sexual orientation and transgender status, and ends in 2015, the latest year of NVDRS data available. The valid sample was limited to cases in which sexual orientation or transgender status could be determined postmortem, n = 2,209.

RESULTS

Almost one quarter (24%) of 12- to 14-year-olds who died by suicide were LGBT, whereas only 8% of 25- to 29-year-olds who died by suicide were LGBT. Most non-LGBT males and bisexual males died by firearm and had intimate partner problems contribute to their deaths. Non-LGBT females and LGBT persons other than bisexual males were generally less likely to use firearms. They were also more likely to have psychiatric diagnoses, prior suicidality, and family problems contributing to their deaths. Rates of many circumstances varied widely among LGBT subgroups.

CONCLUSIONS

The LGBT versus non-LGBT suicide disparity is greatest at younger ages, and each LGBT subgroup has its own specific risk profile for suicide. Suicide prevention and intervention efforts targeted at LGBT youth may increase their effectiveness by attending to these distinct risk profiles.

Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study

BACKGROUND

There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared with heterosexuals. We compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from when they were aged 10 years to 21 years, and examined self-harm at ages 16 years and 21 years.

METHODS

The study included 4828 adolescents born between April 1, 1991, and Dec 31, 1992, from the Avon Longitudinal Study of Parents and Children birth cohort (Bristol, UK) who reported their sexual orientation when aged 16 years. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire (sMFQ) at seven timepoints between ages 10 years and 21 years. A self-harm questionnaire was completed at ages 16 years and 21 years. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the previous year at ages 16 years and 21 years), and multinomial regression (lifetime self-harm with and without suicidal intent at age 21 years).

FINDINGS

At age 10 years, depressive symptoms were higher in sexual minorities (mean sMFQ 4·58 [SD 3·59]) than in heterosexuals (3·79 [3·36]) and increased with age to a larger extent. Depressive symptoms increased at each timepoint by 0·31 sMFQ points in hetereosexuals (95% CI 0·27-0·34), and by 0·49 sMFQ points in sexual minorities (0·40-0·59). Sexual-minority adolescents were more likely than heterosexual adolescents to report self-harm in the previous year at ages 16 years and 21 years (adjusted odds ratio 4·23, 95% CI 2·90-6·16), with no evidence that this estimate decreased with age (p=0·80). When aged 21 years, sexual minorities were 4·53 (95% CI 3·02 to 6·78) times more likely to report lifetime self-harm (ie, on at least one previous occasion) with suicidal intent than heterosexuals.

INTERPRETATION

Mental health disparities between heterosexuals and sexual minorities are present early in adolescence and increase throughout the school years, persisting to young adulthood. Prevention of these mental health problems and early intervention must be a priority.

FUNDING

Medical Research Council, Wellcome Trust.

Accounting for Diversity in Suicide Research: Sampling and Sample Reporting Practices in the United States

Research on suicidal thoughts and behaviors (STB) has identified many risk factors, but whether these findings generalize to diverse populations remains unclear. We review longitudinal studies on STB risk factors over the past 50 years in the United States and evaluate the methodological practices of sampling and reporting sample characteristics. We found that articles frequently reported participant age and sex, less frequently reported participant race and ethnicity, and rarely reported participant veteran status or lesbian, gay, bisexual, and transgender status. Sample reporting practices modestly and inconsistently improved over time. Finally, articles predominantly featured White, non-Hispanic, young adult samples.