Health disparities among young adult sexual minorities in the U.S

BACKGROUND

Emerging research suggests that young adult sexual minorities (identifying as lesbian, gay, or bisexual or engaging in same-sex attractions or behaviors) experience poorer health than their majority counterparts, but many measures of health inequity remain unexamined in population-based research.

PURPOSE

To describe a wide range of health status and healthcare access characteristics of sexual minorities in comparison with those of the majority population in a national sample of U.S. young adults.

METHODS

Binary and multinomial logistic regression analyses of Wave IV data (2008) from the National Longitudinal Study of Adolescent Health (participants aged 24-32 years, n=13,088) were conducted. Health measures were self-rated health; diagnosis of any of several physical or mental illnesses or sexually transmitted infections; measured BMI; depression classified from self-reported symptoms; use of antidepressant and anxiolytic medication; uninsured; forgone care; and receipt of physical, dental, and psychological services. Analyses were conducted in 2012-2013.

RESULTS

Sexual minority women had elevated odds of most adverse health conditions and lower odds of receiving a physical or dental examination. Sexual minority men had elevated odds of fewer adverse health conditions.

CONCLUSIONS

Young adult sexual minorities are at higher risk of poor physical and mental health. The results highlight the multidimensionality of sexual minority status and respond to calls for greater understanding of the health of this population.

Educational Attainment by Life Course Sexual Attraction: Prevalence and Correlates in a Nationally Representative Sample of Young Adults

Researchers know relatively little about the educational attainment of sexual minorities, despite the fact that educational attainment is consistently associated with a range of social, economic, and health outcomes. We examined whether sexual attraction in adolescence and early adulthood was associated with educational attainment in early adulthood among a nationally representative sample of US young adults. We analyzed Waves I and IV restricted data from the National Longitudinal Study of Adolescent Health (n=14,111). Sexual orientation was assessed using self-reports of romantic attraction in Waves I (adolescence) and IV (adulthood). Multinomial regression models were estimated and all analyses were stratified by gender. Women attracted to the same-sex in adulthood only had lower educational attainment compared to women attracted only to the opposite-sex in adolescence and adulthood. Men attracted to the same-sex in adolescence only had lower educational attainment compared to men attracted only to the opposite-sex in adolescence and adulthood. Adolescent experiences and academic performance attenuated educational disparities among men and women. Adjustment for adolescent experiences also revealed a suppression effect; women attracted to the same-sex in adolescence and adulthood had lower predicted probabilities of having a high school diploma or less compared to women attracted only to the opposite-sex in adolescence and adulthood. Our findings challenge previous research documenting higher educational attainment among sexual minorities in the US. Additional population-based studies documenting the educational attainment of sexual minority adults are needed.

The association of sexual orientation measures with young adults' health-related outcomes

OBJECTIVES

We examined associations among 3 dimensions of sexual orientation (identity, behavior, and attraction) and key health-related indicators commonly studied among sexual minority populations: depressive symptoms, perceived stress, smoking, binge drinking, and victimization.

METHODS

We analyzed data from the National Longitudinal Study of Adolescent Health, Wave IV (2007-2008) when respondents were aged 24 to 32 years (n=14,412). We used multivariate linear and logistic regressions to examine consistency of associations between sexual orientation measures and health-related indicators.

RESULTS

Strength of associations differed by gender and sexual orientation measure. Among women, being attracted to both sexes, identifying as "mostly straight" or "bisexual," and having mostly opposite-sex sexual partners was associated with greater risk for all indicators. Among men, sexual attraction was unrelated to health indicators. Men who were "mostly straight" were at greater risk for some, but not all, indicators. Men who had sexual partners of the same-sex or both sexes were at lower risk for binge drinking.

CONCLUSIONS

Using all 3 dimensions of sexual orientation provides a more complete picture of the association between sexual orientation and health among young adults than does using any 1 dimension alone.

Elucidating women's (hetero)sexual desire: definitional challenges and content expansion

The literature on women's sexual desire is reviewed with an emphasis on definitional challenges, an assessment of the empirical basis for the distinction between spontaneous and responsive desire, a reconsideration of the extent to which women's sexual desire is relational in nature, and an exploration of the incentive value of sex for women as a factor partially independent from the experience of sexual desire. Nine recommendations are made regarding research and diagnostic directions. The article concludes with an appeal for the inclusion of eroticism in research and clinical work on sexual desire.

A dynamic-ecological model of identity formation and conflict among bisexually-behaving African-American men

Understanding how ethnic, sexual, and masculine (ESM) identities form and possibly conflict among African-American men may be important to consider in explaining bisexual behavior in this population. It is proposed that the bisexual behavior among African-American who are primarily sexually attracted to other men may be a function of conflicting ESM identities. Comprehensively understanding the formation and conflict of ESM identities requires an examination of individuals, social contexts, and interactions between individuals and contexts. The current article presents a dynamic-ecological model of identity formation and conflict among ethnic minority men who have sex with men and uses the model to demonstrate how bisexual behavior among African-American men may be examined.