Community norms for the eating disorder examination questionnaire (EDE-Q) among cisgender bisexual plus women and men

PURPOSE

Cisgender bisexual plus (including bisexual, pansexual, and polysexual) women and men experience unique health concerns including eating disorders. The purpose of this study was to develop community norms for eating disorder attitudes and disordered eating behaviors in cisgender bisexual plus women and men using the Eating Disorders Examination Questionnaire (EDE-Q).

METHODS

Participants were cisgender bisexual plus women (n = 462) and men (n = 93) participants in The PRIDE Study, an existing study of sexual and gender minority people.

RESULTS

Mean and standard deviation of EDE-Q scores among cisgender bisexual plus women and men, respectively, were: Global (1.75 ± 1.26, 1.56 ± 1.18), Restraint (1.34 ± 1.44, 1.42 ± 1.53), Eating Concern (0.96 ± 1.13, 0.63 ± 0.96), Weight Concern 2.27 ± 1.55, 1.89 ± 1.46), and Shape Concern 42 ± 1.62, 2.30 ± 1.57). Among cisgender bisexual plus women and men, respectively, 27.5% and 22.6% scored in the clinically significant range on the Global score. Bisexual plus women and men reported any occurrence (≥ 1/28 days) of dietary restraint (19.3%, 23.7%), objective binge episodes (11.1%, 10.8%), excessive exercise (4.5%, 5.4%), self-induced vomiting (1.7%, 0.0%), and laxative misuse (0.4%, 1.1%), respectively. A lower percentage of age-matched cisgender bisexual plus women (18-25 years) reported any occurrence of objective binge episodes, self-induced vomiting, laxative misuse, and excessive exercise than previously published in young women. Age-matched cisgender bisexual plus men (18-26 years) reported higher weight concern subscale scores than previously published in young men.

CONCLUSIONS

These norms should aid clinicians in applying and interpreting the EDE-Q scores of cisgender bisexual plus women and men.

LEVEL OF EVIDENCE

Level V: cross-sectional descriptive study.

Too Common to Count? "Mild" Sexual Assault and Aggression among U.S. College Women

National estimates indicate that approximately 1 in 5 women will experience sexual assault during her time in college. However, measures of assault often exclude "mild" experiences, such as incidents of unwanted touching that were not preceded by force, incapacitation, or coercion. We aimed to document the characteristics of "mild" sexual assault and aggression that college women experience at large parties and bars. In addition, we considered women's descriptions of assaultive and aggressive incidents in the context of campus climate survey items to evaluate the potential for measurement gaps. Across six focus groups (N = 36) at a large, public university in the midwestern U.S., women described routine experiences of "mild" sexual assault and aggression, so common that often only imprecise counts of their frequency (e.g., "all the time") were possible. Our findings document the many forms and frequencies of "mild" assault and aggression in college women's lives, as well as the limits of campus climate surveys in measuring the mundane sexual mistreatment of women in campus life. We develop the term "sexualized aggression" to capture such mistreatment and situate this concept within the larger body of research on campus sexual violence.

When, If, and How: Young Women Contend With Orgasmic Absence

While cultural ideas about "healthy" and "fulfilling" sexuality often include orgasm, many young women do not experience orgasm during partnered sex. The current study examined how women described this absence of orgasm in their sexual experiences with male partners. We examined interviews (N = 17) with women ages 18 to 28 and focused on their ideas about orgasm and their explanations concerning when and why they do not orgasm. We explored three themes that illustrate the strategies young women use to contend with orgasmic absence: (1) What's the big deal?; (2) It's just biology; and (3) Not now, but someday. We found that young women's explanations allowed them to reduce feelings of abnormality and enabled them to distance themselves from sexual expectations regarding the perceived value of orgasm. In analyzing the complicated gender and sexual dynamics surrounding orgasm, we turned to Fahs' (2014) work on sexual freedom and the importance of articulating freedom from sexual obligations as a key intervention in critical sexuality research. In our discussion, we examine the implications of our findings for critical researchers looking to better understand the role of sexual norms in how young women imagine and discuss the role of pleasure in their own sexual lives.

Disparities for LGBTQ and Gender Nonconforming Adolescents

OBJECTIVES

To identify patterns of childhood adversity in a sample of adolescents and assess disparities in these experiences for lesbian, gay, bisexual, transgender, and questioning adolescents and by level of gender nonconformity.

METHOD

By using the cross-sectional, statewide, anonymous 2016 Minnesota Student Survey, 81 885 students were included in the current study (50.59% male; mean age = 15.51). Participants were enrolled in grades 9 and 11 in a total of 348 schools.

RESULTS

Four patterns of childhood adversity were identified with sex-stratified latent class analyses (entropy = 0.833 males; 0.833 females), ranging from relatively low levels of abuse (85.3% males; 80.1% females) to polyvictimization (0.84% males; 1.98% females). A regression analysis showed that compared with heterosexual adolescents, gay, lesbian, bisexual, and questioning adolescents were more likely to be classified into profiles characterized by polyvictimization (odds ratio [OR] 1.81-7.53) and psychological and/or physical abuse (OR 1.29-3.12), than no or low adversity. Similarly, compared with nontransgender adolescents, transgender adolescents were more likely to be classified into profiles characterized by patterns of polyvictimization (OR 1.49-2.91) and psychological and/or physical abuse (OR 1.23-1.96). A higher level of gender nonconformity predicted a higher likelihood of being classified into each adversity profile compared with the no or low adversity profile (OR 1.14-1.45).

CONCLUSIONS

Sexual minority adolescents and adolescents with high levels of gender nonconformity are vulnerable to experience adversity. The disparities for lesbian, gay, bisexual, transgender, and questioning adolescents and adolescents with high gender nonconformity highlight the variation in patterns of childhood adversity that these youth are at risk of experiencing. The findings reveal the need for further research on the benefits and harm of screening for childhood adversity by physicians and pediatricians.

Disclosure Stress, Social Support, and Depressive Symptoms Among Cisgender Bisexual Youth

Bisexual youth are at elevated risk for depression compared to lesbians and gay men. Research on bisexual stigma suggests these youth are uniquely vulnerable to stress related to sexual identity disclosure. Depression associated with this stress may be buffered by social support from parents and friends. We examined the differential influence of social support from parents and friends (Child and Adolescent Social Support Scale) on the relation between disclosure stress (LGBTQ Coming Out Stress Scale) and depressive symptoms (Beck Depression Inventory) and differences by gender in a sample of cisgender bisexual youth (n = 383) using structural equation modeling. Parental support buffered the association between stressful disclosure to family and depressive symptoms, especially for bisexual men; bisexual women seemed not to benefit from such support when disclosure stress was high. This nuanced examination elucidates the ways family members and clinicians can best support bisexual youth sexual identity disclosure.