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Salerno JP, Lea CH, Alcántara C. Effects of Racist Microaggressions and Sexual and Gender Minority Stress on Mental Health Among Latinx Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning + Young Adults. HEALTH EDUCATION & BEHAVIOR 2024; 51:691-699. [PMID: 38760930 DOI: 10.1177/10901981241254068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2024]
Abstract
This study examines the effects of racist microaggressions and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)-related minority stressors (i.e., identity concealment, family rejection, internalized LGBTQ-phobia, victimization, and racialized heterosexism/cisgenderism) on psychological distress among Latinx LGBTQ+ young people, specifically college students. Participants are a Latinx subset (n = 80) from a national online nonprobability cross-sectional survey of LGBTQ+ college students. The study aim was examined using linear/logistic regression. Findings indicated that racist microaggressions and family rejection were associated with psychological distress. In addition, racist microaggressions were the only stressor associated with clinically significant psychological distress that may warrant psychiatric/psychological treatment. Therefore, racist microaggressions and family rejection are unique stressors that may saliently affect mental health among Latinx LGBTQ+ students. There is a great need to integrate minority stress theory with other critically-oriented theories, such as intersectionality, in research and intervention to eliminate mental health inequities faced by Latinx LGBTQ+ young people.
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Affiliation(s)
- John P Salerno
- Columbia University, School of Social Work, New York, NY, USA
| | - Charles H Lea
- Columbia University, School of Social Work, New York, NY, USA
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Keel C, Stewart R, Mellberg J. Operationalizing Street Harassment Using Survey Instruments: A Systematic Review of Measuring Harassment in Public Spaces Using Surveys. TRAUMA, VIOLENCE & ABUSE 2024; 25:2609-2621. [PMID: 38317377 PMCID: PMC11370194 DOI: 10.1177/15248380231219258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Quantitative research has an omitted variable problem when it comes to measuring and modeling non-criminal threats in the urban environment. This systematic review identified questionnaires and surveys used to measure incidences of street harassment/harassment in public, to discuss how they operationalize street harassment/harassment in public, and to report the characteristics of those with the best evidence of reliability and validity. We searched five databases and included peer-reviewed articles published in English from 1994 to 2022 that measured street harassment using a survey instrument. Our search resulted in 54 included studies. Of these studies, 16 primarily focused on understanding street harassment. To design effective prevention strategies in response to street harassment, research must first effectively measure the prevalence of street harassment and the contexts in which street harassment occurs. Due to the inconsistencies in definition, our review identified prevalence rates were inconsistent. Incidents of street harassment provide a promising avenue for future research, although scholars must first seek to appropriately operationalize this concept in survey research. We provide suggestions for future research that seeks to use surveys to understand harassment in public places.
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Affiliation(s)
- Chloe Keel
- Monash University, Clayton, VIC, Australia
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Surwill DL, Pharr JR. Socioecological Predictors of Resilience in Sexual and Gender Minority Individuals. J Community Health 2024:10.1007/s10900-024-01398-7. [PMID: 39235544 DOI: 10.1007/s10900-024-01398-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/06/2024]
Abstract
Many factors affect an individual's resilience. Low resilience has been attributed to increased stress, anxiety, depression, and suicidality within the LGBTQIA + population, which is heightened compared to different populations. This study identifies predictors of resilience in the LGBTQIA + population and aims to identify predicting factors at all levels of the socioecological model. This was a cross-sectional study of data from a web-based survey that was conducted from January to February 2022. A national sample of 1033 LGBTQIA + adults was utilized for hierarchical regression analysis. Hierarchical regression analyses were performed for total resilience, which had an average score of 143.66 (SD = 33.88) and accounted for 53.4% of resiliency variance. Factors that were found to decrease an individuals resiliency score were depression, stress, suicidality, and isolation discrimination distress. Factors found to increase an individuals resiliency scores are college graduate 4 years+, married, outness, personal comfortability with being SGM, gender expression discrimination distress, and vicarious discrimination distress. Understanding the factors that influence resilience is vital to improving the resilience of the LGBTQIA + communities. Interventions that focus on decreasing depression, stress, and suicidality may be particularly impactful for all types of resilience.
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Affiliation(s)
- Dana L Surwill
- Department Environmental and Occupational Health, School of Public Health, University of Nevada, 4700, South Maryland Parkway, Las Vegas, NV, 89119, USA.
| | - Jennifer R Pharr
- Department Environmental and Occupational Health, School of Public Health, University of Nevada, 4700, South Maryland Parkway, Las Vegas, NV, 89119, USA
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Mereish EH, Miranda R. Vicarious heterosexism-based stress induces alcohol, nicotine, and cannabis craving and negative affect among sexual minority young adults: An experimental study. Neurobiol Stress 2024; 32:100668. [PMID: 39252986 PMCID: PMC11381502 DOI: 10.1016/j.ynstr.2024.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 08/07/2024] [Accepted: 08/09/2024] [Indexed: 09/11/2024] Open
Abstract
Purpose Sexual minority young adults are at increased risk for hazardous drinking and alcohol use disorder compared to heterosexual adults. Heterosexism-based stressors contribute and often explain inequities in alcohol outcomes. However, the extant research primarily relies on correlational designs, and often neglects the importance of alcohol craving, despite its foundational role in addiction. Leveraging a novel experimental mood induction paradigm, this study examined the effects of exposure to vicarious heterosexism-based stress on alcohol craving and negative affect among sexual minority young adults who drink heavily. We also examined its effects on cannabis and nicotine craving among participants who used cannabis and nicotine, respectively. Lastly, we examined moderating factors that could influence the impact of exposure to heterosexism-based stress on alcohol craving. Methods Participants were 101 heavy drinking sexual minority young adults, ages 20-35 (M = 26.46 years old; SD = 3.49), recruited from the community (51.5% female sex assigned at birth; 76.3% cisgender; 51.5% plurisexual; and 42.6% racial and ethnic minorities). They completed three mood induction trials counterbalanced over three visits on different days: heterosexism stress, general stress, and neutral. Structured interviews assessed criteria for DSM-5 alcohol use disorder (AUD) and substance use, and self-report measures assessed lifetime traumatic stressors. Results Most participants met criteria for past-year AUD (74.7%). Exposure to heterosexism stress produced more negative affect and substance craving than the neutral mood induction, even while controlling for demographic variables and lifetime exposure to traumatic and heterosexism stressors. Exposure to heterosexism-based stress had large effects on alcohol craving among participants who had greater drinking to cope motives and heterosexism-specific rejection sensitivity, whereas the effects were small for those who had lower drinking to cope motives and heterosexism-specific rejection sensitivity. Demographic, lifetime stress, prior alcohol use, and AUD symptom severity variables were not significant moderators. Greater substance craving induced by heterosexism-based stress in the laboratory was associated with greater recent and current substance use. Conclusions This study findings show that vicarious exposure to heterosexism elicits negative mood and alcohol, cannabis, and nicotine craving among sexual minority young adults who engaged in heavy drinking. The effects for alcohol craving were largest among those who endorse high levels of drinking to cope motives and heterosexism-based rejection sensitivity. These findings have implications for oppression-based stress and motivational models of addiction.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Psychology, University of Maryland, College Park, MD, USA
- Department of Health Studies, American University, Washington, DC, USA
| | - Robert Miranda
- Department of Psychiatry & Human Behavior, Brown University, Providence, RI, USA
- E. P. Bradley Hospital, Providence, RI, USA
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Lee YF, Chang TS, Haynes AM. Internalized Sexual Stigma, Sexual Orientation Disclosure, and Patient Experience Among Gay Men and Lesbian Women in Taiwan: A Cross-Sectional Survey. LGBT Health 2024. [PMID: 39207256 DOI: 10.1089/lgbt.2023.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Purpose: Previous research has found that stigma, discrimination, and depression are associated with the sexual minority population's medical experiences. However, there is still a lack of relevant research results in Taiwan. This study investigated the health-seeking experiences and influencing factors of gay men and lesbian women in Taiwan. Methods: We recruited gay men and lesbian women through lesbian, gay, bisexual, and transgender (LGBT)-friendly websites and associations between November 2019 and June 2020. Surveys included the demographics, medical visiting experiences, Measure of Internalized Stigma, Patient Health Questionnaire-9, and Daily Heterosexist Experiences Questionnaire. Results: There were 270 participants, including 188 gay men and 82 lesbian women. Most respondents refused to disclose their sexual orientation to health care providers; some feared seeking medical care and preferred seeking LGBT-friendly health care services. Compared with lesbian women, gay men had higher levels of internalized sexual stigma, victimization, concealing sexual orientation, and experiences of medical staff denying services. Discrimination, depressive severity, and internalized sexual stigma affected the medical visit experience. Conclusion: In Taiwan, the health care experiences of gay men and lesbian women are affected by discrimination, internalized sexual stigma, and severe depression, while facing challenges of fear of seeking medical care or reluctance to disclose their sexual orientation.
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Affiliation(s)
- Yen-Fan Lee
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Te-Sheng Chang
- Department of Education and Human Potentials Development, Hua-Shih College of Education, National Dong Hwa University, Shoufeng, Taiwan
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Saade Z, Hanshaw BD, Keuroghlian AS. Including Sexually and Gender Diverse Populations in 3,4-Methylenedioxymethamphetamine-Assisted Psychotherapy Trial Research. LGBT Health 2024. [PMID: 39158366 DOI: 10.1089/lgbt.2024.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024] Open
Abstract
Sexually and gender diverse (SGD) populations experience an increased prevalence and severity of posttraumatic stress disorder (PTSD) compared with the general population. Minority stress theory contextualizes this increased disease burden by outlining how stigma and discrimination (e.g., homophobia and transphobia) contribute to worse mental health outcomes. The standard-of-care pharmacotherapy for PTSD is associated with significant treatment resistance. 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has emerged as an investigational treatment for PTSD but has lacked consideration for SGD populations. This article explores next steps in clinical trial design and implementation for the study of MDMA-AP with SGD populations who have PTSD.
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Affiliation(s)
- Ziad Saade
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alex S Keuroghlian
- Harvard Medical School, Boston, Massachusetts, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Ellis É, Wieling E, Tate A. Complex Posttraumatic Stress Disorder Links Trauma Exposure and Suicidal Behaviors Among Sexual Minority Populations: A New Target in Suicide Prevention? JOURNAL OF HOMOSEXUALITY 2024; 71:2300-2318. [PMID: 37466931 DOI: 10.1080/00918369.2023.2233654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Exposure to potentially traumatic events and posttraumatic stress are known risk factors for suicidal thoughts and behaviors (STB). Research suggests that sexual minorities are disproportionately exposed to traumatic events and experience greater STB than their heterosexual peers, although few studies have explored connections between these parallel disparities. Further, existing literature may implicate complex posttraumatic stress disorder (CPTSD) as a potential mechanism in the trauma-suicide connection among sexual minorities. This study uses a sample from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; n = 1351) to test structural equation models for associations between trauma exposure, heterosexist discrimination, and CPTSD with suicide attempt status. We found CPTSD mediated associations between exposure to traumatic events and presence of a lifetime suicide attempt among sexual minority male and female samples. Discrimination demonstrated a synergistic effect on the association between trauma exposure and CPTSD, but, among males, CPTSD did not fully explain associations between discrimination and suicide attempts. Our findings suggest that CPTSD should be considered an important mechanism in the trauma-suicide connection for sexual minorities and may be a potentially important target for suicide prevention and that interventions should address the influence of discrimination on traumatic stress in this high-risk population.
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Affiliation(s)
- Émilie Ellis
- College of Public Health, University of Georgia School of Public Health, Athens, Georgia, USA
| | - Elizabeth Wieling
- Human Development and Family Science, University of Georgia Department of Human Development and Family Science, Athens, Georgia, USA
| | - Allan Tate
- College of Public Health, University of Georgia School of Public Health, Athens, Georgia, USA
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Bishop CJ, Morrison TG. "We Can Do Better": Developing Attitudinal Scales Relevant to LGBTQ2S+ Issues-A Primer on Best Practice Recommendations for Beginners in Scale Development. Behav Sci (Basel) 2024; 14:611. [PMID: 39062434 PMCID: PMC11273634 DOI: 10.3390/bs14070611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/27/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
In this primer, following best practice recommendations and drawing upon their own expertise in psychometrics, the authors provide a step-by-step guide for developing measures relevant to sexual- and gender-marginalized persons (SGMPs). To ensure that readers operate from a uniform understanding, definitions for central elements of psychometric testing (e.g., reliability and validity) are provided. Then, detailed information is given about developing and refining scale items. Strategies designed to reduce a pool of items to a manageable number are also highlighted. The authors conclude this primer by discussing various forms of validation (e.g., convergent, discriminant, and known groups). To further readers' understanding, illustrative examples from measures designed for SGMPs are brought into focus throughout.
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Affiliation(s)
- CJ Bishop
- Psychology Program, Grenfell Campus, Memorial University of Newfoundland and Labrador, Corner Brook, NL A2H 5G4, Canada
| | - Todd Graham Morrison
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK S7N 5A5, Canada;
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Algarin AB, Salerno JP, Shrader CH, Lee JY, Fish JN. Associations between living arrangement and sexual and gender minority stressors among university students since the start of the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1379-1386. [PMID: 35658096 PMCID: PMC9718887 DOI: 10.1080/07448481.2022.2076560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine the associations between COVID-19-related living arrangements and sexual and gender minority (SGM)-related stressors (ie, identity concealment and familial rejection). PARTICIPANTS N = 478 SGM university students (Mage = 22 years, SD = 4.00). METHODS SGM university students were surveyed cross-sectionally between May and August 2020 regarding SGM-related stressors and living arrangements since the start of COVID-19. RESULTS Approximately half (48.7%) of the sample reported a living rearrangement to their parents' home due to COVID-19. Living rearrangement to parents' homes was associated with an increased degree of identity concealment (β [95% C.I.] = 0.62 [0.10, 1.15]; p = .020) and familial rejection (β [95% C.I.] = 1.56 [0.72, 2.41]; p < .001) since the start of COVID-19 compared to stably living without parents (34.3%). Stably living with parents (17.0%) was not associated with increased degree of SGM-related stressors compared to experiencing a living rearrangement. CONCLUSIONS Stakeholders must consider the unique identity-related vulnerabilities of SGM students living with parents and who experience living rearrangements due to COVID-19.
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Affiliation(s)
- Angel B Algarin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - John P Salerno
- Department of Behavioral & Community Health, University of Maryland, College Park, MD, USA
| | - Cho-Hee Shrader
- ICAP at Columbia University, Mailman School of Public Health
| | - Ji-Young Lee
- Center for Sexuality and Health Disparities, University of Michigan USA
| | - Jessica N Fish
- Department of Family Science, University of Maryland, College Park, MD, USA
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Terry E, Pharr JR, Batra R, Batra K. Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. LGBT Health 2024; 11:392-405. [PMID: 38324060 DOI: 10.1089/lgbt.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.
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Affiliation(s)
- Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Ravi Batra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Ruiz RA, Lehavot K, Heffner JL, Kava CM, Ornelas IJ. Associations of Sexual Orientation-Related Minority and Military Stressors With Past-Year Cigarette Use Among Lesbian, Gay, and Bisexual Veterans. Nicotine Tob Res 2024; 26:852-860. [PMID: 37878537 PMCID: PMC11190049 DOI: 10.1093/ntr/ntad210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/28/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Lesbian, gay, and bisexual (LGB) individuals and Veterans are more likely to report current smoking than the general adult population in the United States. The Minority Stress Model may explain the high prevalence of cigarette smoking among LGB individuals, who experience unique interpersonal (e.g., discrimination) and intrapersonal (e.g., identity concealment) stressors related to their minoritized sexual orientation. AIMS AND METHODS This study assessed whether three types of stressors (interpersonal, intrapersonal, and LGB-specific military) were associated with past-year smoking among LGB Veterans. Veterans were recruited online for a prospective cohort study. We conducted secondary data analysis of baseline surveys collected from 2019 to 2020. The study sample included cisgender, LGB Veterans (n = 463). Adjusted nested multivariable logistic regression models were used to estimate the association of each stressor with past-year cigarette smoking. RESULTS Participants were mostly male (54.0%), non-Hispanic white (82.1%), and at least a college graduate (58.5%). LGB Veterans who were younger, had lower levels of education, income, and healthcare coverage, higher general stressors, and post-traumatic stress disorder and depression symptoms were more likely to smoke in the past year (n = 98, 21.2%). The adjusted odds of past-year smoking were higher among those who reported higher levels of harassment (aOR = 1.13, 95% confidence interval [CI]: 1.01 to 1.26), victimization (aOR = 1.13, 95% CI: 1.02 to 1.43), and family rejection (aOR = 1.13, 95% CI: 1.08 to 1.36). CONCLUSIONS Multiple interpersonal stressors were associated with past-year smoking, highlighting the need to intervene on these stressors. Future interventions should aim to address policies that reduce prejudice against LGB Veterans, while helping those who smoke identify and develop positive coping skills that support cessation. IMPLICATIONS Our findings contribute to the growing body of literature on tobacco use disparities among LGB individuals, particularly LGB Veterans. Results of this analysis provide some evidence for the Minority Stress Model as a conceptual model for understanding and intervening in disparities in smoking prevalence among LGB Veterans.
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Affiliation(s)
- Raymond A Ruiz
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seattle, WA, USA
| | - Keren Lehavot
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seattle, WA, USA
| | - Jaimee L Heffner
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Christine M Kava
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seattle, WA, USA
| | - India J Ornelas
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seattle, WA, USA
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Elmer EM, van Tilburg TG, Fokkema T. Age and Gender Identity in the Relationship Between Minority Stress and Loneliness: A Global Sample of Sexual and Gender Minority Adults. JOURNAL OF SEX RESEARCH 2024:1-20. [PMID: 38861488 DOI: 10.1080/00224499.2024.2339511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
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.
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Affiliation(s)
- Eddy M Elmer
- Department of Sociology, Vrije Universiteit Amsterdam
| | | | - Tineke Fokkema
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW/University of Groningen
- Department of Public Administration and Sociology, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam
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Baiocco R, Antoniucci C, Pistella J, Alessandri G, Alivernini F, Borghi AM, Chirico A, Filosa L, Fini C, Palombi T, Rosati F, Tavolucci S, Lucidi F. Aging well in an aging society: physical health in older lesbian, gay, and bisexual adults. Front Psychol 2024; 15:1369021. [PMID: 38860050 PMCID: PMC11163588 DOI: 10.3389/fpsyg.2024.1369021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/09/2024] [Indexed: 06/12/2024] Open
Abstract
Introduction Older sexual minority people meet a double stigma in our society related to their sexual identity and chronological age. The present study explores how experiences of discrimination and prejudice, coming out, and personal resiliency influence physical health of older lesbian, gay, and bisexual (LGB) adults. Methods Respondents were recruited through online advertisements and an online-based survey. The sample included 82 Italian cisgender LGB adults over 65 years: young older adults (65-70 years; 78%) and old-old adults (over 71 years; 22%). Regarding sexual orientation, the sample was composed of sexual minority women (n = 30; 37%) and sexual minority men (n = 52; 63%). Results ANOVAs' findings showed that sexual minority women described lower levels of physical health compared to sexual minority men. At the same time, old-old adults reported higher experiences of discrimination and prejudice compared to young older adults. Moreover, findings from hierarchical multiple regression analysis described that coming out, higher levels of personal resiliency, and fewer experiences of discrimination were predictors of physical health, regardless of age and sexual minority categories. Conclusion These findings seem to align with previous studies that underline the relevance of investigating aging well in sexual minority people. Knowledge and awareness of LGBTQ+ issues are necessary for recognizing the unique needs and resources of older LGB people for promoting a healthy aging process.
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Affiliation(s)
- Roberto Baiocco
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Chiara Antoniucci
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Jessica Pistella
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Guido Alessandri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Alivernini
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna M. Borghi
- Department of Dynamic, Clinical Psychology and Health, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Filosa
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Chiara Fini
- Department of Dynamic, Clinical Psychology and Health, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Tommaso Palombi
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fau Rosati
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Simone Tavolucci
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Eng Hui E, Berezina EB. Burden of the Fruity: Family Support and Suicide Ideation as Mediators Between Discrimination and Suicide Behavior in LGBTQ+ Malaysians. JOURNAL OF HOMOSEXUALITY 2024:1-22. [PMID: 38767868 DOI: 10.1080/00918369.2024.2354409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Malaysian pervasive climate places its LGBTQ+ residents at heightened risk for suicidal behaviors (SB). This cross-sectional study aimed to elucidate connections between minority stressors (discrimination), types of social supports, and suicidality in this marginalized population. Utilizing online surveys, 317 LGBTQ+ Malaysians aged 18-49 provided data regarding experienced discrimination, perceived social support from family, friends, and significant others, suicidal ideation (SI), and SB. Quantitative analyses illuminated several key findings. First, discrimination is positively associated with SB, while all support types are inversely related to SB, with family support demonstrating the strongest correlation. Regression modeling revealed family support as the sole unique predictor of reduced SB. Serial mediation analysis uncovered nuanced indirect pathways from discrimination to SB, with SI, but not family support alone, significantly mediating this relationship. However, reduced family support resulting from discrimination sequentially heightened SI and SB. Despite pervasive societal bias, family and friend acceptance may curb the LGBTQ+ community's elevated suicide risk by mitigating resultant ideation. These insights highlight the need for public health initiatives promoting social support and LGBTQ+ inclusivity laying the groundwork to safeguard this population's psychological wellbeing.
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Affiliation(s)
- Ellern Eng Hui
- Department of Psychology, Sunway University, Sunway, Malaysia
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15
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Isbășoiu AB, Sava FA, Larsen TMB, Anderssen N, Rotaru TS, Rusu A, Sălăgean N, Tulbure BT. An Internet-Based Intervention to Increase the Ability of Lesbian, Gay, and Bisexual People to Cope With Adverse Events: Single-Group Feasibility Study. JMIR Form Res 2024; 8:e56198. [PMID: 38749024 PMCID: PMC11137425 DOI: 10.2196/56198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people are at higher risk of mental health problems due to widespread hetero- and cisnormativity, including negative public attitudes toward the LGBTQ+ community. In addition to combating social exclusion at the societal level, strengthening the coping abilities of young LGBTQ+ people is an important goal. OBJECTIVE In this transdiagnostic feasibility study, we tested a 6-week internet intervention program designed to increase the ability of nonclinical LGBTQ+ participants to cope with adverse events in their daily lives. The program was based on acceptance and commitment therapy principles. METHODS The program consists of 6 web-based modules and low-intensity assistance for homework provided by a single care provider asynchronously. The design was a single-group assignment of 15 self-identified LGB community members who agreed to participate in an open trial with a single group (pre- and postintervention design). RESULTS Before starting the program, participants found the intervention credible and expressed high satisfaction at the end of the intervention. Treatment adherence, operationalized by the percentage of completed homework assignments (32/36, 88%) was also high. When we compared participants' pre- and postintervention scores, we found a significant decrease in clinical symptoms of depression (Cohen d=0.44, 90% CI 0.09-0.80), social phobia (d=0.39, 90% CI 0.07-0.72), and posttraumatic stress disorder (d=0.30, 90% CI 0.04-0.55). There was also a significant improvement in the level of self-acceptance and behavioral effectiveness (d=0.64, 90% CI 0.28-0.99) and a significant decrease in the tendency to avoid negative internal experiences (d=0.38, 90% CI 0.09-0.66). The level of general anxiety disorder (P=.11; d=0.29, 90% CI -0.10 to 0.68) and alcohol consumption (P=.35; d=-0.06, 90% CI -0.31 to 0.19) were the only 2 outcomes for which the results were not statistically significant. CONCLUSIONS The proposed web-based acceptance and commitment therapy program, designed to help LGBTQ+ participants better manage emotional difficulties and become more resilient, represents a promising therapeutic tool. The program could be further tested with more participants to ensure its efficacy and effectiveness. TRIAL REGISTRATION ClinicalTrials.gov NCT05514964; https://clinicaltrials.gov/study/NCT05514964.
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Affiliation(s)
- Andreea Bogdana Isbășoiu
- Department of Psychology, West University of Timisoara, Timisoara, Romania
- Department of Psychology and Educational Sciences, Transilvania University of Brasov, Brasov, Romania
| | - Florin Alin Sava
- Department of Psychology, West University of Timisoara, Timisoara, Romania
| | - Torill M B Larsen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Norman Anderssen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Tudor-Stefan Rotaru
- Department of Bioethics, University of Medicine and Pharmacy "Gr. T. Popa" Iași, Iasi, Romania
| | - Andrei Rusu
- Department of Psychology, West University of Timisoara, Timisoara, Romania
| | - Nastasia Sălăgean
- Department of Psychology, West University of Timisoara, Timisoara, Romania
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16
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Fergerson AK, Karnick A, Caulfield NM, Tennity CL, Capron DW. The Indirect Effects of Proximal Stressors Associated with Posttraumatic Stress Symptoms Severity among Sexually Victimized Sexual Minority Women: A Cross-Sectional Path Analysis. Violence Against Women 2024; 30:1517-1537. [PMID: 36744378 DOI: 10.1177/10778012231153362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sexual minority women (SMW) are at risk for sexual victimization and stressors specifically related to their minority identity (e.g., discrimination). However, SMW experience posttraumatic stress disorder (PTSD) at rates beyond what may be explained by elevated risk for sexual victimization alone. This study aimed to examine the impact of stigma on PTSD symptoms among SMW survivors of sexual victimization. Results indicate that in relation to minority-specific distal stressors (i.e., heterosexist experiences), both minority-specific and general proximal stressors (i.e., internalized heterosexism, negative posttraumatic cognitions) indirectly affected PTSD symptom severity among this cross-sectional sample of sexually victimized SMW.
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Affiliation(s)
- Ava K Fergerson
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Aleksandrs Karnick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Nicole M Caulfield
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Cassidy L Tennity
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
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17
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Shrader CH, Salerno JP, Lee JY, Johnson AL, Algarin AB. Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent class analysis. Epidemiol Psychiatr Sci 2024; 33:e22. [PMID: 38602075 PMCID: PMC11022265 DOI: 10.1017/s2045796024000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/18/2023] [Accepted: 02/03/2024] [Indexed: 04/12/2024] Open
Abstract
AIMS In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress. METHODS We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N = 482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress. RESULTS Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress. CONCLUSION Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.
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Affiliation(s)
- C.-H. Shrader
- Department of Epidemiology, Columbia University, New York City, NY, USA
- ICAP at Columbia University, New York City, NY, USA
| | - J. P. Salerno
- School of Social Work, Columbia University, New York City, NY, USA
| | - J.-Y. Lee
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, USA
| | - A. L. Johnson
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, USA
| | - A. B. Algarin
- Department of Nursing and Health Innovations, Arizona State University, Phoenix, AZ, USA
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18
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Pharr JR, Chien LC, Gakh M, Flatt JD, Kittle K, Terry E. Moderated Mediation Analysis of Structural Stigma and Suicidal Ideation and Behaviors Among Sexual and Gender Minority Adults. LGBT Health 2024; 11:239-248. [PMID: 38285526 DOI: 10.1089/lgbt.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Purpose: This study aimed to conduct a moderated mediation analysis to understand further the complex pathways through which structural stigma in the form of transgender sports bans was associated with suicidal ideation and behaviors among sexual and gender minority (SGM) adults. Methods: A cross-sectional survey of 1033 adults who identified as SGM from across the 50 U.S. states and Washington, DC was conducted between January 28 and February 7, 2022. Distal discrimination distress was the mediation variable; individual resilience and social resources were the moderation variables. Familiarity with transgender sports bans represented structural stigma. The conditional process analysis was applied to build a moderated mediation model. Both conditional direct and indirect effects were computed by estimated coefficients. All models were based on linear regression. Results: Our final model explained nearly half (46%) of the variation in suicidal ideation and behaviors between those SGM adults familiar and those not familiar with transgender sports bans. Social resources significantly moderated the conditional indirect effect of distal discrimination distress (adjusted estimate = -0.23; 95% confidence interval = -0.37 to -0.08). Conclusion: Both discrimination distress and social resources influenced the association between structural stigma as measured by familiarity with transgender sports bans and suicidal ideation and behaviors among SGM adults. Findings support the need for future research examining the pathway between structural stigma and suicidal ideation and behaviors among SGM adults and how minority stress, social safety, and other constructs shape this pathway.
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Affiliation(s)
- Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jason D Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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19
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Mezza F, Mezzalira S, Pizzo R, Maldonato NM, Bochicchio V, Scandurra C. Minority stress and mental health in European transgender and gender diverse people: A systematic review of quantitative studies. Clin Psychol Rev 2024; 107:102358. [PMID: 37995435 DOI: 10.1016/j.cpr.2023.102358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
The current study aimed at systematically reviewing evidence on the relationships between gender minority stress and mental health outcomes among European transgender and gender diverse (TGD) individuals. A systematic search was conducted in PsycINFO, PubMED, Scopus, and Google Scholar. It was based on Boolean operators to combine terms related to minority stress, TGD identities, and mental health. Thirty studies were identified as eligible. The results confirmed that gender minority stress factors are significantly related with mental health problems among European TGD individuals. Distal stressors were identified as strongly associated with poorer mental health, with gender-related discrimination emerging as the most documented risk factor. The significant role of proximal stressors was also highlighted, with some mediation analyses detecting an indirect effect on mental health. However, identity concealment appeared unrelated to mental health outcomes. Resilience-promoting factors buffering the impact of stressors were also identified, including self-esteem, pride, transitioning, and social support. Conversely, data on community connectedness as a source of resilience were inconclusive. The studies reviewed have several limitations, including lack of longitudinal designs, sampling bias, variability in measurement methods, and unaccounted ethnic variables. Research and clinical recommendations in this field are reported.
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Affiliation(s)
- Fabrizio Mezza
- SInAPSi Center, University of Naples Federico II, Via Giulio Cesare Cortese 29, Napoli 80133, Italy
| | - Selene Mezzalira
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy.
| | - Rosa Pizzo
- SInAPSi Center, University of Naples Federico II, Via Giulio Cesare Cortese 29, Napoli 80133, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy.
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, Rende 87036, Italy.
| | - Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, Napoli 80133, Italy.
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20
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Keum BT, Maurin-Waters E, Chong ESK. The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:525-541. [PMID: 37943472 DOI: 10.1007/s10508-023-02733-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.
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Affiliation(s)
- Brian TaeHyuk Keum
- Department of Counseling, Developmental & Educational Psychology, Lynch School of Education and Human Development, Boston College, 140 Commonwealth Ave., Chestnut Hill, MA, 02467, USA.
| | - Emily Maurin-Waters
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Eddie S K Chong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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21
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Davidson JD, Neilson EC, Staples JM, Turner RB. Group differences in gender expression discrimination and depressive and anxiety symptoms among transgender and gender-expansive adults: The role of gender identity pride. Bull Menninger Clin 2024; 88:214-238. [PMID: 39226226 DOI: 10.1521/bumc.2024.88.3.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Despite established associations between discrimination and mental health, little research has focused on gender expression discrimination and integrated individual strengths such as transgender and gender-expansive (TGE) identity pride. This study examined the roles of gender expression discrimination and pride in mental health among TGE adults across gender identity, race, and class. A national sample of TGE adults (N = 212) completed online measures assessing gender identity, race, income, gender expression-related discrimination, TGE identity pride, and depression and anxiety symptoms. Gender expression discrimination was positively associated with depressive and anxiety symptoms. Black, Indigenous, People of Color (BIPOC), higher income, transfeminine participants reported more gender expression discrimination. High TGE identity pride buffered the association between gender expression discrimination and depression-most robustly for BIPOC, lower income, transfeminine participants. TGE identity pride may buffer the effects of gender expression discrimination on depression. Intersectionality in case formulation and treatment planning with TGE individuals is vital.
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Affiliation(s)
- Jonathan D Davidson
- Crisis and Residential Recovery Therapist, Pathways, Inc., Ashland, Kentucky
| | - Elizabeth C Neilson
- Director, Community Behavioral Health Clinic, and Assistant Professor, Department of Psychology, Morehead State University, Morehead, Kentucky; Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Jennifer M Staples
- Associate Professor, California School of Professional Psychology, Alliant International University, San Diego, California
| | - Rachel B Turner
- Undergraduate research assistant, Department of Psychology, Morehead State University, Morehead, Kentucky
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22
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Smith AU, Bostwick WB, Burke L, Hequembourg AL, Santuzzi A, Hughes TL. How deep is the cut? The influence of daily microaggressions on bisexual women's health. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2023; 10:535-548. [PMID: 38737574 PMCID: PMC11086984 DOI: 10.1037/sgd0000556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Bisexual women experience disproportionately poorer health outcomes in comparison to lesbian and gay groups, and the general population, including inequities related to mental and physical health. Although bisexual-specific health inequities are increasingly well-documented, research examining putative causes of such inequities, as well as research that accounts for differences within bisexual populations - particularly among racial minorities- remains limited. To address these gaps, this paper reports findings from the Women's Daily Experiences Study (WoDES), a multi-method study that explored the relationship between microaggressions and health outcomes among racially/ethnically diverse cisgender, bisexual women in Chicago. Data from 28-day daily e-diaries (N = 2,104 observations; 99 participants, 57% women of color) were analyzed using multilevel modeling to (1) measure the frequency of microaggressions among bisexual women; (2) examine the influence of sexual orientation, racial, and gender microaggressions on mental and physical health; and (3) investigate how race influences relationships between microaggressions and health. Participants reported an average of 8.1 microaggressions in the previous 28 days, and at least one microaggression was reported for more than 42% of days (n = 802). Microaggressions of any type were associated with increased same-day negative affect and somatic complaints. Latina bisexual women experienced worse health outcomes in comparison to Black bisexual women. This study demonstrated the detrimental impact of microaggressions on the health of bisexual women and highlights the critical need for strategies on broader structural changes that could improve the health and well-being of bisexual women.
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Affiliation(s)
- Ariel U Smith
- Ariel U. Smith, Assistant Professor, University of Illinois at Chicago, College of Nursing, Population Health Nursing Science
| | - Wendy B Bostwick
- Wendy B. Bostwick, Associate Professor, University of Illinois at Chicago, College of Nursing, Population Health Nursing Science
| | - Larisa Burke
- Larisa A. Burke, Visiting Research Specialist, University of Illinois at Chicago, College of Nursing, Office of Research Facilitation
| | - Amy L Hequembourg
- Amy L. Hequembourg, Associate Professor, State University of New York at Buffalo, School of Nursing
| | - Alecia Santuzzi
- Alecia Santuzzi, Professor, Northern Illinois University, College of Liberal Arts and Sciences, Department of Psychology
| | - Tonda L Hughes
- Tonda L. Hughes, Professor and Associate Dean, Columbia University, School of Nursing and Department of Psychiatry
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23
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Charak R, Cano-Gonzalez I, Ronzon-Tirado R, Schmitz RM, Tabler J, Karsberg S, Flores A, Ford JD. LGBTQ+ identity-related abuse during childhood and associations with depression and suicide behavior: Role of adulthood cisheterosexism and expressive suppression. CHILD ABUSE & NEGLECT 2023; 145:106433. [PMID: 37660426 DOI: 10.1016/j.chiabu.2023.106433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/28/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Exposure to minority stressors specific to LGBTQ+ individuals, such as heterosexism and cissexism (or cisheterosexism) is not covered under the traditional adverse childhood experiences framework. This is important because childhood identity-related abuse by a parent/caregiver can lead to mental health challenges in later life through the adoption of maladaptive coping mechanisms. OBJECTIVE The present study aimed to examine the role of cisheterosexism and expressive suppression as serial mediators in the associations between identity-related abuse and depressive symptoms and suicide behavior. PARTICIPANTS AND SETTING Participants included 563 LGBTQ+ identifying adults between 18 and 64 years (M = 30.02, SD = 9.05) from different regions of Spain and were recruited through social media (e.g., Twitter, Facebook, and Instagram). METHOD A serial mediation model was conducted with cisheterosexism and expressive suppression as the mediators in the associations between LGBTQ+ identity-related childhood abuse and depressive symptoms and suicide behavior. RESULTS Findings indicated a positive indirect effect of identity-related abuse on depressive symptoms through cumulative cisheterosexism (B = 0.628, p < .01), and via cumulative cisheterosexism and suppression (B = 0.146, p < .05). No significant indirect effect was found for identity-related abuse on depressive symptoms via suppression (B = 0.086). An indirect effect was found for identity-related abuse on suicide behavior via cumulative cisheterosexism (B = 0.250, p < .01). CONCLUSIONS Findings reveal that LGBTQ+ identity-related cisheterosexist experiences perpetrated by parents or caregivers are associated with harmful, long-term impacts on symptoms of depression and suicide behavior via experiences of cisheterosexism and expressive suppression.
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Affiliation(s)
- Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA.
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | - Rachel M Schmitz
- Department of Sociology, Oklahoma State University, Stillwater, OK, USA
| | - Jennifer Tabler
- Department of Criminal Justice and Sociology, University of Wyoming, Laraime, USA
| | - Sidsel Karsberg
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Ayleen Flores
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
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24
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Noebel NA, Vela RB, Arreguin DH, Oberle CD. Orthorexia nervosa symptomatology in the LGBTQ community: Gender and sexual orientation differences. Eat Behav 2023; 50:101771. [PMID: 37315429 DOI: 10.1016/j.eatbeh.2023.101771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/18/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023]
Abstract
This study investigated whether gender and sexual minority groups exhibit differences in orthorexia nervosa (ON) symptomatology compared to cisgender, straight individuals. A sample of 441 non-clinical participants (65 % White, mean age = 27) reported their gender (104 cisgender men, 229 cisgender women, 28 transgender men, 27 transgender women, 53 nonbinary) and sexual orientation (144 straight, 45 gay, 54 lesbian, 105 bisexual/pansexual, 68 queer), and completed the Orthorexia Nervosa Inventory. The LGBTQ group exhibited greater ON symptomatology compared to the cisgender, straight group. ANOVAs demonstrated significant group differences according to gender and sexual orientation. Post-hoc tests revealed that transgender women exhibited greater ON symptomatology than cisgender men and cisgender women. However, nonbinary individuals exhibited lower ON symptomatology than cisgender women, transgender men, and transgender women. Additionally, lesbians exhibited greater ON symptomatology than straight individuals. Our findings suggest that individuals with an LGBTQ identity, particularly transgender women and lesbians, may experience greater ON symptomatology than cisgender, straight individuals. However, nonbinary individuals appear to experience lower ON symptomatology, which may relate to a lack of alignment with masculine or feminine ideals, such that these individuals may feel a lack of need to conform to a certain appearance ideal based on gender norms.
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Affiliation(s)
- Natalie A Noebel
- Department of Psychology, Texas State University, United States of America
| | - Rheanna B Vela
- Department of Psychology, Texas State University, United States of America
| | - Dilan H Arreguin
- Department of Psychology, Texas State University, United States of America
| | - Crystal D Oberle
- Department of Psychology, Texas State University, United States of America.
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25
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Salerno JP, Pease MV, Gattamorta KA, Fryer CS, Fish JN. Impact of Racist Microaggressions and LGBTQ-Related Minority Stressors: Effects on Psychological Distress Among LGBTQ+ Young People of Color. Prev Chronic Dis 2023; 20:E63. [PMID: 37471634 PMCID: PMC10364828 DOI: 10.5888/pcd20.220371] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND College students situated at the nexus of racial and sexual and gender minority (SGM) identities may experience multiple identity-related oppressions. We assessed whether racist microaggressions and lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ)-related minority stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) are associated with greater psychological distress among SGM college students of color (SOC) (students who identified as Hispanic/Latinx and/or any nonwhite race). METHODS Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study of SGM college students. Participants were recruited by using online social media platforms and university email listserves from May through August 2020. Participants completed an online Qualtrics survey using previously validated measures of minority stress, racist microaggressions, and psychological distress. Simple and covariate-adjusted multiple linear regression models were used to examine the associations between racist microaggressions and LGBTQ-related minority stressors with psychological distress. RESULTS In simple linear regression models, racist microaggressions and all LGBTQ-related stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) were significantly and positively associated with greater psychological distress. In covariate-adjusted multiple linear regression, racist microaggressions, internalized LGBTQ-phobia, and LGBTQ-related family rejection (but not identity concealment, racialized heterosexism and/or cisgenderism, and victimization) were independently and significantly associated with greater psychological distress. CONCLUSION Study findings reveal that racist microaggressions, along with LGBTQ-related family rejection and internalized LGBTQ-phobia, have a significant impact on psychological distress among SGM SOC. Public health leaders have an important opportunity for policy and program development and reform to address the identity-related mental health needs of SGM SOC.
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Affiliation(s)
- John P Salerno
- John P. Salerno, PhD, MPH, School of Social Work, Columbia University, 1255 Amsterdam Ave, #922, New York, NY 10027
| | - M V Pease
- Department of Psychology, College of Behavioral and Social Sciences, University of Maryland, College Park, Maryland
| | - Karina A Gattamorta
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
| | - Craig S Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland
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Pachankis JE, Jackson SD. A Developmental Model of the Sexual Minority Closet: Structural Sensitization, Psychological Adaptations, and Post-closet Growth. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1869-1895. [PMID: 35978203 PMCID: PMC9935753 DOI: 10.1007/s10508-022-02381-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/11/2022] [Accepted: 07/11/2022] [Indexed: 05/15/2023]
Abstract
Across the lifespan, most sexual minority individuals experience the closet-a typically prolonged period in which no significant others know their sexual identity. This paper positions the closet as distinct from stigma concealment given its typical duration in years and absolute removal from sources of support for an often-central identity typically during a developmentally sensitive period. The Developmental Model of the Closet proposed here delineates the vicarious learning that takes place before sexual orientation awareness to shape one's eventual experience of the closet; the stressors that take place after one has become aware of their sexual orientation but has not yet disclosed it, which often takes place during adolescence; and potential lifespan-persistent mental health effects of the closet, as moderated by the structural, interpersonal, cultural, and temporal context of disclosure. The paper outlines the ways in which the model both draws upon and is distinct from earlier models of sexual minority identity formation and proposes several testable hypotheses and future research directions, including tests of multilevel interventions.
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Affiliation(s)
- John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, Suite 316, New Haven, CT, 06510, USA.
| | - Skyler D Jackson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Sheerin KM, Brodell R, Huey SJ, Kemp KA. Applying ecological systems theory to juvenile legal system interventions outcomes research: a measurement framework. Front Psychol 2023; 14:1177568. [PMID: 37425162 PMCID: PMC10327555 DOI: 10.3389/fpsyg.2023.1177568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Intervention research and development for youth in the juvenile legal system (JLS) has often focused on recidivism as the primary outcome of interest. Although recidivism is an important outcome, it is ultimately a downstream marker of success and is affected by changes in other domains of youths' lives (e.g., family and peer relations, neighborhood safety, local and state-level policies). Thus, the present manuscript proposes the application of ecological systems theory to selecting outcomes to assess intervention effects in JLS intervention research to better capture proximal and distal influences on youth behavior. To that end, we first provide an overview of the strengths and limitations of using recidivism as an outcome measure. Next, the current application of social ecology theory to existing research on both risk and protective factors of JLS involvement is discussed, as well as existing work on assessing social-ecological domains within intervention studies. Then, a measurement framework is introduced for selecting pertinent domains of youths' social ecologies to assess as intervention outcomes, moderators, and mediators. To facilitate this, we provide examples of concrete constructs and measures that researchers may select. We conclude with potential new avenues of research to which our proposed framework could lead, as well as potential limitations of implementing our framework.
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Affiliation(s)
- Kaitlin M. Sheerin
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
| | - Regina Brodell
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Stanley J. Huey
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Kathleen A. Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
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Cisek A, Rogowska AM. The Relationship between Minority Stress and Depressive Symptoms in the LGBTQA Population from Poland. Eur J Investig Health Psychol Educ 2023; 13:1000-1014. [PMID: 37366780 DOI: 10.3390/ejihpe13060076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
The cross-sectional study examines minority stress and depression symptoms regarding various sexual and gender minority (SGM) identities in lesbian, gay, bisexual, transgender, queer, and asexual (LGBTQA) individuals from Poland. The online survey was conducted among 509 people. Participants aged between 18 and 47 (M = 22.39, SD = 4.78). Gender identity included 262 cisgender women, 74 cisgender men, 31 transgender women, 53 transgender men, and 89 nonbinary individuals. Sexual identity comprises 197 bisexual, 150 homosexual, 78 pansexual, 33 asexual, 21 undefined, 14 heterosexual, 9 demisexuals, 6 queer, and 1 sapiosexual individual. The Daily Heterosexist Experiences Questionnaire (DHEQ) and the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) were used to measure minority stress and depression symptoms, respectively. Among LGBTQA participants, 99.80% declared minority stress at least once during the past year. In particular, vicarious trauma was experienced in 99.80% of participants, vigilance in 95.87%, harassment and discrimination in 80.35%, stress related to the family of origin in 69.16%, and to gender expression in 68.76% of respondents. Depression symptoms were found in 62.50% of respondents. Significantly higher rates of depression and minority stress were presented in dual than single SGM individuals. Binomial logistic regression showed that such sources of minority stress as vigilance, harassment, and gender expression could predict depression symptoms. Therefore, prevention and intervention programs should be designed for the LGBTQA population focusing on coping with these sources of minority stress, especially among those of dual SGM identity.
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Affiliation(s)
- Aleksandra Cisek
- Institute of Psychology, University of Opole, 45-052 Opole, Poland
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Gattamorta KA, Vega G, Kania V. Impact of Living Arrangements of LGBTQ College Students During COVID-19. JOURNAL OF STUDENT AFFAIRS RESEARCH AND PRACTICE 2023; 61:251-265. [PMID: 38586549 PMCID: PMC10997324 DOI: 10.1080/19496591.2023.2186241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
This study examines the relationships between living arrangements and educational outcomes, access to LGBTQ affirming care, sexual and gender minority (SGM) stressors, and mental health. Bivariate analyses were implemented to examine relationships between living arrangements and academic outcomes, SGM stressors, access to care, and alcohol and substance use. Differences between undergraduate and graduate students are also reported. Students who continued living on campus were less likely to report increased family rejection, transphobia, and identity concealment.
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Salerno JP, Gattamorta KA, Williams ND. Impact of family rejection and racism on sexual and gender minority stress among LGBTQ young people of color during COVID-19. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:637-647. [PMID: 35511543 PMCID: PMC10361835 DOI: 10.1037/tra0001254] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Given the inequitable impact of COVID-19 on sexual and gender minority (SGM) youth and current sociopolitical racial justice concerns in the United States, this study examines the impact of SGM-related family rejection and racism since the start of COVID-19 on SGM-related internalized homophobia and identity concealment among SGM college students of color (SOC). METHOD Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study about minority stress and COVID-19 pandemic experiences among SGM college students. Participants completed survey items specifically related to changes in minority stress and racism experiences since the start of COVID-19. Logistic regression models were used to examine the independent and interactive effects of racism and family rejection on identity concealment and internalized homophobia since the start of COVID-19 (adjusting for covariates). RESULTS Main effects models revealed that increased racism and family rejection were significantly associated with greater odds of experiencing identity concealment since the start of COVID-19. The interaction of increased racism and family rejection was also significantly associated with greater odds of experiencing identity concealment since the start of COVID-19. CONCLUSIONS Study findings suggest that the intersection of racism and family rejection since the start of COVID-19 consequently translates to increased experiences of identity concealment. Such experiences are known to negatively impact mental health across the life course among SGM young people. Public health, medical, mental health, and higher education stakeholders must implement SGM-affirmative and antiracist practices and interventions to support SGM SOC during COVID-19 and beyond its containment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- John P. Salerno
- Department of Behavioral & Community Health, School of Public Health, University of Maryland
| | | | - Natasha D. Williams
- Department of Family Science, School of Public Health, University of Maryland
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Parrott DJ, Bresin K, Hequembourg A, Velia B, Swartout KM, Stappenbeck CA, Masyn KE, Grom JL. Dyadic effects of minority stress and problematic alcohol use on sexual intimate partner violence in same sex couples. Aggress Behav 2023; 49:198-208. [PMID: 36693274 PMCID: PMC10089976 DOI: 10.1002/ab.22072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/17/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
Little is known about the factors that facilitate the perpetration of sexual violence within the context of same-sex romantic relationships (sexual intimate partner violence perpetration [S-IPV]). The present study sought to identify the effects of external and internal minority stress and problematic drinking on perpetration of S-IPV within a dyadic framework. A community-based sample of 137 sexual and gender minority (SGM) couples (N = 274; 59 male assigned at birth and 78 female assigned at birth couples) completed self-report surveys about minority stressors, alcohol use, and S-IPV perpetration. Multilevel logistic regression analyses were conducted within an actor-partner interdependence framework. This approach accounted for both actor effects (e.g., how much one's S-IPV perpetration is predicted by their own risk factors) and partner effects (e.g., how much one's S-IPV perpetration is influenced by their partner's risk factors). Both Actor external minority stress and internal minority stress were positively associated with Actor S-IPV perpetration. Actor problematic drinking was not associated with Actor S-IPV perpetration; however, Partner problematic drinking was positively associated with Actor S-IPV perpetration. Observed effects were robust above the addition of other risk factors. This research innovatively extricates S-IPV perpetration from other forms of IPV and indicates that Actor minority stress and Partner problematic drinking increase S-IPV likelihood. Results serve as a starting point for development of etiological models to inform the design of culturally-informed interventions to reduce S-IPV among SGM couples.
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Affiliation(s)
- Dominic J Parrott
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Konrad Bresin
- Department of Counseling and Human Development, University of Louisville, Louisville, Kentucky, USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Amy Hequembourg
- School of Nursing, State University of New York at Buffalo, Buffalo, New York, USA
| | - Brynne Velia
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Kevin M Swartout
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | | | - Katherine E Masyn
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Jessica L Grom
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
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32
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Weeks SN, Renshaw TL, Vinal SA. Minority Stress as a Multidimensional Predictor of LGB+ Adolescents' Mental Health Outcomes. JOURNAL OF HOMOSEXUALITY 2023; 70:938-962. [PMID: 34806974 DOI: 10.1080/00918369.2021.2006000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The minority stress model has been used to explain added daily stressors that non-heterosexual (LGB+) individuals experience. While the emphasis of minority stress research is frequently broad (global minority stress) or narrow (specific stressors) in focus, the literature often refers to specific stressors at the domain level as either distal (external) or proximal (internal). This study found that, compared with broad and narrow levels, a domain level approach may be best for understanding the predictive value of minority stress. Multiple regression analyses with a sample of 152 LGB+ adolescents found that distal stress predicted substance misuse (p < .001) and suicidality (p = .002) and was a stronger predicter than proximal stress for psychological inflexibility. This study might contribute to an evidence base that could guide measurement approaches for assessing minority stress and using related results to inform the prediction of-and, ultimately, intervention with-LGB+ adolescents' mental health outcomes.
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Affiliation(s)
- Sean N Weeks
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Tyler L Renshaw
- Department of Psychology, Utah State University, Logan, Utah, USA
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Stigma and Barriers in Health Care Among a Sample of Transgender and Gender-Diverse Active Duty Service Members. Med Care 2023; 61:145-149. [PMID: 36728493 DOI: 10.1097/mlr.0000000000001818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Transgender and/or gender-diverse (TGD) persons are vulnerable to stigma and health care inequities; however, data are particularly limited among TGD active duty military service members despite ongoing changes to service policies. TGD-related stressors may impede access to and utilization of health care due to fear of potential discrimination and distress, thereby adversely impacting military readiness. METHODS We examined stigma and barriers in health care and associations with physical and mental health in an online sample of 177 active duty service members who self-identified as TGD. To assess associations between stigma and barriers in health care with mental and physical health, linear regressions were conducted adjusting for age, gender identity, race, and rank. RESULTS Over half (65%) of the participants reported at least 1 instance of stigma and/or barrier in health care. Stigma and barriers to health care were significantly associated with greater self-reported depressive symptoms (β=0.20, P =0.03), anxiety (β=0.21, P =0.03), stress (β=0.30, P =0.001), and poorer overall mental health (β=-0.23, P =0.007), after adjusting for covariates. Nearly one-quarter of participants had not disclosed their gender identity to their primary care clinician. CONCLUSIONS Findings suggested that stigma and barriers to affirming health care were prevalent among active duty service members identifying as TGD, specifically, difficulty accessing gender-affirming care and negative assumptions from clinicians. These experiences may adversely affect mental health and impede the quality of health care received by a population already vulnerable to health inequities. Given recent changes to military policy, efforts may be warranted to improve access to timely, affirming care and clinician training.
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Zascirinskis RH, Pepper BI, Tischler AE. An Exploratory Study of the Coming Out Road Drawing: A Novel Growth Promoting Intervention for Sexual and Gender Minority Individuals. ARTS IN PSYCHOTHERAPY 2023. [DOI: 10.1016/j.aip.2023.102004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Ronzón-Tirado R, Charak R, Cano-González I. Daily Heterosexist Experiences in LGBTQ+ Adults from Spain: Measurement, Prevalence, and Clinical Implications. PSYCHOSOCIAL INTERVENTION 2023; 32:1-10. [PMID: 37361633 PMCID: PMC10268542 DOI: 10.5093/pi2022a15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/12/2022] [Indexed: 06/28/2023]
Abstract
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face unique stressors related to their sexual and gender identities that have a detrimental impact on their mental health. Nonetheless, studies have not yet investigated these minority stressors among LGBTQ+ individuals from Spain. The limited availability of standardized tools/instruments to measure minority stressors in Spanish makes it challenging to explore these experiences among Spanish speaking individuals. The present study aimed to examine the factor structure of the Daily Heterosexist Experiences Questionnaire (DHEQ) among LGBTQ+ adults from Spain, compare rates of minority stressors across diverse gender and sexual orientations, and examine the impact of daily heterosexist experiences (henceforth referred to as heterosexist experiences) on symptoms of depression and suicidal behavior. The sample was composed of 509 LGBTQ+ identifying adults in the age range of 18 to 60 years old. Confirmatory factor analysis indicated a good fit for the six dimensions of the DHEQ scale. Individuals identified as transgender or reporting a minority sexual orientation (i.e., asexual, pansexual) indicated higher levels of exposure to heterosexist experiences. Moreover, those with higher levels of heterosexist experiences had higher symptoms of depression and suicide behavior. The present study provides a tool for examining minority stressors in Spanish speaking LGBTQ+ adults. Assessing for minority stressors may aid in the identification of risk and protective factors when working with LGBTQ+ treatment seeking adults.
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Affiliation(s)
- Román Ronzón-Tirado
- Autonomous University of MadridMadridSpainAutonomous University of Madrid, Spain
| | - Ruby Charak
- University of Texas Rio Grande ValleyEdinburgTexasUSAUniversity of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Inés Cano-González
- University of Texas Rio Grande ValleyEdinburgTexasUSAUniversity of Texas Rio Grande Valley, Edinburg, Texas, USA
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Xin Y, Schwarting CM, Wasef MR, Davis AK. Exploring the intersectionality of stigma and substance use help-seeking behaviours among lesbian, gay, bisexual, transgender, queer, questioning or otherwise gender or sexuality minority (LGBTQ+) individuals in the United States: A scoping review. Glob Public Health 2023; 18:2277854. [PMID: 37939481 DOI: 10.1080/17441692.2023.2277854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
Problematic substance use (SU) is a significant issue among LGBTQ+ individuals, but rates of treatment/help-seeking in this population remain low. This review aimed to investigate literature about intersectional stigma of SU and LGBTQ+ identity and its impact on SU help-seeking behaviours in the U.S. Eligible studies from eight-database were included if peer-reviewed, in English, from the U.S., published between 2000 and 2022, focused on SU, stigma, SU help-seeking behaviours, among LGBTQ+ adults. Of 458 search results, 50 underwent full-text review, 12 were included in the final sample. Minority Stress Theory emerged as a relevant theoretical framework. Findings revealed that increased SU as a coping strategy was associated with minority stress. Intersectional stigma negatively impacted SU treatment experience among LGBTQ+ individuals, leading to avoidance of help-seeking or poor treatment outcomes. Patterns of SU and impact of stigma among LGBTQ+ individuals differ, wherein bisexual and transgender individuals reported significantly more treatment barriers and unique stressors. LGBTQ+ individuals reported earlier age of SU onset and were more likely to encounter opportunities for SU. This review highlights the impact of intersectional stigma on SU help-seeking behaviour among LGBTQ+ individuals in the U.S. Recommendations are provided for future clinical practice, research, and policy to better support LGBTQ+ individuals.
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Affiliation(s)
- Yitong Xin
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Corrine M Schwarting
- Department of Psychology, Psychology Department, Iowa State University, Ames, IA, USA
| | - Mary R Wasef
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Alan K Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA
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Turpin R, King-Marshall E, Dyer T. Latent syndemic profiles among sexual and gender minority college students and psychological distress amid the COVID-19 pandemic. JOURNAL OF LGBT YOUTH 2022; 20:724-741. [PMID: 38107510 PMCID: PMC10721232 DOI: 10.1080/19361653.2022.2149659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/20/2022] [Accepted: 11/15/2022] [Indexed: 12/19/2023]
Abstract
Sexual and gender minority (SGM) college students experience compounding psychological effects as a result of the COVID-19 pandemic. Using latent profile analysis of cross-sectional data from a sample of SGM students (n=565) we tested for a syndemic of victimization, internalized LGBTQ+ stigma, racism, racialized heterosexism/cisgenderism, family rejection, and isolation associated with psychological distress. We also tested if increases in these factors since the start of the COVID-19 pandemic were associated with greater psychological distress among syndemic profiles. We identified four profiles: "Lowest syndemic factors" (reference), "High isolation only," "High isolation and rejection only," and "High syndemic." The greatest distress was observed among the "High syndemic" profile (aPR=2.99, 95% CI 2.20, 4.06), followed by the "High isolation and rejection only" profile (aPR=2.11, 95% CI 1.61, 2.76), and the "High isolation only" profile (aPR=1.32, 95% CI 1.03, 1.70). Among the "High syndemic profile," increases in every factor since the start of the COVID-19 pandemic were associated with greater psychological distress. The strongest associations were seen among increased victimization (aPR=5.85, 95% CI 1.33, 25.71). Victimization, internalized LGBTQ+ stigma, racism, family rejection, and isolation form a syndemic among SGM students, which has magnified since the start of the COVID-19 pandemic.
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Affiliation(s)
- Rodman Turpin
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Evelyn King-Marshall
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Typhanye Dyer
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, USA
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Casper AMA, Rebolledo N, Lane AK, Jude L, Eddy SL. "It's completely erasure": A Qualitative Exploration of Experiences of Transgender, Nonbinary, Gender Nonconforming, and Questioning Students in Biology Courses. CBE LIFE SCIENCES EDUCATION 2022; 21:ar69. [PMID: 36112619 PMCID: PMC9727607 DOI: 10.1187/cbe.21-12-0343] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 07/11/2022] [Accepted: 07/26/2022] [Indexed: 05/13/2023]
Abstract
Biology is the study of the diversity of life, which includes diversity in sex, gender, and sexual, romantic, and related orientations. However, a small body of literature suggests that undergraduate biology courses focus on only a narrow representation of this diversity (binary sexes, heterosexual orientations, etc.). In this study, we interviewed students with queer genders to understand the messages about sex, gender, and orientation they encountered in biology and the impact of these messages on them. We found five overarching themes in these interviews. Students described two narratives about sex, gender, and orientation in their biology classes that made biology implicitly exclusionary. These narratives harmed students by impacting their sense of belonging, career preparation, and interest in biology content. However, students employed a range of resilience strategies to resist these harms. Finally, students described the currently unrealized potential for biology and biology courses to validate queer identities by representing the diversity in sex and orientation in biology. We provide teaching suggestions derived from student interviews for making biology more queer-inclusive.
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Affiliation(s)
- A. M. Aramati Casper
- Department of Biology, Department of Civil and Environmental Engineering & Graduate Degree Program in Ecology, Colorado State University, Fort Collins, CO 80523-1372
| | - Nico Rebolledo
- Department of Biological Sciences, Florida International University, Miami, FL 33199
| | - A. Kelly Lane
- Biology Teaching and Learning, Minneapolis, MN 55455
| | | | - Sarah L. Eddy
- Department of Biological Sciences, Florida International University, Miami, FL 33199
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Choo S, Kim R, Lee H, Yi H, Kim R, Kim SS. Association between discrimination and poor sleep health outcomes among 2192 South Korean gay, lesbian, and bisexual adults: A nationwide cross-sectional survey. Sleep Health 2022; 8:587-592. [PMID: 36220734 DOI: 10.1016/j.sleh.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The study aimed to assess the prevalence of poor sleep health outcomes and examine the associations between experiences of discrimination and the sleep health outcomes among lesbian, gay, and bisexual (LGB) adults in Korea. DESIGN & SETTING The study used data from Rainbow Connection Project I, a nationwide cross-sectional survey of Korean LGB adults, conducted via online in 2016. MEASUREMENTS Participants were asked about experiences of anti-LGB discrimination and discrimination based on other characteristics (ie, gender, age, place of origin, nationality/race, religion, appearance including height and weight, disability status, and other) in the past 12 months. Using the responses, the participants were categorized into 4 groups: those who experienced (1) none, (2) only anti-LGB discrimination, (3) only other types of discrimination, and (4) both anti-LGB and other types of discrimination. Past-week sleep quality, unrestful sleep, and long sleep latency were included as sleep health outcomes. RESULTS Of the 2192 participants, 740 (33.8%) had poor sleep quality, 1211 (55.2%) had unrestful sleep, and 681 (31.1%) had long sleep latency in the past week. Participants who experienced both anti-LGB and other types of discrimination had 1.65 times (95% confidence interval [CI] = 1.38-1.98), 1.30 times (95% CI = 1.16-1.45), and 1.58 times (95% CI = 1.31-1.90) higher prevalence of poor sleep quality, unrestful sleep, and long sleep latency, respectively, compared to those without any experiences of discrimination. CONCLUSIONS Experiencing discrimination may deprive Korean LGB adults of good quality sleep. Interventions that seek to prevent discrimination are needed to promote sleep health among Korean LGB individuals.
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Affiliation(s)
- Sungsub Choo
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, South Korea; Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ranyeong Kim
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, South Korea; Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Hyemin Lee
- Jeju Institute of Public Health & Health Policy, Jeju, South Korea
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, South Korea
| | - Rockli Kim
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, South Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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Katz-Wise SL, Boskey ER, Godwin EG, Thomson K, Post J, Gordon AR. "We're Moving in the Right Direction. Still a Long Way to Go": Experiences and Perceptions of the Climate for LGBTQ+ Employees at a Pediatric Hospital. JOURNAL OF HOMOSEXUALITY 2022; 69:2286-2304. [PMID: 34115579 DOI: 10.1080/00918369.2021.1938468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A positive LGBTQ+ (lesbian, gay, bisexual, transgender/nonbinary, queer) workplace climate is critical for healthcare employee satisfaction, productivity, and patient care. The current study assessed LGBTQ+ workplace climate among 791 employees from a large urban pediatric hospital. Several workplace climate domains were assessed in an online survey: employee attitudes, training, experiences related to working with LGBTQ+ colleagues, patients and families, and LGBTQ+-specific experiences. For most domains, half or more of respondents perceived an affirming LGBTQ+ climate. LGBTQ+ employees perceived a less affirming climate than cisgender heterosexual employees. LGBTQ+ employees, especially transgender/nonbinary employees, experienced numerous discriminatory situations. Over 90% of participants felt competent and qualified to work with LGB patients/families; 80% felt competent and qualified to work with TNB patients/families. Themes from open-ended survery responses reflected three LGBTQ+ climate components: systemic, interpersonal, and "grassroots" (affinity group) initiatives. Findings inform strategies to improve LGBTQ+ employee experiences and competency caring for LGBTQ+ patients and families.
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Affiliation(s)
- Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth R Boskey
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Center for Gender Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Eli G Godwin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Katharine Thomson
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Julian Post
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
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Källström M, Nousiainen N, Jern P, Nickull S, Gunst A. Mental health among sexual and gender minorities: A Finnish population-based study of anxiety and depression discrepancies between individuals of diverse sexual orientations and gender minorities and the majority population. PLoS One 2022; 17:e0276550. [PMID: 36331970 PMCID: PMC9635740 DOI: 10.1371/journal.pone.0276550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
Substantial empirical evidence suggests that individuals who belong to sexual and gender minorities experience more anxiety and depression than heterosexual and cisgender people. Many previous studies have not, however, used population-based samples. There is also a shortage of evidence about certain sexual and gender minorities (e.g., nonbinary individuals). We examined differences in levels of anxiety and depression within sexual and gender minorities, as well as compared to the heterosexual and cisgender majority in a population-based Finnish sample (N = 8,589). We also explored if individuals who belong to both a gender and a sexual minority (double minority) reported higher rates of anxiety and depression than individuals who hold either a gender or a sexual minority status (single minority). Individuals who belonged to either a sexual or a gender minority overall experienced significantly higher rates of anxiety and depression than cisgender and heterosexual individuals. Among the different sexual and gender minorities, bisexual, emerging identity, and nonbinary individuals reported the highest rates of anxiety and depression. We found no differences in anxiety and depression between single minority and double minority individuals. Our results suggest that even though Finland is a country with an inclusive social climate, sexual and gender minorities are, nevertheless, disproportionately affected by mental health issues. The present study gives further support to the claim that individuals holding a sexual or gender minority status experience higher levels of depression and anxiety compared to cisgender and heterosexual individuals and pinpoints the need to acknowledge these issues both in the context of health care and in the society at large.
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Affiliation(s)
- Marianne Källström
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
- * E-mail:
| | - Nicole Nousiainen
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Patrick Jern
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Sabina Nickull
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Annika Gunst
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
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Ronzón-Tirado R, Charak R, Cano-Gonzalez I, Karsberg S, Schnarrs PW. Latent Classes of Bidirectional Face-to-Face and Cyber Intimate Partner Violence Among Lesbian, Gay, and Bisexual Emerging Adults: The Role of Minority Stressors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21092-NP21118. [PMID: 34839733 PMCID: PMC10704391 DOI: 10.1177/08862605211055158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The rates of intimate partner violence have been found to be higher among lesbian, gay, and bisexual (LGB) individuals when compared with heterosexual populations. However, lesser is known about the impact of specific minority stressors experienced by LGB populations on their face-to-face intimate partner violence (IPV) and cyber IPV experiences. Using a three-step latent class approach, the present study investigated (i) the latent classes of self-reported types of face-to-face IPV and cyber IPV perpetration and victimization and (ii) their associations with LGB distal and proximal minority stressors (i.e., vicarious trauma, discrimination, family rejection, and LGB-identity disclosure). Participants were 288 LGB emerging adults in the age range of 18-29 years (bisexual: n = 168, gay: n = 72, and lesbian: n = 48). Findings showed the presence of four latent classes, namely, face-to-face IPV (n = 32; 37.5% gay, 18.8% lesbian, and 43.8% bisexual individuals), cyber IPV (n = 66; 33.3% gay, 12.1% lesbian, and 54.5% bisexual individuals), psychological and stalking cyber IPV (n = 89; 15.7% gay, 15.7% lesbian, and 68.5% bisexual individuals), and low IPV (n = 101; 23.8% gay, 19.8% lesbian, and 56.4% bisexual individuals). Furthermore, multinomial logistic regressions indicated that greater exposure to the minority stressors such as exposure to heterosexism, namely, discrimination and harassment, rejection from one's family of origin, and exposure to vicarious trauma, as well as a lower degree of LGB-identity disclosure, largely predicted latent classes with greater probabilities of IPV exposure, namely, cyber IPV, face-to-face IPV classes, and psychological and stalking cyber IPV. Findings suggest the importance of addressing the role of minority stressors in IPV interventions and the creation of competent LGB-related services and training modules for clinicians.
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Affiliation(s)
- Roman Ronzón-Tirado
- Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Sidsel Karsberg
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Phillip W. Schnarrs
- Department of Population Health, The University of Texas at Austin, Austin, TX, USA
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43
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Weeks SN, Renshaw TL, Serang S. Validating the Structure of Proximal and Distal Factors within the Sexual Minority Adolescent Stress Inventory. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2022. [DOI: 10.1177/07342829221133172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Minority stress theory is a model for understanding health disparities among sexual minorities, defined as those who experience a level of same-sex attraction, identity, or behavior. Methods for assessing minority stress among youth included only adult measures until the development of the Sexual Minority Adolescent Stress Inventory (SMASI). The SMASI appears to be a robust scale in its ability to measure specific stressors and global minority stress among adolescents; however, it does not measure the domain-level constructs of proximal and distal stress, which are integral features of the underlying theory. This study tests the psychometric defensibility of including these domain-level factors within an updated SMASI measurement model. Results provide evidence for the structural validity of the proximal and distal domains within the SMASI measurement model and suggest this updated model has more informational value than the original model for capturing minority stress.
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44
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Tabler J, Schmitz RM, Charak R, Propst A. Forgone Care among LGBTQ and Non-LGBTQ Americans during the COVID-19 Pandemic: The Role of Health, Social Support, and Pandemic-Related Stress. South Med J 2022; 115:752-759. [PMID: 36191911 PMCID: PMC9512140 DOI: 10.14423/smj.0000000000001456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES In this study, we explore the role of Coronavirus Disease 2019 pandemic-related stress, social support, and health on unmet healthcare needs during the Coronavirus Disease 2019 pandemic, particularly among lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) adults. METHODS We collected data using a self-administered online survey of US adults. Using logistic regression, we modeled potential risk and protective factors for not receiving needed care during the pandemic (forgone care) among LGBTQ+ individuals (n = 121), cisgender and heterosexual-identifying women (n = 235), and cisgender and heterosexual-identifying men (n = 62). Limiting analyses to the LGBTQ+ subsample, we also assessed the unique role of LGBTQ+ discrimination and depressive symptoms. RESULTS Logistic regression results suggested that social support was associated with lower odds of forgone care (odds ratio [OR] 0.95, P < 0.01). Furthermore, better self-rated health and higher levels of income were associated with lower odds of forgone care (OR 0.56, P < 0.001, and OR 0.92, P < 0.05, respectively). Finally, LGBTQ+ individuals experienced uniquely high levels of forgone care, and LGBTQ+ discrimination (OR 1.03, P < 0.05) and depressive symptoms (OR 1.09, P < 0.01) were associated with higher odds of forgone care among LGBTQ+ participants. CONCLUSIONS Future research should examine the unique factors shaping the access to health care of LGBTQ+ adults in the United States, and healthcare practitioners should consider strategies to screen for discrimination and leverage the protective benefits of social support.
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Affiliation(s)
- Jennifer Tabler
- From the Department of Criminal Justice and Sociology, University of Wyoming, Laramie, the Department of Sociology, Oklahoma State University, Stillwater, and the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Rachel M. Schmitz
- From the Department of Criminal Justice and Sociology, University of Wyoming, Laramie, the Department of Sociology, Oklahoma State University, Stillwater, and the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Ruby Charak
- From the Department of Criminal Justice and Sociology, University of Wyoming, Laramie, the Department of Sociology, Oklahoma State University, Stillwater, and the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Aidan Propst
- From the Department of Criminal Justice and Sociology, University of Wyoming, Laramie, the Department of Sociology, Oklahoma State University, Stillwater, and the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
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45
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Koziara K, Mijas ME, Galbarczyk A, Wycisk J, Pliczko MP, Krzych-Miłkowska K, Grabski B. It gets better with age: Resilience, stigma, and mental health among lesbian, gay, bisexual, transgender and queer persons from Poland. Front Psychol 2022; 13:958601. [PMID: 36204734 PMCID: PMC9531266 DOI: 10.3389/fpsyg.2022.958601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Lesbian, gay, bisexual, transgender, and queer populations are disproportionately affected by chronic stress associated with stigma which contributes to health adversities including depression. Negative impact of stigma on health can be alleviated by factors such as resilience. Little is known however on how exposure to stigma, protective factors and mental health change with age among gender and sexually diverse persons. Our study aimed at investigating this issue. Our sample consisted of (i) 245 sexually diverse cisgender women, (ii) 175 sexually diverse cisgender men, and (iii) 98 transgender and gender diverse persons. We collected data through a web-based survey. Linear regression models were performed to investigate the interactions of age and each group of participants for resilience, stigma exposure, and mental health indicators (depression and self-esteem). We hypothesized that resilience and mental health indicators will be positively associated with age in all distinguished groups despite the continued exposure to minority stress. The analysis yielded no significant relationships between stigma exposure and age among study participants. However, we observed significant interaction effects of distinguished groups of participants and age in case of self-esteem, depression, and resilience. Self-esteem and resilience were related positively, and depression was negatively associated with age in all study groups. Additionally, we observed that sexually diverse cisgender men demonstrated significantly increased resilience, reduced depression and higher self-esteem compared to other groups. Although the exposure to stigma did not decrease with age, resilience and self-esteem increased, suggesting that LGBTQ persons manage to thrive despite adversities.
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Affiliation(s)
- Karolina Koziara
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena E Mijas
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Jowita Wycisk
- Faculty of Psychology and Cognitive Sciences, Adam Mickiewicz University, Poznan, Poland
| | - Mateusz P Pliczko
- Sexology Lab, Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Karolina Krzych-Miłkowska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Bartosz Grabski
- Sexology Lab, Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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46
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Pharr JR, Chien LC, Gakh M, Flatt J, Kittle K, Terry E. Serial Mediation Analysis of the Association of Familiarity with Transgender Sports Bans and Suicidality among Sexual and Gender Minority Adults in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710641. [PMID: 36078355 PMCID: PMC9518152 DOI: 10.3390/ijerph191710641] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Discriminatory laws and policies are a form of structural stigma that is associated with increased suicidality among sexual and gender minority (SGM) people. Unfortunately, in the United States, there has been an increase in state-level discriminatory laws and policies targeting SGM people in 2021 and 2022, particularly, transgender sports bans. The purpose of this study was to (1) determine if familiarity with transgender sports bans was associated with suicidality among SGM adults; and (2) determine if interpersonal stigma and/or individual stigma mediated this association. METHODS This was a cross-sectional study of data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and serial mediator models were used in this analysis. RESULTS The increased suicidality was associated with familiarity with state-level transgender sports bans among SGM adults (p-value = 0.0150). Even after interpersonal and individual stigma mediated this relationship, the association between suicidality and familiarity with state-level transgender sports bans remained (p-value = 0.0106). CONCLUSION State-level transgender sports bans appear to exacerbate existing disparities in mental health, especially for individuals who are familiar with the bans. They directly discriminate against people who are transgender and indirectly stigmatize the broader SGM community.
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Affiliation(s)
- Jennifer R. Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Correspondence: ; Tel.: +1-(702)-895-2006
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Jason Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
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47
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Rice TM, Ogolsky BG, Oswald RF. Individuals in same-sex relationships maintain relational well-being despite the frequency and severity of heterosexism. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2020.1854835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- TeKisha M. Rice
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Brian G. Ogolsky
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ramona Faith Oswald
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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48
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Salerno JP, Boekeloo BO. LGBTQ Identity-Related Victimization During COVID-19 Is Associated with Moderate to Severe Psychological Distress Among Young Adults. LGBT Health 2022; 9:303-312. [PMID: 35537518 PMCID: PMC9347301 DOI: 10.1089/lgbt.2021.0280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose: Existing evidence indicates significant threats against the mental health of sexual and gender minority (SGM) young adults as a result of the COVID-19 pandemic, including elevated rates of substance use, anxiety, depression, and traumatic stress. Therefore, it is imperative to understand the mechanistic identity-related factors that may influence the mental health needs of SGM young adults in the time of COVID-19. This study aims to examine the impact of increases in lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) identity-related victimization since the start of COVID-19 on psychological distress among SGM college students. Methods: A nonprobability, cross-sectional online survey was conducted between May and August 2020 to explore the psychological impacts of COVID-19 on U.S. SGM college students (N = 565). Previously validated scales were used to measure LGBTQ identity-related victimization and psychological distress. Chi-square tests of independence, independent samples T-tests, and adjusted logistic regression were used to examine the study aim. Results: Adjusted logistic regression findings revealed that reporting past year+more frequent LGBTQ identity-related victimization since the start of COVID-19 (compared to no report) was associated with over four times greater odds of experiencing moderate to severe psychological distress. Conclusion: Findings highlight the importance of research, practice, and policy stakeholders toward addressing the unique identity-related mental health needs and victimization experiences of SGM college students. Mental health, social service, and higher education practitioners have an important opportunity and responsibility toward identifying and intervening on SGM college students and young adults facing identity-related victimization amid the ongoing COVID-19 pandemic.
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Affiliation(s)
- John P. Salerno
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
- University of Maryland Prevention Research Center (UMD-PRC), College Park, Maryland, USA
| | - Bradley O. Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
- University of Maryland Prevention Research Center (UMD-PRC), College Park, Maryland, USA
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49
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Gattamorta K, Salerno JP, Laporte RR. Family Rejection During COVID-19: Effects on Sexual and Gender Minority Stress and Mental Health Among LGBTQ University Students. LGBTQ+ FAMILY : AN INTERDISCIPLINARY JOURNAL 2022; 18:305-318. [PMID: 37151804 PMCID: PMC10162589 DOI: 10.1080/27703371.2022.2083041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examines the relationship between family rejection and moderate to severe psychological distress during COVID-19 among LGBTQ university students. Data were obtained from a national cross-sectional electronic survey of LGBTQ university students (N = 565) collected in the summer of 2020. Hierarchical logistic regression models were used to examine the predictive association between increased family rejection and moderate to severe psychological distress. Respondents who reported increased rejection were more than twice as likely to report moderate to severe psychological distress, with social isolation and LGBTQ identity concealment being significant covariate predictors in the model. These results demonstrate the importance of public health, medical, mental health, and higher education stakeholders understanding the significance of LGBTQ-identity related family rejection when addressing the mental health and well-being of LGBTQ young people.
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Affiliation(s)
- Karina Gattamorta
- University of Miami, School of Nursing and Health Studies, Coral Gables, 33124 United States
| | - John P Salerno
- University of Maryland at College Park, School of Public Health, College Park, 20742-5031 United States
| | - Roberto Roman Laporte
- University of Miami, School of Nursing and Health Studies, Coral Gables, 33124 United States
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Dyar C, Kaysen D. Multiple diverse drinking trajectories among sexual minority women: Unique and joint prediction by minority stress and social influence risk factors. Addict Behav 2022; 129:107273. [PMID: 35219035 DOI: 10.1016/j.addbeh.2022.107273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sexual minority populations are at heightened risk for alcohol use disorders compared to heterosexual populations, and these disparities are particularly pronounced for sexual minority women (SMW). Little research has examined the diversity of drinking trajectories among sexual minorities, despite evidence that such trajectories have high predictive utility and are useful in understanding how risk factors may be uniquely associated with specific trajectories. METHOD We utilized four waves of data (12 months between waves) from a sample of 1,057 SMW ages 18-25 at Wave 1. The goals were to (a) identify multiple distinct trajectories of alcohol use; (b) examine the predictive utility of these trajectories; and (c) test associations between minority stress (e.g., discrimination) and social influence (e.g., sexual minority community involvement) risk factors and alcohol trajectories. RESULTS Using growth mixture modeling, we identified five classes based on drinking patterns at Wave 1 and change over time (stable low, stable high drinking, stable high HED, low increasing, and high decreasing). These classes were differentially associated with Wave 1 levels and changes in alcohol consequences. Minority stressors uniquely predicted a low increasing trajectory, while social influences uniquely predicted a stable high trajectory. Both minority stress and social risk factors predicted high decreasing and stable high HED trajectories. CONCLUSIONS Findings indicate that some drinking trajectories among SMW appear similar to those found in the general population, while others appear unique. Results provide insight into how minority stress and social influence risk factors may uniquely and jointly contribute to disparities affecting this population.
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Affiliation(s)
- Christina Dyar
- College of Nursing, The Ohio State University, United States.
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
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