Unmasking Individual and Institutional HIV Stigma in Hospitals: Perspectives of Dutch Healthcare Providers

People with HIV continue to experience HIV stigma. Quantitative data on HIV stigma perpetrated by healthcare providers of hospitals providing HIV care in high-income countries are limited. The aim of this study is to investigate factors associated with HIV stigma in Dutch healthcare settings from the healthcare providers' perspective. We conducted a cross-sectional study using the questionnaire 'Measuring HIV Stigma and Discrimination Among Health Facility Staff - Monitoring Tool for Global Indicators' to assess HIV stigma among healthcare providers (n = 405) in two academic hospitals. Healthcare providers licensed to provide medical care were eligible for inclusion. The primary outcome was the self-reported prevalence of at least one manifestation of HIV stigma measured by six stigma indicators (four individual, two institutional). Secondary outcomes were the prevalence of HIV stigma per indicator, per occupation, per department, and factors associated with individual stigma indicators. HIV stigma was prevalent among 88.1% (95%CI 84.5% - 91.2%) of participants. Stigma was mostly driven by negative attitudes towards people with HIV and worry to acquire HIV. Multivariate analysis showed that several factors were associated with HIV stigma, including younger age, male sex, working at one of the surgical departments, and working as a nurse. Having received any training on HIV stigma and/or discrimination was associated with less HIV stigma among all indicators. In conclusion, HIV stigma is highly prevalent among Dutch healthcare providers. Targeted approaches, including training on HIV stigma and discrimination, are needed to reduce HIV stigma in healthcare and should, among others, focus on younger healthcare providers.

Same-Sex Kissing and Having a Gay or Lesbian Child: A Bridge Too Far? Parent-Child Similarities in Homophobic Attitudes and Observed Parental Discomfort

This study examined parent-child similarities in homophobic attitudes and observed parental discomfort with coming-out vignettes in interactions with their adolescent children (14-18 years old). Based on gender schema theory and the family process model we expected parent-child similarities in homophobic attitudes to be stronger in same-gender dyads. Further, we expected that observed parental discomfort with coming-out vignettes would occur and is stronger when the gender of the parent, child, and character in the vignette match. We used questionnaires and observation data from 199 White Dutch families in the Netherlands. Our results showed that parents' homophobic attitudes were associated with their children's homophobic attitudes. For same-sex kissing and (imagining) having a gay son, these associations were stronger between parents and children of the same gender. Further, parental discomfort with coming-out vignettes occurred and was stronger when parents and children had the same gender, regardless of the gender of the vignette character. In conclusion, policies aiming at gay and lesbian inclusion should not be limited to accepting gay/lesbian identities, but also pay attention to the acceptance of same-sex intimacy expressions, having gay or lesbian family members, and normalizing discussions about gay/lesbian lives.

Can agentic messages help? Linguistic strategies to counteract voice-based sexual orientation discrimination

Gay men who believe to sound 'gay' expect to be discriminated against because of their voices and gay-sounding men are discriminated against in the hiring process. We examined whether uttering an agency-based message decreased discrimination expectancy and enactment. In Study 1a (N = 256; gay and bisexual men) and Study 1b (N = 216; gay men), speakers uttered agentic (vs. neutral) messages. We assessed their self-perception as gay sounding, agency self-attribution and discrimination expectancy. Uttering agentic (vs. neutral) messages made the speakers self-perceive as more agentic and this decreased discrimination expectancy. Additionally, self-perception as gay sounding predicted discrimination expectancy. In Study 2 (N = 466), heterosexual participants listened to gay- and straight-sounding speakers uttering either neutral or agentic messages and rated them in terms of agency and employability. Gay-sounding speakers uttering agentic messages were less likely to be discriminated against than when uttering neutral messages. Results show the positive impact of linguistic strategies involving agentic messages to reduce discrimination expectancy and hiring biases.

Association Between Egalitarian Gender Attitudes and Attitudes Toward Same-Sex Marriage: Findings from a National Representative Survey

Egalitarian gender attitudes are linked to increased support for same-sex marriage, with previous studies mainly focusing on Western countries. Limited existing research from Asian countries often relied on non-representative, convenient samples. Taiwan, the first Asian country to legalize same-sex marriage in 2019, offers a valuable context. Since surveys before 2020 lacked questions on attitudes toward same-sex marriage, we utilized the 2020 PSFD data for a cross-sectional analysis. Logistic regression analyses were conducted to explore the relationship between gender attitudes (assessed through six questions) and attitudes toward same-sex marriage, along with examining the moderation effects of socio-demographic variables. The results revealed significant associations between embracing egalitarian gender attitudes and increased support for same-sex marriage (adjusted odds ratio [aOR] ranged from 1.34 to 2.08, 95% CI = [1.15, 2.45]). Moderation analysis indicated that this connection appeared to be more pronounced among younger individuals, those who were not currently married, and those with higher educational attainment. Individuals who are older, less educated, or married and hold negative views on gender equality should be targeted for efforts to enhance their support for same-sex marriage. Advocating for gender equality aligns with principles of equality, nondiscrimination, and recognizing fundamental rights for all, irrespective of sexual orientation.

Age and Gender Identity in the Relationship Between Minority Stress and Loneliness: A Global Sample of Sexual and Gender Minority Adults

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.

Missed Opportunities in HIV Testing in Turkiye: Implications for Late Diagnoses

BACKGROUND

Late diagnosis of HIV infection is a major global problem. In Turkiye, only 41%-50% of people living with HIV are diagnosed, suggesting that many opportunities for HIV testing might be missed.

SETTING

The aim of this study was to determine the missed testing opportunities for HIV in healthcare settings in Turkiye and the predictors for missed opportunities (MOs).

METHODS

The study included patients with a new HIV diagnosis, presenting to care between January 2018 and December 2020. They were given a verbal questionnaire face to face, by a telephone call or an online meeting for visits to a health care setting within the year before their diagnosis. Electronic medical records were also examined.

RESULTS

The sample included 198 patients with at least 1 visit to any health care setting, with a total of 1677 visits. Patients had an indication for HIV testing in 51.3% (861/1677) of the visits; an HIV test was not offered in 77.9% (671/861) and was considered a MO. The highest number of MOs was in emergency departments (59.8%) (180/301). The most common reason for visiting was constitutional symptoms and indicator conditions (55.4%) (929/1677). University graduates and those with a CD4+ T-cell count <200/mm 3 were more likely to have a MO.

CONCLUSIONS

Many opportunities to diagnose HIV at an early stage are missed in health care settings in Turkiye. Considering the rapidly increasing number of new diagnoses in the last decade, urgent action needs to be taken.

Comfort with LGB people and attitudes toward same-sex parenting in Continental American Hispanic Nations

Negative attitudes toward Lesbian, Gay, and Bisexual (LGB) individuals leads to a perceived inability of LGB individuals to foster 'appropriate' family relationships, inciting negative attitudes specifically toward same-sex parenting. Intergroup and interpersonal relationships play a critical role in fostering attitudes toward others wherein type of contact, frequency, degree of closeness in the relationship, and the positivity/negativity of interactions are potential mediator of these relations, Moreover, the mechanism behind co-constructing positive relationships with sexual and gender minorities is comfort with contact with LGB individuals. The present study explored the effects of interpersonal contact and the mediator role of comfort with LGB people in explaining attitudes toward same-sex parenting in Spanish-speaking countries in North, Central, and South America. These countries are of particular interest given the dearth of research in the region on attitudes toward same-sex parenting as well as the varying degrees of acceptance of and protections for same-sex parented families. A non-probabilistic sample of 1955 heterosexual cisgender participants from 14 countries was asked to complete a series of sociodemographic questions, a questionnaire about their interpersonal contact/comfort experiences with LGB people, and the Attitudes Toward Gay and Lesbian Parenting Scale. Results showed that comfort was vital in fostering accepting attitudes toward Same-Sex Parenting across countries. Findings also suggested that comfort with LGB people has a particularly powerful influence in regions with less legal and cultural acceptance of LGB individuals. Policies are not enough to instill widespread change: we must encourage, facilitate, and supervise the formation of relationships with LGB people.

The Association Between Sexual Identity, Depression, and Adolescent Substance Use

Sexual minority youth (SMY) represent a population vulnerable to several adverse health consequences. Specifically, SMY experience depression and substance use at substantially higher rates than heterosexual peers. Better understanding the relationship between depression and substance use among SMY may help reduce morbidity and mortality. We hypothesize that depression will moderate increased substance use rates seen in SMY. Weighted logistical analyses of covariance, adjusted for race/ethnicity, sex, and age, compared the relationship between sexual identity, depression, and substance use (14 outcomes), using data from the 2019 Youth Risk Behavior Survey (n = 13,677) of high school students. SMY reported depression at rates nearly double than heterosexual peers (63.9% vs 33.0%). Except for vaping and alcohol, SMY had significantly higher odds of all SU (aORs 1.41-2.45, p < 0.001-0.0011). After adjusting for depression, odds of all SMY substance use decreased; most relationships remained significant (aORs 0.73-1.89), though the relationship between SMY and lifetime cannabis use became non-significant. The relationship between SMY and current vaping became significant and the relationship between SMY and alcohol and binge-drinking remained non-significant. SMY are at higher risk for use of most substances and depression compared to heterosexual youth. As depression consistently plays a role in the relationship between sexual minority status and adolescent substance use across a wide variety of substances, it may be a modifiable risk factor for substance use among sexual minority youth that should be screened for and treated. This study additionally provides important information for future studies examining nuances of SMY substance use patterns.

The Roles of Gender and Sexual Orientation in Predicting Reactions to Suitors: Revealing Intersectional Complexities

Relatively little is known about how gender and sexual orientation intersect to predict young adults' responses to unwanted romantic and sexual overtures from men and women suitors. To better understand these potential differences, and explore possible mechanisms that explain them, this pre-registered study used an online questionnaire to assess reactions to both hypothetical and recalled suitors among a sample of 855 cisgender heterosexual and gay young adults (18-35) from the United States. Results revealed that gay women and heterosexual men reported the most negative hypothetical reactions to men (versus women) suitors, while gay women, heterosexual men, and heterosexual women all recalled more negative reactions to men than women suitors. Gay men recalled relatively benign reactions to suitors of both genders. A desire to be seen as one's true orientation was a mediating factor for both gay women's and heterosexual men's negative reactions to men suitors. These findings and their potential explanations highlight the complexity of how gender and sexual orientation intersect to shape responses to romantic and sexual overtures from men and women suitors.

Project Respect: experiences of seriously ill LGBTQ+ patients and partners with their health care providers

Discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons in health care creates barriers to serious illness care, including patients avoiding or delaying necessary care, providers disrespecting wishes of surrogates, and adverse outcomes for patients and families. A cross-sectional mixed-methods study using an online survey was used to determine the extent to which LGBTQ+ patients and spouses, partners, and widows experienced disrespectful or inadequate care due to sexual orientation or gender identity. A total of 290 LGBTQ+ patients and partners reported high levels of disrespectful and inadequate care, including 35.2% stating their provider was insensitive to them because of their identity; 30% reporting their provider was unaware of LGBTQ+ health needs; 23.1% feeling judged; 20.7% experiencing rudeness; 20.3% stating providers did not use their correct pronouns; and 19.7% reporting their treatment decisions were disregarded. Black and Hispanic patients were 2-4 times more likely than non-Hispanic White patients to report discrimination. This study demonstrated high levels of disrespectful and inadequate care towards patients and partners due to being LGBTQ+, which was especially problematic for Black and Hispanic patients and those living in politically conservative regions. Recommendations include federal and state civil rights laws to prohibit LGBTQ+ discrimination and institutional practices to address discrimination, including cultural sensitivity training for staff.

The mother of violations: Motherhood as the primary expectation of women

Recent conservative political rhetoric support women having careers but emphasize that this should not be an obstacle to having children. We propose that this sentiment reflects the hierarchy of gender norms in today's society whereby motherhood is the ultimate role that women are expected to fulfil and denying such role evokes social penalties, above and beyond other prescribed gender norms. Across five experiments (N = 738), we predicted and found that voluntarily childless women elicit more negative reactions than mothers, and importantly, also more than women violating other gender norms in the realm of occupation (Study 1), power (Study 2) or sexual orientation (Study 3). We demonstrate that these patterns cannot be explained merely by a perceived lack of communal qualities of the non-mothers (Study 4) and also show that involuntary childless women do not receive the same negativity (Study 5). We discuss this, often neglected, gender bias and its resistance to social change.

From Flirting to F*cking: Examining the Robustness of the Precarious Sexuality Effect

Men, versus women, face more doubts about their heterosexuality based on a single same-gender sexual experience, a phenomenon known as the precarious sexuality effect. This phenomenon has thus far only been examined with sexually explicit same-gender acts (e.g., kissing, oral sex). Here, we conducted secondary data analyses of five large datasets of US adults (total N = 9770) to examine the replicability and robustness of the precarious sexuality effect across a range of same-gender acts varying in sexual explicitness. Using cross-classified hierarchical linear modeling, we replicated the precarious sexuality effect across all samples and demonstrated-in preregistered exploratory and confirmatory tests-that this effect was moderated by sexual explicitness. Consistent with our predictions, same-gender acts that were merely flirtatious (e.g., blowing a kiss) elicited stronger precarious sexuality (i.e., target gender) effects than same-gender acts that were explicitly sexual (e.g., oral sex), presumably because the former acts are more ambiguous and thereby allow more room for interpretation. Further, we found no consistent evidence that the precarious sexuality effect was moderated by perceiver characteristics including gender, sexual orientation, age, race, gender role beliefs, religiosity, or political orientation. Discussion considers possible explanations for the precarious sexuality effect and identifies important avenues for future research.

The relationship between physical activity, stress, and resilience in sexual and gender minority college students

OBJECTIVE

To assess the role of sexual orientation and gender identity in the relationship between physical activity (PA), stress and resilience.

PARTICIPANTS

A nationally-representative sample of students (n = 91,718) from United States postsecondary institutions.

METHODS

Students reported aerobic and strength training (ST) behaviors, stress, resilience, gender identity and sexual orientation. Moderated regressions examined the influence of gender identity and sexual orientation on the relationship between PA and stress or resilience.

RESULTS

Men and heterosexual students reported higher PA and resilience and lower stress than did women, gender minorities, and sexual minorities. Significant moderation was found for women, queer students, bisexual students, trans women and lesbians in the various models.

CONCLUSIONS

Gender minority and sexual minority students display poorer levels of PA and mental health than cisgender and heterosexual counterparts, but this relationship varies by identity group.

Is everyone a mix of straight and gay? A social pressure theory of sexual orientation, with supporting data from a large global sample

Sigmund Freud, Alfred Kinsey, E.O. Wilson, and others have suggested that social pressure suppresses natural tendencies for humans to express bisexuality, the apparent norm for one of our two closest genetic relatives, the bonobo. An analysis of data obtained from a new online sample of 1,150,938 people in 215 countries and territories (63.9% from the United States, United Kingdom, and Canada) who completed the English version of a validated questionnaire of sexual orientation lends support to this idea. A histogram of scores from 0 (exclusive opposite-sex inclinations) to 18 (exclusive same-sex inclinations) forms a near-normal distribution. Although this distribution was likely caused to some extent by sampling bias, it may also reflect the unusual honesty people show when taking online tests anonymously, as an increasing body of evidence demonstrates. We present a formal mathematical expression of a social pressure theory of sexual orientation, along with empirical evidence and computational explorations that support the theory. We also present an analysis of the new data set. Among other findings: sexual orientation labels corresponded to broad, skewed, overlapping distributions of scores. Self-labeled gays/lesbians and, to a greater extent, self-labeled straights, reported that the larger the mismatch between their sexual orientation label and their actual sexual inclinations, the more distress they felt regarding their sexual orientation, a finding that is predictable from cognitive dissonance theory. Educating the public about the true nature of sexual orientation might quell the often rancorous public debates on this topic, as well as give comfort to a large number of mislabeled people.

Sexual minorities and substance use treatment utilization: New evidence from a national sample

INTRODUCTION

Minority stress theory suggests that sexual minorities would be, on average, less likely than heterosexual individuals to seek out substance use treatment (due to concerns of stigma and rejection). However, prior research on the subject is mixed, and largely dated. In light of historic increases in societal acceptance and legal protections for sexual minorities, the field needs an up-to-date assessment of treatment utilization among this population.

METHODS

This study used data from the 2015-2019 National Survey on Drug Use and Health to examine the association between key independent variables (sexual identity, gender) and substance use treatment utilization using binary logistic regression. We conducted analyses using a sample of adults with a past-year substance use disorder (N = 21,926).

RESULTS

Controlling for demographic factors, with heterosexual individuals as the comparison group, gay/lesbian individuals (AOR = 2.12, CI = 1.19-3.77) were significantly more likely and bisexual individuals (AOR = 0.49, CI = 0.24-1.00) significantly less likely to report treatment utilization. Bisexual individuals were also less likely than gay/lesbian individuals to report treatment utilization (AOR = 0.10, CI = 0.05-0.23). Interaction tests examining sexual orientation and gender showed no difference in treatment utilization between gay men and lesbian women, and revealed that bisexual identity was associated with decreased likelihood of treatment utilization for men (p = .004) but not for women.

CONCLUSION

Sexual orientation, particularly in the context of social identity, plays a significant role in substance use treatment utilization. Bisexual men face unique barriers to treatment, which is concerning given the high rates of substance use among this and other sexual minority populations.

Sexual activities and condom use among heterosexual men and women engaged in mixed-gender group sex events in Melbourne, Australia

BACKGROUND

Few studies investigate group sex among heterosexuals. The aim of this study was to provide an exploration of characteristics and practices among heterosexual men and women who engage in group sex.

METHOD

We conducted a cross-sectional survey between May 2019 and March 2020 among heterosexual men and women attending a sexual health clinic in Melbourne, Australia. Participants were asked whether they had participated in group sex (sex involving more than two participants) in the past 3months, the size of the most recent event, sexual activities in which they engaged, and condom use.

RESULTS

Of 3277 heterosexuals surveyed (1509 women and 1768 men), the mean age was 29.9years (s.d. 8.8) and more than half (56.0%, n =1834) were born outside Australia. One in 20 participants (5.4%) had engaged in group sex in the past 3months with the number of events ranging 1-10times. Kissing was the most common activity in group sex, and women were significantly more likely to kiss a same-sex partner than men. Overall, of 165 participants who engaged in vaginal sex, 57 (34.5%) reported always using condoms and changing condoms between consecutive partners. Of the 100 men and women who had condomless vaginal sex, 79 (79.0%) received or performed fellatio after condomless vaginal sex.

CONCLUSION

About two-thirds of heterosexuals who engaged in group sex neither used condoms nor changed condoms between partners in the most recent group sex event. Safe sex messages on changing condoms between partners and between sexual activities should be reinforced for sexually transmitted infections prevention.

Status quo and predictors of Weibo users' attitudes toward lesbians and gay men in 31 provinces in the Chinese mainland: Analysis based on supervised machine learning and provincial panel data

Introduction

Public attitudes toward consensual same-sex relations are crucial to lesbians' and gay men's rights and society's well-being, but research addressing this topic in China is limited. We comprehensively explored the current status and predictors of Weibo users' attitudes toward individuals who are lesbian or gay (IWLG) at the provincial level in the Chinese mainland.

Methods

Natural language processing and machine learning techniques were incorporated to analyze 1,934,008 Weibo posts from January 1, 2010, to December 31, 2020, to evaluate Weibo users' expressed attitudes toward IWLG in 31 provinces in the Chinese mainland guided by the ABC Model of attitude.

Results

Although the general attitudes, feelings, and support for the rights of Weibo users toward IWLG among different provinces were relatively positive, knowledge about IWLG was noticeably inaccurate. Economic development and educational level positively predicted certain aspects of attitudes at the provincial level.

Conclusion

Weibo users from different provinces are generally supportive and accepting of people who are gay and the rights of the gay community. However, considerable misconceptions and inaccurate knowledge of IWLG surfaced in Weibo users' posts. Economic development and educational level were important predictors of specific attitudes toward IWLG at the provincial level. Increased efforts to address the unbalanced and insufficient development between different provinces could help reduce the public's prejudice, stigma, and discrimination toward IWLG. Policies that facilitate greater implementation of Comprehensive Sexuality Education sequentially and effectively are suggested as well.

Whose Rights are Civil Rights? Evaluating Group Threat as an Explanation for Racial Differences in Attitudes Toward Same-Gender Sexuality

The alleged prevalence of anti-gay bias among Black communities in the United States has received ample popular and academic attention in recent decades. But just how consistent is the purported relationship between race and homophobia? In this paper, we use the American National Election Studies and the General Social Survey to show that public claims about "Black homophobia" have been dangerously overstated. Moreover, where racial differences in attitudes toward same-gender sexuality do occur, we find that the two most prevalent scholarly explanations for such gaps-religious institutions and gender ideologies-do not predict anti-gay bias for Black survey respondents. We thus derive an alternative explanation from scholarship on group threat: that perceived competition for political resources is what motivates racial differences in antagonism toward same-gender sexuality. Our results support that alternative and, in so doing, evince the importance of a relational approach to homophobia in academic and activist spheres alike.

Integrating the tripartite influence, minority stress, and social comparison theories to explain body image and disordered eating in Chinese sexual minority men and women

Theories of eating pathology explain body image and disordered eating in diverse populations, including sexual minority (SM) individuals. Yet, previous efforts to extend theories of eating pathology to SM individuals have mostly focused on Western populations. The present study integrated the tripartite influence, minority stress, and social comparison models to explain variance in body image and disordered eating in Chinese SM men and women. Chinese self-identified SM adults (N = 1051; n = 519 men, n = 532 women) completed an online, cross-sectional study that assessed sociocultural influences (e.g., tripartite influence), minority stress, social comparisons, drive for muscularity, and disordered eating. Two integrated models were tested for men and women using structural equation modeling. Across both populations, sociocultural influences exerted the largest direct positive effects on body image and disordered eating. In men, only downward body image comparisons were uniquely related to outcomes. In women, higher upward body image comparisons were uniquely associated with higher drive for muscularity and higher downward body image comparisons were uniquely associated with higher thinness-oriented disordered eating. Minority stressors (e.g., sexual orientation concealment, internalized homophobia) were uniquely related to outcomes in men, not women. Findings extend existing theories of body image and disordered eating to Chinese SM populations.

An Empirical Investigation of Variations in Outcomes Associated with Heterosexual Adults' Most Recent Mixed-Sex Threesome Experience

Research reveals that a substantial proportion of North American adults report interest in and experience with mixed-sex threesomes (MSTs; sexual activity involving three people at the same time in which persons of more than one sex are present). Despite the prevalence of MST participation, little is known about the outcomes of MST experiences. Thus, the current study assessed MST outcomes using various metrics including the extent to which one's most recent MST met expectations, the likelihood of participating in the MST again, and whether an orgasm was experienced. In addition, the extent to which one's sex, the sex of those involved, and the inclusion of one's romantic partner impacted outcomes was examined. Data from 276 heterosexual adults (217 men, 59 women) revealed that, overall, adults report fairly positive outcomes from their most recent MST and that males reported more positive outcomes than did females (particularly when engaging in a MST with two members of the other sex). In addition, MSTs involving one's romantic partner resulted in more positive outcomes than did those with casual partners. These results confirm that MSTs can be a satisfying experience particularly for heterosexual males and those participating with a romantic partner. Implications for educators looking to destigmatize various forms of nonmonogamies and for practitioners who intend to assist adults interested in safely exploring multi-person sexual behavior are discussed.

Media representation matters: The effects of exposure to counter-stereotypical gay male characters on heterosexual men’s expressions of discrimination

Presence of gay men in mainstream media may have a positive impact on viewers’ attitude change. However, gay male characters are often stereotypically portrayed as feminine, and no research has yet explored audiences’ reactions to counter-stereotypical gay characters. Heterosexual Italian men ( N = 158) were exposed to a clip portraying (i) a stereotypical feminine gay male character, (ii) a counter-stereotypical masculine gay male character, or (iii) a nature documentary. Compared to the other conditions, exposure to the counter-stereotypical gay character increased discrimination toward gay men, in the form of anti-gay jokes, the higher the level of participants’ prejudice against gay men. Results further demonstrated that this effect was explained by reduced perceived stereotypicality of the character. Findings are in line with the social identity theory prediction that when gay men (outgroup) are perceived as too similar, and potentially threaten the group identity, heterosexual men would attempt to restore ingroup distinctiveness.

The perceived social rejection of sexual minorities: Substance use and unprotected sexual intercourse

INTRODUCTION

This study presents associations between the perceived social rejection of sexual minorities and tobacco, alcohol and cannabis consumption and unprotected sexual intercourse in the capital of Greece, Athens. This is the first Greek study to evaluate the concept of the minority stress theory on sexual minorities' substance use and unprotected sexual intercourse. In addition, this is among the first international studies to examine whether periods of adverse economic conditions are associated with sexual minorities' substance use and unprotected sexual intercourse.

METHODS

Two-panel datasets covering the periods 2013-2014 and 2018-2019 were used to determine the perceived social rejection, that is, whether sexual minorities have been rejected by friends, treated unfairly in educational and/or workplace environments, treated negatively in social situations and received poor health and public services due to their sexuality.

RESULTS

The estimates indicate that perceived social rejection is associated with the increased consumption of tobacco (by 9.1%, P < 0.01), alcohol (by 7.1%, P < 0.01) and cannabis (by 12.5%, P < 0.01), as well as unprotected sexual intercourse (by 6.5%, P < 0.01). In the first three cases, the magnitude of the associations is stronger for men than women and there is increased cannabis consumption during periods of deteriorated economic conditions (by 5.5%, P < 0.01).

DISCUSSION AND CONCLUSIONS

In the European Union, reducing stigma, substance use, risky sexual behaviours and health inequalities for sexual minorities is a goal of public health. If minority stress is correlated with substance use and risky sexual behaviours leading to detrimental physical/mental health outcomes then prevention and support interventions should be designed.

A systematic review and meta-analysis investigating the impact of childhood adversities on the mental health of LGBT+ youth

Background

The presence of trauma as a backdrop to the lives of LGBT+ youth has been recognised in recent literature. LGBT+ youth report a higher frequency, severity and pervasiveness of adverse childhood experiences when compared to their heterosexual and cisgender counterparts. This exposure has been directly related to an increased risk of mental health problems.

Method

A systematic literature search of Medline, Embase, PsycINFO, PubMed and Web of Science was conducted from the date of their inception until the 1st September 2021. The study protocol was registered in PROSPERO (CRD42021240472).

Results

A total of 27 studies satisfied the inclusion criteria and were used in the systematic review, representing 199,285 participants, 26,505 of whom identified as LGBT+ (mean age 16.54). Female participants (ranging from 11% to 74%) and white participants (7.7%-96%) made up the largest percentage of most samples. Depressive symptoms were the most commonly described psychiatric outcome (n = 17, 63%), followed by anxiety symptoms (n = 6, 31.5%). 18 studies provided meta-analysable data, compromising 21,781 LGBT+ young people. LGBT+ youth reported a higher prevalence of adverse experiences in comparison to their heterosexual or cisgender counterparts (p < .001), with sexual abuse representing the most commonly reported experience (29.7%), followed by verbal abuse (28.7%), physical abuse (26.5%) and cyberbullying (19.1%). LGBT+ youth were also at a heightened risk of mental health disorders (p < .001), with 36.9% and 31.5% of sample meeting the clinical criteria for depression and anxiety, respectively.

Conclusions

Continued advocacy is needed from communities and Allies to support and empower LGBT+ youth in the face of adversity. Longitudinal and longer-term studies are required to further understand the relationship between adverse experiences in LGBT+ youth and the impact on mental health.

Fear and cultural background drive sexual prejudice in France – a sentiment analysis approach

Sexual prejudice and its negative consequences remain major issues in Western societies, and numerous studies have tried to pinpoint its sociocultural underpinnings. However, most research has operationalized sexual prejudice via self-report measures or via implicit association tests (IATs), although it surfaces in language use and can be traced in spontaneous speech.

Here, we report results from an experimental study investigating sexual prejudice in a corpus of spontaneous speech samples. Specifically, we tested in a context-sensitive sentiment analysis approach which attitudes (negative vs. positive) and emotions (joy, sadness, anger, fear, disgust) were voiced by the participants in response to picture prompts displaying homosexual couples. We also considered the sociocultural basis of prejudicial attitudes, in particular the effects of the participants’ cultural background (France vs. Maghreb), age and gender. We find strong effects of cultural background and gender both on the frequency of negative vs. positive attitudes expressed, and on discrete emotion categories, namely that male Maghrebian participants were more negative and conveyed more fear. The results are discussed in the context of current diversity approaches in France and their implications for potential prejudice regulation strategies. We further discuss in how far our context-sensitive sentiment analysis approach advances research on sexual prejudice.

Disgust sensitivity relates to attitudes toward gay men and lesbian women across 31 nations

Previous work has reported a relation between pathogen-avoidance motivations and prejudice toward various social groups, including gay men and lesbian women. It is currently unknown whether this association is present across cultures, or specific to North America. Analyses of survey data from adult heterosexuals ( N = 11,200) from 31 countries showed a small relation between pathogen disgust sensitivity (an individual-difference measure of pathogen-avoidance motivations) and measures of antigay attitudes. Analyses also showed that pathogen disgust sensitivity relates not only to antipathy toward gay men and lesbians, but also to negativity toward other groups, in particular those associated with violations of traditional sexual norms (e.g., prostitutes). These results suggest that the association between pathogen-avoidance motivations and antigay attitudes is relatively stable across cultures and is a manifestation of a more general relation between pathogen-avoidance motivations and prejudice towards groups associated with sexual norm violations.

"We Do Exist": The Experiences of Women Living with a Sexual Interest in Minors

The current body of the literature studying minor-attracted persons (MAPs) predominantly focuses on the experiences of men who experience sexual attractions to children. To shed more light on the experiences of women within this population, we conducted anonymous semi-structured interviews with six self-identified female MAPs, who were recruited through online support forums for individuals with sexual attractions to children. Interpretative phenomenological analysis (IPA) was used to analyze the interview transcripts. Two superordinate themes were identified from the dataset that highlighted the uniqueness of the experience of being a woman within the MAP community ("A minority within a minority") and themes of social isolation and the effects of this on identity ("A lonely secret existence"). The findings reported here highlight how the experiences of female MAPs both converge with and diverge from their male counterparts in important ways. We discuss the implications of these experiences in relation to more effective service provision for women who are sexually attracted to children.

Perceived Stress Levels among Ukrainian Migrant and LGBT+ Minorities in Poland during the COVID-19 Pandemic

The Coronavirus disease 2019 (COVID-19) pandemic, immigrant status and being a member of the LGBT+ community are all independent factors associated with increased stress levels. Few studies provide more complex analysis on this issue, and there has been no research on the cumulative burden of perceived stress that people belonging to both minorities experience in the current epidemiological situation. The aim of this study was to assess the ability to deal with an external situation during the third wave of the COVID-19 pandemic in Poland in the following groups with different stress levels (total sample n = 370): Polish heterosexual men (n = 202), heterosexual men from Ukraine (n = 131) and homo- and bisexual men (men who have sex with men-MSM) from Ukraine (n = 37). A Perceived Stress Scale (PSS-10) was used. The analysis of the survey did not show statistically significant differences between the three study groups in the general level of perceived stress (24.71, 24.77 and 26.49 points, respectively, p = 0.551), but it revealed numerous differences in coping with various aspects of everyday functioning between these groups. Negative assessment of one's own health proved to be the main factor negatively affecting the level of perceived stress, however specific health risks, medical history or the participants' previous experience have not been taken into account in the study. Our research shows differences in the needs, resources and methods of coping with stress between men who are Polish citizens and migrants from Ukraine, both heterosexual and belonging to the MSM group. Proper identification and addressing of these needs, taking into account different availability of health services, could be the responsibility of NGOs or insurance providers. This should result in the reduction of mental health burdens and the risk of developing serious mental disorders, and consequently in better functioning of persons belonging to minorities and in a reduced burden on the health care system.

Associations Between Fathers' Masculinity Orientation and Anticipated Reaction Toward Their Child's Coming Out

The present study examined associations between fathers' masculinity orientation and their anticipated reaction toward their child's coming out as lesbian or gay (LG). Participants were 134 German fathers (28 to 60years) of a minor child. They were asked how they would personally react if, one day, their child disclosed their LG identity to them. As hypothesized, fathers with a stronger masculinity orientation (i.e., adherence to traditional male gender norms, such as independence, assertiveness, and physical strength) reported that they would be more likely to reject their LG child. This association was serially mediated by two factors: fathers' general anti-LG attitudes (i.e., level of homophobia) and their emotional distress due to their child's coming out (e.g., feelings of anger, shame, or sadness). The result pattern was independent of the child's gender or age. The discussion centers on the problematic role of traditional masculinity when it comes to fathers' acceptance of their non-heterosexual child.

A poststructural discourse analysis of the attitudes, beliefs, and values of undergraduate Canadian university students regarding sexual orientation

The socio-politico-cultural context of sexual orientation often influences the attitudes, beliefs, and values produced in a given society. This study employed a qualitative methodology to explore the current attitudes, beliefs, and values of Canadian undergraduate students about sexual orientation. Students in a large human sexuality course at a Canadian university completed open-ended questions on the educational platform Top Hat. The data were analyzed using discourse analysis and four threads of discourse emerged: 1) The Nature of Sexual Orientation, 2) Gender Norms and Bisexuality, 3) Shared Connections, and 4) Foundations of Friendships. These findings contribute to the growing body of knowledge relating to changing attitudes, beliefs, and values about sexual orientation of Canadian university students.

Sex on the Screen: A Content Analysis of Free Internet Pornography Depicting Mixed-Sex Threesomes from 2012-2020

Viewing online pornography is common among US adults, with mixed-sex threesome (MST) videos being one of the top 10 most popular categories of pornography for both men and women. The current content analysis applied sexual script theory to understand the themes present in these mixed-sex threesome videos. Independent coders viewed a total of 50 videos (25 MMF and 25 FFM) at each timepoint (2012, 2015, 2020) and coded for different sexual behaviors and themes in each video. By examining both same-sex (female–female, male–male) and other-sex (female–male) behaviors, as well as themes of aggression and sexual initiation in different videos and across three timepoints, it was determined that other-sex behaviors are more common in MST videos than same-sex behaviors. Same-sex behaviors between two female actors were more common than same-sex behaviors between two male actors. Aggression was a common theme in videos, with male actors being more aggressive on average than female actors. Most of these trends did not change across 8 years, suggesting that the impacts of traditional sexual scripts are pervasive in pornography, even in current online content. Important implications for both researchers and clinical professionals are discussed.

The New Genetic Evidence on Same-Gender Sexuality: Implications for Sexual Fluidity and Multiple Forms of Sexual Diversity

In September of 2019, the largest-ever (N = 477,522) genome-wide-association study of same-gender sexuality was published in Science. The primary finding was that multiple genes are significantly associated with ever engaging in same-gender sexual behavior, accounting for between 8-25% of variance in this outcome. Yet an additional finding of this study, which received less attention, has more potential to transform our current understanding of same-gender sexuality: Specifically, the genes associated with ever engaging in same-gender sexual behavior differed from the genes associated with one's relative proportion of same-gender to other-gender behavior. I review recent research on sexual orientation and sexual fluidity to illustrate how these findings speak to longstanding questions regarding distinctions among subtypes of same-gender sexuality (such as mostly-heterosexuality, bisexuality, and exclusive same-gender experience). I conclude by outlining directions for future research on the multiple causes and correlates of same-gender expression.

The feminine target: Gender expression in same-sex relationships as a predictor of experiences with public displays of affection

The extent to which sexual minority individuals present publicly as masculine, feminine, or both has been associated with their perceptions of threat and safety in public spaces. The current study investigates the role of gender expression in men and women’s experiences of public displays of affection (PDAs) in same-sex relationships. Participants (N = 528) reported their own gender expression as well as that of their partner, perceptions of support for PDAs, PDA-related vigilance, general vigilance and overall PDA frequency. Men in same-sex relationships reported less frequent PDAs and greater PDA-related vigilance than women, while women reported greater overall variability in their gender expression than men. Multiple regression analyses show femininity within the participant (for men) or their partner (for both men and women) was associated with greater general and PDA-related vigilance. These findings align with previous research on femmephobia, in which femininity is described as making individuals feel ‘targeted’ for other forms of oppression (e.g., homophobia, sexism, transphobia; Hoskin, 2019 ). Although femininity was associated with greater vigilance, the association between masculinity within a same-sex relationship and vigilance was more tenuous, demonstrating evidence of masculinity serving as both a potential target for homophobic violence as well as a source of protection. The dual nature of masculinity was particularly salient among women in same-sex relationships, where masculinity tempered by femininity was associated with greater perceived support for PDAs but for women with partners low in femininity, the more masculine their partner, the greater their reported levels of vigilance.

Ingroup identification, hope and system justification: Testing hypothesis from social identity model of system attitudes (SIMSA) in a sample of LGBTQIA+ individuals

The social identity model of system attitudes (SIMSA) suggests that system justification among low-status groups can be explained by ingroup identification and the hope for a collective future improvement. In this report, we summarize the results of a cross-sectional investigation concerning the relationship between system justification, hope and identification based on a sample of 200 LGBTQIA+ individuals (identifying themselves as non-normative with respect to gender identity and sexual orientation). The results were supportive of SIMSA expectations and showed that system justification was positively linked to hope for future advancement. Importantly, hope played a key role influencing the relations between ingroup identification and perceived ingroup status: for low-status individuals who had high hope, ingroup identification was positively associated with system justification. Limits are acknowledged.

Testing the Disgust-Based Mechanism of Homonegative Attitudes in the Context of the COVID-19 Pandemic

Negative attitudes and stigmatization can originate from the perception of a disease-related threat. Following the spread of the COVID-19 pandemic, it is often suggested that incidents of discriminatory behavior are the result of defense mechanisms aimed at avoiding pathogens. According to the behavioral immune system theory, people are motivated to distance themselves from individuals who show signs of infection, or who are only heuristically associated with a disease, primarily because of the disgust they evoke. In this paper we focus on negative attitudes toward gay men and lesbians who are among social groups that have been persistently framed as "unclean." In our correlational study (N = 500 heterosexual participants; Polish sample data collected during the first COVID-19 lockdown in Poland, in March/April 2020) we tested moderation models derived from the behavioral immune system theory. Specifically, we investigated whether perceived vulnerability to disease and perceived threat of contracting COVID-19 moderate the relation between disgust and homonegativity. We found that sexual disgust (but not pathogen nor moral disgust) predicted homonegative attitudes. This effect was stronger for participants expressing higher levels of perceived vulnerability to disease but was not dependent on the perception of the COVID-19 threat. The results reaffirm previous evidence indicating a pivotal role of disgust in disease-avoidance mechanisms. They also point to functional flexibility of the behavioral immune system by demonstrating the moderating role of perceived vulnerability to disease in shaping homonegative attitudes. Finally, they show that the threat of COVID-19 does not strengthen the relationship between disgust and homonegativity.

Changes in Sexual Identity Labels in a Contemporary Cohort of Emerging Adult Women: Patterns, Prevalence and a Typology

Sexual attraction, behavior and identity are subject to change across the life course for some individuals, and certain developmental periods such as emerging adulthood appear particularly conducive to this. However, the evidence documenting these phenomena comes overwhelmingly from data collected 10-20 years ago. In the brief interlude since, the socio-political context has changed markedly and increasing numbers of women are reporting non-heterosexuality. Drawing on contemporary data from the Australian Longitudinal Study on Women's Health (n = 16,870), we provide up to date evidence on changes in sexual identity labels among emerging adult women. We found that 19% of women changed their sexual identity label from one survey wave to the next, and 30.6% changed their identity label at least once across the four waves. Mostly heterosexual and bisexual labels were both more common and more stable in our sample than in previous studies. We propose a new typology of sexual identity sequences and fit this to our data, providing a blueprint for researchers looking to define sexual minority status longitudinally. Findings suggest that the ways women perceive and label their sexual orientation should be treated as dynamic phenomena situated within the nested temporalities of biographical and historical time.

Heteronormativity, Disgust Sensitivity, and Hostile Attitudes toward Gay Men: Potential Mechanisms to Maintain Social Hierarchies

Within a social hierarchy based on sexual orientation, heteronormative ideology serves as a social force that maintains dominant group members' status (e.g., heterosexual men). Disgust may be an emotional reaction to gay men's violation of heteronormativity (i.e., same-sex sexual behavior) and motivate hostile attitudes toward gay men to promote interpersonal and intergroup boundaries. Based on this theoretical framework, we hypothesized that sexual disgust-compared to pathogen or moral disgust-would be most strongly associated with antigay hostility and would statistically mediate its relationship with heteronormativity. Heterosexual men in the United States (n = 409) completed an online questionnaire assessing heteronormative ideology, disgust sensitivity, and hostile attitudes toward gay men. Results support the hypotheses and suggest that gay men's sexual behavior is the most likely elicitor of disgust and antigay hostility, as opposed to a perceived pathogen threat or moral transgression. The findings indicate that heteronormative attitudes and sexual disgust are likely contributors to antigay hostility. Thus, intervention efforts should seek to improve tolerance of same-sex sexual behavior among heterosexual men, which may mitigate emotional reactions and hostile attitudes toward gay men.