Perceived psychosocial impacts of legalized same-sex marriage: A scoping review of sexual minority adults' experiences

Integrating developmental neuroscience with community-engaged approaches to address mental health outcomes for housing-insecure youth: Implications for research, practice, and policy

One in three children in the United States is exposed to insecure housing conditions, including unaffordable, inconsistent, and unsafe housing. These exposures have detrimental impacts on youth mental health. Delineating the neurobehavioral pathways linking exposure to housing insecurity with children's mental health has the potential to inform interventions and policy. However, in approaching this work, carefully considering the lived experiences of youth and families is essential to translating scientific discovery to improve health outcomes in an equitable and representative way. In the current paper, we provide an introduction to the range of stressful experiences that children may face when exposed to insecure housing conditions. Next, we highlight findings from the early-life stress literature regarding the potential neurobehavioral consequences of insecure housing, focusing on how unpredictability is associated with the neural circuitry supporting cognitive and emotional development. We then delineate how community-engaged research (CEnR) approaches have been leveraged to understand the effects of housing insecurity on mental health, and we propose future research directions that integrate developmental neuroscience research and CEnR approaches to maximize the impact of this work. We conclude by outlining practice and policy recommendations that aim to improve the mental health of children exposed to insecure housing.

The impact of marriage equality campaigns on stress: Did a Swiss public vote get under the skin?

Lesbian, gay, bisexual, trans, intersex, and queer (LGBTIQ+) individuals encounter persistent structural inequalities and discrimination that can lead to detrimental psychological and physiological health outcomes. Amid evolving legal landscapes, little attention has been directed toward understanding the physiological health effects of societal shifts on these communities. This study aims to explore the impact of a national marriage equality vote and associated debates on psychological and biological stress among LGBTIQ+ individuals and cisgender, heterosexual, endosex individuals (termed cis-heterosexual) in Switzerland. We gathered longitudinal survey and biological data collected in hair samples among LGBTIQ+ and cis-heterosexual individuals before, during, and after the 2021 national vote (survey data: NT1T2 = 954; NT2T3 = 880; biological data: NT1T2 = 393; NT2T3 = 354). Preregistered analyses reveal a notable increase in biological stress levels (i.e., cortisol and cortisone levels), but not perceived stress, among both LGBTIQ+ as well as cis-heterosexual individuals who were close to them during the campaign. Results further point out the negative impacts of the campaign against marriage equality (i.e., no-campaign) on LGBTIQ+ individuals' biological stress levels as well as on those of their allies. These effects were, however, moderated by exposure to the campaign for marriage equality (i.e., yes-campaign), indicating the powerful buffering effects of the yes-campaign on the impact of discrimination on individuals' health. However, these positive effects appear to come at a cost, potentially impacting the well-being of individuals engaged in advocating for the yes-campaign. This research underscores the lasting impact of political campaigns on individuals' health.

Health disparities in one of the world's most progressive countries: a scoping review of mental health and substance use among sexual and gender minority people in the Netherlands

BACKGROUND

Evidence from many parts of the world shows that sexual and gender minority (SGM) people have poorer health than their cisgender heterosexual counterparts. Minority stressors, particularly stigma and discrimination, have been identified as major contributors to sexual orientation- and gender identity-related health disparities, particularly negative mental health and behavioral health outcomes. To better understand factors that contribute to these disparities, we conducted a scoping review of SGM mental health and substance use research in the Netherlands-a country with a long-standing reputation as a pioneer in SGM equality.

METHODS

Using Joanna Briggs Institute guidelines and the PRISMA-ScR protocol, we searched seven databases to identify studies published between 2010 and 2022 that focused on substance use and/or mental health of SGM youth and adults in the Netherlands.

RESULTS

Although there was some evidence that SGM people in the Netherlands report fewer substance use and mental health concerns than those in less progressive countries, with very few exceptions studies found poorer outcomes among SGM participants than cisgender, heterosexual participants. However, this observation must be considered cautiously given major gaps in the literature. For example, only one study focused exclusively on adult sexual minority women, two focused on older SGM adults, and very little attention was given to nonbinary individuals. Most studies used non-probability samples that were quite homogenous. Many studies, especially those with youth, assessed sexual orientation based on sexual attraction; some studies of adults operationalized SGM status as having a same-sex partner. Importantly, we found no studies that directly assessed associations between structural-level stigma and health outcomes. Studies were mostly focused at the individual level and on health problems; very little attention was given to strengths or resilience.

CONCLUSIONS

Findings of persistent health disparities-despite the relatively long history of SGM supportive policies in the Netherlands-highlight the need for more research and greater attention to population groups that have been underrepresented. Such research would not only provide guidance on strategies to improve the health of SGM people in the Netherlands, but also in other countries that are seeking to reduce health inequities. Addressing SGM health disparities in the Netherlands and elsewhere is complex and requires a multifaceted approach that addresses individual, interpersonal and structural factors.

Trends in Cannabis and Alcohol Use by Sexual Identity in the 2015-2019 National Survey on Drug Use and Health

OBJECTIVE

Sexual minority individuals are at substantially elevated risk for both cannabis use disorder (CUD) and alcohol use disorder (AUD). Although recent increases in the legalization of cannabis have been linked to increases in cannabis use among the general population, few studies have examined if changes in cannabis use and CUD vary by sexual identity. The purpose of the current study was to examine sexual identity differences in trends for CUD and compare them to trends for AUD.

METHOD

We used data from 2015-2019 National Survey on Drug Use and Health to examine annual prevalence and year-specific disparities in cannabis use, CUD, heavy episodic drinking, and AUD. We also examined sex-specific sexual identity differences in linear trends for these substance use outcomes over this 5-year period.

RESULTS

All groups except lesbian females experienced significant increases in cannabis use rates from 2015 to 2019. Heterosexual males, heterosexual females, and bisexual females also experienced significant increases in CUD rates. In contrast, no group exhibited significant increases in heavy episodic drinking or AUD rates. Bisexual women exhibited some of the largest year-specific disparities in cannabis use and CUD as well as the largest growth in disparities across time.

CONCLUSIONS

The few changes in heavy episodic drinking and AUD alongside numerous changes in cannabis use and CUD suggest that changes in cannabis use may be attributable to legalization of cannabis use in many states during this period. Given profound disparities and increasing rates of CUD affecting bisexual females, further research is needed to identify factors that may explain their disproportionate burden.

"A Tremendous Outpouring of Love and Affection": A Template Analysis of Positive Experiences During a Major LGBTQ Rights Campaign

Human rights for lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people have frequently been decided via popular vote. Australia conducted one such vote on the topic of marriage equality in 2017. Research has tended to focus on the negative experiences reported by LGBTQ people during such votes, with little attention paid to any positive experiences identified. This paper seeks to redress that imbalance, reporting the findings of two qualitative studies asking LGBTQ Australians about positive experiences during the marriage equality vote. The first study analyzed 673 typed responses collected during the two-month voting period, while the second analyzed interview data from 19 LGBTQ Australians collected two-and-a-half years after the vote. Both were analyzed using template analysis. Results identified sources of support, types of support, empowerment through activism, changes in general and LGBTQ communities, and positive personal changes. As public votes continue to be used to determine LGBTQ human rights, the findings may guide interventions to help LGBTQ people and their allies cope with such campaigns.

Romantic Attachment, Relationship Satisfaction, Internalized Sexual Stigma, and Motives for Parenthood in Italian Lesbian Women and Gay Men

This study examines romantic attachment, internalized sexual stigma, relationship satisfaction, and motives for parenthood in a sample of 313 Italian lesbian women (47.9%) and gay men (52.1%) aged 18-71 years (M = 36.2; SD = 11.9) and in same-sex relationships. The following hypotheses were tested: that romantic attachment is positively correlated with internalized stigma and motives to not have children, while it is negatively correlated with relationship satisfaction; that relationship satisfaction is negatively correlated with internalized stigma and motives for parenthood; that internalized stigma is negatively correlated with motives for parenthood; and that relationship satisfaction mediates the relationships between romantic attachment and motives for parenthood and between internalized stigma and motives for parenthood. The results strongly support the hypotheses. Furthermore, the results indicate that the lesbian participants reported lower levels of avoidance and internalized stigma and higher levels of relationship satisfaction and motives to not have children, and the participants in civil unions reported lower levels of anxiety and internalized stigma and higher levels of relationship satisfaction and motives to not have children. Taken together, our findings contribute to the growing body of research on LG parenthood and may inform social policy and psychological support for LG individuals pursuing parenthood.

Associations of adult roles and minority stressors with trajectories of alcohol dependence symptoms throughout adulthood among sexual minority women

OBJECTIVE

In the present study, we sought to identify trajectories of symptoms of potential alcohol dependence (AD) among adult sexual minority women (SMW). Theoretical correlates were examined in relation to the empirically identified trajectories.

METHOD

Data were collected at three time points between 2000 and 2012 from SMW drinkers (n = 434) enrolled in a longitudinal study (M Age = 37.49 at baseline, SD = 11.55). Using an accelerated-cohort longitudinal design, latent growth curve mixture models identified homogeneous patterns of any past-year symptoms of potential AD. Correlates of trajectories included alcohol-related developmental risk factors, adult roles, and exposure to minority stressors.

RESULTS

Three trajectories were identified that captured risk of symptoms of potential AD over time, reflecting: (a) relatively consistent, low risk over time; (b) deceleration in risk throughout adulthood; (c) relatively persistent, high risk over time. Consistent with prior work, SMW drinkers who reported higher levels of perceived stigma or masculinity showed persistently high risk of reporting at least one past-year symptom of potential AD.

CONCLUSIONS

Most SMW drinkers report deceleration in risk of AD symptoms over time. Findings have implications for prevention and intervention efforts tailored to SMW drinkers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Coping with the stress of providing mental health-related informal support to peers in an LGBTQ context

Many lesbian, gay, bisexual, trans or gender diverse, or queer-identifying (LGBTQ) people provide informal support to peers experiencing mental ill health. This reflects both the high prevalence of mental ill health in their communities - often a product of discrimination - and barriers to accessing formal services. In this article, we explore how LGBTQ people who help peers with their mental health seek to cope with the stress of providing such support. Drawing on interviews with 25 LGBTQ people in Melbourne, Australia, we consider how community members being 'leant on' engage in self-care practices and seek help from their communities to cope with the stress of their support roles. We demonstrate that participants' ways of coping, even when similar, can vary in effectiveness and often come with limitations. Thus, we conclude that LGBTQ people providing informal support to peers should be better assisted to do so, in ways that acknowledge the diversity of support provided in LGBTQ communities.

Examining perceived effects of same-sex marriage legalization among sexual minority women: Identifying demographic differences and factors related to alcohol use disorder, depression, and self-perceived health

Background

Reductions in structural stigma, such as gaining access to legalized same-sex marriage, is associated with positive psychological and physical health outcomes among sexual minorities. However, these positive outcomes may be less robust among sexual minority women (SMW).

Methods

This study examined how perceptions of the impact of legalized same-sex marriage among SMW may 1) differ by demographic characteristics and 2) predict alcohol use disorder, depression, and self-perceived health. A diverse sample of SMW (N=446) completed an online survey in 2020 assessing the perceived impact of legalized same-sex marriage across six social-ecological domains: 1) personal impact, 2) stigma-related concerns, 3) couple impact, 4) family support, 5) work/school impact, and 6) local social climate towards LGBTQ people.

Results

Perceived impact across multiple domains differed by relationship status and sexual identity (e.g., lesbian compared to bisexual identity); only family support differed by race/ethnicity. Stigma-related concerns (e.g., experiencing or witnessing hostility or discrimination because of sexual identity, despite legalized same-sex marriage) were associated with greater odds of depression and lower odds of reporting excellent, very good, or good health. Odds of depression were lower among participants who reported higher personal impact, a greater number of family members supportive of same-sex marriage, and a more positive local social climate. Family support also predicted self-perceived health. However, participants who perceived increased support in work/school contexts after legalized same-sex marriage had higher odds of alcohol use disorder.

Conclusions

Overall, findings underscore the importance of policy in improving health outcomes through reducing stigma-related concerns and improving social acceptance.

Effects of Same-Sex Marriage Legalization for Sexual Minority Men in Taiwan: Findings From a Prospective Study

Objective: On May 24, 2019, same-sex marriage (SSM) was legalized in Taiwan. Increasing research in western countries has yielded longitudinal evidence about the psychosocial benefits of SSM for sexual minority individuals, but they have rarely included sexual minority-specific measures or considered participants’ relationship status. This study aimed to examine the short-term effects associated with the legalization of SSM for gay and bisexual men in Taiwan.

Methods: A panel sample of 731 gay and 132 bisexual men participated in baseline (May 2019) and follow-up (October 2020) online surveys to report their depressive symptoms, distal sexual minority stress, internalized homophobia, and outness status.

Results: The results demonstrated significant reductions in depressive symptoms and distal sexual minority stress along with increased rates of coming out to friends, family, and parents. These changes were similar for partnered and un-partnered individuals. Fixed-effect regression analysis indicated that the decline in distal sexual minority stress and internalized homophobia contributed to the decline in depressive symptoms.

Conclusion: This study preliminarily supports the positive effects of SSM in promoting sexual minority men’s mental health and disclosure in Taiwan.

Sexual Minority Orientation Is Associated With Greater Psychological Impact Due to the COVID-19 Crisis-Evidence From a Longitudinal Cohort Study of Young Swiss Men

Background: The COVID-19 pandemic and its countermeasures may have had a significant impact on the psychological well-being of specific population subgroups. The present study investigated whether sexual minority men (defined here as attracted partly or exclusively to men) from an ongoing cohort study of young Swiss men experienced different psychological impacts, levels of substance use and addictive behaviors, and to which degree pre-existing vulnerabilities and participants experiences during the crisis might explain these differences.

Methods: An ongoing cohort sample based on the general population of young Swiss men (mean age = 29.07 years; SD = 1.27) was assessed before and during the COVID-19 crisis for depression, stress, sleep quality, substance use and addictive behaviors. Additionally, during the crisis, we assessed its impact in form of fear, isolation and traumatic experiences. Potential associations between these outcomes and sexual orientation (sexual minority vs. heterosexual) were tested using linear regression models. It was additionally estimated to which degree these associations were attenuated if adjusted for differences in mental health, personality and socioeconomic status before the crisis, as well as the experience of the COVID-19 crisis (infection with the virus and changes to work situation).

Results: Compared to heterosexual men, sexual minority men showed higher levels of psychological trauma (b = 0.37 [0.25, 0.49]), fear (b = 0.18 [0.06, 0.30]) and isolation (b = 0.32 [0.20, 0.44]) due to the COVID-19 pandemic as well as higher levels of depression (b = 0.31 [0.20, 0.41]) and lower sleep quality (b = −0.13 [−0.24, −0.02]) during the crisis. These differences were to a large degree explained by higher pre-crisis levels of mental health problems and the personality dimension of neuroticism-anxiety. Sexual minority men showed higher overall levels of substance use and addictive behaviors, but these differences were already present before the crisis.

Conclusion: The COVID-19 crisis may have worsened pre-existing vulnerabilities in sexual minority men, leading to its greater psychological impact on them than on heterosexual men. Reducing minority stress due to sexual orientation may help not only to improve mental health among important proportions of the population but also to reduce their vulnerability to crises. Services offering psychological support to sexual minorities may need to be reinforced during crises.