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Lin PC, Chang YP, Chen YL, Yen CF. Mediating effect of loneliness on the associations of perceived and internalized sexual stigma with suicide in gay and bisexual men. J Formos Med Assoc 2024:S0929-6646(24)00398-X. [PMID: 39242223 DOI: 10.1016/j.jfma.2024.08.030] [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: 03/12/2024] [Revised: 07/03/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND/PURPOSE Loneliness is prevalent among gay and bisexual men (GBM). This study evaluated the mediating effect of loneliness on the associations of perceived sexual stigma (PSS) and internalized sexual stigma (ISS) with suicide in 400 GBM. METHODS A moderated mediation model was used to test the mediating effects of loneliness between the associations of PSS from family members and ISS with suicide and the moderating effects of sexual orientation, age, and education level on the mediating effects. RESULTS The results indicated that both PSS and ISS were positively associated with suicide through the full mediation of loneliness. The association of ISS with loneliness was stronger in older GBM. CONCLUSIONS Intervention programs promoting changes in attitudes toward GBM are warranted to prevent the development of PSS and ISS, loneliness, and suicide in this population.
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Affiliation(s)
- Po-Chun Lin
- Department of Psychiatry, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, NY, USA
| | - Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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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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Tian X, Yuan B. Beyond Translation: Exploring the Stigmatization of Rainbow Works Translation Under Frame Theory. JOURNAL OF HOMOSEXUALITY 2024:1-23. [PMID: 38923916 DOI: 10.1080/00918369.2024.2368205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Drawing on Goffman's frame theory, this study examines the attitudes of nine Chinese university teacher translators in translating rainbow works, ranging from hesitancy to resistance. The primary objective is to uncover the frames of stigmatization inherent in their negative attitudes toward rainbow works translation. The research clarifies the identities of perpetrators and victims in these frames leading to stigmatization. Findings indicate that various stigmatization events in rainbow works translation share a common feature-an unfavorable depiction of rainbow culture and related elements, encompassing the rainbow community, works, and translators. Perpetrators and victims vary across events, demonstrating diversity. The research interprets stigmatization in rainbow works translation at individual, institutional, and sociocultural levels. Providing a unique Chinese perspective, the study contributes to international understanding of stigmatization in a heteronormative society. It challenges traditional Chinese norms, advocates reevaluating identity labels for the rainbow community, and underscores the importance of addressing translators' circumstances in translating rainbow works within specific societal contexts.
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Affiliation(s)
- Xiaoming Tian
- School of Humanities and Foreign Languages, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Boya Yuan
- Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
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O'Donnell AT, Foran AM. The link between anticipated and internalized stigma and depression: A systematic review. Soc Sci Med 2024; 349:116869. [PMID: 38678910 DOI: 10.1016/j.socscimed.2024.116869] [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: 01/19/2024] [Revised: 03/20/2024] [Accepted: 04/04/2024] [Indexed: 05/01/2024]
Abstract
Stigmatized groups may experience psychological distress. Yet, some studies show no significant relation between stigma and mental health outcomes. This systematic review investigates the link between anticipated and internalized stigma, and one mental health outcome, depression. We aimed to (1) determine whether anticipated and internalized stigma predict levels of depression, and (2) review the quality of evidence for this link. We searched PsycInfo, PubMed and EMBASE databases. Eighty-three studies (N = 34,705) met our inclusion criteria, across five stigma categories: Sexual and gender minorities; HIV/AIDS; Illness or disability-related (non-HIV); Weight, and Other. We reviewed evidence within each category and study design and developed a narrative synthesis. Sixty studies (72.3%) supported the proposed link, which varied across categories from 53.6% to 100%. Using the NIH quality assessment tool, most studies were of fair quality. Most cross-sectional studies (76.7%) straightforwardly supported the positive relation between internalized and/or anticipated stigma and depression, while only 40% of longitudinal studies did. Implications for the study of stigma and mental health outcomes are discussed.
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Affiliation(s)
- Aisling T O'Donnell
- Centre for Social Issues Research, Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Aoife-Marie Foran
- Centre for Social Issues Research, Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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5
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Wang PW, Chang YP, Tsai CS, Yen CF. Predictors of depressive and anxiety symptoms among lesbian, gay and bisexual young adult individuals experiencing the COVID-19 pandemic: A four-year follow-up study. J Formos Med Assoc 2024:S0929-6646(24)00138-4. [PMID: 38423925 DOI: 10.1016/j.jfma.2024.02.013] [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: 01/22/2024] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND/PURPOSE Depressive and anxiety symptoms were common among lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic. This 4-year follow-up study was conducted to investigate the predictors of depressive and anxiety symptoms in Taiwan's young adult LGB population. METHODS Baseline data, including depressive and anxiety symptoms, demographic characteristics, sexual stigma, self-identity confusion, and family support were collected from 1000 LGB individuals. The participants' depressive and anxiety symptoms were reassessed 4 years after the baseline measurements. The predictive effects of the baseline factors on depressive and anxiety symptoms at follow-up were examined through linear regression analysis. RESULTS Greater lack of identity, unconsolidated identity, sexual orientation microaggression, and lower perceived family function at baseline were significantly associated with more severe depressive and anxiety symptoms at follow-up. After adjustment for baseline depressive symptoms, being men, greater lack of identity, lower perceived family function, and more severe anxiety symptoms at baseline were significantly associated with more severe depressive symptoms at follow-up. After adjustment for baseline anxiety symptoms, greater unconsolidated identity and more severe depressive symptoms at baseline were significantly associated with more severe anxiety symptoms at follow-up. CONCLUSIONS Intervention aimed at reducing depressive and anxiety symptoms in LGB individuals should be developed considering the predictors identified in this study.
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Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, USA
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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Huang MF, Chang YP, Chou WJ, Yen CF. A 4-year prospective investigation of predictive effects of prepandemic sexual stigma, affective symptoms, and family support on fear of COVID-19 among lesbian, gay, and bisexual individuals. Front Public Health 2024; 11:1297042. [PMID: 38259737 PMCID: PMC10800656 DOI: 10.3389/fpubh.2023.1297042] [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: 09/19/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Aim This prospective study examined whether prepandemic sexual stigma, affective symptoms, and family support can predict fear of coronavirus disease 2019 (COVID-19) among lesbian, gay, and bisexual (LGB) individuals. Methods Data of 1,000 LGB individual on prepandemic sociodemographic characteristics, sexual stigma (familial sexual stigma [FSS] measured by the Homosexuality-Related Stigma Scale, internalized sexual stigma [ISS] measured by the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and sexual orientation microaggression [SOM] measured by the Sexual Orientation Microaggression Inventory), affective symptoms (i.e., depression measured by the Center for Epidemiologic Studies-Depression Scale and anxiety measured by the State-Trait Anxiety Inventory-State version), and family support measured by the Adaptability, Partnership, Growth, Affection, and Resolve Index were collected. Four years later, the fear of COVID-19 was assessed using the Fear of COVID-19 Scale and the associations of prepandemic sexual stigma, affective symptoms, and perceived family support on fear of COVID-19 4 years later were analyzed using multiple linear regression analysis. Results In total, 670 (67.3%) participants agreed and completed the follow-up assessment. Greater prepandemic FSS, ISS, SOM, affective symptoms, and perceived family support were significantly associated with a greater fear of COVID-19 at follow-up. Conclusion The identified predictors should be considered when designing interventions aimed at preventing and reducing the fear of COVID-19 in LGB individuals.
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Affiliation(s)
- Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, United States
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
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Huang MF, Chang YP, Chou WJ, Yen CF. Predictors of problematic smartphone use among young adult lesbian, gay and bisexual individuals during the COVID-19 pandemic: a four-year follow-up study. BMC Psychiatry 2023; 23:905. [PMID: 38053156 PMCID: PMC10696814 DOI: 10.1186/s12888-023-05326-2] [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: 08/20/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND This 4-year follow-up study was conducted to evaluate the predictive effects of prepandemic individual and environmental factors on problematic smartphone use (PSU) among young adult lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic. METHODS Data on prepandemic PSU, demographics, sexual stigma (e.g., perceived sexual stigma from family members, internalized sexual stigma, and sexual microaggression), self-identity confusion (e.g., disturbed identity, unconsolidated identity, and lack of identity), anxiety, depression, and family support were collected from 1,000 LGB individuals between August 2018 and June 2019. The participants' PSU was surveyed again after 4 years (between August 2022 and June 2023). The associations of prepandemic individual and environmental factors with PSU at follow-up were analyzed through linear regression. RESULTS In total, 673 (67.3%) participants completed the follow-up assessment. The severity of PSU significantly decreased after 4 years (p = .001). Before the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels depressive symptoms (p < .001), disturbed identity (p < .001), and perceived sexual stigma from family members (p = .025) at baseline were significantly associated with PSU at follow-up. After the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels PSU (p < .001) and depressive symptoms (p = .002) at baseline were significantly associated with PSU at follow-up. CONCLUSION Interventions aimed at reducing the severity of PSU among LGB individuals should be designed considering the predictors identified in our study.
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Affiliation(s)
- Mei-Feng Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, USA
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 32 Dapi Rd. Niaosong Dist, Kaohsiung, 83341, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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Lin YJ, Chang YP, Yen CF. Predicting the Influences of Depression and Sexual Stigma on Motivation to Get Vaccinated against COVID-19 in Lesbian, Gay, and Bisexual Young Adults: A 4-Year Follow-Up Study. Vaccines (Basel) 2023; 11:1430. [PMID: 37766107 PMCID: PMC10536742 DOI: 10.3390/vaccines11091430] [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: 07/24/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Vaccination is a crucial preventive measure against COVID-19. However, limited research has focused on identifying the factors predicting motivation to get vaccinated against COVID-19 (MoVAC-19) among lesbian, gay, and bisexual (LGB) individuals. This study examined the predictive effects of depression and sexual stigma (i.e., perceived sexual stigma from family members, perceived sexual orientation microaggression, and internalized sexual stigma) before the COVID-19 pandemic on MoVAC-19 among LGB individuals 4 years later during the COVID-19 pandemic in Taiwan. Baseline data related to depression and sexual stigma were collected in 2018 and 2019. Depression was assessed using the 20-item Mandarin Chinese version of the Center for Epidemiologic Studies Depression Scale. Perceived sexual stigma from family members was assessed using the Homosexuality-Related Stigma Scale. Internalized sexual stigma was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men. Perceived sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. Participant MoVAC-19 during the pandemic was assessed using the nine-item Motors of COVID-19 Vaccination Acceptance Scale. The associations of depression and sexual stigma at baseline with MoVAC-19 at follow-up were examined through multivariate linear regression analysis. Internalized sexual stigma was negatively associated with MoVAC-19, whereas perceived sexual orientation microaggression was positively associated with MoVAC-19. Depression and perceived sexual stigma from family members were not significantly associated with MoVAC-19. Although male sex and older age were positively associated with increased MoVAC-19, sex and age did not moderate the relationship between sexual stigma and motivation to get vaccinated. Among LGB individuals, sexual stigma experiences should be considered when developing intervention strategies aimed at enhancing MoVAC-19.
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Affiliation(s)
- Yen-Ju Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY 14214-8013, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Wang PW, Chang YP, Tsai CS, Yen CF. Sexual stigmas among lesbian, gay, and bisexual individuals with problematic internet use and depression. Front Psychiatry 2023; 14:1163032. [PMID: 37255683 PMCID: PMC10225597 DOI: 10.3389/fpsyt.2023.1163032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Sexual stigma causes psychological distress among lesbian, gay, and bisexual (LGB) individuals. LGB individuals are more likely to exhibit both problematic Internet use (PIU) and significant depression than are heterosexual individuals. Whether the severities of sexual stigma varied among LGB individuals with various statuses of comorbid PIU and depression warrants study. The present study aimed to investigate the differences in the experiences of familial sexual stigma (FSS), internalized sexual stigma (ISS), and sexual orientation microaggressions (SOMs) among LGB individuals with various statuses of comorbid PIU and depression. Methods In total, 1,000 self-identified LGB young adult individuals participated in the study. The level of PIU was assessed using the Chen Internet Addiction Scale, depression was assessed using the Center for Epidemiological Studies-Depression Scale, the experience of FSS was assessed using the Homosexuality-Related Stigma Scale, the experience of ISS was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, and the experience of sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. The differences in the levels of FSS, ISS, and SOMs among the four groups [i.e., the groups with both PIU and depression (comorbid group), only depression, only PIU, and neither PIU nor depression (neither group)] were investigated using multivariate analysis of covariance. Results The results indicated that LGB individuals with comorbid PIU and depression reported higher levels of ISS and SOMs than did those with depression only and PIU only, respectively. Moreover, LGB individuals with PIU or significant depression had higher levels of FSS and SOMs than did those with neither PIU nor depression. Discussion The results of this study supported that the experiences of FSS, ISS, and SOMs were significantly associated with various levels of PIU and depression in LGB individuals.
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Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, United States
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
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Guzmán-González M, Gómez F, Bahamondes J, Barrientos J, Garrido-Rojas L, Espinoza-Tapia R, Casu G. Internalized homonegativity moderates the association between attachment avoidance and emotional intimacy among same-sex male couples. Front Psychol 2023; 14:1148005. [PMID: 37063530 PMCID: PMC10090517 DOI: 10.3389/fpsyg.2023.1148005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/08/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionThe present study aimed to examine dyadic associations between attachment insecurity and emotional intimacy in same-sex male couples, and to investigate whether and how each partner’s internalized homonegativity (IH) moderated these associations.MethodsThe sample included 138 same-sex male couples. Both dyad members completed self-report measures of attachment insecurity, emotional intimacy, and IH. The actor-partner interdependence model with moderation analysis was applied.ResultsIndicated that higher levels of actor’s and partner’s attachment anxiety and attachment avoidance were associated with lower actor’s emotional intimacy. IH moderated the partner effects of attachment avoidance on emotional intimacy. The partner’s higher attachment avoidance was associated with one’s own lower emotional intimacy at low (but not high) levels of one’s own IH and at high (but not low) levels of the partner’s IH.DiscussionFindings suggest that the partner’s attachment avoidance may differently affect one’s own emotional intimacy depending on the IH levels of both dyad members. Helping partnered sexual minority men decrease attachment insecurity while recognizing their own and their partners’ IH may promote relationship quality.
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Affiliation(s)
- Mónica Guzmán-González
- Laboratory of Research in Attachment, Couple Relationships and Family, School of Psychology, Universidad Católica del Norte, Antofagasta, Chile
- *Correspondence: Mónica Guzmán-González,
| | - Fabiola Gómez
- School of Psychology, Pontificia Universidad Católica, Santiago, Chile
| | - Joaquín Bahamondes
- School of Psychology, Universidad Católica del Norte, Antofagasta, Chile
| | - Jaime Barrientos
- Faculty of Psychology, Universidad Alberto Hurtado, Santiago, Chile
| | | | | | - Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy
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Lin CY, Chang YP, Chou WJ, Yen CF. Assessing Enacted Sexual Stigma toward Gay and Bisexual Men in the Military: The Enacted Sexual Stigma Experiences Scale in Military Service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1260. [PMID: 36674010 PMCID: PMC9858839 DOI: 10.3390/ijerph20021260] [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] [Received: 12/29/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Gay and bisexual military servicemembers experience disproportionately high rates of victimization due to enacted sexual stigma (ESS). This study formulated a new scale, called the Enacted Sexual Stigma Experiences Scale in Military Service (ESSESiMS) for gay and bisexual servicemembers, and examined its psychometric propensities. The five-item ESSESiMS was first developed based on the results of focus group interviews with 12 participants. A total of 399 gay and bisexual men who have experience of the military service participated in the study. Exploratory factor analysis (EFA) was implemented to determine the factor structure of the ESSESiMS; the internal consistency and concurrent validity of the ESSESiMS was also examined. The EFA results indicate that the ESSESiMS should have a single-item structure. The ESSESiMS exhibited acceptable internal consistency and concurrent validity. Incidents of ESS in the ESSESiMS were significantly associated with perceived sexual stigma outside the military service and with higher levels of depression, loneliness, and suicidal ideation. The results of our study supported the psychometric properties of the newly developed ESSESiMS for assessing the experiences of ESS among gay and bisexual servicemembers in Taiwan. Experiences of ESS toward gay and bisexual servicemembers were common; ESS was significantly associated with adverse mental health outcomes.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14260, USA
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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12
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Lin CY, Huang YT, Lee CH, Fan CW, Yen CF. Gay Community Stress Scale with Its Cultural Translation and Adaptions in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11649. [PMID: 36141909 PMCID: PMC9517012 DOI: 10.3390/ijerph191811649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/04/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to adapt the Gay Community Stress Scale (GCSS) into the traditional Chinese version for measuring gay community stress experienced. Additionally, we examined its psychometric propensities among gay and bisexual men (GBM) in Taiwan. In total, 736 GBM participated in this study and completed the 35-item traditional Chinese version of the GCSS (29 items from the original GCSS and six items from the results of the focus group interviews among GBM in Taiwan); the Measure of Internalized Sexual Stigma for Lesbians and Gay Men (MISS-LG); the State-Trait Anxiety Inventory (STAI); and the Center for Epidemiological Studies Depression Scale (CES-D). Exploratory factor analysis results suggest a five-factor structure (i.e., Sex, Status, Competition, Exclusion, and Externals) for the 32-item traditional Chinese version of the GCSS among Taiwanese GBM; three items were deleted due to low factor loadings (i.e., <0.3). The five-factor "Externals" were not observed in the original GCSS. Moreover, the concurrent validity of the traditional Chinese version was supported by the positive correlations with MISS-LG, STAI, and CES-D. In conclusion, the traditional Chinese version of the GCSS showed relatively satisfactory psychometric properties. However, further research is needed to investigate the reasons for the possible etiology account for the different factor structures between the traditional Chinese version and the original GCSS.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong RM543, China
| | - Chiu-Hsiang Lee
- Department of Nursing, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL 32803, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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13
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Lin CY, Griffiths MD, Pakpour AH, Tsai CS, Yen CF. Relationships of familial sexual stigma and family support with internalized homonegativity among lesbian, gay and bisexual individuals: The mediating effect of self-identity disturbance and moderating effect of gender. BMC Public Health 2022; 22:1465. [PMID: 35915488 PMCID: PMC9344633 DOI: 10.1186/s12889-022-13815-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background The mediators of the association between familial attitudes toward sexual orientation and internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals have not been well examined. Methods A cross-sectional survey study was carried out to examine the (i) associations of familial sexual stigma and family support with internalized homonegativity among young adult LGB individuals in Taiwan, and (ii) mediating effect of self-identity disturbance and the moderating effect of gender. Self-identified LGB individuals (N = 1000; 50% males and 50% females; mean age = 24.6 years) participated in the study. Familial sexual stigma, family support, self-identity disturbance, and internalized homonegativity were assessed. Structural equation modeling was used to examine relationships between the variables. Results The results indicated that familial sexual stigma was directly associated with increased internalized homonegativity, and indirectly associated with increased internalized homonegativity via the mediation of self-identity disturbance among LGB individuals. Family support was indirectly associated with decreased internalized homonegativity via the mediation of low self-identity disturbance. The direct association between family support and internalized homonegativity was only found among lesbian and bisexual women but not among gay and bisexual men. Conclusions Program interventions for familial sexual stigma, family support, and self-identity disturbance are warranted to help reduce internalized homonegativity among LGB individuals.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung and School of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 32 Dapi Rd. Niaosong Dist., Kaohsiung, 83341, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan. .,College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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14
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Lin CY, Tsai CS, Fan CW, Griffiths MD, Chang CC, Yen CF, Pakpour AH. Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138095. [PMID: 35805754 PMCID: PMC9265606 DOI: 10.3390/ijerph19138095] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State–Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants’ sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL 32803, USA;
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden;
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15
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Lin HC, Chang CC, Chang YP, Chen YL, Yen CF. Associations among Perceived Sexual Stigma from Family and Peers, Internalized Homonegativity, Loneliness, Depression, and Anxiety among Gay and Bisexual Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106225. [PMID: 35627760 PMCID: PMC9141414 DOI: 10.3390/ijerph19106225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to examine the moderating factors of the association between perceived sexual stigma from family and peers and internalized homonegativity, as well as to compare the effects of perceived sexual stigma from family and peers and internalized homonegativity on loneliness, depression, and anxiety in gay and bisexual men. In total, 400 gay and bisexual men participated in this study. The experiences of perceived sexual stigma from family and peers on the Homosexuality subscale of the HIV and Homosexuality Related Stigma Scale, internalized homonegativity on the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, loneliness on the UCLA Loneliness Scale (Version 3), depression on the Center for Epidemiological Studies-Depression Scale, and anxiety on the State subscale of the State-Trait Anxiety Inventory were collected. The results indicated that perceived sexual stigma from family and peers was significantly associated with internalized homonegativity in both gay and bisexual men, and that sexual orientation moderated the association. Moreover, the association between internalized homonegativity and loneliness was significantly greater than that between perceived sexual stigma from family and peers and loneliness, although no significant differences were observed in their associations with depression and anxiety. Intervention programs that promote changes in the attitudes toward gay and bisexual men among the general population are needed to help prevent the development of internalized homonegativity and further loneliness, depression and anxiety.
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Affiliation(s)
- Huang-Chi Lin
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan;
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY 14214-3079, USA;
| | - Yi-Lung Chen
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
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Relationships of Homophobic Bullying Victimization during Childhood with Borderline Personality Disorder Symptoms in Early Adulthood among Gay and Bisexual Men: Mediating Effect of Depressive Symptoms and Moderating Effect of Family Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084789. [PMID: 35457655 PMCID: PMC9027503 DOI: 10.3390/ijerph19084789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
This study investigated (1) the associations of homophobic bullying victimization in childhood with borderline personality disorder (BPD) symptoms in early adulthood among gay and bisexual men; (2) the mediating effect of depressive symptoms on the association between homophobic bullying victimization and BPD symptoms, and (3) the moderating effects of perceived family support on the association between homophobic bullying victimization and BPD symptoms. A total of 500 gay or bisexual men aged between 20 and 25 years were recruited into this study. The experiences of physical, verbal and social relationship bullying victimization during childhood were evaluated using the Mandarin Chinese version of the School Bullying Experience Questionnaire. The experiences of cyberbullying victimization during childhood were evaluated using the Cyberbullying Experiences Questionnaire. BPD symptoms were assessed using the Borderline Symptom List. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale. Perceived family support was evaluated using the Family Adaptation, Partnership, Growth, Affection, and Resolve index. The results of mediation analyses demonstrated that all the types of homophobic bullying victimization in childhood were directly associated with BDP symptoms in young adulthood as well as indirectly associated with BPD symptoms through the mediation of depressive symptoms. The results of moderation analyses demonstrated that the association between homophobic bullying victimization and BPD symptoms decreased when the individuals had more family support. Intervention programs to reduce homophobic bullying victimization and enhance family support for gay and bisexual men and their families are necessary. Interventions to improve depressive and BPD symptoms among gay and bisexual men are also necessary, especially for those who experienced homophobic bullying victimization during childhood.
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