1
|
Choo S, Kim R, Lee H, Eom YJ, Yi H, Kim R, Williams DR, Kim SS. Heightened vigilance and its associations with suicidal ideation and suicide attempt among 285 Korean transgender and nonbinary adults: Effect modification by connectedness to the LGBTQ+ community. Suicide Life Threat Behav 2024. [PMID: 38888372 DOI: 10.1111/sltb.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/19/2024] [Accepted: 06/06/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Anti-transgender stigma presents threats of discrimination to transgender and nonbinary (TGNB) individuals, prompting them to stay vigilant. Using a longitudinal data of 285 South Korean TGNB adults, we examined vigilance and its associations with suicidal ideation and suicide attempt and explored the protective role of connectedness to the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. METHODS Data were collected in October 2021 (baseline) and October 2022 (follow-up). Vigilance was measured using the 4-item Heightened Vigilance Scale at baseline. At follow-up, 12-month suicidal ideation and suicide attempt, and connectedness to the LGBTQ+ community were measured. RESULTS Having heightened levels of vigilance was associated with increased prevalence of suicidal ideation (Prevalence Ratio [PR]: 1.33, 95% Confidence Interval [CI]: 1.09-1.62) and suicide attempt (PR: 2.18, 95% CI: 1.23-3.86), after adjusting for covariates including anti-transgender discrimination experiences and lifetime suicidality at baseline. When stratified by connectedness to the LGBTQ+ community, the associations between vigilance and suicidality remained statistically significant among those with low connectedness whereas no statistically significant association was observed among those with high connectedness. CONCLUSION The study provides empirical evidence for policies and interventions that ensure safety of TGNB individuals from discrimination and promote connectedness to the LGBTQ+ community to reduce the suicide risk among TGNB individuals.
Collapse
Affiliation(s)
- Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ranyeong Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Hyemin Lee
- Department of Psychology, University of Maryland College Park, College Park, Maryland, USA
| | - Yun-Jung Eom
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, South Korea
| | - Rockli Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| |
Collapse
|
2
|
Matías R, Matud MP. Sexual Orientation, Health, and Well-Being in Spanish People. Healthcare (Basel) 2024; 12:924. [PMID: 38727481 PMCID: PMC11083809 DOI: 10.3390/healthcare12090924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/23/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Although several studies have found disparities in health outcomes between heterosexual and lesbian, gay, and bisexual (LGB)-identifying individuals, few studies have focused on subjective well-being and protective factors for health and well-being. The purpose of this work is twofold: (1) to examine the relevance of sexual orientation to health and well-being in women and men; (2) to identify protective and risk factors for psychological distress, self-rated health, and well-being for gay men, lesbian women, bisexual women and men, and heterosexual women and men. The sample consisted of 908 women and 586 men from the general Spanish population aged 16-64, half of whom identified themselves as LGB and half as heterosexual. All were assessed using eight questionnaires and inventories. The results showed that differences varied depending on the health indicator considered. In general, bisexuals had the poorest health, with lower self-rated health and lower self-esteem. In all groups, self-esteem was a protective factor against psychological distress and was associated with better health and well-being. To a lesser extent, social support served as a protective factor against psychological distress and was associated with greater well-being in all groups. It is concluded that although sexual orientation is relevant to the health and well-being of individuals, there are differences among sexual minorities, with bisexuals having lower self-esteem than homosexuals.
Collapse
Affiliation(s)
| | - M. Pilar Matud
- Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna, 38200 San Cristobal de La Laguna, Spain;
| |
Collapse
|
3
|
Kim DJ, Hwang NH, Lee JY, Park SH, Lee BI, Yoon ES. An Analysis of the Demographics and Clinical Characteristics of Transgender and Intersex Populations in Korea: A Retrospective Study Using HIRA Database. J Korean Med Sci 2023; 38:e385. [PMID: 38147835 PMCID: PMC10752747 DOI: 10.3346/jkms.2023.38.e385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/11/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Transgender and intersex populations have long remained under-documented in South Korea, largely due to the absence of comprehensive epidemiological data. With increasing societal acknowledgment, there's an urgent need to understand the demographics and health challenges faced by these communities. METHODS This retrospective, large-scale data study included people who received the F64 codes from the Korean Health Insurance Review & Assessment Service between January 2007 and December 2021. Demographics, gender-affirmative treatments, and psychiatric related medications were examined. RESULTS Between 2007 and 2021, 8,602 patients were diagnosed with "gender identity disorder" and 45 with "intersex." A steadily increasing annual prevalence was observed, peaking at 986 cases in 2021. The majority (79.8%) were aged between 10 and 30. Nearly half (53.2%) exhibited mental and behavioral disorders. Two-thirds had been prescribed anxiolytics or sedatives either before or after diagnosis. Merely 12.1% received hormone therapy covered by health insurance. CONCLUSION This is the first large-scale study highlighting the demographics and clinical characteristics of the transgender and intersex populations in Korea. The study reveals a consistent growth of these communities over the past 15 years, with a significant proportion under 30 years of age facing mental and behavioral challenges. Findings underscore the need for targeted healthcare interventions, early psychological support, and comprehensive insurance coverage tailored to the specific needs of these individuals in Korea.
Collapse
Affiliation(s)
- Dong-Jin Kim
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Na-Hyun Hwang
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Ji Yoon Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Seung Ha Park
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Byung-Il Lee
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Eul-Sik Yoon
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
4
|
Zhu B, Xiao C, Ding C, Yan H, Wang L, Jiang Q, Tian J, Wei L. Adverse childhood experiences and depressive symptoms among lesbian and bisexual women in China. BMC Womens Health 2023; 23:679. [PMID: 38114972 PMCID: PMC10731884 DOI: 10.1186/s12905-023-02686-5] [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: 10/08/2021] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Despite the relationship between Adverse childhood experiences (ACEs) and depressive symptoms, which has been well researched in general populations, little is known about homosexual and bisexual populations, especially lesbian and bisexual women in China. This study aims to investigate the prevalence of ACEs and depressive symptoms and to analyze the relationship between them among lesbian and bisexual women in China. METHODS The eligible participants were aged 16 years or older who report their sexual orientation as homosexual or bisexual. The data was collected through anonymous questionnaires with the help of Lespark in Beijing from July 18 to December 29, 2018, and all participants had informed consent to this study. Univariate analysis and multiple linear regression analyses were performed to explore the relationship between ACEs and depressive symptoms among lesbian and bisexual women. All statistical analyses were conducted by the software of SPSS 22.0. RESULTS Among 301 lesbian and bisexual women, 81.4% were lesbian, 18.4% were bisexual women, and the majority were 21-30 years. As for ACEs, 51.5% reported at least one ACE, in which emotional neglect (22.6%) and emotional abuse (22.3%) were common ACEs. As for depressive symptoms of lesbian and bisexual women, the detection rate was 56.1%. The multiple linear regression analyses showed that abuse (β = 2.95, 95%CI:1.07-4.83) and neglect (β = 3.21, 95%CI:1.09-5.31) were positively associated with depressive symptoms and lesbian and bisexual women with three (β = 4.11, 95%CI: 0.99-7.22) or more (β = 6.02, 95%CI: 3.23-8.78) ACEs suffered from more depressive symptoms than others. CONCLUSION Adverse childhood experiences (ACEs) and depressive symptoms were at high prevalence among lesbian and bisexual women in China. ACEs were associated with depressive symptoms, especially childhood abuse and neglect experiences that have a significant effect on lesbian and bisexual women mental health.
Collapse
Affiliation(s)
- Biao Zhu
- School of Public Health, Wuhan University, Wuhan, China
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | | | - Changmian Ding
- Department of Medical Record, The People's Hospital of Dehong, Dehong, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, China.
| | - Liyin Wang
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Jiawei Tian
- School of Public Health, Wuhan University, Wuhan, China
| | - Liqing Wei
- School of Public Health, Wuhan University, Wuhan, China
| |
Collapse
|
5
|
Kim R, Choo S, Lee H, Eom YJ, Yi H, Kim R, Kim SS. Does discrimination prevent transgender and gender diverse people from seeking healthcare?: A nationwide cohort study in South Korea. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:283-294. [PMID: 38681498 PMCID: PMC11044721 DOI: 10.1080/26895269.2023.2215750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Introduction Using Asia's first nationwide cohort dataset, this study aimed to assess the prevalence of anti-transgender discrimination and healthcare avoidance and delay (HAD) and examine their associations among transgender and gender diverse (TGD) adults in South Korea. Methods We analyzed a two-wave (2020-2021) longitudinal dataset of 190 Korean TGD adults. Anti-transgender discrimination were classified accordingly: experienced at (1) neither wave, (2) baseline (2020) only, (3) follow-up (2021) only, and (4) both waves. We also asked about HAD in the past 12 months at follow-up for both transition-related and non-transition-related healthcare services. Multivariate modified Poisson regression was used to examine the associations between anti-transgender discrimination and HAD. Results Of 190 participants, 102 (53.7%) experienced anti-transgender discrimination at both waves, and 130 (68.4%) reported HAD at follow-up. Compared to those without any experiences of anti-transgender discrimination, those who experienced it in both waves had a 1.78-times (95% CI: 1.21-2.63) higher prevalence of non-transition-related HAD, but not among those who experienced it in either wave. In contrast, anti-transgender discrimination was not associated with transition-related HAD. Conclusion In order to enhance healthcare access for transgender and gender diverse (TGD) individuals, it is necessary to implement interventions, such as anti-discrimination laws, that protect them from discrimination.
Collapse
Affiliation(s)
- Ranyeong Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Sungsub Choo
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Hyemin Lee
- Healthcare Policy Team, Jeju Institute of Public Health & Health Policy, Jeju, Republic of Korea
| | - Yun-Jung Eom
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, Republic of Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts, USA
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Toh GW, Koh WL, Ho J, Chia J, Maulod A, Tirtajana I, Yang P, Lee M. Experiences of conflict, non-acceptance and discrimination are associated with poor mental well-being amongst LGBTQ-identified individuals in Singapore. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2023. [DOI: 10.1108/edi-10-2021-0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PurposeHealth disparities affecting lesbian, gay, bisexual, transgender and queer (LGBTQ) populations have been reported in many countries. For Singapore, no large quantitative studies on mental health and well-being in the local LGBTQ community have been published. The authors conducted a community-based survey (National LGBT Census Singapore, 2013; NLCS2013) that covered a comprehensive set of demographic, social and health indicators. Here, the authors investigated mental health status and its correlates in 2,350 LGBTQ individuals within the NLCS2013 sample.Design/methodology/approachThe NLCS2013 was an anonymous online survey conducted amongst self-identified LGBTQ adults (aged ≥ 21 years) residing in Singapore. The survey included the World Health Organisation Well-being Index (WHO-5) as a measure of mental well-being, with low WHO 5 scores (<13/25) indicating poor mental well-being. The authors analysed relationships between low WHO-5 score and a range of respondent characteristics using multivariate logistic regression.FindingsStrikingly, 40.9% of 2,350 respondents analysed had low WHO-5 scores, indicating poor mental well-being. Parental non-acceptance, experience of conflict at home and bullying/discrimination in the workplace or educational environments were all significantly associated with poor mental well-being. Conversely, community participation appeared protective for mental well-being, as respondents who participated in LGBTQ community organisations or events were less likely to have poor mental well-being than non-participants.Originality/valueThe NLCS2013 represents one of the first broad-based efforts to comprehensively and quantitatively capture the sociodemographic and health profile, including mental health status, within Singapore’s resident LGBTQ population. These findings affirm the need to address the mental health needs of LGBTQ individuals in Singapore and to foster safe spaces and allyship.
Collapse
|
7
|
Lee H, Operario D, Agénor M, Yi H, Choo S, Kim SS. Internalized homophobia and HIV testing among Korean gay and bisexual men: a study in a high-income country with pervasive HIV/AIDS stigma. AIDS Care 2022; 35:672-677. [PMID: 35642248 DOI: 10.1080/09540121.2022.2083056] [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: 10/18/2022]
Abstract
Limited research has been conducted on factors contributing to HIV testing among sexual minority populations in South Korea (hereafter, Korea), where stigma against homosexuality and HIV/AIDS is pervasive. We used a nationwide cross-sectional survey of 907 Korean cisgender gay and bisexual (GB) men who were HIV-negative or HIV-unknown in 2016. Regarding internalized homophobia (IHP), participants were categorized into tertiles (low, moderate, and high). Past 12-month HIV testing was assessed via a single yes/no question. Using a modified Poisson regression model, we examined the association between IHP and HIV testing among cisgender GB men in Korea. The overall prevalence of obtaining an HIV test was 41.8% among Korean cisgender GB men. We also found a statistically significant association between IHP and past 12-month HIV testing in this population. Specifically, participants with low IHP had a higher prevalence of HIV testing (adjusted PR = 1.37, 95% CI = 1.14-1.65) compared to those with high IHP. Given these findings, more efforts are needed in Korea to enhance GB men's access to HIV testing, such as improving social circumstances to lower IHP of GB men and creating an environment that enables and facilitates GB men to receive HIV testing without stigma against their sexual identity.
Collapse
Affiliation(s)
- Hyemin Lee
- Jeju Institute of Public Health & Health Policy, Jeju, South Korea
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Madina Agénor
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, South Korea
| | - Sungsub Choo
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.,Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
8
|
Park J, Lee H, Choi B, Kim JH, Yoon J, Yi H, Choo S, Kim SS. Adolescent Bullying Victimization at Secondary School and Adult Suicidality and Depressive Symptoms Among 2152 Lesbian, Gay, and Bisexual Adults in South Korea. Asia Pac J Public Health 2022; 34:338-345. [DOI: 10.1177/10105395211073283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the association between adolescent bullying victimization (ABV) and adult mental health among lesbian, gay, and bisexual (LGB) individuals in South Korea (hereafter Korea). We conducted a cross-sectional survey of 2152 Korean LGB adults in 2016. Based on experiences of and reasons for ABV, participants were categorized into 4 groups: “never bullied,” “bullied due to sexual orientation and gender expression (SOGE),” “bullied due to other reasons,” and “bullied, reason unspecified.” Compared with participants who have never been bullied during adolescence, those who have been “bullied due to SOGE” were 1.56 times (95% confidence interval [CI] = 1.36-1.80), 1.53 times (95% CI = 1.30-1.81), and 3.59 times (95% CI = 2.05-6.28) more likely to report depressive symptoms, suicidal ideation, and suicide attempts, respectively. Statistically significant associations with all 3 mental health indicators were also observed among those who have been “bullied due to other reasons”: depressive symptoms (adjusted prevalence ratio [aPR] = 1.72, 95% CI = 1.55-1.92), suicidal ideation (aPR = 1.48, 95% CI = 1.29-1.70), and suicide attempts (aPR = 3.15, 95% CI = 1.84-5.38). This study suggests that ABV may increase depressive symptoms and suicidality in adulthood among LGB individuals.
Collapse
Affiliation(s)
- Jooyoung Park
- Healthcare Policy Team, Jeju Institute of Public Health & Health Policy, Jeju, South Korea
| | - Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Bokyoung Choi
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ji-Hwan Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Jaehong Yoon
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Horim Yi
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
9
|
Kim E, Kim H, Lee K. A qualitative investigation of the romantic relationship experiences. of South Korean lesbians in early adulthood. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1990116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eunha Kim
- Department of Psychology, Ajou University, Suwon, South Korea
| | - Haebeen Kim
- Department of Psychology, Ajou University, Suwon, South Korea
| | - Kahee Lee
- Ginue Student Counseling Center, Gyeongin National University of Education, Incheon, South Korea
| |
Collapse
|
10
|
Adzrago D, Osaghae I, Ananaba N, Ayieko S, Fwelo P, Anikpezie N, Cherry D. Examining differences in suicidality between and within mental health disorders and sexual identity among adults in the United States. AIMS Public Health 2021; 8:636-654. [PMID: 34786425 PMCID: PMC8568595 DOI: 10.3934/publichealth.2021051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Suicide is a leading but preventable cause of death and is preceded by domains of thoughts, plans, and attempts. We assessed the prevalence of suicidality domains and determined the association of suicidality domains with sexual identity, mental health disorder symptoms, and sociodemographic characteristics. METHODS We used the 2019 National Survey on Drug Use and Health (NSDUH) data to perform weighted multivariable logistic regression and margins analyses to examine between and within-group differences in suicidality by sexual identity among adults aged ≥ 18 years. RESULTS About 4.89%, 1.37%, and 0.56% of the population experienced suicidal thoughts, plans, and attempts, respectively. Those aged 18-25 years old had a higher odds of suicidality compared to those aged 26 years or older. Compared to those who reported having no alcohol use dependence, illicit drug use dependence, and major depressive episodes (MDEs), those who reported alcohol use dependence, illicit drug use dependence, and MDE had higher odds of suicidal thoughts, plans, and attempts. Between all sexual identity groups, bisexuals who experienced MDEs had the highest probability of having suicidal thoughts while lesbians and gays who experienced MDE showed a higher probability of suicidal plans and attempts compared to heterosexuals. Within each sexual identity group, the probability of having suicidal thoughts, suicidal plans, and suicidal attempts was higher for those who had experienced MDEs compared to those who had not experienced MDEs. CONCLUSION Substance use disorder and MDE symptoms were associated with increased suicidality, especially among young adults and sexual minority people. This disparity underscores the need for tailored interventions and policies to enhance the provision of prompt mental health screening, diagnosis, and linkage to care for mental health services, particularly among the most vulnerable in the population.
Collapse
Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ikponmwosa Osaghae
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School, Houston, Texas, USA
| | - Nnenna Ananaba
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sylvia Ayieko
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Pierre Fwelo
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School, Houston, Texas, USA
| | - Nnabuchi Anikpezie
- Department of Population Health Science, The University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Donna Cherry
- Department of Social Work, East Tennessee State University, Johnson City, Tennessee, USA
| |
Collapse
|
11
|
Lee H, Streed CG, Yi H, Choo S, Kim SS. Sexual Orientation Change Efforts, Depressive Symptoms, and Suicidality Among Lesbian, Gay, and Bisexual Adults: A Cross-Sectional Study in South Korea. LGBT Health 2021; 8:427-432. [PMID: 34061676 DOI: 10.1089/lgbt.2020.0501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: We examined the association of sexual orientation change efforts (SOCE) with past-week depressive symptoms and past 12-month suicidal ideation and suicide attempts among Korean lesbian, gay, and bisexual adults. Methods: A cross-sectional study of 2168 participants was used. Lifetime SOCE was classified as "never experienced," "been advised but not undergone SOCE," and "undergone SOCE." Results: Participants who had undergone SOCE showed 1.44- and 2.35-times higher prevalence of suicidal ideation and suicide attempts than those without such practices. Significant associations were also observed between having advice on SOCE alone and all mental health indicators. Conclusion: Strict legal sanctions that prohibit SOCE are required in Korea.
Collapse
Affiliation(s)
- Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Carl G Streed
- Center for Transgender Medicine and Surgery, Boston Medical Center, Boston, Massachusetts, USA.,Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Horim Yi
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.,Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.,Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
12
|
Kim S, Choi-Kwon S. Physical and Mental Health Related Quality of Life and Their Influencing Factors on Sexual Minority Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2115. [PMID: 33671565 PMCID: PMC7926774 DOI: 10.3390/ijerph18042115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/14/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022]
Abstract
Korean sexual minority women (SMW) often experience discrimination, but their health-related quality of life (HRQoL) remains to be investigated. Therefore, we aimed to assess the levels of mental and physical HRQoL of Korean SMW and their influencing factors using data from the Korean Sexual Minority Women's Health Study (2017) in a cross-sectional study, which included lesbian and bisexual females (N = 736; age ≥19 years). The HRQoL was measured using SF-36v2®; moreover, separate multiple linear regression analyses were conducted to identify the factors influencing mental and physical HRQoL. The physical and mental HRQoL scores were average (52.38 ± 7.65) and low (38.33 ± 12.64), respectively. Significant factors influencing the physical HRQoL were bisexuality, minority stress, perceived social support, and physical activity. The same factors-apart from physical activity-were associated with mental HRQoL. Therefore, to improve the HRQoL of SMW, it is necessary to lower their minority stress and increase social support. Moreover, special attention is needed regarding bisexual women in Korea.
Collapse
Affiliation(s)
- Ssirai Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- Department of Healthcare Administration, Seoul National University Hospital, Seoul 03080, Korea
| | - Smi Choi-Kwon
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea
| |
Collapse
|
13
|
Rentería R, Benjet C, Gutiérrez-García RA, Abrego-Ramírez A, Albor Y, Borges G, Covarrubias Díaz-Couder MA, Durán MDS, González-González R, Guzmán Saldaña R, E Hermosillo De la Torre A, Martínez-Jerez AM, Martinez Martinez KI, Medina-Mora ME, Martínez Ruiz S, Paz Pérez MA, Pérez Tarango G, Zavala Berbena MA, Méndez E, Auerbach RP, Mortier P. Prevalence of 12-month mental and substance use disorders in sexual minority college students in Mexico. Soc Psychiatry Psychiatr Epidemiol 2021; 56:247-257. [PMID: 32886133 DOI: 10.1007/s00127-020-01943-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.
Collapse
Affiliation(s)
- Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - Corina Benjet
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico.
| | - Raúl A Gutiérrez-García
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Adrián Abrego-Ramírez
- Dirección de Investigación, Universidad Politécnica de Aguascalientes, Aguascalientes, Aguascalientes, Mexico.,Dirección de Educación a Distancia, Universidad Cuauhtémoc, Plantel Aguascalientes, Aguascalientes, Mexico
| | - Yesica Albor
- Departamento de Salud Púbica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Del Socorro Durán
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | - Rogaciano González-González
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Rebeca Guzmán Saldaña
- Instituto de Ciencias de la Salud y Coordinación de Investigación, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico
| | | | - Ana María Martínez-Jerez
- Unidad Académica de Ciencias Jurídicas y Sociales, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Tamaulipas, Mexico
| | - Kalina I Martinez Martinez
- Departamento de Psicología, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, Mexico
| | - María Elena Medina-Mora
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Abigail Paz Pérez
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Gustavo Pérez Tarango
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | | | - Enrique Méndez
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| |
Collapse
|
14
|
Lee H, Park J, Choi B, Yi H, Kim SS. Association between Discrimination and Depressive Symptoms Among 2,162 Lesbian, Gay, and Bisexual Adults in South Korea: Does Community Connectedness Modify the Association? JOURNAL OF HOMOSEXUALITY 2021; 68:70-87. [PMID: 31194923 DOI: 10.1080/00918369.2019.1624456] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study investigated the association between perceived discrimination and depressive symptoms among Korean lesbian, gay, and bisexual (LGB) individuals and explored the role of community connectedness in that association. We analyzed a nationwide cross-sectional survey of 2,162 LGB adults in Korea. Discrimination based on its types, including sexual orientation, over the past 12 months was classified into four categories: (1) 'never experienced discrimination,' experienced (2) 'only sexual orientation discrimination,' (3) 'any of the other types of discrimination,' and (4) 'both sexual orientation discrimination and any of the other types of discrimination.' Our findings suggest that there was a statistically significant association between 'only sexual orientation discrimination' and depressive symptoms among LGB individuals with a low-level of community connectedness, but not among those with a high-level. In the other two categories of discrimination, which included the other types of discrimination, the associations were statistically significant, regardless of the level of community connectedness.
Collapse
Affiliation(s)
- Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University , Seoul, South Korea
| | - Jooyoung Park
- Healthcare Policy Team, Jeju Institute of Public Health & Health Policy , Jeju, South Korea
| | - Bokyoung Choi
- Department of Public Health Sciences, Graduate School of Korea University , Seoul, South Korea
| | - Horim Yi
- Department of Public Health Sciences, Graduate School of Korea University , Seoul, South Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University , Seoul, South Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, Massachusetts, USA
| |
Collapse
|
15
|
Kim S, Lee SY, Choi-Kwon S. Cervical Cancer Screening and Human Papillomavirus Vaccination among Korean Sexual Minority Women by Sex of Their Sexual Partners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8924. [PMID: 33266281 PMCID: PMC7731128 DOI: 10.3390/ijerph17238924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/17/2020] [Accepted: 11/27/2020] [Indexed: 01/10/2023]
Abstract
Cervical cancer-preventive behaviors in Korean sexual minority women (SMW) are underexplored. We aimed to assess the differences in cervical cancer screening uptake and completion of human papillomavirus (HPV) vaccination among Korean SMW by sex of their sexual partners. This cross-sectional study used data from the 2017 Korean Sexual Minority Women's Health Study; we included Korean lesbian and bisexual women aged ≥20 years. They were divided into three groups: SMW with more than one male sexual partner (male only/both), SMW with only female sexual partners (female-only), or no sexual partner (no partner). Among the 671 participants, 266 (39.6%), 294 (43.8%), and 111 (16.5%) belonged to the male-only/both, female-only, and no partner groups, respectively. Compared to the male-only/both group, the female-only group was significantly less likely to have undergone cervical cancer screening (Adjusted odds ratio (AOR) = 0.24, 95% confidence interval (CI) = 0.15-0.37) and to have completed HPV vaccinations (AOR = 0.58, 95% CI = 0.37-0.91). In conclusion, Korean SMW with only female sexual partners had lower cervical cancer screening and HPV vaccination completion rates than SMW who had male sexual partners. More extensive efforts are needed to improve cervical cancer-preventive behaviors among Korean SMW.
Collapse
Affiliation(s)
- Ssirai Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- Department of Healthcare Administration, Seoul National University Hospital, Seoul 03080, Korea
| | - Sun-Young Lee
- Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Korea;
| | - Smi Choi-Kwon
- College of Nursing, Seoul National University, Seoul 03080, Korea;
- The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea
| |
Collapse
|
16
|
Depression and suicidal behavior in LGB and heterosexual populations in Serbia and their differences: Cross-sectional study. PLoS One 2020; 15:e0234188. [PMID: 32511283 PMCID: PMC7279590 DOI: 10.1371/journal.pone.0234188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 05/17/2020] [Indexed: 11/27/2022] Open
Abstract
Background Sexual identity is a significant risk factor for triggering symptoms of depression, as well as for suicide attempts in lesbian, gay and bisexual (LGB) population compared to the heterosexual population. To the best of our knowledge, data on the mental health of LGB persons in Serbia are lacking, and this is the first study to address this problem. The aim of the study was to examine the association between selected determinants and depression, and selected determinants and suicide attempts in LGB and heterosexual populations in the Republic of Serbia, as well as, their differences. Methods We conducted a cross-sectional study in 2015 of 264 heterosexual and LGB respondents using the "snowball sampling" method. We used linear regression analyses to investigate the relationship between socio-demographic variables and different sexual identity categories with PHQ-9 scores. We assessed associations between suicide attempts, and socio-demographic characteristics, sexual identity, depression, and suicidal thoughts using logistic regression. Results Depression symptoms were higher in female relative to male participants, in participants who were single, divorced or widowed in comparison to currently married, among people with a middle level of education compared to highly educated, and in respondents identified as bisexual or homosexual in comparison to heterosexual. Homosexual and bisexual participants reported suicidal attempts 27 [Odds Ratio (OR) = 27.31] and six times (OR = 6.40) more often than did heterosexual respondents, respectively. Suicide attempts were less frequently reported by single, divorced or widowed participants in comparison to married (OR = 0.25) and those with middle education (OR = 0.38) compared to highly educated. Conclusions The present study showed that LGB persons in Serbia have significantly more symptoms of depression and suicide attempts compared to heterosexuals. Public health interventions should focus on the early detection of depression and on overcoming prejudicial and discriminatory attitudes. Also, intervention should emphasize that homosexuality and bisexuality are normal, equal and morally acceptable expressions of human sexuality.
Collapse
|
17
|
Lee H, Operario D, van den Berg JJ, Yi H, Choo S, Kim SS. Health Disparities Among Transgender Adults in South Korea. Asia Pac J Public Health 2020; 32:103-110. [DOI: 10.1177/1010539520912594] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to identify health disparities among transgender adults in South Korea (hereafter Korea), where they widely experience social stigma. We assessed prevalence of nine health indicators using a nationwide cross-sectional survey of 255 Korean transgender adults in 2017. Standardized prevalence ratios of these indicators were estimated using four nationally representative surveys in Korea that included the same health measures. Overall, transgender adults had a significantly higher risk of adverse health outcomes than the general population in Korea. Specifically, disparities in mental health outcomes between transgender adults and the general population were statistically significant. The prevalence of depressive symptoms was 6.44 and 9.71 times higher among transgender adults than women and men in the general population, respectively. For suicidal ideation, transgender adults reported 6.49 and 18.83 times greater risk than women and men in the general population, respectively. Our findings indicate that Korean transgender adults are at a higher risk of negative health outcomes than the general population.
Collapse
Affiliation(s)
- Hyemin Lee
- Korea University, Seoul, Republic of Korea
- Brown University, Providence, RI, USA
| | | | | | - Horim Yi
- Korea University, Seoul, Republic of Korea
| | | | - Seung-Sup Kim
- Korea University, Seoul, Republic of Korea
- Harvard University, Boston, MA, USA
| |
Collapse
|
18
|
Hughes TL, Veldhuis CB, Drabble LA, Wilsnack SC. Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review. PLoS One 2020; 15:e0229869. [PMID: 32187200 PMCID: PMC7080264 DOI: 10.1371/journal.pone.0229869] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/15/2020] [Indexed: 12/31/2022] Open
Abstract
Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.
Collapse
Affiliation(s)
- Tonda L. Hughes
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Cindy B. Veldhuis
- School of Nursing, Columbia University, New York, New York, United States of America
| | - Laurie A. Drabble
- San Jose State University, San Jose, California, United States of America
| | - Sharon C. Wilsnack
- University of North Dakota, Grand Forks, North Dakota, United States of America
| |
Collapse
|
19
|
Lee H, Tomita KK, Habarth JM, Operario D, Yi H, Choo S, Kim SS. Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:182-193. [PMID: 33015668 PMCID: PMC7430457 DOI: 10.1080/26895269.2020.1745113] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Introduction: Transgender people are stigmatized in South Korea (hereafter Korea), where cultural expectations of a biologically-based, binary sex and gender system present fundamental challenges to those whose gender identity does not align with their birth-assigned sex. A growing international body of literature implicates gender minority stress as a key contributor to transgender mental health disparities, but little research has been conducted on this topic in Korea. As in other cultural settings, depression and suicidality are urgent public health concerns for transgender people in Korea, primarily for those who have not initiated gender affirming medical treatment (GAMT), such as cross-sex hormone therapy. In the current study, an international and interdisciplinary team of authors apply the lens of gender minority stress to elucidate the relationships between a key facet of gender minority stress, internalized transphobia (ITP), and outcomes of depressive symptoms and suicidality. Methods: Based on a cross-sectional survey of 207 Korean transgender adults, the current study evaluates the relationships between ITP and depressive symptoms, suicidal ideation, and suicide attempts. ITP was measured with an eight-item, Korean-language questionnaire adapted from the Gender Minority Stress and Resilience Measure through a translation and back-translation process. Results: Korean trans women and trans men mean (mean age = 26.4) were included in the analysis, most of whom had at least one experience of any GAMT. The findings of this study show that Korean transgender adults face similar public health concerns such as high prevalence of depressive symptoms, suicidal ideation, and suicide attempts. As predicted, ITP was significantly related to depressive symptoms, suicidal ideation, and suicide attempts. Conclusion: The authors suggest potential clinical, policy, and research applications, including institutional interventions, to address structural and cultural barriers to optimal mental health and GAMT as well as mental health interventions to reduce Korean transgender people's internalized negative beliefs about their gender identity.
Collapse
Affiliation(s)
- Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Kevin K. Tomita
- Counseling and Student Development Center, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | | | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Horim Yi
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- CONTACT Seung-Sup Kim Department of Public Health Sciences, Graduate School of Korea University, Anam-ro 145, Seongbuk-gu, Seoul 02841, Republic of Korea.
| |
Collapse
|
20
|
Lee H, Operario D, Yi H, Choo S, Kim SS. Internalized Homophobia, Depressive Symptoms, and Suicidal Ideation Among Lesbian, Gay, and Bisexual Adults in South Korea: An Age-Stratified Analysis. LGBT Health 2019; 6:393-399. [DOI: 10.1089/lgbt.2019.0108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Horim Yi
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
21
|
Kim JH, Lee N, Kim JY, Kim SJ, Okechukwu C, Kim SS. Organizational response to workplace violence, and its association with depressive symptoms: A nationwide survey of 1966 Korean EMS providers. J Occup Health 2019; 61:101-109. [PMID: 30698342 PMCID: PMC6499351 DOI: 10.1002/1348-9585.12025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/31/2018] [Accepted: 10/04/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study investigated whether organizational responses modified the associations between experiencing violence and depressive symptoms among emergency workers. METHODS A nationwide survey of 1966 Korean emergency medical service (EMS) providers was analyzed. Experience of workplace violence (ie, physical violence, verbal abuse) was classified into four groups based on the victims' reporting and organizational responses: (i) "Not experienced," (ii) "Experienced, not reported," (iii) "Experienced, reported, responded by organization,"and (iv) "Experienced, reported, not responded by organization." Depressive symptoms were assessed by 11-item version of the Centers for Epidemiologic Studies Depression Scale. RESULTS Compared to "Not experienced" group, physical violence was significantly associated with depressive symptoms among EMS providers responding "Experienced, not reported" (PR: 1.67, 95% CI: 1.37, 2.03) and "Experienced, reported, not responded by organization" (PR: 2.58, 95% CI: 1.75, 3.82), after adjusting for confounders. No significant difference was detected for workers responding "Experienced, reported, responded by organization" group (PR: 1.45, 95% CI: 0.87, 2.41). Similar trends were observed in the analysis with verbal abuse. CONCLUSIONS Our findings suggest that organizational responses could play a critical role in mitigating depressive symptoms among EMS providers who experience violence at work.
Collapse
Affiliation(s)
- Ji-Hwan Kim
- Department of Public Health Sciences, Korea University, Seoul, Republic of Korea
| | - Nagyeong Lee
- Health Care Policy Research Department, Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Ja Young Kim
- Gyeonggi Public Health Policy Institute, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Soo Jin Kim
- Fire Science Research Center, Seoul Metropolitan Fire Service Academy, Seoul, Republic of Korea.,Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Cassandra Okechukwu
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Seung-Sup Kim
- Department of Public Health Sciences, Korea University, Seoul, Republic of Korea.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
22
|
Lee N, Kim JH, Kim JY, Kim SS. Association between workplace discrimination and depressive symptoms among firefighters in South Korea. Am J Ind Med 2018; 61:741-750. [PMID: 29998517 DOI: 10.1002/ajim.22876] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Workplace discrimination is associated with poor mental health. However, there is a lack of studies examining the effects of discrimination on depressive symptoms among firefighters. METHODS We analyzed a national cross-sectional survey of 6369 firefighters in South Korea. Workplace discrimination during the past year was measured and main reasons for the discriminatory experience (gender, birth region, age, education, field/office work, job division) were identified separately by gender and job division. Depressive symptoms during the previous week were measured by the CES-D11. RESULTS Overall, 30.3% of firefighters experienced workplace discrimination and the main reasons for discrimination differed by gender and job division. Firefighters who experienced workplace discrimination had a higher likelihood of depressive symptoms than those who did not after adjusting for potential confounders (PR: 1.73; 95%CI: 1.55, 1.92). CONCLUSIONS This finding suggests that experience of workplace discrimination could aggravate the mental health of firefighters who provide an important public service.
Collapse
Affiliation(s)
- Nagyeong Lee
- Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Ji-Hwan Kim
- Department of Public Health Sciences, Korea University, Seoul, Republic of Korea
| | - Ja Young Kim
- Gyeonggi public health policy institute, Seongnam, Gyeonggi, Republic of Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Korea University, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|