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Yan E, Lo IPY, Sun R, Chan ASW, Ng HKL, Wu A. Intimate Partner Violence Among Lesbian, Gay, and Bisexual Adults: A Cross-Sectional Survey in Hong Kong. LGBT Health 2024. [PMID: 38563664 DOI: 10.1089/lgbt.2023.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Purpose: This study investigated the prevalence rates of various types of intimate partner violence (IPV) among lesbian, gay, and bisexual (LGB) adults in Hong Kong and examined the associations between IPV and different addictive behavior and mental health problems. Methods: A total of 759 LGB adults completed an online cross-sectional survey between November 2021 and February 2022. Data on past-year IPV and LGB-specific tactics (whether perpetrated or experienced by participants), addictive behavior, anxiety, depression, and demographics were collected and analyzed with descriptive statistics and logistic regressions. Results: Psychological aggression was the most common type of IPV within an LGB relationship (22.1%), followed by physical assault (10.8%) and IPV-related injury (4.1%). LGB-specific tactics were experienced by 39.0% of the LGB adults. Depression, anxiety, and frequent gambling were significantly associated with specific types of IPV and LGB-specific tactics. Conclusion: IPV was prevalent in the LGB population. Findings on correlates provided insights for future development of IPV detection and intervention.
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Affiliation(s)
- Elsie Yan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Iris Po Yee Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Rongwei Sun
- School of Arts and Humanities, Tung Wah College, Hong Kong, Hong Kong
| | - Alex Siu Wing Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Haze Ka Lai Ng
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Anise Wu
- Department of Psychology, University of Macao, Macao, Macao
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Morand E, Blais M, Côté I, Chamberland L, Baiocco M, Samoilenko M. Disclosing One's Non-Heterosexual Sexual Orientation at Work in 2020: A Survey of Quebec LGBQ Workers. J Homosex 2024; 71:1030-1056. [PMID: 36625561 DOI: 10.1080/00918369.2022.2160941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Concealing one's non-heterosexual orientation (NHO) remains a protection strategy against workplace discrimination used by many lesbian, gay, bisexual, and queer (LGBQ+) individuals. This article explores four sets of correlates (identity and individual trajectory, social support, professional position, and structural and cultural work context) relative to three levels of outness (total, partial, and null). Online cross-sectional data of 2,106 LGBQ+ participants from Quebec (Canada) showed that 27% reported total outness, while 64% reported partial outness, and 9%, null outness. Multinomial hierarchical regression analyses revealed that each set of correlates significantly contributed to levels of workplace NHO outness. The two sets of variables making the largest contributions to levels of outness were those pertaining to identity and individual trajectory (14% of the variance) and structural and cultural work context (9%). Compared to partial outness, null outness was associated with an unaccepting work climate, while total outness was more likely in contexts with organizational support (e.g., with the presence of an inclusivity policy). Without trivializing the influence of non-workplace factors on outness levels, the present findings support the need to develop an inclusive and accepting work climate for LGBQ+ individuals.
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Affiliation(s)
- Emilie Morand
- Chaire de recherche sur la diversité sexuelle et la pluralité des genres, Université du Québec à Montréal, Montréal, Québec, Canada
- CERLIS, Centre d'étude sur les liens sociaux, Université de Paris, Paris, France
| | - Martin Blais
- Chaire de recherche sur la diversité sexuelle et la pluralité des genres, Université du Québec à Montréal, Montréal, Québec, Canada
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Isabel Côté
- Département du travail social, université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Line Chamberland
- Chaire de recherche sur la diversité sexuelle et la pluralité des genres, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Michele Baiocco
- Chaire de recherche sur la diversité sexuelle et la pluralité des genres, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mariia Samoilenko
- Chaire de recherche sur la diversité sexuelle et la pluralité des genres, Université du Québec à Montréal, Montréal, Québec, Canada
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Sierra JC, Muñoz-García LE, Mangas P. And how do LGB adults rate their orgasms in a relational context? J Sex Med 2024; 21:255-261. [PMID: 38269427 DOI: 10.1093/jsxmed/qdad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/13/2023] [Accepted: 11/29/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Subjective orgasm experience (SOE) refers to the perception, assessment, and/or sensation of orgasm on a psychological level, with the particularity that the study of SOE in nonheterosexual populations is currently very scarce. AIM The study sought to analyze differences in SOE dimensions, comparing the intensity of each adjective of the Orgasm Rating Scale (ORS) and creating a ranking of the adjectives that better represent it in LGB men and women. METHODS In a sample of 1475 adults organized into 4 groups according to the type of sexual relationships reported, comparisons were made using multivariate analysis of variance and chi-square tests. OUTCOMES Differences were obtained in the intensity of all the SOE dimensions, and in 23 of the 25 ORS adjectives. RESULTS Lesbians and bisexual women reported higher intensity in SOE compared with bisexual and gay men. CLINICAL IMPLICATIONS Because the ORS has been established as a good tool for detecting orgasmic difficulties in nonheterosexual populations, this study could provide LGBT affirmative psychotherapy with evidence on how these individuals evaluate their orgasms in a relational context. STRENGTHS AND LIMITATIONS This study extends prior limited knowledge about how LGB people evaluate their orgasmic experiences in the context of sexual relationships. Despite this, the study poses limitations such as nonprobability sampling or the inclusion of exclusively cisgender and young individuals, making it difficult to generalize the results. CONCLUSION Although significant differences were found between LGB men and women, all groups agree on the adjectives they use to describe the subjective experience of orgasm in the context of sexual relationships; therefore, evidence is provided about how LGB people evaluate their orgasmic experiences in this context.
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Affiliation(s)
- Juan Carlos Sierra
- Mind, Brain, and Behavior Research Center, University of Granada, Granada, Spain
| | | | - Pablo Mangas
- Mind, Brain, and Behavior Research Center, University of Granada, Granada, Spain
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Angelo NL, Brullo G, Marsiglia A, Tirelli A, Piroddi E, Viti C, Aicardi I, Pozza A. Romantic relationship obsessive-compulsive doubts, perfectionism, and DSM-5 personality traits in LGB people: a comparison with heterosexual individuals. Front Psychol 2024; 15:1187179. [PMID: 38449756 PMCID: PMC10916694 DOI: 10.3389/fpsyg.2024.1187179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/02/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Relationship Obsessive-Compulsive Disorder is characterized by the presence of relationship-centered or partner-focused obsessions and compulsions that determine a great sense of doubt toward the partner or the relationship. Personality characteristics, including perfectionism, are involved in the development of Relationship Obsessive-Compulsive Disorder, and could predispose the individual to excessive doubts and preoccupations regarding the "adequacy of the couple" or the physical appearance of one's partner. Evidence from epidemiological research shows that the LGB community can present a high risk and prevalence of obsessive-compulsive symptoms and recent research demonstrated the usefulness of the DSM-5 personality model in understanding the personality of sexual minorities. However, further research is necessary to deepen our knowledge of the relationship between these variables in the LGB community. The aim of the present study was to compare a group of heterosexual individuals to a group of LGB individuals regarding personality traits, perfectionism, and relationship obsessive-compulsive symptoms. Methods A total of 200 participants, 98 in the heterosexual group and 102 in the LGB group, were enrolled in the study and completed a psychological battery comprised of the Obsessive-Compulsive Inventory-Revised, Personality Inventory for DSM-5, Relationship Obsessive-Compulsive Inventory, Partner-Related Obsessive-Compulsive Symptom Inventory, and Multidimensional Perfectionism Scale. Results The results show that LGB individuals tend to report greater feelings of doubt regarding the partner's love, more negative emotions (Negative Affect) and Antagonism, and greater perfectionism traits compared to heterosexual individuals. Conclusion These findings underline the necessity to consider the implementation of personalized interventions in clinical practice and the importance of initiating early preventive programs in sexual minority communities.
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Affiliation(s)
- Nicole Loren Angelo
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Greta Brullo
- Miller Institute of Cognitive Behavioral Therapy, Genoa, Italy
| | | | | | - Elisa Piroddi
- Miller Institute of Cognitive Behavioral Therapy, Genoa, Italy
| | - Chiara Viti
- Miller Institute of Cognitive Behavioral Therapy, Genoa, Italy
| | | | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
- Psychology Unit, Azienda Ospedaliera Universitaria Senese AOUS, Siena, Italy
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Martins P, Potard C, Gohier B, Lignier B. Definitions and Measurement Tools for Assessing Parental Reactions to LGB People Coming Out: A Critical Review. J Homosex 2024:1-22. [PMID: 38377338 DOI: 10.1080/00918369.2024.2320241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Parental responses to young people's coming out as lesbian, gay or bisexual (LGB) are a crucial experience in identity formation and subsequent mental health outcomes. However, how parents react to coming out varies and remains relatively imprecise in the literature. The aim of the present critical review was to explore and discuss the different definitions and measurement tools used in studies assessing perceived parental reactions to the coming out of LGB people aged 18 years and over. Following PRISMA guidelines, a review of 14 selected articles was carried out to examine the different tools used. Then, based on this selection of articles, a review of the different proposed definitions of parental reactions was carried out. Analysis revealed that the Perceived Parental Reactions Scale emerged as the most widely used and most appropriate international scale for capturing the diversity of perceived parental reactions. Then, parental responses were often addressed in a dichotomous manner, focusing primarily on acceptance or rejection. Future studies will need to consider a more nuanced approach to understanding parental reactions to coming out.
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Affiliation(s)
- Paul Martins
- Pays de la Loire Psychology Laboratory (LPPL), Psychology Department, Angers University, Angers, France
| | - Catherine Potard
- Pays de la Loire Psychology Laboratory (LPPL), Psychology Department, Angers University, Angers, France
| | - Bénédicte Gohier
- Pays de la Loire Psychology Laboratory (LPPL), Psychology Department, Angers University, Angers, France
- Department of Psychiatry and Addictology, University Hospital, Angers, France
| | - Baptiste Lignier
- Psy-DREPI Laboratory, Psychology Department, University of Burgundy, Dijon, France
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Kidd G, Marston L, Nazareth I, Osborn D, Pitman A. Suicidal thoughts, suicide attempt and non-suicidal self-harm amongst lesbian, gay and bisexual adults compared with heterosexual adults: analysis of data from two nationally representative English household surveys. Soc Psychiatry Psychiatr Epidemiol 2024; 59:273-283. [PMID: 37291332 PMCID: PMC10838834 DOI: 10.1007/s00127-023-02490-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/30/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE We aimed to compare differences in suicidality and self-harm between specific lesbian, gay and bisexual (LGB) groups, and investigate whether minority stress factors might contribute to any associations, addressing methodological limitations of previous research. METHODS We analysed data combined from two population-based representative household surveys of English adults (N = 10,443) sampled in 2007 and 2014. Using multivariable logistic regression models adjusted for age, gender, educational attainment, area-level deprivation, and common mental disorder, we tested the association between sexuality and three suicide-related outcomes: past-year suicidal thoughts, past-year suicide attempt, and lifetime non-suicidal self-harm (NSSH). We added bullying and discrimination (separately) to final models to explore whether these variables might mediate the associations. We tested for interactions with gender and survey year. RESULTS Lesbian/gay people were more likely to report past-year suicidal thoughts [adjusted odds ratio (AOR) = 2.20; 95% CI 1.08-4.50] than heterosexuals. No minority group had an increased probability of suicide attempt. Bisexual (AOR = 3.02; 95% CI = 1.78-5.11) and lesbian/gay (AOR = 3.19; 95% CI = 1.73-5.88) individuals were more likely to report lifetime NSSH than heterosexuals. There was some evidence to support a contribution of bullying in the association between lesbian/gay identity and past-year suicidal thoughts, and of each minority stress variable in the associations with NSSH. There was no interaction with gender or survey year. CONCLUSION Specific LGB groups are at elevated risk of suicidal thoughts and NSSH, with a possible contribution of lifetime bullying and homophobic discrimination. These disparities show no temporal shift despite apparent increasing societal tolerance towards sexual minorities.
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Affiliation(s)
- Garrett Kidd
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Louise Marston
- UCL Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | - Irwin Nazareth
- UCL Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | - David Osborn
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK
| | - Alexandra Pitman
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK.
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7
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Grady A, Stinchcombe A. The impact of COVID-19 on the mental health of older sexual minority Canadians in the CLSA. BMC Geriatr 2023; 23:816. [PMID: 38062412 PMCID: PMC10704833 DOI: 10.1186/s12877-023-04513-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Limited research has examined the mental health impacts of the COVID-19 pandemic on sexual minority (i.e., lesbian, gay, bisexual; LGB) older adults using a longitudinal approach. This study aimed to compare the mental health trajectories (i.e., reported symptoms of depression and loneliness) of LGB and heterosexual participants across four time points. METHODS Data were drawn from the Canadian Longitudinal Study on Aging (CLSA), an ongoing study on the experiences of adults between 45 to 85 at Baseline. Data included for analysis were collected at Baseline (2011-2015), Follow-up 1 (2015-2018), and two time points during the COVID-19 pandemic (April-December 2020). We used General Estimating Equations (GEE) to model changes in depression symptoms (CESD-10; n = 47,728) and loneliness (UCLA 3-item loneliness scale; n = 41,698), adjusting for covariates (i.e., age, sex, race/ethnicity, education, and income). RESULTS Results indicated that LGB participants reported more symptoms of depression (B = .595, p < .001) and loneliness (B = .313, p < .001) in comparison to heterosexual peers across the four time points. Mean depression and loneliness scores increased regardless of sexual orientation. CONCLUSION This study highlighted the detrimental effects of the pandemic on the mental health of older adults regardless of sexual orientation. It also showed that LGB older adults experienced more loneliness and depression symptoms than heterosexual older adults both before and during the pandemic. Understanding diverse identities, needs, and disparities in mental health is critical to promoting equitable aging experiences for everyone.
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Affiliation(s)
- Alexandra Grady
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Arne Stinchcombe
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.
- Bruyère Research Institute (BRI), Ottawa, ON, Canada.
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Kinitz DJ, Shahidi FV, Ross LE. Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study. SSM Popul Health 2023; 24:101535. [PMID: 38021458 PMCID: PMC10661442 DOI: 10.1016/j.ssmph.2023.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/23/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Employment outcomes among sexual minority (i.e., lesbian, gay, bisexual) workers are poorly understood, and previous research on this topic has focused almost exclusively on inequities in earnings, neglecting other important dimensions of job quality. We address this gap by describing and comparing the job quality of straight and sexual minority workers in Canada. Methods Data are from the 2016 General Social Survey: Canadians at Work and Home, the only national survey providing both a measure of sexual orientation and a multidimensional view of job quality in Canada. We identified 25 unique job quality indicators (e.g., temporary employment; job insecurity; health benefits; low income; job satisfaction; job control; discrimination). Latent class cluster analysis was used to establish a typology of job quality describing standard, flexible, and precarious employment types. We used multivariable regression methods to examine the association between sexual orientation and job quality. Results Sexual minorities reported lower job quality than their straight counterparts along many dimensions, with bisexual people reporting the lowest job quality. While inequities were generally observed among both sexual minority men and women, they sometimes differed in magnitude by gender. The prevalence of precarious employment was nearly three times higher among lesbian, gay, and bisexual workers (PR: 2.94, CI: 1.89-4.58 among all sexual minorities; PR: 3.04, CI: 1.71-5.43 among gay/lesbian workers; and PR: 2.81, CI: 1.45-5.47 among bisexual workers) compared to their straight counterparts. Conclusion Inequities in job quality among sexual minorities persist despite comprehensive human rights protections in Canada. These inequities are pervasive, extending well beyond conventional indicators such as dollars earned and hours worked. Multi-pronged interventions are needed that move beyond simply ensuring that sexual minority workers are employed. Sexual minority workers deserve access to secure, well-paid work with benefits where they can foster connection and be free from discrimination.
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Affiliation(s)
- David J Kinitz
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
| | - Faraz Vahid Shahidi
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, Ontario, M5G 1S5, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
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Hickey PM, Best LA, Speed D. Access to Healthcare and Unmet Needs in the Canadian Lesbian-Gay-Bisexual Population. J Homosex 2023:1-19. [PMID: 38019536 DOI: 10.1080/00918369.2023.2287034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Individuals who identify as a sexual minority, including those who are lesbian, gay, or bisexual (LGB), face barriers to healthcare as well as increased discrimination, stigmatization, and negative experiences during healthcare use. Further, few healthcare providers have education and training focused on the specific healthcare needs of individuals who are part of a sexual minority group. Given the limited research on Canadian healthcare access for sexual minorities, our purpose was to use data (n > 2,800) from the 2015-16 Canadian Community Health Survey (CCHS) to investigate the perceptions of healthcare access for LGB and non-LGB Canadians. Although non-LGB and LGB participants reported comparable access to a regular care provider and were equally likely to have consulted with a general practitioner in the past 12 months, LGB respondents were more likely to have seen a specialist and reported more unmet health needs. Although we expected the linear effects of both race and sex to vary by LGB status, this effect only occurred in one model. Current results have implications for addressing health inequalities for sexual minorities, including poorer health outcomes and greater discrimination.
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Affiliation(s)
- Patrick M Hickey
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - Lisa A Best
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - David Speed
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
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10
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Vogel EA, Romm KF, Berg CJ. Differences by Emotion Regulation in the Association Between Discrimination and Tobacco Use Among Sexual Minority Young Adults. J Homosex 2023:1-15. [PMID: 37988127 DOI: 10.1080/00918369.2023.2283864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Little research has examined factors, such as emotion regulation strategies, that amplify or mitigate associations between discrimination and tobacco use among sexual minority young adults (SMYAs). SM-identifying YA (ages 18-34) women (N = 450; Mage = 24.11; 31.1% racial or ethnic minority) and men (N = 254; Mage = 24.68; 28.0% racial or ethnic minority) residing in 6 US metropolitan areas were surveyed. Bivariate analyses examined associations of sociodemographics (i.e. age, race, ethnicity, education), discrimination, and emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression) with tobacco use outcomes (i.e. past 30-day cigarette, e-cigarette, other tobacco [aggregated across cigars, hookah] use). Multivariable logistic regressions were built for each tobacco use outcome and included sociodemographic covariates, discrimination and emotion regulation strategies, and interactions between discrimination and emotion regulation strategies. Among SMYA women, a significant interaction of discrimination and cognitive reappraisal indicated that discrimination was associated with greater odds of past 30-day e-cigarette use only among women with lower levels of cognitive reappraisal. Discrimination and emotion regulation were not significantly associated with tobacco use among men. SMYA women with lesser use of cognitive reappraisal may be at heightened risk for e-cigarette use if they experience discrimination. Tobacco cessation programs for SM women should incorporate emotion regulation skills.
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Affiliation(s)
- Erin A Vogel
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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Li H, Liu X, Zheng Q, Zeng S, Luo X. Minority stress, social support and mental health among lesbian, gay, and bisexual college students in China: a moderated mediation analysis. BMC Psychiatry 2023; 23:746. [PMID: 37833656 PMCID: PMC10576333 DOI: 10.1186/s12888-023-05202-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The existing body of research exploring minority stressors and their impact on the mental health of Lesbian, Gay, and Bisexual (LGB) students in China remains limited in scope and often restricted to specific geographic regions.. METHODS A combination of snowball and targeted sampling strategies was used to recruit lesbian, gay and bisexual students (N = 1,393) for a cross-sectional, online survey in China. Participants (Mage = 20.00 years; 60.23% assigned male at birth) were tasked with completing a comprehensive questionnaire designed to capture various dimensions, including gender expression, minority stressors (e.g., school bullying, internalized homophobia), social psychological resources (e.g., perceived social support), and mental health-related outcomes (e.g., depression, anxious and stress). Our analytical approach involved hierarchical multiple regression analyses, mediation and moderated mediation modeling to elucidate the intricate interplay among these factors. RESULTS Our findings shed light on the pronounced mental health disparities afflicting LGB college students in China, with notable prevalence rates of depression (48.1%), anxiety (57.1%), and stress (37.5%). A significant positive correlation was observed between experiences of school-based victimization and internalized homophobia, which, in turn, exhibited a direct association with affective symptoms.School bullying was positive with internalized homophobia, which was positively associated with affective symptoms.In addition to unveiling the indirect effects of school bullying on affective symptoms, our study identified direct links in this complex relationship. Notably, the availability of social support emerged as a pivotal factor, serving as a moderator within the mediation model by mitigating the path from school-based victimization bullying to internalized homophobia (β = -0.077, P = 0.040). CONCLUSIONS This study underscores the pervasive and concerning mental health disparities experienced by LGB college students in China. In response, institutions of higher learning should intensify anti-bullying initiatives tailored to LGB students and implement comprehensive gender education programs. Moreover, concerted efforts should be directed at enhancing the accessibility of social support resources for LGB college students, with the aim of cultivating and sustaining favorable psychological well-being.
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Affiliation(s)
- Huijun Li
- School of Public Health, Lanzhou University, Lanzhou, China
- Wenzhou Center for Disease Control and Prevention, Wenzhou, China
| | - Xiaoling Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qingyong Zheng
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Siyuan Zeng
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Xiaofeng Luo
- School of Public Health, Lanzhou University, Lanzhou, China.
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12
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Gordon AR, Egan KA, Wang ML, Ziyadeh NJ, Kenney EL, Rosario M, Austin SB. Weight-based discrimination and disordered eating behaviors in a cohort of U.S. sexual minority young adults. Int J Eat Disord 2023; 56:1983-1990. [PMID: 37345224 PMCID: PMC10592576 DOI: 10.1002/eat.24015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE Though prevalent, weight-based discrimination is understudied and has been linked to disordered eating behaviors (DEB) among adolescents and adults. Sexual minority populations experience elevated risk of DEB, but little is known about the role of weight discrimination in this elevated risk. METHODS Participants were 1257 sexual minority women and men (ages 18-31 years) in the US Growing Up Today Study cohort. We examined cross-sectional associations between weight discrimination victimization and three DEB in the past year: unhealthy weight control behaviors, overeating, and binge eating. Generalized estimating equations, adjusted for potential confounders, were used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS Three in 10 participants (31%) reported weight-based discrimination victimization. Sexual minority young adults who reported weight-based discrimination had greater relative prevalence of unhealthy weight control behaviors (PR [95% CI]: 1.92 [1.35, 2.74]), overeating (3.15 [2.24, 4.44]), and binge eating (3.92 [2.51, 6.13]), compared with those who reported no weight-based discrimination. Associations with overeating and binge eating remained significant after adjusting for BMI. DISCUSSION The role of weight-based discrimination, and its intersections with other forms of stressors for sexual minority young adults, must be included in efforts to advance eating disorder prevention for this underserved population. PUBLIC SIGNIFICANCE Three in 10 sexual minority young adults in this study had experienced weight-based discrimination, a common but understudied form of discrimination. Sexual minority young adults who experienced weight-based discrimination were at greater risk of disordered eating behaviors than those who had not experienced weight-based discrimination. These findings suggest that weight-based discrimination may be an important-and preventable-risk factor for disordered eating behaviors among sexual minority young adults.
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Affiliation(s)
- Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kelsey A. Egan
- Division of General Academic Pediatrics, Department of Pediatrics, Boston Medical Center, Boston University School of Medicine
| | - Monica L. Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Office of Narrative, Boston University Center for Antiracist Research, Boston, MA, USA
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Najat J. Ziyadeh
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Margaret Rosario
- Department of Psychology, City University of New York—City College and Graduate Center, New York, NY, USA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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13
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DeBerry JA, Adams EM, Cascalheira CJ, Hitter TL. The Effectiveness of Didactic and Perspective-Taking Interventions on Reducing Multiple Dimensions of Heterosexism. J Homosex 2023; 70:2295-2318. [PMID: 35452377 PMCID: PMC9587129 DOI: 10.1080/00918369.2022.2059969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study examined the effect of two interventions (didactic and perspective-taking) on five dimensions of heterosexism (hostile, aversive, amnestic, paternalistic, and positive stereotypic). Participants were 117 undergraduate students, randomly assigned to one of three groups in this posttest-only control group experiment. After the intervention, the participants completed measures of sexual prejudice, right-wing authoritarianism (RWA), gender role beliefs (GRB), and a demographic questionnaire. Results from the first step of hierarchical regression models showed that RWA and GRB were significantly predictive of all dimensions of heterosexism except for positive stereotypic, accounting for 13.8% to 56.7% of the variance. This suggests that interventions targeting sexual prejudice should examine both variables. When between-group comparisons were added during the second step, the didactic intervention in comparison with the control group was significantly predictive of lower paternalistic heterosexism; the perspective-taking intervention in comparison with the control group was significantly predictive of lower positive stereotypic heterosexism.
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Affiliation(s)
- John A DeBerry
- Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Eve M Adams
- Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Cory J Cascalheira
- Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Tracie L Hitter
- Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, New Mexico, USA
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14
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Williams DY, Hall WJ, Dawes HC, Srivastava A, Radtke SR, Ramon M, Bouchard D, Chen WT, Goldbach JT. Relationships between internalized stigma and depression and suicide risk among queer youth in the United States: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1205581. [PMID: 37547195 PMCID: PMC10399219 DOI: 10.3389/fpsyt.2023.1205581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Background Queer youth experience high rates of depression and suicidality. These disparities stem from stigma-based stressors, including internalized stigma (i.e., negative social views that minoritized individuals internalize about their own identity). Given the importance of this factor in understanding mental health disparities among queer youth, we completed a systematic review and meta-analysis examining the relationships between internalized stigma and outcomes of depression and suicide risk (i.e., suicidal ideation, non-suicidal self-injury, and suicidal behavior). Methods We followed the PRISMA standards. Six bibliographic databases were searched for studies in the United States from September 2008 to March 2022. Dual independent screening of search results was performed based on a priori inclusion criteria. Results A total of 22 studies were included for data extraction and review. Most studies examined general internalized homophobia, with few examining internalized biphobia or transphobia. Many studies examined depression as an outcome, few studies examined suicidal ideation or behavior, and no studies examined non-suicidal self-injury. Meta-analyses model results show the association between general internalized queer stigma and depressive symptoms ranged r = 0.19, 95% CI [0.14, 0.25] to r = 0.24, 95% CI [0.19, 0.29], the latter reflecting more uniform measures of depression. The association between internalized transphobia and depressive outcomes was small and positive (r = 0.21, 95% CI [-0.24, 0.67]). General internalized queer stigma and suicidal ideation had a very weak positive association (r = 0.07, 95% CI [-0.27, 0.41]) and an even smaller, weaker positive association with suicide attempt (r = 0.02, 95% CI [0.01, 0.03]). Conclusion Implications for clinical practice, policy, and future research are discussed.
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Affiliation(s)
| | - William J. Hall
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Hayden C. Dawes
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Ankur Srivastava
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Spenser R. Radtke
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Magdelene Ramon
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - D. Bouchard
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Wan-Ting Chen
- School of Social Work, University of North Carolina, Chapel Hill, NC, United States
| | - Jeremy T. Goldbach
- Brown School of Social Work at Washington University, St. Louis, MO, United States
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15
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Perrone D, Fischer R, Florek J. COVID-19-Related Shifts in Polysubstance Use. Subst Use Misuse 2023; 58:1314-1323. [PMID: 37317983 DOI: 10.1080/10826084.2023.2181034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Big Events, such as economic crises and natural disasters, affect drug use patterns (e.g. Friedman & Rossi, 2015). The COVID-19 pandemic is a Big Event that led to lockdowns, travel restrictions, protocols on businesses, and rules for social engagements across the globe. Studies primarily in Europe and Oceania show that the pandemic impacted the type and amount of substances used (e.g. Winstock et al., 2020). Objectives: This study examines the impact of COVID-19 on substance use using a sample of 257 individuals across 36 states, who engage in polysubstance use. Results: The sample was recruited via DanceSafe, Inc.'s social media to complete an online survey (April-October 2020) about drug use during the pandemic. The mostly White, heterosexual sample used an average of seven different substances in the past 12 months. Slightly less than half reported increasing use since the onset of the COVID-19 pandemic, with young adults and lesbian, gay, bisexual, pansexual, or queer (LGBPQ) identifying individuals significantly more likely to do so. Relative to other substances, benzodiazepine use increased, and 3,4- methylenedioxymethamphetamine (MDMA) and psychedelic use decreased, while alcohol use stayed the same. Conclusions: The COVID-19 pandemic disproportionately affected those who are young adults, LGBPQ, and use drugs. Their unique needs during the pandemic warrant attention. The swap from leisure (e.g. MDMA) to anti-anxiety (e.g. Xanax) drugs is not surprising. Yet, the rise in novel benzodiazepines (Laing et al., 2021) is a point of concern that suggests drug checking and educational efforts can best reduce potential risks.
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Affiliation(s)
- Dina Perrone
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, California, USA
| | - Ryan Fischer
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, California, USA
| | - Jianna Florek
- School of Criminology, Criminal Justice, and Emergency Management, California State University, Long Beach, California, USA
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16
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Cheung CK, Tsang EYH. Conditions for Social Exclusion Leading to Distress Change in Chinese Lesbian, Gay, and Bisexual ( LGB) People. Int J Environ Res Public Health 2023; 20:ijerph20105911. [PMID: 37239639 DOI: 10.3390/ijerph20105911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023]
Abstract
Lesbian, gay, and bisexual (LGB) people are likely to be at risk of distress because of social exclusion, including the feelings of resentment, resistance, and rejection they might experience from society. Nevertheless, the conditions for social exclusion leading to changes in distress are empirically unclear, especially in Chinese LGB people. To examine these conditions, this study surveyed 303 Chinese LGB people in Taiwan, Hong Kong, and various places in Mainland China. For comparability with other LGB studies, the study did not explicitly identify asexual, demisexual, or pansexual people in the LGB group. Results show that the retrospective reporting of social exclusion in 2016 did not significantly and unconditionally predict levels of distress in 2017. However, the reporting of exclusion significantly predicted current distress when the retrospective report of distress in 2016 was high. These results from the stress-vulnerability model indicate that prior distress is a vulnerability condition that allows social exclusion to exert its stressful effect. This study implies the need to prevent the social exclusion of highly distressed LGB people.
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Affiliation(s)
- Chau-Kiu Cheung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong 518000, China
| | - Eileen Yuk-Ha Tsang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong 518000, China
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17
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Shepp K, Drescher CF, Griffin JA, Stepleman LM. Loneliness in Sexual Minority Individuals in the Southeastern United States: The Role of Minority Stress and Resilience. J Homosex 2023; 70:963-988. [PMID: 34806943 DOI: 10.1080/00918369.2021.2006001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Health disparities in the sexual minority population may be exacerbated by the loneliness experienced due to minority stress. Using a minority stress framework, this study examined minority stress, protective variables, and mental health as correlates of loneliness in sexual minority individuals in a small metropolitan area in the southeastern United States. Participants (n = 273) were a subsample of sexual minority individuals from a broader sample of LGBTQ adults in the Central Savannah River area who completed a health needs assessment. Bivariate correlations were calculated to assess for degree of significant relationships between loneliness and barriers to health care, minority stress, and mental health. Hierarchical linear regression was conducted to examine the relative importance of the study variables' associations with loneliness. A multiple regression model found household income, assault victimization, depressive symptoms, and sense of community to be significant correlates of loneliness. Interventions to decrease loneliness in this population will need to consider these interconnected, multi-level influences.
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Affiliation(s)
- Kasey Shepp
- Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Christopher F Drescher
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - James A Griffin
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- LGBT Health Resource Center, Chase Brexton Health Care, Baltimore, Maryland, USA
| | - Lara M Stepleman
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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18
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Abstract
The minority stress model has been used to explain added daily stressors that non-heterosexual (LGB+) individuals experience. While the emphasis of minority stress research is frequently broad (global minority stress) or narrow (specific stressors) in focus, the literature often refers to specific stressors at the domain level as either distal (external) or proximal (internal). This study found that, compared with broad and narrow levels, a domain level approach may be best for understanding the predictive value of minority stress. Multiple regression analyses with a sample of 152 LGB+ adolescents found that distal stress predicted substance misuse (p < .001) and suicidality (p = .002) and was a stronger predicter than proximal stress for psychological inflexibility. This study might contribute to an evidence base that could guide measurement approaches for assessing minority stress and using related results to inform the prediction of-and, ultimately, intervention with-LGB+ adolescents' mental health outcomes.
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Affiliation(s)
- Sean N Weeks
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Tyler L Renshaw
- Department of Psychology, Utah State University, Logan, Utah, USA
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19
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Nielsen A, Azra KK, Kim C, Dusing GJ, Chum A. Is the association between sexual minority status and suicide-related behaviours modified by rurality? A discrete-time survival analysis using longitudinal health administrative data. Soc Sci Med 2023; 325:115896. [PMID: 37084702 DOI: 10.1016/j.socscimed.2023.115896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND While self-reported data shows that lesbian, gay, and bisexual (LBG) individuals have a greater suicide-related behaviours (SRB) risk, little is known about how rurality may amplify SRB risk associated with sexual minority status. Sexual minority individuals in rural areas may experience unique stressors due to stigma and a lack of LGB-specific social and mental health services. Using a population-representative sample linked to clinical SRB outcomes, we examined whether rurality modifies the association between sexual minority status and SRB risk. METHODS A nationally representative survey linked to administrative health data was used to construct a cohort of individuals (unweighted n = 169,091; weighted n = 8,778,115) in Ontario, Canada, and captured all SRB-related emergency department visits, hospitalizations, and deaths between 2007 and 2017. Sex-stratified discrete-time survival analyses were used to examine interactions between rurality and sexual minority status on SRB risk while controlling for potential confounders. RESULTS Sexual minority men had 2.18 times higher SRB odds compared to their heterosexual counterparts (95%CI 1.21-3.91), while sexual minority women had 2.07 times higher odds (95%CI 1.48-2.89) after adjusting for the confounders. The Rurality Index of Ontario and the Index of Remoteness were associated with the odds of SRB in a dose-response manner. No significant interactions were observed between rural and sexual minority status. CONCLUSIONS Our study provides evidence that rural and sexual minority status both independently contribute to an elevated likelihood of SRB; however, rurality did not appear to modify SRB risk by sexual orientation. Implementation and evaluation of interventions to reduce SRB in both rural and sexual minority populations are required.
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Affiliation(s)
- Andrew Nielsen
- Canadian Institute for Health Information, 4110 Yonge St Suite 300, North York, ON M2P 2B7, Canada
| | - Karanpreet Kaur Azra
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, Whitby, Ontario, L1N 5S9, Canada
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada; Unity Health Toronto, MAP Centre for Urban Health Solutions, 209 Victoria Street, 3rd floor, Toronto, Ontario, M5B 1T8, Canada.
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20
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Livingston NA, Gatsby E, Shipherd JC, Lynch KE. Causes of alcohol-attributable death and associated years of potential life lost among LGB and non-LGB veteran men and women in Veterans Health Administration. Addict Behav 2023; 139:107587. [PMID: 36571942 DOI: 10.1016/j.addbeh.2022.107587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/08/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alcohol use is a significant concern nationally and research now highlights higher rates of alcohol attributable death (AAD) and years of potential life lost (YPLL) among lesbian, gay, and bisexual (LGB) veterans compared to non-LGB veterans. In this study, we examined specific causes of AAD and associated YPLL between LGB and non-LGB veteran men and women to highlight needed outreach, prevention, and treatment strategies. METHODS Using data from the nationwide Veterans Health Administration electronic health record and National Death Index from 2014 to 2018, we examined the top ten ranked causes of AAD among LGB (n = 102,085) and non-LGB veteran (n = 5,300,521) men and women, as well as associated YPLL per AAD. RESULTS We observed higher rates of AAD among men than women, but higher rates among LGB veterans relative to their same-sex non-LGB counterparts. We noted greater YPLL per AAD among LGB men and all women compared to non-LGB men, even when of similar or same rank in cause of death. Acute-cause AAD death (e.g., alcohol-related suicide, poisonings) was ranked higher among LGB men and all women. YPLL was greater for both acute- and chronic-cause AAD (e.g., liver disease) among LGB men and all women compared to non-LGB men. CONCLUSIONS Causes of AAD differ between LGB and non-LGB men and women. The differences observed highlight disparities in acute- and chronic-cause AAD between groups help explain the higher number of YPLL per AAD that disfavor LGB men and women veterans, and essential next steps in primary and secondary prevention of hazardous drinking and mortality risk.
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Affiliation(s)
- Nicholas A Livingston
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States.
| | - Elise Gatsby
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Jillian C Shipherd
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; LGBTQ+ Health Program, Veterans Health Administration, Washington, DC, United States; Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, United States; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
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21
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Chang CJ, Dorrell KD, Feinstein BA, Depp CA, Ehret BC, Selby EA. Testing the interpersonal theory of suicide in a sample of sexual minority young adults: Attention to within-group differences. Suicide Life Threat Behav 2023. [PMID: 36897041 DOI: 10.1111/sltb.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION This study investigated demographic differences in interpersonal theory of suicide factors and their associations with suicide attempts among sexual minority young adults. METHODS 784 sexual minority young adults ages 18-29 (42.7% cisgender men, 42.2% cisgender women, 15.1% transgender/gender diverse; 62.2% non-Hispanic White; 50.5% gay/lesbian, 49.5% bisexual+) completed an online survey assessing lifetime suicide attempts and interpersonal theory of suicide factors. RESULTS Demographic differences included (1) greater perceived burdensomeness among transgender/gender diverse participants compared to other gender groups; (2) greater acquired capability for suicide and suicide attempts among cisgender men compared to cisgender women; (3) greater acquired capability for suicide among bisexual+ compared to gay/lesbian participants; and (4) a lower number of suicide attempts among Asian/Asian American sexual minority participants compared to most other sexual minority participants. All interpersonal theory of suicide factors were significantly associated with a higher number of suicide attempts, though only perceived burdensomeness and acquired capability for suicide remained significant when examining all three simultaneously. No two- or three-way interactions between interpersonal theory of suicide factors were significant. CONCLUSION The interpersonal theory of suicide may be useful for understanding suicide attempts in this population, with perceived burdensomeness and acquired capability being particularly relevant to consider.
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Affiliation(s)
- Cindy J Chang
- U.S. Department of Veterans Affairs, Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Kate D Dorrell
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Colin A Depp
- U.S. Department of Veterans Affairs, Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Blaire C Ehret
- U.S. Department of Veterans Affairs, Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Edward A Selby
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
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22
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Flesia L, Monaro M, Jannini EA, Limoncin E. "I'm Too Old for That": The Role of Ageism and Sexual Dysfunctional Beliefs in Sexual Health in a Sample of Heterosexual and LGB Older Adults: A Pilot Study. Healthcare (Basel) 2023; 11. [PMID: 36832993 DOI: 10.3390/healthcare11040459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
The role of ageism (i.e., discrimination against individuals or groups on the basis of their age), in particular toward the sexuality of the elderly, remains, to date, an overlooked issue. A few studies have suggested that ageistic stereotypes can negatively affect older adults' sexual health. No data are available, in particular, about differences among heterosexual and LGB (lesbian, gay, and bisexual) populations. The present study aimed to investigate differences in perceived ageism and related dysfunctional beliefs in a sample of heterosexual (n = 104) and LGB (n = 103) older adults (aged 55 or older; mean age 66.5) and their impact on sexual health and satisfaction. LGB individuals reported higher rates of masturbation and sexual intercourse and an increased quality of sexual activity as compared to heterosexuals. In addition, no differences between the groups emerged as regards perceived ageism and dysfunctional beliefs toward ageing. In conclusion, LGB individuals perceived more ageism toward sexuality than their counterparts; however, heterosexuals were more likely to have dysfunctional beliefs toward sexuality in ageing. The study findings highlight the significance of examining sexual orientation to understand experiences of sexuality in ageing of the growing older population. Renewed socio-educational efforts based on these data are clearly needed.
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Abstract
Purpose: This study aimed to examine physical activity (PA) as a protective measure of health outcomes among sexual minority (SM) and heterosexual adults. Methods: Using data from the 2018 National Health Interview Survey, differences in key health outcomes between three groups (heterosexual, SM, and "other") and the mediating effects of PA were explored. Chi-square tests were used to examine group differences. Multinomial logistic regression models were fit to examine associations between PA and health outcomes (body mass index [BMI], psychological distress, health status, and use of alcohol, cigarettes, and e-cigarettes). Results: Compared with heterosexual respondents, "other" adults had higher levels of BMI above 24.9 and were less active; SM respondents had elevated levels of alcohol use, smoking, binge drinking, and psychological distress, and reported worse overall health status. Unadjusted models showed that PA served as a protective factor for BMI above 30 and health status for all groups. PA was also protective for BMI below or above 18.5-24.9, smoking, psychological distress, and health status for both heterosexual and SM groups. Alternatively, PA behaved as a risk factor for alcohol use and binge drinking for all groups. Adjusted modeling removed PA as a risk factor for light alcohol use and binge drinking for SM respondents and added a protective factor for e-cigarette use for heterosexual respondents. Conclusion: This study adds to current literature on health disparities affecting SM populations and the health benefits associated with PA. Further research is needed to explore tailored PA intervention for SM populations and those who mark "other," "something else," "don't know," or refuse to answer questions on sexual orientation.
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Affiliation(s)
- Jaimi L Allen
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kristin Wiginton
- College of Health Professions/College of Nursing, Walden University, Minneapolis, Minnesota, USA
| | - Janet Nakarmi
- Department of Mathematics, University of Central Arkansas, Conway, Arkansas, USA
| | - Mandy Golman
- School of Health Promotion and Kinesiology, Texas Woman's University, Denton, Texas, USA
| | - Benjamin C Amick
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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24
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McNeill SG, McAteer J, Jepson R. Interactions Between Health Professionals and Lesbian, Gay and Bisexual Patients in Healthcare Settings: A Systematic Review. J Homosex 2023; 70:250-276. [PMID: 34292130 DOI: 10.1080/00918369.2021.1945338] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The ways in which health professionals (HPs) interact with individuals from sexual minorities can impact their perception of the health service and influence engagement. This systematic literature review aimed to identify and synthesize the qualitative literature exploring interactions between HPs and lesbian, gay and bisexual (LGB) patients in healthcare settings. A search strategy was developed and applied to CINAHL and Medline, inclusion criteria were then applied to results by two screeners with good agreement. Thematic analysis was carried out on papers meeting the inclusion criteria in three stages, beginning with coding the text line-by-line, developing descriptive themes and finally, analytical themes. Electronic searches identified 348 papers with 20 of these meeting the inclusion criteria. Thematic analysis found five themes; HPs' lack of knowledge regarding LGB specific issues, identification of sexual orientation, discomfort in interactions, LGB patients' experience of heteronormative attitudes and perceived judgment or other negative attitudes.
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Affiliation(s)
- Sarah G McNeill
- Centre for Public Health, Royal Victoria Hospital, Belfast, United Kingdom
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - John McAteer
- Grow Public Health Research and Consultancy, Edinburgh, Scotland, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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25
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Mann AJD, Kurtz AJ, Tull MT, Gratz KL. The moderating role of sexual minority status in the associations of the experience and tolerance of shame-related emotions to suicide risk. J Clin Psychol 2022; 78:2579-2594. [PMID: 35509115 PMCID: PMC9790715 DOI: 10.1002/jclp.23367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 03/18/2022] [Accepted: 04/15/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study examined the associations of the experience and tolerance of shame-related emotions to suicide risk, as well as the moderating role of sexual minority status. METHODS Community adults (N = 360) were recruited via MTurk and completed self-report questionnaires. Hierarchical regression analyses examined the main and interactive associations of sexual minority status and shame-related variables to suicide risk. RESULTS Results revealed significant positive associations between self-disgust and suicide risk for sexual minority and heterosexual participants, although the magnitude was greater for sexual minority participants. Additionally, tolerance of shame was significantly negatively related to suicide risk only among sexual minority participants. Finally, exploratory analyses examining the three-way interaction of self-disgust, shame tolerance, and sexual minority status revealed a significant negative association between shame tolerance and suicide risk only among sexual minority participants with high levels of self-disgust. CONCLUSION Results highlight the relevance of shame-related experiences to suicide risk among sexual minorities.
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Affiliation(s)
| | | | | | - Kim L. Gratz
- Department of PsychologyUniversity of ToledoToledoOhioUSA
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Choo S, Kim R, Lee H, Yi H, Kim R, Kim SS. Association between discrimination and poor sleep health outcomes among 2192 South Korean gay, lesbian, and bisexual adults: A nationwide cross-sectional survey. Sleep Health 2022; 8:587-592. [PMID: 36220734 DOI: 10.1016/j.sleh.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The study aimed to assess the prevalence of poor sleep health outcomes and examine the associations between experiences of discrimination and the sleep health outcomes among lesbian, gay, and bisexual (LGB) adults in Korea. DESIGN & SETTING The study used data from Rainbow Connection Project I, a nationwide cross-sectional survey of Korean LGB adults, conducted via online in 2016. MEASUREMENTS Participants were asked about experiences of anti-LGB discrimination and discrimination based on other characteristics (ie, gender, age, place of origin, nationality/race, religion, appearance including height and weight, disability status, and other) in the past 12 months. Using the responses, the participants were categorized into 4 groups: those who experienced (1) none, (2) only anti-LGB discrimination, (3) only other types of discrimination, and (4) both anti-LGB and other types of discrimination. Past-week sleep quality, unrestful sleep, and long sleep latency were included as sleep health outcomes. RESULTS Of the 2192 participants, 740 (33.8%) had poor sleep quality, 1211 (55.2%) had unrestful sleep, and 681 (31.1%) had long sleep latency in the past week. Participants who experienced both anti-LGB and other types of discrimination had 1.65 times (95% confidence interval [CI] = 1.38-1.98), 1.30 times (95% CI = 1.16-1.45), and 1.58 times (95% CI = 1.31-1.90) higher prevalence of poor sleep quality, unrestful sleep, and long sleep latency, respectively, compared to those without any experiences of discrimination. CONCLUSIONS Experiencing discrimination may deprive Korean LGB adults of good quality sleep. Interventions that seek to prevent discrimination are needed to promote sleep health among Korean LGB individuals.
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Affiliation(s)
- Sungsub Choo
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, South Korea; Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ranyeong Kim
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, South Korea; Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Hyemin Lee
- Jeju Institute of Public Health & Health Policy, Jeju, South Korea
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, South Korea
| | - Rockli Kim
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, South Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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27
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Ledesma GCM, Reyes MES, Delariarte CF. Meaning in Life, Death Anxiety, and Spirituality in the Lesbian, Gay, and Bisexual Community: A Scoping Review. Sex Cult 2022; 27:636-658. [PMID: 36405399 PMCID: PMC9645752 DOI: 10.1007/s12119-022-10032-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
The changes in people's way of life through the years raise questions on how they address existential needs and concerns, particularly those related to life and death and spiritual connections. Through a scoping review, we surveyed studies on meaning in life, death anxiety, and spirituality within the lesbian, gay, and bisexual (LGB) community. We determined the extent to which these variables have been studied among LGB participants. A total of 28 eligible articles were reviewed. Six studies were found about meaning in life, five studies about death anxiety, and 16 studies about spirituality. Results suggest that meaning in life was derived from experiences related to parenthood, couplehood, and work satisfaction. Studies on death anxiety among LGB participants, which date back to the 1980 and 1990s, indicated the need to conduct present studies in this area. The review showed that LGB members distinguished between spirituality and religion, giving them more positive recognition of the former than the latter. The forms of spiritual expression were anchored to religious practices, for some, and other expressions of belief and faith outside the confines of formally established religions. Spiritual expressions generally accorded the LGB members direction and satisfaction in life. Not all segments of the LGB community were represented in the studies. The available studies, dominantly quantitative, centered only on the LGB experience. Target age groups varied across the studies. The review indicates that future studies can work on exploring these existential factors considering the emerging contexts and paradigms. Future research can focus on determining what factors contribute to meaning in life, given the changes in time.
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Affiliation(s)
- Gian Carlo M. Ledesma
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Department of Interdisciplinary Studies, Faculty of Arts and Letters, University of Santo Tomas, Manila, Philippines
| | - Marc Eric S. Reyes
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Department of Psychology, College of Science, University of Santo Tomas, Manila, Philippines
| | - Clarissa F. Delariarte
- The Graduate School, University of Santo Tomas, 1008 Manila, Philippines
- Far Eastern University, Manila, Philippines
- De La Salle University, Manila, Philippines
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28
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Wilchek-Aviad Y, Oren L. Linking minority stress to substance abuse in LGB adults: the mediating effect of sexual harassment. Curr Psychol 2022; 42:1-10. [PMID: 36187903 PMCID: PMC9510283 DOI: 10.1007/s12144-022-03636-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Employing a psychological mediation framework, the study investigated the interaction between minority stress and psychoactive substance abuse mediated by sexual harassment among LGB individuals. METHOD One hundred and forty-seven LGB individuals answered a questionnaire measuring internalized homophobia, concealment, discrimination, sexual harassment, and psychoactive substance abuse. Logistic hierarchical regression models were conducted to test the proposed relations and mediating hypotheses. FINDINGS Incidents of discrimination and internalized homophobia correlated with cigarette smoking and alcohol drinking. Sexual harassment was related to the use of cannabis and hard drugs. Sexual harassment mediated the relationships between the dimensions of minority stress and the use of cannabis and hard drugs. CONCLUSION Minority stress appears to be linked directly and indirectly, via sexual harassment, to the use of psychoactive substances by LGB individuals. Interventions addressing the prevention or mitigation of sexual harassment experienced by LGB individuals are likely to attenuate the negative effects of minority stress on their levels of substance use.
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Affiliation(s)
| | - Lior Oren
- Department of Psychology, Ariel University, Ariel, Israel
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Rosik CH, Lefevor GT, McGraw JS, Beckstead AL. Is Conservative Religiousness Inherently Associated with Poorer Health for Sexual Minorities? J Relig Health 2022; 61:3055-3075. [PMID: 34075507 DOI: 10.1007/s10943-021-01289-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 05/02/2023]
Abstract
Results of path analysis involving sexual minority participants (N = 1317) from diverse sociopolitical contexts revealed health outcomes to be associated with internalized homonegativity and the resolution of conflict between religious and sexual minority identities. Contrary to expectations, several markers of religiousness were not directly associated with either improved or worsened health outcomes for depression or anxiety. However, religious activity moderated the influence of internalized homonegativity (IH) on depression such that IH was less strongly related to depression among individuals who frequently attended religious services than among individuals who infrequently attended religious services. These findings have special salience for advancing a more accurate understanding of conservatively religious sexual minorities and directing culturally sensitive research, clinical services, and public policy.
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Affiliation(s)
- Christopher H Rosik
- Link Care Foundation, 1734 W. Shaw Ave, Fresno, CA, 93711, USA.
- Department of Psychology, Fresno Pacific University, Fresno, USA.
| | - G Tyler Lefevor
- Department of Psychology, Utah State University, Logan, UT, USA
| | - James S McGraw
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
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30
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McGraw JS, McManimen S, Chinn J, Angoff HD, Docherty M, Mahoney A. Adverse Childhood Experiences, Suicidal/Self-Harming Thoughts, and Suicide Attempts Among LGB and Heterosexual Utahns. J Homosex 2022; 69:1141-1159. [PMID: 33861680 DOI: 10.1080/00918369.2021.1909396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Current research suggests that sexual minorities living in Utah may be at higher risk for experiencing suicidal/self-harming thoughts and suicide attempts than heterosexuals in Utah. However, to date no research has been conducted examining potential reasons sexual minorities living in Utah may be at higher risk. Using two representative samples of Utahns, we examine (a) disparities in adverse childhood experiences (ACEs) between sexual minorities and heterosexual Utahn, (b) how ACEs and sexual orientation may predict recent suicidal/self-harming thoughts and lifetime prevalence of suicide attempts, and (c) how sexual orientation and ACEs might interact to predict suicidal outcomes. Results with each sample showed that sexual minority Utahns reported higher levels of ACEs and suicidal/self-harming thoughts than heterosexual Utahns. Both sexual orientation and ACEs uniquely predicted suicidality when both were entered into regression models, but no interaction effects were found between these predictors.
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Affiliation(s)
- James S McGraw
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | | | - Jessica Chinn
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Harrison D Angoff
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Meagan Docherty
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Annette Mahoney
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
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31
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Kiekens WJ, Fish JN, Gordon AR, Russell ST. Everyday Discrimination and Alcohol use among Sexual Minority Adults in a U.S. National Probability Sample. Subst Use Misuse 2022; 57:1383-1391. [PMID: 35658825 PMCID: PMC10676011 DOI: 10.1080/10826084.2022.2083172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: Limited research assesses how sexual orientation and gender identity and expression (SOGIE)-based discrimination affects alcohol use above and beyond non-SOGIE-related discrimination and how this may differ for sexual minority subgroups. We examined if SOGIE-related discrimination is additive in affecting alcohol use above and beyond non-SOGIE-related discrimination and examined differences in alcohol use, everyday discrimination, and the attribution of discrimination by sex and sexual identity. Methods: A national probability sample of sexual minority adults in the United States was used (N = 1311, female = 56.4%). Bivariate sexual identity and sex-based differences in drinking frequency, heavy episodic drinking (HED), everyday discrimination, and the attribution of discrimination were assessed. Sexual identity and sex-stratified logistic regression models were estimated, where everyday discrimination and the attribution of discrimination predicted drinking frequency and HED. Results: Several differences by sex assigned at birth and sexual identity in drinking frequency, HED, everyday discrimination, and the attribution of discrimination were found in bivariate analyses. In logistic regression models, experiencing SOGIE-related in addition to other types of discrimination was associated with higher odds of HED only for gay males. No other associations were found for everyday discrimination or the attribution of discrimination with drinking frequency or HED. Conclusions: Findings suggest sex and sexual identity-based differences in everyday discrimination and the attribution of discrimination.
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Affiliation(s)
- Wouter J Kiekens
- Department of Sociology/Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Allegra R Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Stephen T Russell
- Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
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Abstract
Sexual minorities (individuals with a lesbian, gay, bisexual, queer, or other non-heterosexual identity) are at elevated risk of developing common mental health disorders relative to heterosexual people, yet have less favourable mental health service experiences and poorer treatment outcomes. We investigated the experiences of sexual minority service users accessing mental health services for common mental health problems (e.g. depression or anxiety) in the UK. We recruited 26 sexual minority adults with experiences of being referred to Improving Access to Psychological Therapies (IAPT) or primary care counselling services. Semi-structured interviews explored participants' experiences of service use and views on service development. Interviews were analysed using thematic analysis. Barriers to effective relationships with practitioners included service users' fears surrounding disclosure, and practitioners' lack of understanding and/or neglect of discussions around sexuality. Regarding service development, participants highlighted the value of seeing practitioners with shared identities and experiences, visible signs of inclusivity, sexual minority training, tailored supports, and technological adjuncts. Our findings offer insights into possible contributory factors to treatment inequalities, and highlight potential methods for improving service provision for sexual minorities.
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Affiliation(s)
- Daniel D A Morris
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vanessa Fernandes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katharine A Rimes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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33
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Wittgens C, Fischer MM, Buspavanich P, Theobald S, Schweizer K, Trautmann S. Mental health in people with minority sexual orientations: A meta-analysis of population-based studies. Acta Psychiatr Scand 2022; 145:357-372. [PMID: 35090051 DOI: 10.1111/acps.13405] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 12/23/2022]
Abstract
AIMS To conduct a meta-analysis of population-based studies to quantify the association between sexual minority status (lesbian women, gay men, and bisexual people) and the risk of common mental disorders (depressive disorders, alcohol use disorders (AUD), anxiety disorders, and suicidality). METHOD PubMed, PsycInfo, Web of Science, the Cochrane Library Database, the Applied Social Sciences Index and Abstracts, and ProQuest were searched for relevant studies published between 2000 and May 2020. The PRISMA guidelines were followed for selection processes. Twenty-six studies met the inclusion criteria which included a total of 519,414 heterosexuals, 10,178 lesbian/gay people and 14,410 bisexual people. RESULTS Lesbian/gay people (ORs between 1.97, 95% [CI = 1.76, 2.19] and 2.89, 95% [CI = 2.41,3.38]) and bisexual people (ORs between 2.70; 95% [CI = 2.21,3.18], and 4.81; 95% [CI = 3.63, 5.99]) had a higher risk for mental disorders than heterosexuals for all investigated diagnostic categories. The risk for depression (OR = 2.70; 95% [CI = 2.21, 3.18]) and suicidality (OR = 4.81; 95% [CI = 3.63, 5.99]) was higher in bisexual compared with lesbian/gay people. Exploratory meta-regressions revealed no evidence for a decrease in mental health differences between people with minority sexual orientations and heterosexuals in more recent years of data assessment, except for AUD. CONCLUSIONS These findings clearly suggest disparities in mental health between people with minority sexual orientations and heterosexual people. There is a lack of data regarding a wider spectrum of sexual orientations and mental disorders and studies in non-Western countries.
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Affiliation(s)
- Charlotte Wittgens
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Mirjam M Fischer
- Institute of Sociology and Social Psychology (ISS), Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Pichit Buspavanich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Theobald
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Katinka Schweizer
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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Choo S, Lee H, Yi H, Kim SS. Expectation of Rejection and Its Association with Health Care Avoidance and Delay Among 2175 Korean Lesbian, Gay, and Bisexual Adults: A Nationwide Cross-Sectional Survey. LGBT Health 2022; 9:282-286. [PMID: 35275735 DOI: 10.1089/lgbt.2021.0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The study examined an association between expectation of rejection and health care avoidance and delay (HAD) among lesbian, gay, and bisexual (LGB) adults in South Korea. Methods: We analyzed data from a nationwide cross-sectional survey of 2175 South Korean LGB adults, which was approved by the Korea University Institutional Review Board. We categorized expectation of rejection into tertiles ("low," "medium," and "high" levels) and investigated its association with past 12-month HAD using multivariate modified Poisson regression. Results: After adjusting for covariates, including experiences of discrimination, participants with high levels of expectation of rejection had 1.38-times (95% confidence interval: 1.16-1.65) higher prevalence of HAD compared with those with low levels. Conclusion: Living in anticipation of rejection can negatively impact LGB adults' health care utilization.
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Affiliation(s)
- Sungsub Choo
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Hyemin Lee
- 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 Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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35
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Agueli B, Celardo G, Esposito C, Arcidiacono C, Procentese F, Carbone A, Di Napoli I. Well-Being of Lesbian, Gay, Bisexual Youth: The Influence of Rural and Urban Contexts on the Process of Building Identity and Disclosure. Front Psychol 2022; 12:787211. [PMID: 35095674 PMCID: PMC8794765 DOI: 10.3389/fpsyg.2021.787211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
The study investigates how the territorial community can influence the individual and social well-being of lesbian, gay, bisexual (LGB) youth and especially the recognition of their feelings and the construction of their own identity as well as their needs to be socially recognized. This research focuses on the experiences of 30 LGB individuals (23 males and 7 females), with a mean age of 25.07 years (SD = 4,578), living in urban and rural areas of Southern Italy. Focalized open interviews were conducted, and the Grounded Theory Methodology, supported by the Atlas.ti 8.0 software, was used for data analysis. The textual material was first coded, and then codes were grouped into five macro-categories: Freedom of identity expression in the urban and rural context, identity construction and acceptance process, need of aggregation and identification with the LGB community, role of the interpersonal relationship in the process of identity acceptance, socio-cultural context, and LGB psychological well-being. The results showed a condition common to the two contexts that we can define as “ghettoization.” The young LGB is alone in the rural area due to a lack of places and people to identify with and greater social isolation. On the contrary, although there are more opportunities in the urban area, young people feel stigmatized and ghettoized because “their places” are frequented exclusively by the lesbian, gay, bisexual, transexual, queer (LGBTQ) community. The work will extensively discuss the limitations of the research, future proposals, and the practical implications of the results.
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Affiliation(s)
- Barbara Agueli
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Giovanna Celardo
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Ciro Esposito
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | | | - Fortuna Procentese
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Agostino Carbone
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Makita M, Bahena A, Almack K. The role of sexual orientation, age, living arrangements and self-rated health in planning for end-of-life care for lesbian, gay and bisexual ( LGB) older people in the UK. Sexualities 2022; 25:99-116. [PMID: 35177950 PMCID: PMC8841625 DOI: 10.1177/1363460720932381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article reports on findings from the quantitative phase of a two-year research project designed to explore end-of-life care experiences and needs of lesbian, gay, bisexual and transgender people. We draw on a subset of the sample (N = 180/237) to analyse the relationship between advance care planning, sexual orientation, living arrangements and self-rated health. The results contribute to a growing body of evidence on how sexual minorities approach and make decisions on advance care planning. A greater understanding of such patterns could help inform the way healthcare professionals engage in conversations about end-of-life care planning with older LGB people.
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37
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Sönmez İ, Palamar JJ. Sexual Orientation and Age of First Drug Use Among Adults in the United States. Subst Use Misuse 2022; 57:1313-1321. [PMID: 35614545 PMCID: PMC9202448 DOI: 10.1080/10826084.2022.2079138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Early onset of drug use could lead to long-term impairments, and research suggests that substance use and substance use disorders are more common among lesbian, gay, and bisexual (LGB) individuals. We sought to determine whether adults of different sexual identities were at differential risk for an earlier onset of drug use. METHODS We examined data from adults participating in the five waves (2015-2019) of the National Survey on Drug Use and Health, a nationally representative sample of noninstitutionalized adults in the United States. We determined whether current sexual identity was associated with retrospectively reported age of the first use of marijuana, cocaine, inhalants, ecstasy, and methamphetamine. RESULTS Compared to heterosexual individuals of the same sex, gay men had a later age of onset of use of all five drugs examined (marijuana, cocaine, inhalants, ecstasy, and methamphetamine) and bisexual men had a later onset of marijuana and inhalant use. Bisexual women had earlier age of onset for marijuana, cocaine, and ecstasy use. When examining early initiation (prior to age 15), both lesbian and bisexual women had greater odds of early initiation for marijuana, cocaine, and ecstasy; bisexual men had greater odds of early initiation for cocaine. Gay men had lower odds of initiation prior to age 15 for marijuana, inhalants, and methamphetamine. CONCLUSIONS Current sexual identity is a correlate of earlier onset drug use. Longitudinal research is needed to further examine such associations as sexual identity can shift over time. Results are discussed in relation to prevention efforts aiming younger LGB persons.
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Affiliation(s)
- İbrahim Sönmez
- Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Bishop J, Crisp DA, Scholz B. A systematic review to determine how service provider practises impact effective service provision to lesbian, gay and bisexual consumers in a mental health setting. Clin Psychol Psychother 2021; 29:874-894. [PMID: 34873771 DOI: 10.1002/cpp.2699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/31/2021] [Accepted: 11/29/2021] [Indexed: 11/09/2022]
Abstract
Lesbian, gay and bisexual (LGB) consumers utilize mental health services at a similar rate to their heterosexual counterparts yet report greater dissatisfaction with service quality. This dissatisfaction may be explained by service provider's microaggressions, stemming from a lack of cultural competence in working with LGB consumers. This systematic review examines how the practises of mental health service providers impacted effective service provision to LGB people in a clinical practice. Five health databases (Scopus, MEDLINE, PsycINFO, Web of Science and CINAHL) were examined to determine relevant studies for this review. Twenty four qualitative and quantitative studies between 2000 and 2020 examining data related to how service provider practises impacted effective service provision to LGB people were included in the final review. A narrative synthesis, thematic summary approach was employed to account for the multi-method nature of the data. Themes developed in our analysis are organized under the three components of cultural competence, service provider attitudes, knowledge and skills. Provider attitudes ranged from positive to negative towards LGB people and heterosexism were present in several services. Poor service provider knowledge about the issues impacting LGB consumers leads to a weakened therapeutic alliance and service providers often lacked a comprehensive understanding of the issues impacting LGB people. Service providers were seen as more skilful if they were LGB, created a safe space and had completed cultural competence training. Trends within the characteristics (explorative nature, mixed service provider samples, potential for bias) of the 24 studies included in the review are discussed. Based on the results, recommendations are included to ensure services demonstrate cultural competence in working with LGB consumers.
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Affiliation(s)
- Joshua Bishop
- Centre of Applied Psychology, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Dimity A Crisp
- Centre of Applied Psychology, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Brett Scholz
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Rehman Z, Jaspal R, Fish J. Service Provider Perspectives of Minority Stress among Black, Asian and Minority Ethnic Lesbian, Gay and Bisexual People in the UK. J Homosex 2021; 68:2551-2573. [PMID: 32924868 DOI: 10.1080/00918369.2020.1804256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mental health inequalities among Black, Asian and Minority Ethnic (BAME) people from lesbian, gay and bisexual (LGB) communities persist and remain under-researched. This study is the first in the UK to explore, from the perspective of service providers, minority stress experienced by BAME LGB people. Twenty-three participants were interviewed and data were analyzed using qualitative thematic analysis. Minority stress theory was utilized to inform the analysis, yielding the following themes: (1) Stress induced by conflicting sociocultural norms, (2) interpersonal inhibitors of coming out, (3) and problematic coping. BAME LGB individuals are exposed to stressors due to their intersecting sexual, gender, religious, and cultural identities. Major psychological stressors include stigmatized identity, expectations of a heterosexual marriage, and maladaptive coping strategies. This study sheds light on the potential steps that can be taken to ensure effective coping responses among BAME LGB people.
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Affiliation(s)
- Zaqia Rehman
- Health and Well-being, Health and Life Sciences, De Montfort University, Leicester, UK
| | - Rusi Jaspal
- Psychology and Sexual Health, De Montfort University, Leicester, UK
| | - Julie Fish
- Social Work and Health Inequalities, Centre for LGBTQ Research, De Montfort University, Leicester, UK
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Klein R, Elboim-Gabyzon M. Attitudes of registered physiotherapists in Israel toward people identifying as lesbian, gay, and bisexual: a cross-sectional survey. BMC Med Educ 2021; 21:581. [PMID: 34789223 PMCID: PMC8597222 DOI: 10.1186/s12909-021-03018-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study aimed to explore the attitudes of registered physiotherapists (PTs) in Israel toward people identifying as lesbian, gay, or bisexual (LGB) and to identify background characteristics associated with their attitudes toward LGB individuals. METHODS This nationwide study in Israel employed an observational design. Participants completed an anonymous online questionnaire which included demographic characteristics (e.g., age, sex, gender, sexual orientation, religious affiliation, and religiousness) and questions regarding sources of knowledge about LGB individuals, and type of acquaintance with an LGB individual. In addition to two self-assessment questions regarding levels of homophobia (active engagement against LGB individuals) and heterosexism (holding negative opinions regarding LGB individuals) answered on a five point Likert scale (1 - not at all homophobic/ heterosexist, 5- very homophobic/ heterosexist) and the Hebrew version of the Attitudes Toward Homosexuality Scale (ATHS). Participants were recruited through professional organizations, social media, and word of mouth. RESULTS The data of 383 registered PTs practicing in Israel were analyzed. The median score regarding level of homophobia and heterosexism was one ("not at all"). ATHS scores ranged between 32 and 110 (out of 110), with a median score of 106 and 41% scoring below the median. Multivariant logistic regression indicated that identifying as men, heterosexual orientation, and religiousness were significantly associated with less positive attitudes toward LGB individuals. Only 2% of the participants reported having been introduced to issues regarding the LGB community during their professional physiotherapy education. CONCLUSIONS Registered PTs in Israel demonstrated favorable attitudes toward LGB individuals, as reflected both by ATHS scores and levels of self-reported homophobia and heterosexism. Based on the current results regarding sources of knowledge, updating the physiotherapy curriculum to include information regarding sexual orientation and health of the LGB community is suggested.
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Affiliation(s)
- Roei Klein
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, (Eshkol Bldg., Floor 9, room 910), Haifa, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, (Eshkol Bldg., Floor 9, room 910), Haifa, Israel.
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41
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Shin RQ, Smith LC, Vernay CN, Welch JC, Sharma R, Eberhardt M. Accessing Counseling Services Where the Rainbow Doesn't Shine: A Heterosexism Audit Study. J Homosex 2021; 68:2246-2265. [PMID: 32207668 DOI: 10.1080/00918369.2020.1734377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Through a field experiment set among licensed therapists (N = 425), we found nuanced evidence of heterosexist discrimination at the entry point of mental health services for a fictitious White, presumably gay man seeking counseling. We called therapists in LGB-affirming and LGB-hostile states and left voicemails requesting services. To manipulate perceived sexual orientation, a confederate using the name "Jon" recorded one of three conditions (a) heterosexual-presenting Jon, (b) gay-presenting Jon, and (c) gay-sounding Jon. Analyzes comparing the rate of returned calls for each condition within LGB-affirming versus LGB-hostile states against our referent group, gay-presenting Jon calling mental health professionals in an LGB-affirming region, revealed a number of significant effects. Notably, being perceived as gay in LGB-hostile states significantly decreased the rate of returned calls, with the reverse being true in an LGB-affirming state. The use of "gay-sounding" voice, however, did not appreciably affect these relationships.
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Affiliation(s)
- Richard Q Shin
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, Maryland, USA
| | - Lance C Smith
- Graduate Program in Counseling, University of Vermont, Burlington, Vermont, USA
| | - Collin N Vernay
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, Maryland, USA
| | - Jamie C Welch
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, Maryland, USA
| | - Rajni Sharma
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, Maryland, USA
| | - Maeve Eberhardt
- Department of Romance Languages and Linguistics, University of Vermont, Burlington, Vermont, USA
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42
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Mallory AB, Pollitt AM, Bishop MD, Russell ST. Changes in disclosure stress and depression symptoms in a sample of lesbian, gay, and bisexual youth. Dev Psychol 2021; 57:570-583. [PMID: 34711995 DOI: 10.1037/dev0001168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Disclosing a sexual minority (e.g., lesbian, gay, or bisexual) identity to others is an ongoing process throughout life. Research shows that disclosure is stressful, and this stress is related to poorer mental health for sexual minority youth. However, there are few theoretically grounded studies examining disclosure stress and its prospective association with mental health. The current study utilizes two conceptualizations of sexual identity development-stage models and milestone models-to contextualize how changes in disclosure-related stress are associated with depression symptoms from adolescence into young adulthood. Data come from a sample of lesbian, gay, and bisexual youth between ages 15-24 surveyed over three years (N=555; 82% youth of color; 40% bisexual; 63% free and reduced lunch; and 49% assigned female at birth). We estimated (1) parallel process models and (2) growth curve models with disclosure stress as a time-varying covariate, which were respectively informed by stage and milestone conceptualizations of sexual identity development. Results indicated that depression symptoms declined while disclosure stress increased. In the parallel process model, higher baseline disclosure stress correlated with higher baseline levels and steeper declines in depression symptoms. When disclosure stress was modeled as a time-varying covariate, it was most strongly associated with higher depression symptoms at earlier ages. Disclosure is a developmental process that confers differential risk for depression symptoms earlier in the life course, which can hinder the typical decline of depression symptoms in young adulthood. Supporting sexual minority youth when they disclose their sexual identity throughout adolescence can have long-term benefits for mental health.
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Affiliation(s)
| | | | - Meg D Bishop
- University of Texas at Austin.,University of Texas Population Research Center
| | - Stephen T Russell
- University of Texas at Austin.,University of Texas Population Research Center
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Niemet CJ, Rice K. LGBTQ&A: Development of a needs assessment to define access, needs, and barriers to health care services among LGBTQ older adults. J Prev Interv Community 2021; 50:8-22. [PMID: 34605360 DOI: 10.1080/10852352.2021.1915937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While health-related research on lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults has grown, more research is necessary to understand this population. Howard Brown Health (HBH) conducted a mixed-method needs assessment in Cook County, IL. The purpose of this article is to describe the development of the community survey, focus group guidebook, and study protocol. HBH created the needs assessment to increase knowledge about access to and need for services and barriers to care among LGBTQ aging patients. Furthermore, the study explored how subgroups based on sexual orientation, gender identity, race, ethnicity, and veteran status differed in access, need, and barriers to care. Study participants were 50 years and older, self-identified as LGBTQ, and resided in Cook County. With this knowledge, HBH plans to launch culturally competent wellness programs to improve the quality of life of its LGBTQ older adult patients.
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Affiliation(s)
| | - Kelly Rice
- American College of Surgeons, Chicago, Illinois, USA
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44
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Hartnett CS, Butler Z, Everett BG. Disparities in smoking during pregnancy by sexual orientation and race-ethnicity. SSM Popul Health 2021; 15:100831. [PMID: 34169137 PMCID: PMC8207226 DOI: 10.1016/j.ssmph.2021.100831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/20/2022] Open
Abstract
The intersection between sexual orientation and race-ethnicity is emerging as an important dynamic for health. Prior research indicates that sexual orientation can have very different health implications for White, Black, and Latina individuals and that these patterns are unpredictable. Here we use U.S. data from the National Survey of Family Growth (2006-2019, n = 15,163 pregnancies) to examine how an important health indicator - smoking during pregnancy - is shaped jointly by sexual orientation and race-ethnicity. Smoking during pregnancy was more common among sexual minority women (both bisexual-identified and heterosexual-identified who expressed same-gender attraction/behavior), compared to heterosexual women. Second, the association between sexual orientation and smoking during pregnancy differed by race-ethnicity: sexual minority status was more strongly associated with smoking among Latina women, compared to White women. Finally, the subgroup with the highest rates of smoking during pregnancy was bisexual White women. These findings indicate that smoking rates among pregnant sexual minority women warrant attention (regardless of race-ethnicity), particularly as births within this group are rising. It is important to address structural factors that may create more stress for sexual minority women, since smoking is often a response to stress. These findings also highlight the role of heterogeneity: low smoking rates among pregnant Latina women mask within-group disparities.
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Affiliation(s)
- Caroline Sten Hartnett
- Department of Sociology, Sloan College #321, University of South Carolina, Columbia, SC, 29205, USA
| | - Zackery Butler
- Department of Sociology, Sloan College #321, University of South Carolina, Columbia, SC, 29205, USA
| | - Bethany G. Everett
- Department of Sociology, 380 S 1530 E Room 301, University of Utah, Salt Lake City, UT, 84112, USA
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45
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Azagba S, Shan L. Tobacco Craving, Nicotine Dependence, and Quit Intentions among LGB and Non-LGB High School Students: A Quasi-Experimental Analysis. Int J Environ Res Public Health 2021; 18:9000. [PMID: 34501586 PMCID: PMC8431691 DOI: 10.3390/ijerph18179000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
There is evidence of higher tobacco use among lesbian or gay and bisexual (LGB) populations. However, a limited number of studies have examined whether there are differences in potential indicators of future tobacco cessation behaviors between LGB and non-LGB populations. This study examined whether sexual identity is associated with craving, nicotine dependence, and quit intentions among high school students. Data were drawn from the 2020 National Youth Tobacco Survey (n = 1642). A propensity score matching (PSM) technique was used to address covariate imbalance among sexual identity groups. Additionally, subgroup analyses were performed for both males and females. The PSM results showed higher odds of craving among students who were gay or lesbian (aOR, 1.70; 95% CI = 1.13-2.55) and bisexual (aOR, 1.89; 95% CI = 1.23-2.92) compared to heterosexual (straight) students. In the sex-based subgroup analyses, we found that gay or lesbian (aOR, 1.92; 95% CI = 1.10-3.34) and bisexual (aOR, 3.12; 95% CI, 1.46-6.66) male students had significantly higher odds of craving when compared to heterosexual/straight male adolescents. However, the association was not significant in female students. Additionally, female bisexuals had significantly lower odds for quit intention (aOR, 0.48; 95% CI = 0.29-0.81) when compared to heterosexual/straight female adolescents. Results also showed no significant differences between LGB and non-LGB students for nicotine dependence. Sexual minority adolescents, especially male adolescents, were more likely to have tobacco cravings and bisexual females had lower odds of quit intention than heterosexual peers. Prevention efforts targeting this subpopulation may be beneficial.
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Affiliation(s)
- Sunday Azagba
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
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46
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Fish JN, Turpin RE, Williams ND, Boekeloo BO. Sexual Identity Differences in Access to and Satisfaction With Health Care: Findings From Nationally Representative Data. Am J Epidemiol 2021; 190:1281-1293. [PMID: 33475134 DOI: 10.1093/aje/kwab012] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 02/01/2023] Open
Abstract
Identification of barriers to adequate health care for sexual minority populations remains elusive given that they are complex and variable across sexual orientation subgroups (e.g., gay, lesbian, bisexual). To address these complexities, we used data from a US nationally representative sample of health-care consumers to assess sexual identity differences in health-care access and satisfaction. We conducted a secondary data analysis of 12 waves (2012-2018) of the biannual Consumer Survey of Health Care Access (n = 30,548) to assess sexual identity differences in 6 health-care access and 3 health-care satisfaction indicators. Despite parity in health insurance coverage, sexual minorities-with some variation across sexual minority subgroups and sex-reported more chronic health conditions alongside restricted health-care access and unmet health-care needs. Gay/lesbian women had the lowest prevalence of health-care utilization and higher prevalence rates of delaying needed health care and medical tests relative to heterosexual women. Gay/lesbian women and bisexual men were less likely than their heterosexual counterparts to be able to pay for needed health-care services. Sexual minorities also reported less satisfactory experiences with medical providers. Examining barriers to health care among sexual minorities is critical to eliminating health disparities that disproportionately burden this population.
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47
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Li Y, Yang B, Chen B. LGB Tobacco Control: Do Health Belief Model Constructs Predict Tobacco Use Intentions Differently between LGB and Heterosexual Individuals? Int J Environ Res Public Health 2021; 18:7008. [PMID: 34209073 PMCID: PMC8297060 DOI: 10.3390/ijerph18137008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022]
Abstract
This research includes two studies testing whether the Health Belief Model (HBM) constructs predict tobacco use intentions differently between heterosexual and lesbian, gay, and bisexual (LGB) people. Focusing on cigarette smoking, Study 1 (n = 1808 U.S. adult current smokers) found that the perceived health threat and perceived benefits of smoking differently predicted intentions to continue smoking between heterosexual and LGB smokers. The perceived health threat of smoking had a weaker negative relationship and perceived benefits of smoking had a stronger positive relationship with smoking intentions among LGB smokers than heterosexual smokers. Focusing on vaping, Study 2 (n = 2801 U.S. adults) found that the perceived health threat and perceived barriers of vaping differentially predicted vaping intentions between heterosexual and LGB individuals. The perceived health threat of vaping only negatively predicted vaping intentions among heterosexual people. Perceived barriers to vaping had a stronger negative relationship with intentions to vape among LGB people than among heterosexual people. Our finding suggests that compared to perceptions of tobacco-related health consequences (perceived heath threat), behavioral perceptions (perceived benefits and barriers) may have stronger impacts on tobacco use intentions among LGB people. Thus, efforts focusing on reducing tobacco-related disparities among the LGB community should address perceived benefits and barriers of tobacco use.
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Affiliation(s)
- Yachao Li
- Department of Communication Studies, The College of New Jersey, Ewing, NJ 08628, USA
- Department of Public Health, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Bo Yang
- Department of Communication, University of Arizona, Tucson, AZ 85721, USA;
| | - Bryan Chen
- Department of Public Health, The College of New Jersey, Ewing, NJ 08628, USA;
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48
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Gewirtz-Meydan A, Mitchell KJ, Spivak-Lavi Z. Attachment and Sexual Functioning: Understanding the Mediating Role of Body Image Among LGB and Non-LGB Women. J Sex Med 2021; 18:1245-1257. [PMID: 37057421 DOI: 10.1016/j.jsxm.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 04/13/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Despite studies showing that individuals with insecure attachment suffer from poor body image, and that poor body image is a main risk factor for sexual dysfunction, the mediating role of body image between attachment insecurities and sexual functioning has not been assessed. Moreover, differences in body self-consciousness among sexual minority women have not been examined, even though LGB individuals have been found to be more conscious of stigma and the disapproval of others. AIM To fill this gap, the current study examines the mediating role of body image self-consciousness between insecure attachment and sexual functioning among LGB and non-LGB women. METHODS The study sample consisted of 1,001 women; of them, 808 defined themselves as heterosexual (80.7%), and 193 (19.3%) identified as LGB. The sample was a convenience sample of women who responded to ads on social media. Participants completed an online questionnaire (via Qualtrics) about their attachment orientation, body-image self-consciousness, and sexual functioning. MAIN OUTCOME Body image self-consciousness mediated the relationship between insecure attachment and sexual dysfunction among women in general and LGB women in particular. RESULTS Results indicated that among LGB women, the relationship between attachment and sexual functioning was fully mediated by body image self-consciousness. For non-LGB women, a full model with statistically significant direct and indirect effects was revealed. Both avoidant attachment and anxious attachment were related to body image self-consciousness which was, in turn, related to sexual functioning. A statistically significant direct path from avoidant attachment to sexual functioning was also revealed. CONCLUSION The study findings contribute to the literature by revealing the mediating role that body image self-consciousness plays between insecure attachment and sexual dysfunction among women in general and LGB women in particular. CLINICAL IMPLICATIONS This study provides support for the negative relationship between body image self-consciousness and sexual functioning of women regardless of sexual orientation, and suggests that women affected by body image concerns might be prone to more sexual dysfunction. Therefore, body image self-consciousness should be brought up in sex therapy sessions and future interventions. Clinicians should also be cognizant of differences between LGB and non-LGB women in terms of this effect, taking into account the history of stigma that LGB women may have endured and how this history affects their body image. Gewirtz-Meydan A, Mitchell KJ, Spivak-Lavi Z. Attachment and Sexual Functioning: Understanding the Mediating Role of Body Image Among LGB and Non-LGB Women. J Sex Med 2021;18:1245-1257.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel. Agewirtz-@univ.haifa.ac.il
| | - Kimberly J Mitchell
- Crimes Against Children Research Center, University of New Hampshire, NH, USA
| | - Zohar Spivak-Lavi
- Faculty of Social Work & Faculty of Education, Max Stern Yezreel Valley College, Emek Yezreel, Israel
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49
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Gordon AR, Fish JN, Kiekens WJ, Lightfoot M, Frost DM, Russell ST. Cigarette Smoking and Minority Stress Across Age Cohorts in a National Sample of Sexual Minorities: Results From the Generations Study. Ann Behav Med 2021; 55:530-542. [PMID: 32970788 DOI: 10.1093/abm/kaaa079] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sexual minority populations in the United States have persistently higher rates of cigarette use than heterosexuals, partially driven by exposure to minority stressors (e.g., discrimination and victimization). Little is known about cigarette use across cohorts of sexual minority adults who came of age in distinctly different sociopolitical environments. PURPOSE To examine cigarette use and minority stressors across three age cohorts of U.S. sexual minority adults. METHODS We used data from the Generations Study, a nationally representative sample (N = 1,500) of White, Black, and Latino/a sexual minority adults in three age cohorts (younger: 18-25 years; middle: 34-41 years; and older: 52-59 years). Survey data were collected from March 2016 to March 2017. We used sex-stratified logistic regression models to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between age cohort, minority stressors (discrimination and victimization), and two indicators of cigarette smoking (lifetime use and current use). RESULTS Prevalence of current cigarette use in each age cohort was high (younger: 20%; middle: 33%; and older: 29%). Relative to the younger cohort, men and women in the middle- and older-age cohorts had significantly higher odds of lifetime and current smoking (e.g., men, current, aOR [95% CI]: middle = 2.47 [1.34, 4.52], older = 2.85 [1.66, 4.93]). Minority stressors were independently associated with higher odds of current smoking; when victimization was included, the magnitude of the association between age cohort and current smoking was diminished but remained significant. CONCLUSIONS Smoking cessation interventions must consider the role of minority stress and the unique needs of sexual minority people across the life course.
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Affiliation(s)
- Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Wouter J Kiekens
- Department of Sociology/Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands
| | - Marguerita Lightfoot
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - David M Frost
- Department of Social Science, University College London, London, UK
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
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50
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Schwab-Reese LM, Currie D, Mishra AA, Peek-Asa C. A Comparison of Violence Victimization and Polyvictimization Experiences Among Sexual Minority and Heterosexual Adolescents and Young Adults. J Interpers Violence 2021; 36:NP5874-NP5891. [PMID: 30406715 DOI: 10.1177/0886260518808853] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Despite recent civil rights advances for sexual minority communities in the United States, disparities in violence victimization have increased in recent years. Polyvictimization, the experience of multiple types of violence, is common in the United States and may result in mental and physical health consequences above and beyond single-type victimization. However, disparities in polyvictimization among sexual minority young people remain understudied. The purpose of this article was to determine whether there were disparities in monovictimization and polyvictimization among sexual minority young people compared with their heterosexual peers. Data for this article were from The National Longitudinal Study of Adolescent to Adult Health, a nationally representative cohort study started in 1994. Participants reported their experiences with eight types of violence across child abuse, criminal assault, intimate partner violence (IPV), and sexual assault domains. We categorized individuals with no violence victimization as nonvictims, individuals with one form of victimization as monovictims, and individuals with multiple types of victimization as polyvictims. We then compared experiences of each type of victimization and overall monovictimization and polyvictimization by sexual orientation (n = 9,828). Among females, the proportions of individuals experiencing victimization by sexual orientation were significantly different for all forms of violence. Among males, criminal assault, IPV resulting in injury, and nonphysically and physically forced sexual assault differed by sexual orientation. Compared with 100% heterosexual peers, individuals who were mostly heterosexual had significantly increased odds of monovictimization and polyvictimization compared with no victimization. Bisexual individuals had significantly increased odds of polyvictimiztion, and mostly/100% homosexual individuals had significantly increased odds of monovictimization. Multiple victimization experiences may be a pathway to lifetime health disparities, so our findings may explain many of the health disparities experienced in sexual minority communities. It will be critical to develop and evaluate intervention and prevention programs to eliminate these disparities.
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