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Annual Review of Clinical Psychology 2016Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT... (Review)
Review
Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.
Topics: Adolescent; Humans; Mental Disorders; Sexual and Gender Minorities
PubMed: 26772206
DOI: 10.1146/annurev-clinpsy-021815-093153 -
International Journal of Environmental... Nov 2021Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are...
BACKGROUND
Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities.
OBJECTIVE
To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system.
METHODS
Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines.
INCLUSION CRITERIA
Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage.
RESULTS
A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care.
CONCLUSIONS
LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health.
Topics: Bisexuality; Female; Health Inequities; Homosexuality, Female; Humans; Sexual and Gender Minorities; Transgender Persons
PubMed: 34831556
DOI: 10.3390/ijerph182211801 -
Archives of Sexual Behavior Nov 2021The study's purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then...
The study's purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then detransitioned by discontinuing medications, having surgery to reverse the effects of transition, or both. Recruitment information with a link to an anonymous survey was shared on social media, professional listservs, and via snowball sampling. Sixty-nine percent of the 100 participants were natal female and 31.0% were natal male. Reasons for detransitioning were varied and included: experiencing discrimination (23.0%); becoming more comfortable identifying as their natal sex (60.0%); having concerns about potential medical complications from transitioning (49.0%); and coming to the view that their gender dysphoria was caused by something specific such as trauma, abuse, or a mental health condition (38.0%). Homophobia or difficulty accepting themselves as lesbian, gay, or bisexual was expressed by 23.0% as a reason for transition and subsequent detransition. The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned. There are many different reasons and experiences leading to detransition. More research is needed to understand this population, determine the prevalence of detransition as an outcome of transition, meet the medical and psychological needs of this population, and better inform the process of evaluation and counseling prior to transition.
Topics: Bisexuality; Female; Gender Dysphoria; Gender Identity; Homosexuality, Female; Humans; Male; Sexual and Gender Minorities; Surveys and Questionnaires; Transgender Persons
PubMed: 34665380
DOI: 10.1007/s10508-021-02163-w -
Current Opinion in Psychology Dec 2022This article is organised into sections that explore three key themes. The first is overarching and cuts across the literature, where within recent bisexuality research... (Review)
Review
This article is organised into sections that explore three key themes. The first is overarching and cuts across the literature, where within recent bisexuality research there has been increased inclusion of those whose identities are defined by attraction to multiple genders (e.g., pansexual, queer, and others). This has sometimes been in the form of an amalgamated bisexual+ category, but recent attention has also been given to definitions of bisexuality and pansexuality and how bisexual and pansexual identities might compare. The second theme explores mental health including substance use/abuse and sexual violence/victimisation. The third section notes that there has, to some extent, also been an interest in bipositivity and positive aspects of bisexual identification.
Topics: Female; Humans; Male; Bisexuality; Sexual and Gender Minorities; Gender Identity; Substance-Related Disorders
PubMed: 36371973
DOI: 10.1016/j.copsyc.2022.101489 -
American Journal of Pharmaceutical... Jul 2020An ally is defined as one who is associated with another as a helper that provides support and assistance in an ongoing struggle or effort. Pharmacists should be allies...
An ally is defined as one who is associated with another as a helper that provides support and assistance in an ongoing struggle or effort. Pharmacists should be allies to their patients by ensuring optimal health outcomes and by helping their patients achieve therapeutic objectives and goals. However, most colleges of pharmacy are currently not well equipped to train future pharmacists to counsel lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) patients. This commentary explores reasons for discrepancies in health care access for LGBTQ patients and how efforts can be advanced to meet the needs of this minority group. Pharmacists require adequate training to provide optimal care for a more diverse patient population and to be both an ally in health and a reassuring supporter for members of the LGBTQ community.
Topics: Bisexuality; Education, Pharmacy; Female; Health Services Accessibility; Humans; Male; Pharmacists; Sexual and Gender Minorities; Transgender Persons; Universities
PubMed: 32773835
DOI: 10.5688/ajpe7835 -
International Journal of Environmental... Sep 2022This article focuses on some of the social, cultural and psychological aspects of drug use in sexualized settings in gay and bisexual men (referred to as "chemsex").... (Review)
Review
This article focuses on some of the social, cultural and psychological aspects of drug use in sexualized settings in gay and bisexual men (referred to as "chemsex"). Using a narrative review approach, the article examines previous empirical research in this area and presents a novel theoretical approach for understanding and predicting chemsex behavior. Tenets of identity process theory from social psychology are drawn upon to offer an integrative theoretical framework within which the social, cultural and psychological underpinnings of chemsex can be collectively examined. Existing empirical research suggests that gay and bisexual men may experience sexuality-related stressors that can undermine feelings of self-esteem, self-efficacy, continuity and positive distinctiveness. Identity process theory examines how individuals react to threats to identity brought about by these stressors. In response to identity threat, gay and bisexual men may engage in chemsex as a coping response that encompasses and facilitates various, largely maladaptive, coping strategies and tactics. The more chemsex is perceived as enhancing identity processes and as averting identity threat, the more central it is likely to be to the identities of participants. The centrality of chemsex to one's identity may preclude self-withdrawal from the practice. Several directions for future research are presented based on existing work on chemsex viewed through the lens of identity process theory. These should form the basis of future empirical research in the sphere of sexual health among gay and bisexual men and the outcomes of this research should inform policy and practice in this area.
Topics: Bisexuality; Homosexuality, Male; Humans; Male; Sexual Behavior; Sexual Health; Sexual and Gender Minorities
PubMed: 36231424
DOI: 10.3390/ijerph191912124 -
Seminars in Reproductive Medicine Sep 2017The family planning needs of sexual minority women (SMW) are an understudied but growing area of research. SMW have family planning needs, both similar to and distinct... (Review)
Review
The family planning needs of sexual minority women (SMW) are an understudied but growing area of research. SMW have family planning needs, both similar to and distinct from their exclusively heterosexual peers. Specifically, SMW experience unintended pregnancies at higher rates than their exclusively heterosexual peers, but factors that increase this risk are not well understood. Contraception use is not uncommon among SMW, but lesbian women are less likely to use contraception than bisexual or exclusively heterosexual women. High rates of unintended pregnancy suggest contraception is underused among SMW. Contraception counseling guidelines specific to SMW do not yet exist, but greater adoption of current best practices is likely to meet the needs of SMW. SMW may have unique needs for their planned pregnancies as well, for which obstetrics and gynecology (Ob/Gyn) providers should provide care and referrals. In general, understandings of the distinct family planning needs for SMW are limited and further research is needed, with particular attention to issues of over-lapping health disparities related to status as a SMW and other factors such as race/ethnicity that may add additional layers of stigma and discrimination. Clinical resources are needed to help Ob/Gyns make their practice more welcoming to the needs of SMW.
Topics: Attitude of Health Personnel; Bisexuality; Contraception; Culturally Competent Care; Family Planning Services; Female; Health Knowledge, Attitudes, Practice; Homosexuality, Female; Humans; Physician-Patient Relations; Pregnancy; Pregnancy, Unplanned; Pregnancy, Unwanted; Risk Factors; Sexual Behavior; Sexual and Gender Minorities
PubMed: 29073685
DOI: 10.1055/s-0037-1604456 -
Obstetrics and Gynecology Clinics of... Mar 2017There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health... (Review)
Review
There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research.
Topics: Bisexuality; Female; Health Services Accessibility; Health Services Needs and Demand; Health Surveys; Healthcare Disparities; Homosexuality, Female; Humans; Minority Groups; Minority Health; Sexual and Gender Minorities; Social Stigma; United States; Women's Health
PubMed: 28160894
DOI: 10.1016/j.ogc.2016.11.003 -
Journal of Behavioral Medicine Oct 2020Sexual minority (non-heterosexual) individuals experience higher rates of physical health problems. Minority stress has been the primary explanatory model to account for... (Review)
Review
Sexual minority (non-heterosexual) individuals experience higher rates of physical health problems. Minority stress has been the primary explanatory model to account for this disparity. The purpose of this study was to identify in published research empirically established relationships between minority stress processes and biological outcomes and identify avenues for future research. The PubMed database was queried with search terms relevant to minority stress and a comprehensive list of physical and biological outcomes. To be included in the analysis, studies had to examine the relationship between minority stress and a biological outcome among sexual minority individuals. Those meeting inclusion criteria were coded for key variables including methodology used, positive and null results, participant characteristics, and specific minority stress processes and biological outcomes considered. In total, 26 studies met inclusion criteria. Studies tested relationships between specific minority stress processes including prejudice, expectations of prejudice, concealment of sexual orientation, and internalized stigma and multiple biological outcomes, such as overall physical health, immune response, HIV specific outcomes, cardiovascular outcomes, metabolic outcomes, cancer related outcomes, and hormonal outcomes. Studies included both analyses that detected this relationship (42% of analyses) and analyses that did not detect this relationship (58%). There is substantial evidence to support the relationship between minority stress and biological outcomes, yet additional research is needed to identify the measurements and outcomes that have the most rigorous and replicable results.
Topics: Bisexuality; Female; Humans; Male; Minority Groups; Sexual Behavior; Sexual and Gender Minorities; Social Stigma; Stress, Psychological
PubMed: 31863268
DOI: 10.1007/s10865-019-00120-6 -
BMC Public Health Oct 2021Globally, LGBT+ people continue to struggle to achieve full realization of their human rights. Amid reported health and mental health disparities, and economic... (Review)
Review
BACKGROUND
Globally, LGBT+ people continue to struggle to achieve full realization of their human rights. Amid reported health and mental health disparities, and economic insecurity, we conducted a scoping review to explore the breadth of the literature, map and summarize the evidence, and identify knowledge gaps on LGBT+ inclusion and human rights in Thailand.
METHODS
We conducted a scoping review in accordance with the methodology developed by the Joanna Briggs Institute and PRISMA-ScR guidelines. We systematically searched 16 databases for peer-reviewed literature, and government and nongovernmental organization websites for grey literature, published in English or Thai from January 1, 2000-August 21, 2020. Two reviewers independently screened studies according to pre-set criteria. We abstracted and analyzed data on publication characteristics and focal populations, and synthesized findings in six domains of LGBT+ inclusion: political and civic participation, education, family, personal security and violence, economic well-being, and health.
RESULTS
The review captured 3327 results in total, which was scoped to 76 peer-reviewed articles and 39 grey literature sources, the majority published after 2010. Gay men and transgender women were the primary focal populations in the peer-reviewed literature, LGBT+ people as a whole in the grey literature. Health was the predominant domain across publications. Key findings include the absence of generalized antidiscrimination legislation for LGBT+ individuals and lack of recourse for transgender individuals to change their legal gender; multifaceted stigma and discrimination in the educational system; social isolation and exclusion in families; disproportionate prevalence of sexual violence and reluctance to report to police; discrimination and marginalization in employment; and LGBT+ disparities in health and mental health.
CONCLUSIONS
Future research and programmatic initiatives on LGBT+ inclusion in Thailand should aim to address: 1) understudied populations-lesbian and bisexual women, transmasculine persons; 2) underrepresented topics, including constraints to LGBT+ advocacy; 3) strategic policy initiatives around anti-discrimination laws and legal recognition of same-sex marriage and families; and 4) the need for consistent collection of disaggregated data on LGBT+ persons in education, family, economic, personal security/violence, and health domains in order to assess indicators of inclusion and progress in advancing human rights for LGBT+ people in Thailand.
Topics: Bisexuality; Female; Human Rights; Humans; Male; Sexual and Gender Minorities; Thailand; Transgender Persons
PubMed: 34625045
DOI: 10.1186/s12889-021-11798-2