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Sexual and Reproductive Health Matters Dec 2020The vulnerability of lesbian, gay, bisexual and transgender (LGBT) persons in Africa to public health and other risks is heightened by their exclusion from... (Review)
Review
The vulnerability of lesbian, gay, bisexual and transgender (LGBT) persons in Africa to public health and other risks is heightened by their exclusion from socio-economic opportunities and services. We analysed existing regional-level legal and policy instruments and treaties for the opportunities they offer to tackle the exclusion of LGBT persons in Africa. We identified seven key living legal and policy instruments, formulated and adopted between 1981 and 2018, by the African Union (AU) or its precursor, the Organization of African Unity. These treaties and instruments do not only highlight the region's challenges related to inclusion, most of them are binding and enforceable, and all enshrine the responsibility of AU member-states to safeguard and ensure the inclusion and protection of citizens, their gender or sexual orientation notwithstanding. The instruments set forth strong and ambitious agendas of inclusion and recognise and affirm the rights of the region's citizens to sexual and reproductive health (SRH), equality, freedom and opportunities, regardless of their sexual orientation. Their language is generally universalist and their rejection of discrimination, criminalisation, and denial of socio-economic opportunities and services to the region's sexual minorities is forthright. However, the instruments do not explicitly mention LGBT persons and lack clear and effective mechanisms for answerability among member-states. Accountability and commitment among member-states towards these instruments and policies will improve national legal and policy environments and propel forward the agenda of LGBT inclusion, SRH and wellbeing in the region.
Topics: Bisexuality; Female; Homosexuality, Female; Homosexuality, Male; Human Rights; Humans; International Cooperation; Male; Public Policy; Reproductive Health; Reproductive Rights; Right to Health; Sexual and Gender Minorities; Transsexualism; Vulnerable Populations
PubMed: 31928329
DOI: 10.1080/26410397.2019.1698905 -
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 -
Journal of Aging Studies Jun 2023Critical gerontologists have called for more diverse and inclusive visions of a good old age, and especially for imaginings that do not depend on health, wealth and...
Critical gerontologists have called for more diverse and inclusive visions of a good old age, and especially for imaginings that do not depend on health, wealth and heterosexuality. They have suggested that LGBTQ people, alongside other marginalized groups, may have particular contributions to make to the project of reimagining ageing. In this paper, we bring together this work with Jose Muñoz's concept of 'cruising utopia' to examine possibilities for imagining a more utopian, queer life course. We present findings from a narrative analysis of Bi Women Quarterly, a grassroots online bi community newsletter with an international readership, analyzing three issues published between 2014 and 2019 that focused on the intersection of ageing and bisexuality. We found several ways in which the authors told counter-narratives that queered normative visions of successful ageing. They queered norms around the stability and reification of sexual and gender identities. They challenged current forms of LGBTQ activism. They embraced and celebrated ageing, through such activities as croning ceremonies, and directly addressed and contemplated death. Finally, they queered the narrative form, by giving accounts of personal experience that were dreamlike, poetic or inconclusive. We conclude that counter-normative spaces, such as activist newsletters, offer valuable resources to progress the wider project of reimagining successful ageing more inclusively.
Topics: Female; Humans; Bisexuality; Gender Identity; Homosexuality, Female; Courage; Sexual and Gender Minorities; Aging
PubMed: 37268378
DOI: 10.1016/j.jaging.2023.101133 -
Ciencia & Saude Coletiva May 2019Bisexuality is the sexual, romantic, emotional and physical attraction that a person experiments for both of the biological sexes (men and women). Since the Venezuelan...
Bisexuality is the sexual, romantic, emotional and physical attraction that a person experiments for both of the biological sexes (men and women). Since the Venezuelan society is built under a heteronormative paradigm sometimes is considered that those sexualities, that drift apart from the social reality, are not comprehended thus generating a reject. Therefore, we conducted a study that was titled "Construction of Bisexual Identity in Venezuelan Adults: 'It is Not a transition, I Just Simply Am Like That'" that had as a general objective the understanding of the bisexual identity in Venezuelan adults. This article contemplates one dimension of this major project degree. In-depths interviews were carried out to willing participants and the obtained data were analyzed with the constant comparative method following an emerging design. Among the results four major categories were described, however, in this article we will be only focusing on the development of the bisexual identity.
Topics: Adult; Bisexuality; Female; Humans; Interviews as Topic; Male; Sexual and Gender Minorities; Venezuela; Young Adult
PubMed: 31166502
DOI: 10.1590/1413-81232018245.04382019 -
European Journal of Cancer Care Mar 2022Prostate cancer is highly prevalent and impacts profoundly on patients' quality of life, leading to a range of supportive care needs. (Review)
Review
BACKGROUND
Prostate cancer is highly prevalent and impacts profoundly on patients' quality of life, leading to a range of supportive care needs.
METHODS
An updated systematic review and thematic synthesis of qualitative data using the Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines, to explore prostate cancer patients' experience of, and need for, supportive care. Five databases (Medline, Embase, PsycInfo, Emcare and ASSIA) were searched; extracted data were synthesised using Corbin and Strauss's 'Three Lines of Work' framework.
RESULTS
Searches identified 2091 citations, of which 105 were included. Overarching themes emerged under the headings of illness, everyday life and biographical work. Illness work needs include consistency and continuity of information, tailored to ethnicity, age and sexual orientation. Biographical work focused on a desire to preserve identity in the context of damaging sexual side effects. Everyday life needs centred around exercise and diet support and supportive relationships with partners and peers. Work-related issues were highlighted specifically by younger patients, whereas gay and bisexual men emphasised a lack of specialised support.
CONCLUSION
While demonstrating some overarching needs common to most patients with prostate cancer, this review offers novel insight into the unique experiences and needs of men of different demographic backgrounds, which will enable clinicians to deliver individually tailored supportive care.
Topics: Bisexuality; Humans; Male; Palliative Care; Prostatic Neoplasms; Quality of Life; Sexual and Gender Minorities
PubMed: 35038783
DOI: 10.1111/ecc.13541 -
American Journal of Preventive Medicine Oct 2022This study investigated whether health disparities exist among lesbian, gay, and bisexual individuals serving in the U.S. military by examining the associations of...
INTRODUCTION
This study investigated whether health disparities exist among lesbian, gay, and bisexual individuals serving in the U.S. military by examining the associations of sexual orientation with mental, physical, and behavioral health among a population-based sample of service members and veterans.
METHODS
Sexual orientation and health outcomes were self-reported on the 2016 Millennium Cohort Study follow-up questionnaire (N=96,930). Health outcomes were assessed across 3 domains: mental health (post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger), physical health (multiple somatic symptoms, physical functioning, BMI), and behavioral health (smoking, problem and risky drinking, insomnia). Adjusted logistic regression models conducted between 2019 and 2022 estimated the associations between sexual orientation and each health outcome.
RESULTS
Lesbian, gay, and bisexual individuals (3.6% of the sample) were more likely to screen positive for post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger, multiple somatic symptoms, and insomnia than heterosexual individuals. Gay/lesbian and bisexual women reported more adverse health outcomes (overweight and obesity, smoking, problem/risky drinking) than heterosexual women. Gay and bisexual men reported some adverse health outcomes (e.g., smoking and problem drinking) but better physical health (e.g., less overweight/obesity) than heterosexual men.
CONCLUSIONS
Lesbian, gay, and bisexual service members reported poorer mental, physical, and behavioral health than heterosexual peers, most notably among gay/lesbian women and bisexual individuals. Findings suggest that lesbian, gay, and bisexual service members experience health disparities, despite many having equal eligibility for health care, highlighting the need for improved equity initiatives that promote cultural responsiveness, acceptance, and approaches to support the healthcare needs of lesbian, gay, and bisexual military members.
Topics: Alcoholism; Bisexuality; Cohort Studies; Female; Humans; Male; Medically Unexplained Symptoms; Obesity; Overweight; Sexual Behavior; Sexual and Gender Minorities; Sleep Initiation and Maintenance Disorders; Veterans
PubMed: 35794031
DOI: 10.1016/j.amepre.2022.04.034 -
International Journal of Environmental... Nov 2021Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a... (Review)
Review
Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a consequence of societal and individual prejudice, stigma and discrimination. Far less research has focussed on protective factors that promote wellbeing for this population. A scoping review was conducted using a six-stage methodological framework, and is reported in accordance with the PRISMA-ScR statement. This explored the extent, range and nature of the peer-reviewed, published, academic literature on what is known about the protective factors that promote LGBTI+ youth wellbeing. Six databases were systematically searched applying Population-Concept-Context key inclusion criteria, complemented by contact with authors to identify additional sources, reference checks and hand searches. Ninety-six individual research records were identified and analysed, drawing from Honneth's Recognition Theory. Interpersonal relations with parents ( = 40), peers ( = 32) and providers ( = 22) were associated with indicators of enhanced wellbeing, as were LGBTI+ community relations ( = 32). Importantly, online ( = 10), faith ( = 10) and cultural ( = 5) communities were potentially protective. Content and thematic analysis highlighted the importance of Gay-Straight Alliances (GSAs) ( = 23) offering powerful protective opportunities through intersecting interpersonal, community and legal forms of recognition. GSAs enhance allyship by peers and providers ( = 21), facilitate access to LGBTI+ community networks ( = 11) and co-exist alongside inclusive policies ( = 12), curricular ( = 5) and extracurricular activities ( = 1). This scoping review underscores the need to move beyond the predominant focus on risk factors for LGBTI+ youth, which subsequently inform protectionist approaches. It concludes with an appeal to develop mechanisms to apply recognitive justice to policy, practice and, importantly, future research directions. This emphasises the salience of enhanced understandings of inclusion, which is rights-based, universally available and of potential benefit to all.
Topics: Adolescent; Bisexuality; Female; Homosexuality, Female; Humans; Protective Factors; Sexual and Gender Minorities; Transgender Persons
PubMed: 34770199
DOI: 10.3390/ijerph182111682 -
Cleveland Clinic Journal of Medicine Jul 2016
Topics: Bisexuality; Humans; Sexual and Gender Minorities
PubMed: 27399855
DOI: 10.3949/ccjm.83b.07016 -
Sociology of Health & Illness Sep 2021In the United States, Black gay and bisexual men account for a quarter of HIV infections and face intersecting social and structural stigmas along the axes of race,...
In the United States, Black gay and bisexual men account for a quarter of HIV infections and face intersecting social and structural stigmas along the axes of race, sexuality and class. For those diagnosed with HIV, these inequities shape their lived experiences which include HIV disclosure. Public health has privileged HIV status disclosure as the appropriate moral and responsible choice to protect sex partners, reduce stigma and obtain social support. Though little is known about the emotional aspects of HIV disclosure for Black gay and bisexual men, or how they are shaped by social and structural contexts. Using the frameworks of healthism and emotion work, I explore HIV disclosure among a sample of 30 Black gay and bisexual men living with HIV in the Deep South. Drawing on in-depth, qualitative interviews, I identify the emotion work that men engaged in to manage their own emotions and protect the emotions of others before, during and after disclosure or nondisclosure. These findings challenge public health research that has explored disclosure as discrete measurable events by illustrating how HIV disclosure is embedded in ongoing social and structural relations and provide insights that can guide new approaches focused on structural inequities that constitute HIV disclosure.
Topics: Bisexuality; Disclosure; Emotions; HIV Infections; Homosexuality, Male; Humans; Male; Sexual and Gender Minorities; United States
PubMed: 34519363
DOI: 10.1111/1467-9566.13372 -
Fertility and Sterility Feb 2022To qualitatively explore and describe fertility information-seeking experiences of sexual minority women (SMW) couples using assisted reproduction.
OBJECTIVE
To qualitatively explore and describe fertility information-seeking experiences of sexual minority women (SMW) couples using assisted reproduction.
DESIGN
Qualitative thematic analysis of 30 semistructured, in-depth individual and dyadic interviews with SMW couples.
SETTING
Video conferencing.
PATIENT(S)
Twenty self-identified lesbian, bisexual, and queer women comprising 10 same-sex cisfemale couples (10 gestational and 10 nongestational partners) using assisted reproduction technology in the United States.
INTERVENTION(S)
Not applicable.
MAIN OUTCOME MEASURE(S)
We describe how SMW came to learn about ways to achieve pregnancy through information seeking, acquisition, appraisal, and use.
RESULT(S)
Analysis revealed three primary themes. First, uncertainty and information scarcity: SMW have basic knowledge about how to conceive but uncertainty persists due to information scarcity regarding how same-sex couples navigate assisted reproduction. Second, women attempt to collect fragmented information from disparate sources. The participants discussed a mixture of formal and informal, online, textual (books), and in-person seeking, finding, and synthesizing information that ranged from reliable to unreliable and from accurate to inaccurate. Finally, persistent heteronormative communication focused on the needs and conditions of male-female couples who experienced subfertility or infertility, rather than barriers related to social constraints and the absence of gametes that SMW sought to overcome.
CONCLUSION(S)
These findings support and extend existing evidence that has focused primarily on online fertility information seeking. Our findings suggest that shifts in fundamental assumptions about who seeks assisted reproductive support and why, together with improvements in fertility-related health communication, may result in more inclusive care for this population.
Topics: Access to Information; Adult; Bisexuality; Consumer Health Information; Female; Fertility; Health Knowledge, Attitudes, Practice; Homosexuality, Female; Humans; Interviews as Topic; Minority Health; Patient Acceptance of Health Care; Pregnancy; Qualitative Research; Reproductive Health Services; Sexual and Gender Minorities; Videoconferencing
PubMed: 34674826
DOI: 10.1016/j.fertnstert.2021.09.023