-
Journal of Sex Research Sep 2022Sexual minority men (e.g., gay, bisexual, queer) are more likely than heterosexual men to be involved in an adolescent pregnancy, but little research has been done on...
Sexual minority men (e.g., gay, bisexual, queer) are more likely than heterosexual men to be involved in an adolescent pregnancy, but little research has been done on the context surrounding this disparity. To address this gap, and as part of the larger Sexual Orientation, Gender Identity, and Pregnancy Experiences (SLOPE) Study, semi-structured interviews and descriptive surveys were conducted with 10 cisgender sexual minority men, ages 29-49, from across the United States. Interview transcripts were analyzed using immersion/crystallization and template organizing style methods, and themes were organized into a conceptual model describing sexual minority men's debut sexual activity and decision-making experiences during adolescence. This model depicts three themes: 1) partnership and negotiation of sexual experiences, 2) psychological processes related to development, pregnancy, and sexuality, and 3) cultural and environmental contexts. These three themes are contextualized by a throughline of (i.e., the existence and chronology of life-impacting events). Findings indicate a complex interplay of psychological (e.g., developmental processes surrounding sexuality and sexual orientation), social (e.g., personal relationships), and policy-level factors (e.g., sex education) influence sexual minority men's sexuality and pregnancy prevention decision-making during adolescence. Care should be taken to consider and include sexual minority men in pregnancy prevention messaging and education.
Topics: Adolescent; Adult; Bisexuality; Female; Gender Identity; Heterosexuality; Humans; Male; Middle Aged; Pregnancy; Pregnancy in Adolescence; Sexual Behavior; Sexual and Gender Minorities; United States
PubMed: 35353659
DOI: 10.1080/00224499.2022.2053043 -
Health Psychology : Official Journal of... Jan 2022Risky sexual behavior among sexual minorities (lesbian, gay, and bisexual individuals) are partly attributed to mental health and other social disparities; but this may...
OBJECTIVES
Risky sexual behavior among sexual minorities (lesbian, gay, and bisexual individuals) are partly attributed to mental health and other social disparities; but this may be confounded by correlated genetic and environmental influences. As preregistered, the present study investigated indirect associations between sexual minority status and increased lifetime sexual partners through increased psychosocial adversity (depressive and anxiety symptoms, intimate partner violence, and early life adversities) and substance use (alcohol, cannabis, and other illicit drugs), confounding by correlated genetic and environmental influences, and sex differences in these relationships.
METHOD
The sample comprised sexual minority and heterosexual twins who participated in the first and second phases of the latest wave of data collection in the U.K. population-based Twins Early Development study cohort (June 2017 through February 2019; = 9,697 and 8,718, respectively, = 22.3 ± .92 years). Structural equation modeling was used to specify psychosocial adversity and substance use as mediators while genetic and environmental confounding was further determined by biometrical genetic analyses in which similarities in identical and nonidentical twins were compared.
RESULTS
Increased psychosocial adversity and substance use fully mediated increased lifetime sexual partners in sexual minority women while this effect was partial (31.1%) in men. The best-fitting genetic models indicated that these relationships were not confounded by correlated genetic and environmental influences.
CONCLUSIONS
The relationships between sexual minority status, psychosocial adversity, substance use, and sexual health disparities appeared independent of genetic and environmental influences. Individual and systemic interventions to reduce psychosocial disadvantage and substance use can also decrease sexual health disparities among sexual minorities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Adult; Bisexuality; Female; Heterosexuality; Humans; Male; Risk-Taking; Sexual Behavior; Sexual and Gender Minorities; Substance-Related Disorders; Young Adult
PubMed: 34843263
DOI: 10.1037/hea0001129 -
Health Reports Nov 2019Previous research indicates that lesbian, gay and bisexual individuals have poorer mental health than their heterosexual counterparts. The concept of complete mental...
BACKGROUND
Previous research indicates that lesbian, gay and bisexual individuals have poorer mental health than their heterosexual counterparts. The concept of complete mental health, which combines the presence of positive mental health and the absence of mental disorder, has not been thoroughly examined in this population.
DATA AND METHODS
Data from the 2015 Canadian Community Health Survey (CCHS) were used to estimate the number and percentage of men and women aged 15 and older who self-identify as lesbian, gay, bisexual, or heterosexual. Complete mental health was defined as the presence of flourishing mental health together with the absence of any self-reported mood disorder, anxiety disorder or suicide ideation in the previous 12 months. Multivariate logistic regression models stratified by sex were used to identify differences in complete mental health among gay, lesbian, bisexual, and heterosexual individuals.
RESULTS
In 2015, an estimated 252,000 (1.9%) Canadian men identified as gay and 145,000 (1.1%) as bisexual, while 153,000 Canadian women (1.1%) identified as lesbian and 299,000 (2.2%) as bisexual. Gay men had significantly lower unadjusted odds of complete mental health, but this association was no longer significant when controlling for sociodemographic and health factors. The likelihood of complete mental health was not significantly different for lesbians than for heterosexual women. Both bisexual men and bisexual women had significantly lower odds of complete mental health in the fully adjusted models.
DISCUSSION
Awareness of poorer mental health outcomes, particularly for bisexual individuals, can help guide specific interventions aimed at improving the mental health and well-being of sexual minority populations.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety Disorders; Bisexuality; Canada; Female; Health Surveys; Homosexuality, Female; Homosexuality, Male; Humans; Logistic Models; Male; Mental Disorders; Mental Health; Middle Aged; Mood Disorders; Sexual and Gender Minorities; Suicidal Ideation; Young Adult
PubMed: 31747043
DOI: 10.25318/82-003-x201901100001-eng -
Journal of Addiction Medicine Dec 2020In light of the opioid epidemic, it is essential to understand which subgroups of youth are at elevated risk for opioid use. Sexual minority groups have increased rates...
OBJECTIVES
In light of the opioid epidemic, it is essential to understand which subgroups of youth are at elevated risk for opioid use. Sexual minority groups have increased rates of substance use compared to heterosexual youth. Our study aims to examine the prevalence of both prescription opioid misuse and heroin use in adolescents. We then examine odds of prescription opioid misuse and heroin use adjusting for common covariates.
METHODS
Using 2017 Youth Risk Behavior Surveillance System data, we examined lifetime odds of prescription opioid misuse and heroin use among sexual minority youth as defined by sexual identity and sexual behavior. We used logistic regression adjusting for age, sex, and race.
RESULTS
28.5% of gay/lesbian and 25.1% of bisexual youth reported misuse compared to 12.5% of heterosexual youth. Nearly 1 in 10 gay/lesbian youth reported a history of heroin use compared to 4.1% of bisexual and 1.1% of heterosexual young people. Among those who reported having a history of sexual contact, those with same sex contact and sexual contact with both sexes had elevated odds of lifetime heroin use compared to those with a history of opposite sex contact only (aOR: 3.77; 95% CI: 1.68, 8.44 and aOR: 7.44; 95% CI: 4.59, 12.06, respectively).
CONCLUSIONS
We demonstrated preliminary evidence sexual minority youth have significant opioid-related health disparities with greater odds of lifetime prescription opioid misuse and heroin use. As early exposure to opioids is associated with greater risk for developing an opioid use disorder and increased opioid-morbidity and mortality, it is critical that providers recognize and incorporate the unique needs for sexual minority youth into traditional treatment and prevention models.
Topics: Adolescent; Analgesics, Opioid; Bisexuality; Female; Heterosexuality; Homosexuality, Female; Humans; Male; Sexual and Gender Minorities
PubMed: 32039933
DOI: 10.1097/ADM.0000000000000628 -
BMC Public Health Sep 2023Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider...
BACKGROUND
Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures inclusive of transgender people and characterize sexual orientation identity, behavior, and attraction in a representative sample of the U.S. transgender population.
METHODS
Between April 2016-December 2018, a U.S. national probability sample of transgender (n = 274) and cisgender (n = 1,162) adults were invited to complete a self-administered web or mailed paper survey. We assessed sexual identity with updated response options inclusive of recent identity terms (e.g., queer), and revised sexual behavior and attraction measures that included transgender people. Multiple response options were allowed for sexual behavior and attraction. Weighted descriptive statistics and sexual orientation differences by gender identity groups were estimated using age-adjusted comparisons.
RESULTS
Compared to the cisgender population, the transgender population was more likely to identify as a sexual minority and have heterogeneity in sexual orientation, behavior, and attraction. In the transgender population, the most frequently endorsed sexual orientation identities were "bisexual" (18.9%), "queer" (18.1%), and "straight" (17.6%). Sexually active transgender respondents reported diverse partners in the prior 5 years: 52.6% cisgender women (CW), 42.7% cisgender men (CM), 16.9% transgender women (TW), and 19.5% transgender men (TM); 27.7% did not have sex in the past 5 years. Overall, 73.6% were "somewhat"/ "very" attracted to CW, 58.3% CM, 56.8% TW, 52.4% TM, 59.9% genderqueer/nonbinary-females-at-birth, 51.9% genderqueer/nonbinary-males-at-birth. Sexual orientation identity, behavior, and attraction significantly differed by gender identity for TW, TM, and nonbinary participants (all p < 0.05).
CONCLUSIONS
Inclusive measures of sexual orientation captured diverse sexual identities, partner genders, and desires. Future research is needed to cognitively test and validate these measures, especially with cisgender respondents, and to assess the relation of sexual orientation and health for transgender people.
Topics: Female; Adult; Humans; Male; Transgender Persons; Gender Identity; Sexual Behavior; Sexual and Gender Minorities; Bisexuality
PubMed: 37715161
DOI: 10.1186/s12889-023-16654-z -
JAMA Pediatrics May 2022Sexual orientation and gender identity change efforts (SOGICE), also called conversion therapy, is a discredited practice attempting to convert lesbian, gay, bisexual,...
IMPORTANCE
Sexual orientation and gender identity change efforts (SOGICE), also called conversion therapy, is a discredited practice attempting to convert lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals to be heterosexual and/or cisgender.
OBJECTIVES
To identify and synthesize evidence on the humanistic and economic consequences of SOGICE among LGBTQ youths in the US.
DESIGN, SETTING, AND PARTICIPANTS
This study, conducted from December 1, 2020, to February 15, 2021, included a systematic literature review and economic evaluation. The literature review analyzed published evidence on SOGICE among LGBTQ individuals of any age. The economic model evaluated the use of SOGICE vs no intervention, affirmative therapy vs no intervention, and affirmative therapy vs SOGICE to estimate the costs and adverse outcomes for each scenario and to assess the overall US economic burden of SOGICE. Published literature and public sources were used to estimate the number of LGBTQ youths exposed to SOGICE, the types of therapy received, and the associated adverse events (anxiety, severe psychological distress, depression, alcohol or substance abuse, suicide attempts, and fatalities).
EXPOSURES
SOGICE (licensed or religion-based practitioners) or affirmative therapy (licensed practitioners).
MAIN OUTCOMES AND MEASURES
Total incremental costs and quality-adjusted life-years (QALYs) vs no intervention and total economic burden of SOGICE.
RESULTS
Among 28 published studies, which included 190 695 LGBTQ individuals, 12% (range, 7%-23%) of youths experienced SOGICE, initiated at a mean age of 25 years (range, 5-58 years), with a mean (SD) duration of 26 (29) months. At least 2 types of SOGICE were administered to 43% of recipients. Relative to LGBTQ individuals who did not undergo SOGICE, recipients experienced serious psychological distress (47% vs 34%), depression (65% vs 27%), substance abuse (67% vs 50%), and attempted suicide (58% vs 39%). In the economic analysis, over a lifetime horizon with a 3% annual discount rate, the base-case model estimated additional $97 985 lifetime costs per individual, with SOGICE associated with 1.61 QALYs lost vs no intervention; affirmative therapy yielded cost savings of $40 329 with 0.93 QALYs gained vs no intervention. With an estimated 508 892 youths at risk for SOGICE in 2021, the total annual cost of SOGICE is estimated at $650.16 million (2021 US dollars), with associated harms totaling an economic burden of $9.23 billion.
CONCLUSIONS AND RELEVANCE
This economic evaluation study suggests that there is a high economic burden and high societal costs associated with SOGICE and identifies additional research questions regarding the roles of private and public funding in supporting this harmful practice.
Topics: Adolescent; Adult; Bisexuality; Female; Financial Stress; Gender Identity; Humans; Male; Sexual Behavior; Sexual and Gender Minorities; United States
PubMed: 35254391
DOI: 10.1001/jamapediatrics.2022.0042 -
International Journal of Environmental... Apr 2022Some (minority) groups (MGs) are more vulnerable to sexual violence (SV) exposure than others. Othering-based stress (OBS) may mediate the relationship between minority...
BACKGROUND
Some (minority) groups (MGs) are more vulnerable to sexual violence (SV) exposure than others. Othering-based stress (OBS) may mediate the relationship between minority identification and SV. This study aims to assess the prevalence of SV in different MGs to explore the relationship between minority identification and SV, to investigate whether belonging to multiple MGs moderates this relationship, and to explore OBS SV moderation for different MGs.
METHOD
Through an online survey administered to a nationally representative sample in Belgium, data was collected from 4632 persons, of whom 21.01% self-identified as belonging to a MG (SI-Minority). SV prevalence was measured using behaviorally specific questions based on the WHO definition of SV. SI-Minority participants received an additional scale on OBS.
RESULTS
SI-Minority participants reported more SV victimization compared to the non-minorities. However, this increased risk was not moderated by minority identification but linked to the socio-demographic SV risk markers common to minority individuals. Multiple-minority participants were found more at risk of SV compared to single-minority respondents. Lesbian, gay, bisexual, pan-/omnisexual, asexual, and other non-heterosexual (LGB+) participants were found more at risk than heterosexual participants. OBS was found to be significantly correlated to SV in sexual and gender minorities and in cultural minorities.
CONCLUSIONS
This study contributes to our understanding of the relationship between minority identification, OBS, and SV. Studying both specific and common SV vulnerabilities and outcomes within specific societal subgroups and the general population may inform policy makers when allocating resources to those interventions with the largest societal impact.
Topics: Bisexuality; Female; Heterosexuality; Humans; Sex Offenses; Sexual Behavior; Sexual and Gender Minorities
PubMed: 35409901
DOI: 10.3390/ijerph19074221 -
Health Promotion Practice Mar 2023Lesbian, gay, bisexual, transgender, queer, nonbinary, and other sexual and gender minority (LGBTQ+) youth are at substantially greater risk than cisgender heterosexual...
Lesbian, gay, bisexual, transgender, queer, nonbinary, and other sexual and gender minority (LGBTQ+) youth are at substantially greater risk than cisgender heterosexual youth for experiencing teen dating violence (TDV) victimization, including emotional, physical, and sexual abuse within dating/romantic relationships. Despite these inequities, there are no evidence-based interventions designed specifically to address TDV among LGBTQ+ youth. To redress this dearth of interventions, we utilized a youth-centric approach, wherein 46 LGBTQ+ youth co-developed intervention concepts for reducing TDV. Participants engaged in a process of generating, prioritizing, and refining intervention concepts for reducing TDV inequities using human-centered design activities. LGBTQ+ youth generated eight intervention concepts, including the name, description, audience, problem focus, goals, and process for each. Their interventions focused on strategies for enhancing education, support systems, and advocacy. The intervention concepts had a wide variety of intended audiences, including LGBTQ+ and non-LGBTQ+ youth, teachers, school administrators, and policymakers. Overall, LGBTQ+ youth sought to improve education and skills pertaining to violence, sexual health, and healthy relationships; enhance support systems and resources for students' basic, mental health, and safety needs; and build advocacy channels related to "outing" and LGBTQ+ students' needs. These LGBTQ+ youth-generated programmatic and policy intervention concepts, in addition to our human-centered design approach, can be directly leveraged by health promotion practitioners and prevention experts into future intervention development, implementation, and evaluation efforts to improve LGBTQ+ youth health, well-being, resilience, and advocacy.
Topics: Female; Humans; Adolescent; Bisexuality; Sexual and Gender Minorities; Homosexuality, Female; Sexual Behavior; Intimate Partner Violence
PubMed: 36419324
DOI: 10.1177/15248399221137276 -
AIDS and Behavior Feb 2017Regular HIV testing enables early identification and treatment of HIV among at-risk men who have sex with men (MSM). Characterizing HIV testing needs for Internet-using... (Review)
Review
Regular HIV testing enables early identification and treatment of HIV among at-risk men who have sex with men (MSM). Characterizing HIV testing needs for Internet-using MSM informs development of Internet-facilitated testing interventions. In this systematic review we analyze HIV testing patterns among Internet-using MSM in the United States who report, through participation in an online study or survey, their HIV status as negative or unknown and identify demographic or behavioral risk factors associated with testing. We systematically searched multiple electronic databases for relevant English-language articles published between January 1, 2005 and December 16, 2014. Using meta-analysis, we summarized the proportion of Internet-using MSM who had ever tested for HIV and the proportion who tested in the 12 months preceding participation in the online study or survey. We also identified factors predictive of these outcomes using meta-regression and narrative synthesis. Thirty-two studies that enrolled 83,186 MSM met our inclusion criteria. Among the studies reporting data for each outcome, 85 % (95 % CI 82-87 %) of participants had ever tested, and 58 % (95 % CI 53-63 %) had tested in the year preceding enrollment in the study, among those for whom those data were reported. Age over 30 years, at least a college education, use of drugs, and self-identification as being homosexual or gay were associated with ever having tested for HIV. A large majority of Internet-using MSM indicated they had been tested for HIV at some point in the past. A smaller proportion-but still a majority-reported they had been tested within the year preceding study or survey participation. MSM who self-identify as heterosexual or bisexual, are younger, or who use drugs (including non-injection drugs) may be less likely to have ever tested for HIV. The overall findings of our systematic review are encouraging; however, a subpopulation of MSM may benefit from targeted outreach. These findings indicate unmet needs for HIV testing among Internet-using MSM and identify subpopulations that might benefit from targeted outreach, such as provision of HIV self-testing kits.
Topics: Bisexuality; Drug Users; HIV Infections; Heterosexuality; Homosexuality; Humans; Internet; Male; Mass Screening; Risk Factors; Sexual and Gender Minorities; Surveys and Questionnaires; United States
PubMed: 27498198
DOI: 10.1007/s10461-016-1506-7 -
Archives of Sexual Behavior May 2022Most prior bisexual research takes a monolithic approach to racial identity, and existing racial/ethnic minority research often overlooks bisexuality. Consequently,...
Most prior bisexual research takes a monolithic approach to racial identity, and existing racial/ethnic minority research often overlooks bisexuality. Consequently, previous studies have rarely examined the experiences and unique health needs of biracial/multiracial and bisexual individuals. This exploratory qualitative study investigated the identity-related experiences of biracial/multiracial and bisexual adults within the context of health and well-being. Data were collected through 90-min semi-structured telephone interviews. Participants were recruited through online social network sites and included 24 adults between ages 18 and 59 years. We aimed to explore how identity-related experiences shape biracial/multiracial and bisexual individuals' identity development processes; how biracial/multiracial and bisexual individuals negotiate their identities; how the blending of multiple identities may contribute to perceptions of inclusion, exclusion, and social connectedness; and how biracial/multiracial and bisexual individuals may attribute positive and negative experiences to their identities. Interview transcripts were analyzed using an inductive thematic approach. Analysis highlighted four major themes: passing and invisible identities, not measuring up and erasing complexity, cultural binegativity/queerphobia and intersectional oppressions, and navigating beyond boundaries. Our findings imply promoting affirmative visibility and developing intentional support networks may help biracial/multiracial and bisexual individuals cultivate resiliency and navigate sources of identity stress. We encourage future research to explore mental health and chronic stress among this community.
Topics: Adolescent; Adult; Bisexuality; Ethnicity; Humans; Middle Aged; Minority Groups; Sexual Behavior; Sexual and Gender Minorities; Young Adult
PubMed: 35622076
DOI: 10.1007/s10508-021-02236-w