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Drug and Alcohol Dependence Sep 2021Black and Hispanic persons who identify as lesbian, gay, or bisexual (LGB) experience health disparities relative to non-Hispanic White and heterosexual groups...
OBJECTIVE
Black and Hispanic persons who identify as lesbian, gay, or bisexual (LGB) experience health disparities relative to non-Hispanic White and heterosexual groups respectively, including higher rates of suicidal ideation (SI) and substance use disorder (SUD). To elucidate intersectional risk, we used a large national sample to examine rates of SI, SUD, and their co-occurrence (SI + SUD) at the intersection of sexual identity and race/ethnicity.
METHOD
Data were from five years (2015-2019) of the National Survey of Drug Use and Heath (unweighted N = 189,127). Multinomial logistic regressions with persons without SI and SUD as references were stratified by gender and controlled for survey year, age, education, marital status, and income.
RESULTS
Compared to same-race and same-gender heterosexual adults, White, Black, and Hispanic LGB men and women showed higher odds of SI (AOR = 2.86-4.45), SUD (AOR = 1.23-3.01), and SI + SUD (AOR = 2.72-6.85). Compared to same-gender White heterosexual adults, Black and Latinx heterosexual men and women showed lower odds of SI (AORs = .54-.65), SUD (AORs = .52-.78) and SI + SUD (AORs = .41-.57). Compared to same-gender White LGB adults, Black and Hispanic women, but not men, showed lower SI odds (AORs = .58-.72). Compared to same-gender White heterosexual adults, Black and Hispanic LGB men and women showed higher odds of SI (AORs = 1.71-2.51) and SI + SUD (AORs = 1.91-2.97).
CONCLUSIONS
Consistent with research showing effects of multiple minority stress on behavioral health, adults with intersecting racial/ethnic and sexual minority identities showed increased odds of SI, SUD, and SI + SUD relative to Non-Hispanic White heterosexual peers. Black, Hispanic, and White LGB adults may benefit from screening and intervention for SI and SUD.
Topics: Adult; Bisexuality; Female; Homosexuality, Female; Humans; Male; Sexual and Gender Minorities; Substance-Related Disorders; Suicidal Ideation
PubMed: 34214885
DOI: 10.1016/j.drugalcdep.2021.108848 -
Psychiatria Polska Jun 2022A number of health problems are more common in the population of men who have sex with men (MSM) as compared with the general population. At the same time, research... (Review)
Review
A number of health problems are more common in the population of men who have sex with men (MSM) as compared with the general population. At the same time, research reveals that the MSM population is far from homogeneous, and that subcultural affiliation is one of the characteristics that should be taken into account in health analyses of this group. One of the subcultures among MSM that has received growing interest from researchers in recent years, is the Bear community. It originated in the USA and comprises men - mostly homosexual or bisexual - who are characterized by larger, massive or muscular figure, and by distinctive male phenotypic traits - especially body hair pattern, including facial hair. The most significant health determinants in this group include a higher prevalence of behaviors contributing to negative health outcomes as compared with other MSM, elevated BMI values, as well as exposure to multiple stigma - both sexual minority and weight stigma. Research to date has shown that these characteristics of Bears have significant implications for their mental and sexual health. The article aims to review the literature, and to discuss the practical and the clinical implications of the studies conducted thus far in this population. The summary gives practical recommendations regarding both the support for Bear men in clinical practice, and the design of adequate and effective health promotion interventions for members of this unique community.
Topics: Humans; Male; Bisexuality; HIV Infections; Homosexuality, Male; Sexual and Gender Minorities; Sexual Behavior; Social Stigma
PubMed: 36342990
DOI: 10.12740/PP/OnlineFirst/127468 -
Revista Gaucha de Enfermagem 2022To evaluate the perception of social support in a sexual minority and to associate it with the risk of drug addiction.
AIM
To evaluate the perception of social support in a sexual minority and to associate it with the risk of drug addiction.
METHOD
Cross-sectional study, with 254 self-declared gay, bisexual, lesbian, or transsexual participants in the city of Fortaleza, between October and December 2019. Data analyzed by descriptive statistics and likelihood ratio tests.
RESULTS
Most were satisfied with social support between low and medium (74.4%). The most commonly used drugs were alcohol (91.5%), tobacco (67.4%) and marijuana (66.9%). Assessing the risk of addiction, 28.7% scored it as low, 46.9% as moderate, and 9.8% as high risk. There was significance between satisfaction of social support and years of study.
CONCLUSION
We found a level of satisfaction between low and medium, and it was possible to report the most consumed drugs. There was no association between social support and drug use, although the weaknesses and strengths of social support have been highlighted.
Topics: Bisexuality; Cross-Sectional Studies; Female; Humans; Sexual and Gender Minorities; Social Support; Substance-Related Disorders
PubMed: 35920481
DOI: 10.1590/1983-1447.2022.20210151.en -
The American Journal of Orthopsychiatry 2022Black sexual minority women (SMW), the largest racial group among the sexual minority community, often report high psychological distress and decreased psychological...
Black sexual minority women (SMW), the largest racial group among the sexual minority community, often report high psychological distress and decreased psychological health and social well-being. Strong, positive, social relationships positive within group identities, and support networks are a key component in coping with minority stressors and promoting overall well-being. This study explored the association between minority stressors, social support, and Black SMW's social well-being and psychological distress. Participants consisted of individuals identifying as Black (including biracial identities, = 48) cisgender women ( = 149) who responded to the Generations Study's initial round of surveys collected in 2016-2017. Participants were between the ages of 18-60, with a mean of 29.3 years old. Descriptive and bivariate correlations were conducted for lesbian, gay, and bisexual (LGB) stigma, internalized homophobia, gender presentation, ethnic identity affiliation, LGB community connectedness, and social support. Multiple regression models were conducted to analyze correlates of social well-being and psychological distress, controlling for age and education level. LGB stigma and internalized homophobia were significant predictors of social well-being and psychological distress. Low internalized homophobia, distress, and stigma were associated with higher social well-being as were high connection to LGB and ethnic communities. Implications for therapy are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Adolescent; Adult; Bisexuality; Female; Homophobia; Humans; Middle Aged; Minority Groups; Psychological Distress; Sexual and Gender Minorities; Social Stigma; Stress, Psychological; Young Adult
PubMed: 35511548
DOI: 10.1037/ort0000617 -
The Gerontologist Oct 2022Understanding the influence of social resources on health is crucial in gerontological research. However, access to social resources may differ by one's particular...
BACKGROUND AND OBJECTIVES
Understanding the influence of social resources on health is crucial in gerontological research. However, access to social resources may differ by one's particular lesbian, gay, bisexual, and transgender (LGBT) identity and the intersection of LGBT identity with other sociodemographic characteristics, including age.
RESEARCH DESIGN AND METHODS
Using 2010 data from Caring and Aging With Pride (N = 2,536), this study examined how access to social resources varied by LGBT identity and whether the effect of LGBT identity was modified by additional sociodemographic characteristics among LGBT adults aged 50-95 years.
RESULTS
Lesbian respondents had larger social networks than gay male respondents, and gay male respondents had smaller networks than transgender respondents. Lesbian respondents reported more social support and community belonging than other identity groups. Bisexual male respondents and transgender respondents had less support than gay male respondents, and bisexual male respondents reported less community belonging than gay male respondents. Age and education moderated the association between LGBT identity and social support.
DISCUSSION AND IMPLICATIONS
This study demonstrated differences in access to social resources according to environmental circumstances that can intersect and govern access to social resources. Findings highlight the importance of considering social support separately from social network size; thus, large social networks do not necessarily provide ample social support. LGBT older adults had different perceptions of social support than their middle-aged counterparts. Health and human service professionals should not only consider the sexual and gender identity of their LGBT clients, but also education and age when assessing access to social resources.
Topics: Male; Female; Humans; Middle Aged; Aged; Transgender Persons; Gender Identity; Sexual and Gender Minorities; Bisexuality; Homosexuality, Female
PubMed: 35106592
DOI: 10.1093/geront/gnac021 -
Gaceta Sanitaria 2021Health systems and professional training are based on gender binarism. At different stages of the life cycle, there are situations that cause inequities, lack of... (Review)
Review
Health systems and professional training are based on gender binarism. At different stages of the life cycle, there are situations that cause inequities, lack of opportunities and risks to the health of lesbian, gay, bisexual, trans and intersex (LGBTI) people. This work aims to explore the need to include affective-sexual, bodily and gender diversity (ASBGD) in the curricula of health sciences degrees. A narrative bibliographic review was performed to identify recommendations based on international frameworks and experiences with new approaches to incorporate ASBGD, as well as a critical analysis of the current situation regarding the deficiencies in the inclusion of ASBGD in health sciences degrees. At present there is a progressive inclusion of ASBGD in health sciences in many countries, which is considered fundamental for ethical professional practices, and excellence in care. We offer a summary of advances, emerging debates and teaching strategies for the inclusion of ASBGD from previous international experiences. These experiences highlight the need for inclusion of ASBGD, the lack of knowledge about specific needs of LGBTI people and the benefits of breaking with the binary imposition. They recommend increasing knowledge about terminology, rights and inequalities, and the active participation of LGBTI people and communities.
Topics: Bisexuality; Female; Gender Identity; Humans; Sexual Behavior; Sexual and Gender Minorities; Transsexualism
PubMed: 32173051
DOI: 10.1016/j.gaceta.2019.12.003 -
Current Opinion in Psychology Feb 2023This article provides a critical review of recent research about bisexual men. It foregrounds research dedicated to this group, rather than when bisexual men are... (Review)
Review
This article provides a critical review of recent research about bisexual men. It foregrounds research dedicated to this group, rather than when bisexual men are included in a broader study, providing a rationale for the importance of doing this. The review finds that there is still a preponderance of research on bisexual men focused on experiences of stigma and discrimination, often from a public health perspective or with a focus on negative health outcomes. Social science research explores disclosure of bisexual identity, with evidence of widespread stigma but also positive experiences of disclosure. Bisexual men have diverse experiences of romantic relationship, with the gender and sexuality of the partner influencing relationship dynamics. Research also highlights sexual health issues, including difficulties in accessing healthcare. The review shows that further research is needed into this understudied population.
Topics: Male; Humans; Sexual Behavior; Bisexuality; Sexual and Gender Minorities; Gender Identity; Social Stigma
PubMed: 36473377
DOI: 10.1016/j.copsyc.2022.101501 -
Eating Behaviors Dec 2021Bisexual individuals experience prejudice specifically related to their bisexual identity, and these experiences may compound extant risk for disordered eating behaviors...
Associations between anti-bisexual minority stress and body esteem and emotional eating among bi+ individuals: The protective role of individual- and community-level factors.
Bisexual individuals experience prejudice specifically related to their bisexual identity, and these experiences may compound extant risk for disordered eating behaviors and body esteem concerns. However, little is known about how sexual minority stress related to bisexual orientation is associated with emotional eating and body esteem. The current study examined the associations between bisexual-specific minority stress and emotional eating and body esteem in a sample of bisexual plus (bi+) adults (including bisexual, pansexual, queer, and those with attractions to more than one gender regardless of identity), and tested the moderating effects of identity centrality, affirmation, and community connectedness as potential protective factors. This study leveraged data from an online survey of 498 adults (77.46% cisgender women; 79.7% White), ages 18 to 64 years (M = 28.5; SD = 9.59). Bisexual-specific minority stress was associated with more emotional eating (β = 0.15, p = .013) and lower body esteem (β = -0.16, p = .005), while controlling for sociodemographic characteristics, body mass index, and heterosexist minority stress. This finding remained the same when sensitivity analyses were conducted with participants who identified specifically as bisexual. Identity centrality and affirmation and community connectedness did not demonstrate moderating effects but they had main effects, such that they were positively associated with body esteem (β = 0.16, p = .001; β = 0.21, p < .001; β = 0.13, p = .004, respectively). Results suggest that anti-bisexual minority stress has a unique association with bi+ individuals' emotional eating and body esteem, and identified potential individual- and community-level protective factors for body esteem. These findings inform future research and interventions for this understudied population.
Topics: Adolescent; Adult; Bisexuality; Female; Humans; Middle Aged; Minority Groups; Prejudice; Sexual Behavior; Sexual and Gender Minorities; Young Adult
PubMed: 34757266
DOI: 10.1016/j.eatbeh.2021.101575 -
JAMA Network Open Feb 2021Medical trainee burnout is associated with poor quality care and attrition. Medical students in sexual minority groups report fear of discrimination and increased...
IMPORTANCE
Medical trainee burnout is associated with poor quality care and attrition. Medical students in sexual minority groups report fear of discrimination and increased mistreatment, but the association between sexual orientation, burnout, and mistreatment is unknown.
OBJECTIVE
To evaluate whether medical student burnout differs by sexual orientation and whether this association is mediated by experiences of mistreatment.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study surveyed US medical students graduating from Association of American Medical Colleges (AAMC)-accredited US allopathic medical schools who responded to the AAMC graduation questionnaire in 2016 and 2017. Statistical analyses were performed from March 15, 2019, to July 2, 2020, and from November 20 to December 9, 2020.
MAIN OUTCOMES AND MEASURES
Burnout was measured using the Oldenburg Burnout Inventory for Medical Students, and sexual orientation was categorized as either heterosexual or lesbian, gay, or bisexual (LGB). Logistic regression models were constructed to evaluate the association between sexual orientation and experiencing burnout (defined as being in the top quartile of exhaustion and disengagement burnout dimensions) and to test the mediating association of mistreatment.
RESULTS
From 2016 to 2017, 30 651 students completed the AAMC Graduation Questionnaire, and 26 123 responses were analyzed. Most respondents were younger than 30 years (82.9%) and White (60.3%). A total of 13 470 respondents (51.6%) were male, and 5.4% identified as LGB. Compared with heterosexual students, a greater proportion of LGB students reported experiencing mistreatment in all categories, including humiliation (27.0% LGB students vs 20.7% heterosexual students; P < .001), mistreatment not specific to identity (17.0% vs 10.3%; P < .001), and mistreatment specific to gender (27.3% vs 17.9%; P < .001), race/ethnicity (11.9% vs 8.6%; P < .001), and sexual orientation (23.3% vs 1.0%; P < .001). Being LGB was associated with increased odds of burnout (adjusted odds ratio, 1.63 [95% CI, 1.41-1.89]); this association persisted but was attenuated after adjusting for mistreatment (odds ratio, 1.36 [95% CI, 1.16-1.60]). The odds of burnout increased in a dose-response manner with mistreatment intensity. Lesbian, gay, or bisexual students reporting higher mistreatment specific to sexual orientation had and 8-fold higher predicted probability of burnout compared with heterosexual students (19.8% [95% CI, 8.3%-31.4%] vs 2.3% [95% CI, 0.2%-4.5%]; P < .001). Mediation analysis showed that mistreatment accounts for 31% of the total association of LGB sexual orientation with overall burnout (P < .001).
CONCLUSIONS AND RELEVANCE
This study suggests that LGB medical students are more likely than their heterosexual peers to experience burnout, an association that is partly mediated by mistreatment. Further work is needed to ensure that medical schools offer safe and inclusive learning environments for LGB medical students.
Topics: Adult; Bisexuality; Burnout, Professional; Case-Control Studies; Cross-Sectional Studies; Ethnicity; Female; Heterosexuality; Homophobia; Homosexuality; Humans; Logistic Models; Male; Racism; Sexism; Sexual and Gender Minorities; Social Discrimination; Students, Medical; Surveys and Questionnaires; United States
PubMed: 33528552
DOI: 10.1001/jamanetworkopen.2020.36136 -
Culture, Health & Sexuality Dec 2022Young Black gay and bisexual men who have sex with men experience stigma related to race, gender expression, sexuality and HIV status. Stigma impacts access to HIV care...
Young Black gay and bisexual men who have sex with men experience stigma related to race, gender expression, sexuality and HIV status. Stigma impacts access to HIV care and prevention as well as interactions with healthcare providers. The amplification of stigma through popular media is under-researched in the health sciences. HealthMpowerment is a mobile phone optimised intervention to reduce sexual risk and support community-building for young Black gay and bisexual men (age 18-30). We analysed Forum conversations from 48 participants, 45.8% living with HIV. Of 322 stigma-relevant conversations, 18.9% referenced the media (e.g. television, news, social media) as a source of stigma. Forum conversations covered media representations of Black gay and bisexual men, media's influence on identity, and the creation of stigma by association with media representations. Cultural messages embedded in the media may accentuate stereotypes that influence perceptions of Black gay and bisexual men and disregard intersectional identities. HealthMpowerment provided a space to challenge stigmatising representations. Participants used HealthMpowerment to garner social support and celebrate positive media representations. Interventions for young Black gay and bisexual men should consider the influential role of media and include spaces for participants to process and address stigma.
Topics: Male; Humans; Adolescent; Young Adult; Adult; Sexual and Gender Minorities; Homosexuality, Male; Black or African American; HIV Infections; Bisexuality; Social Stigma; Perception
PubMed: 34895082
DOI: 10.1080/13691058.2021.2008506