LGBTQ+ Structural Stigma and College Counseling Center Website Friendliness

Mental health care among marginalized populations in the United States

This study employs critical discourse analysis to explore the construction and representation of lesbian, gay, bisexual, transgender and intersex identities in ‘gay’ media in Cape Town. The study critically engages with intersecting notions of ‘gay space’, the ‘gay village’, ‘gay community’, ‘westernization’, ‘globalization’, ‘whiteness’ and consumption. Findings include Competing Discourses as well as three major discourses which are: Lesbian (non)representation; White homomasculine territory; and The gay consumer. Discourses of social justice and activism are constructed on the pages of the editorial comment and these contrast with discourses constructed elsewhere in the magazine. The ‘gay’ identities constructed and represented in the magazine are predominantly white, young, male and consumerist. The (non)representation of black lesbian women has a long history in South Africa and this reflects racial, class and gender inequalities. The texts also juxtapose heteronormative, white, gay masculinity with black and coloured gender non-normative and transgender identities. The construction of race in the magazine is embedded in discourses of consumerism that give primacy to a white, gay male consumer with access to financial resources. In the post-apartheid context, the construction of identities in the magazine points towards racial, gender and class displacements and reflects ongoing processes of ‘gay globalization’.

Background Structural stigma, including discriminatory laws, inequitable policies, and negative attitudes, has been conceptualized as the general societal climate and institutional conditions that shape sexual minorities’ lives, mental, and physical health. While multidimensional indices have been used globally, U.S.-based studies have largely relied on single indicators (e.g., a law or policy; presence of resources). This scoping review aimed to identify structural sexual minority stigma indicators relevant to the U.S. context, to inform comprehensive, multidimensional future operationalizations. Methods Systematic database searches in PubMed, PsycINFO, and JSTOR, and snowball techniques resulted in 70 articles. After duplicate deletion and abstract review, 25 unique indices were long-listed relevant to structural sexual minority stigma at country or state level (i.e., macro level). School (district) and county (i.e., exo level) indicators were excluded. Results From the long-listed indices, a total of 112 legal and policy indicators were narrowed down to relevant 33 macro-level indicators and grouped across seven domains: criminal justice, hate crime protections, non-discrimination, religious refusal, relationship recognition, parenting, and youth laws and policies. Two different quantifications of population attitudes were identified that aggregated social and policy opinions across states regarding sexual minority adoption, hate crimes, health benefits, labor and housing, public speaking or teaching, marriage, sodomy, and civil unions. Discussion While a large variety of legal and attitudinal indicators was identified, few U.S.-based studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias through population-attitudes-to-law/policy backdoor pathways. To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches. Key messages • With many legal and attitudinal indicators identified, few studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias. • To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches.

When love meets hate: The relationship between state policies on gay and lesbian rights and hate crime incidence

Structural stigma's role in lesbian, gay, and bisexual (LGB) people's attainment of identity development milestones remains unknown. In a sample of 111,498 LGB people (ages 15 to 65+) living across 28 European countries, associations were investigated between structural stigma measured using an objective index of discriminatory country-level laws and policies affecting LGB people and the timing and pacing of LGB self-awareness, coming out, and closet duration, and subgroup differences in these associations. On average, self-awareness occurred at age 14.8 years old (SD = 5.1), coming out occurred at 18.5 years old (SD = 5.7), and the closet was 3.9 years long (SD = 4.9); thereby highlighting adolescence as a key period for sexual identity development and disclosure. Greater structural stigma was associated with higher odds of never coming out, later age of coming out, and longer closet duration. Gender identity, transgender identity, and sexual identity moderated associations between structural stigma and these developmental milestones. Reducing structural stigma can plausibly promote sexual identity development among LGB populations, especially during adolescence when identity related milestones are often attained.

Structural stigma and sexual orientation disparities in adolescent drug use

This chapter considers how corpus-assisted discourse analysis can be applied to the analysis and theorisation of lesbian, gay, bisexual, and transgender identities. It begins with an overview of relevant literature in this area. This will be followed with an example study of how corpus-based discourse analysis can be applied to questions of representation concerning identity. Theorisations of lesbian, gay, bisexual, and transgender (LGBT) identities are necessarily rooted in an analysis of discourse. Representation is important because those with the power to do so construct and reproduce shared meanings that may then become accepted as common sense. This review will begin with corpus studies that consider LGBT representation in governmental debates. It will then consider representation in the press by discussing studies that have looked specifically at trans representation as well as at diachronic approaches to corpus-based discourse analysis. Press representation is a common focus of corpus-based discourse analysis of LGBT identities.

Structural forms of stigma and discrimination are associated with adverse health outcomes across numerous stigmatized groups, including lesbian, gay, and bisexual (LGB) individuals. However, the biological consequences of structural stigma among LGB populations are understudied. To begin to address this gap, we assessed associations between indicators of structural stigma (i.e., state-level policies) targeting LGB individuals and allostatic load (AL) indices representing physiological dysregulations. Pooled data from the continuous 2001-2014 National Health and Nutritional Examination Survey were analyzed (LGB: n = 864; heterosexual: n = 20,310). Ten state-level LGB-related policies (e.g., employment nondiscrimination protections, same-sex marriage) were used to operationalize structural stigma. A sex-specific AL index representing 11 immune, metabolic, and cardiovascular biomarkers was estimated. Multilevel models were used to examine associations between structural stigma and AL, net of nine individual-level characteristics (e.g., education, race/ethnicity, age, and health behaviors). Sexual minority men living in states with low levels of structural stigma experienced significantly lower AL ( β = -0.45, p = .02) compared with sexual minority men living in states with high structural stigma (i.e., fewer protective policies). There was no significant association between structural stigma and AL among sexual minority women. By demonstrating direct associations between structural stigma and indices of physiological dysregulation, our findings provide a mechanistic understanding of how the social environment can "get under the skin and skull" for sexual minority men in the United States. Future research should explore whether these mechanisms generalize to other marginalized groups exposed to structural stigma.

Reviewed by: The Full Spectrum: A New Generation of Writing about Gay, Lesbian, Bisexual, Transgender, Questioning, and Other Identities Cindy Welch Levithan, David , ed. The Full Spectrum: A New Generation of Writing about Gay, Lesbian, Bisexual, Transgender, Questioning, and Other Identities; ed. by David Levithan and Billy Merrell. Knopf, 2006272p Library ed. ISBN 0-375-93290-9$17.99 Paper ed. ISBN 0-375-83290-4$9.95 R Gr. 7 up Forty young adults between the ages of thirteen and twenty-three have exposed themselves on the pages of this "queerthology" of personal essays and poems, culled from hundreds of offerings sent to a website set up by the editors. Through the writers' eyes, readers see the reactions of family, friends, teachers, and even doctors to teens who find themselves attracted to the "wrong" sex, trapped in the wrong body, or generally looking for understanding. Hope rises in these resilient youth, who are finding their way to what they see as their truth, expressed through voices raw, funny, lonely, sometimes profane, and often anguished. Readers will be disappointed that there's no information on the contributors either in the book or the associated website, and the essays' cumulative density makes the collection best suited to a sequential rather than a single-sitting reading; nonetheless, GLBTQ and other gay-friendly teens will embrace this volume eagerly and appreciate the hard-won self-knowledge of the contributors. There have been other gay/lesbian anthologies, such as Sutton's Hearing Us Out (BCCB 11/94) and Heron's Two Teenagers in Twenty (BCCB 7/94), but this is the first to push existing boundaries to include the "trans" set—transgendered, transsexual, transitioning—making this a welcome addition to GLBTQ collections everywhere. Copyright © 2006 The Board of Trustees of the University of Illinois

Bisexual individuals have disproportionately higher rates of physical and mental health concerns compared to both heterosexual and gay/lesbian individuals. Few studies have examined diverse bisexual-identified men’s perceived health concerns for themselves and other bisexual men or their experiences in healthcare settings. This qualitative study explored health and healthcare experiences among cisgender and transgender bisexual men, most of whom were also men of color. Data were collected through semi-structured interviews. Participants included 31 self-identified bisexual men from the Chicago area. Participants were asked questions surrounding bisexual men’s health and healthcare experiences in general and their personal experiences, drawing connections between intersecting bisexual and racial/ethnic identities. Interview transcripts were analyzed using thematic analysis. Participants reported sexual health and mental health as the top health concerns for bisexual men. Participants viewed their bisexual identity as a motivator for seeking healthcare services and adopting safer sex practices. Mental health challenges faced by respondents were connected to bisexual stereotypes and fear of disclosing bisexual and transgender identities. Furthermore, perceptions of masculinity amongst bisexual men of color were particularly salient in connecting to their mental health experiences. The intersection of participants’ transgender and bisexual identities impacted their healthcare experiences in general healthcare settings, with many participants reporting a lack of cultural competence and provider knowledge concerning their identities. LGBTQ Federally Qualified Health Centers, however, were described as providing compassionate care. Our findings suggest the need for more interventions that account for bisexual men’s intersecting identities. Furthermore, increased provider training is necessary for providing affirmative care to bisexual men.

RETRACTED: Structural stigma and all-cause mortality in sexual minority populations

In the late 2000s, LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and others) identities began to surface in Indian audiovisual marketing campaigns. By 2021, brands had produced at least 105 advertisements featuring LGBTQ+ identities. This research conducts an analysis of these campaigns, examining aspects such as their release date, featured characters, gender identity, sexual orientation, character age, narrative usage, genre, theme, and setting. The study reveals a substantial surge in advertising campaigns since 2018, with brands strategically launching them during Pride Month, Valentine's Day, and Women's Day. Characters embodying gay, lesbian, and transgender identities were most prevalent. Advertisements spotlighting gay, lesbian, or both gay and lesbian characters predominantly emphasised themes of love, featuring youthful characters and urban settings. In contrast, advertisements featuring transgender characters centred on human rights, with older characters and non-urban settings. Based on these findings, it is recommended that the number of LGBTQ+ marketing campaigns should continue to rise, diversifying character identities, ages, and settings while being released throughout the year.

In the late 2000s, LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and others) identities began to surface in Indian audiovisual marketing campaigns. By 2021, brands had produced at least 105 advertisements featuring LGBTQ+ identities. This research conducts an analysis of these campaigns, examining aspects such as their release date, featured characters, gender identity, sexual orientation, character age, narrative usage, genre, theme, and setting. The study reveals a substantial surge in advertising campaigns since 2018, with brands strategically launching them during Pride Month, Valentine’s Day, and Women’s Day. Characters embodying gay, lesbian, and transgender identities were most prevalent. Advertisements spotlighting gay, lesbian, or both gay and lesbian characters predominantly emphasised themes of love, featuring youthful characters and urban settings. In contrast, advertisements featuring transgender characters centred on human rights, with older characters and non-urban settings. Based on these findings, it is recommended that the number of LGBTQ+ marketing campaigns should continue to rise, diversifying character identities, ages, and settings while being released throughout the year.

BackgroundAccording to the minority stress theory, stigma affects the health of marginalized populations. Previous stigma research has focused on the health effects of individual and interpersonal stigma, paying less attention to structural factors. Laws on legal gender recognition affect the lives of transgender individuals in unique ways. The fact that these laws and population attitudes vary greatly between European countries, offer a unique opportunity to study the role of structural stigma in the lives of transgender individuals. Little is known about how transgender specific structural stigma relates to individual health determinants. Consequently, the aim of this study was to explore the association between structural stigma and access to gender affirming care, gender identity disclosure in health care, and experiences of discrimination in health care across 28 European countries.MethodsBy using multilevel regression, we combined data on health seeking behavior, transgender identity disclosure to health care providers, and experiences of discrimination in health care from 6,771 transgender individuals participating in the 2012 European Union Lesbian, Gay, Bisexual and Transgender survey with a structural stigma measure, consisting of population attitudes towards transgender individuals as well as national legislation on gender recognition. Reasons to refrain from seeking care and discrimination in health care were assessed by categorizing countries as low or high in structural stigma and using Chi-square statistics.ResultsCountry-level structural stigma was negatively associated experiences of seeking gender affirming care and positively associated with concealment of being transgender to health care providers. Identity concealment was associated with a lower likelihood of exposure to discrimination in the health care setting across countries regardless of their level of structural stigma. The most prevalent reasons to forgo gender affirming care were shared between low and high structural stigma country groups and centered around fear.ConclusionThe results highlight the importance of changing stigmatizing legislation and population attitudes to promote access to gender affirming care as well as openness of being transgender towards providers. Measures to decrease discrimination in the health care setting are warranted in high as well as in low structural stigma countries.

This article examines an emerging issue within the field of governance, the intersection of public policy with transgender identity. It is important that administrators better understand this issue given the lack of consistency in the current policy framework. This article addresses transgender identity's intersection with employment law, marriage, hate crimes, and the current legal framework for sex reassignment in the United States. The article also addresses how transgender identity contrasts with gay and lesbian identities with regard to public policy. Given widespread bias against this population, administrators are called to ensure that these individuals receive equal and equitable policy treatment.