Bisexual Identity Research Articles

Associations Between Gender and Sexuality Characteristics of Cisgender Bisexual Women and Risk of Sexual Assault

Objective Research consistently documents disproportionately high rates of sexual assault among bisexual women, one of the fastest growing sexual minority demographic groups in the United States. This study seeks to better understand how bisexual women’s position as both women and sexual minority people may heighten their risk for sexual assault. Method Using data from 165 bisexual women in the Chicago Health and Life Experience of Women (CHLEW) study, we examine associations between the gender and sexuality characteristics of self-identifying cisgender bisexual women and sexual assault. Results We found that the risk of experiencing sexual assault, including rape, is associated with past experiences of bi-stigma, earlier age of recognizing bisexual identity, gender discrimination, and a less masculine gender presentation. Conclusion Our findings suggest that bisexual women are targeted in specific overlapping sexist, bi-phobic and stereotypical ways that may leave them particularly vulnerable to sexual assault. This study highlights the need for more research that investigates how bisexual women’s high rates of sexual assault are shaped by oppressive systems and social forces related to their gender and sexuality.

College Student Social Network Characteristics and Alcohol Use: Differences (and Similarities) Based on Sexual Identity and Attraction.

Sexual minority (SM) college students have higher alcohol use and alcohol-related consequences than heterosexual students. Peers are salient determinants of young adult drinking, and examining social network characteristics is useful for understanding peer influence. This study used social network methods to understand network characteristics, alcohol use (i.e., max drinks), and alcohol consequences of SM and heterosexual college students. Sexual minority and heterosexual junior-year college students (N = 1,150) were compared on (1) social network features (eigenvector centrality, indegree, outdegree, mutuality, closeness), and (2) alcohol use and consequences. We also determined (3) whether social network characteristics were associated with alcohol use and consequences, and (4) whether these associations differed based on sexual identity or attraction. Students reporting a bisexual identity or same-gender attraction had greater eigenvector centrality (global popularity or prestige) than heterosexual or students reporting exclusively other-gender attraction, respectively. Students reporting same-gender attraction had higher outdegree (expansiveness) and more reciprocated ties (mutuality) than individuals reporting exclusively other-gender attraction, but heterosexual students and students with other-gender attraction reported higher relationship closeness; they also reported a higher number of drinks than bisexual students and students with same-gender attraction. One significant interaction showed that outdegree (expansiveness) was associated with alcohol consequences for students who reported any same-gender attraction, but not for students who reported exclusively opposite-gender attraction. SM college students' greater network prominence differs from research with adolescents and might reflect students' efforts to establish more affirming social connections in a college environment.

Population trends and demographic disparities in sexual identity in Stockholm County, 2010 to 2021

Abstract Background Sexual identity, linked to experiences of disadvantage and discrimination, is crucial in equality monitoring. Sweden’s gender-neutral marriage laws, introduced in 2009, provide a unique context. This study examines the population trends and demographic disparities in sexual identity over time. Methods We analyzed three population surveys (2010, 2014, 2021) from the Stockholm Public Health Cohort, including around 50,000 individuals per survey. Sexual identity was assessed via self-administered questionnaires. Demographic data were sourced from Swedish national registers. Weighted multivariate Poisson regression with robust variance estimators was used to identify demographic disparities in sexual identity. Results were presented as proportion ratio (PR) with 95% confidence interval (CI). Results Overall, 29,607 (2010), 20,249 (2014), and 22,558 (2021) individuals reported sexual identity. Heterosexual identity decreased from 95.7% (95% CI 95.4-96.0%) in 2010 to 89.0% (88.5-89.4%) in 2021, while bisexual identity increased from 1.4% (1.2-1.6%) in 2010 to 2.0% (1.8-2.3%) in 2014, and further up to 2.7% (2.4-2.9%) in 2021. Homosexual identity increased slightly from 1.5% (1.4-1.7%) in 2010 to 1.8% (1.6-2.0%) in 2021. Multivariate analyses showed that female, older age, and lower education were inversely associated, while never-married status and living alone were positively associated, with homosexual identity. In contrast, female, younger age, lower income (100 SEK/year) ( < =2,500 vs > 4,500: 2010: PR 3.32 [95% CI 1.92-5.75]; 2014: 1.83 [1.28-2.60]; 2021: 1.51 [1.14-2.01]), and never-married status (never vs currently married: 2010: 2.03 [1.47-2.80]; 2014: 1.92 [1.39-2.65]; 2021: 1.50 [1.15-1.95]) were positively associated with bisexual identity. Conclusions Heterosexual identity decreased while homosexual/bisexual identities increased in Stockholm County during 2010-2021. Socioeconomic disparities persist in sexual minorities and vary by sexual identity. Key messages • Marked socioeconomic disparities persist in sexual minorities and vary by sexual identity in Stockholm County, although income and marital status disparities in bisexual group seem narrowing. • Future studies are warranted to investigate the social dynamics that continue to produce sexual minority disadvantages.

LGBTQ+ Supportive and Inclusive Care Practices: Survey Data From the T1D Exchange Quality Improvement Collaborative

OBJECTIVE Living with type 1 diabetes is challenging, but more barriers exist when one also identifies as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, or other gender-expansive identities). Acknowledging the importance of identifying this population and providing personalized care, the Health Resources and Services Administration mandated institutions to document sexual orientation and gender identity (SOGI) data. To understand the current state of SOGI documentation in the T1D Exchange Quality Improvement Collaborative, a survey assessing LGBTQ+ supportive and inclusive care practices was given to affiliated sites. RESEARCH DESIGN AND METHODS Thirty-three pediatric and 21 adult care centers were surveyed via Qualtrics. The survey included questions about their electronic health record documentation of patient-identified gender, pronouns, sexual orientation, and sex assigned at birth (SAAB). Care centers also reported on the legality of gender-affirming care in their municipalities, as well as their willingness to change SAAB after patients meet requirements. Fisher’s exact tests were used to evaluate response frequencies. RESULTS All 33 of the pediatric centers and 81% (17 of 21) of the adult centers responded to the survey. Sixty-four percent of pediatric centers had established strategies to support SOGI documentation, whereas only 50% of adult centers had implemented strategies. Some adult centers could not confirm whether they documented SOGI. Differences were seen between the pediatric and adult endocrinology centers in their documentation of gender identity (P = 0.04) and pronouns (P = 0.02). CONCLUSION Although most endocrinology centers documented gender identity and pronouns, fewer documented sexual orientation. Further work is needed to improve SOGI documentation and assess its impact on LGBTQ+ patients with diabetes.

The Role of Shame in Associations with PTSD and Depression Symptoms and Hazardous Drinking Among Bisexual Women Who Experienced Sexual Violence

ABSTRACT Bisexual (i.e. those with attraction to multiple genders) women experience disparities in sexual violence and mental health outcomes, including PTSD, depression, and hazardous drinking, compared to lesbian and heterosexual women. Unique stigma due to bisexual identity (antibisexual stigma), negative reactions to sexual violence (SV) disclosure (e.g. victim blaming), and prior child sexual abuse (CSA) may all contribute to shame. We tested whether shame explained the associations of antibisexual stigma, negative reactions to SV disclosure, and CSA severity with PTSD symptoms, depression, and hazardous drinking among young bisexual women. Participants who self-identified as bisexual women, between the ages of 18–35, residing in the US were recruited via Amazon’s Mechanical Turk (MTurk) and completed online questionnaires. Women who reported SV since age 18 that they disclosed to someone were included in the current study, yielding a sample of 156 bisexual women (Mage = 25.7; 98.1% cisgender, 86.5% White). Path analysis with bias-corrected bootstrapping was conducted. There were significant direct effects of negative reactions on hazardous drinking and CSA on PTSD, and direct effects of shame on PTSD and depression symptoms. Shame explained the associations of antibisexual stigma, negative reactions, and CSA with PTSD symptoms, depression symptoms, and hazardous drinking. Shame may explain why stigmatizing experiences related to bisexual identity, sexual violence, and CSA history relate to distress among bisexual women. Shame is an important treatment target among bisexual survivors of SV.

Challenges and Opportunities in Transitioning Autistic Individuals Into Adulthood.

Approximately 1.2 million autistic youth will reach the legal age of adulthood over the next decade. Given dynamic changes in the socioecological context of the transition to adulthood, we produced an updated transitions research agenda reflecting the perspectives of autistic young adults, care partners (parents), and professionals who use autism research. We conducted 9 focus groups: 4 young adult, 4 care partner, and 1 professional, with 59 total participants. Young adults were grouped by self-reported identity: (1) racial and ethnic minority, (2) lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identities, and (3) nonspeaking, in addition to a general group. We selected care partners who supported youth with varying intensity of support needs. We used rapid qualitative inquiry methods to extract key points from answers to semistructured interview questions. Delays in diagnosis and transition processes, and placement on wait lists resulted in significant obstacles to successful transitions. Parents assumed a dominant role by coordinating services, navigating systems and identifying opportunities for community participation, and providing direct supports. There was an overarching need for inclusion of autistic people in transitions research and consideration of cultural differences in priorities and values. Participants prioritized investigation of variation in transitions among autistic youth with intersecting identities, navigation support (eg, peer mentors), efficacy of services and supports (eg, transition and employment services), differences in available services by location, and problems within specific benefits programs. Research should focus on understanding population-level factors of system performance on outcomes and support needs, service delivery among marginalized groups, and transformation of complex service ecosystems.

Inequities in Self-Reported Social Risk Factors by Sexual Orientation and Gender Identity

Sexual minority (ie, people who self-identify as gay, lesbian, bisexual, and other nonheterosexual identities) and gender minority (ie, people who self-identify as transgender, nonbinary, or other noncisgender identities) adults report worse health outcomes compared with heterosexual and cisgender adults, respectively. Although social risk factors (SRFs; eg, housing instability) are associated with health outcomes, little is known about the prevalence of SRFs among sexual and gender minority adults. To examine differences in the prevalence of SRFs by sexual orientation and gender identity among adults. This cross-sectional study used Behavioral Risk Factor Surveillance System data collected from January 2022 to February 2023 for adults aged 18 years or older residing in 22 US states. Self-reported sexual orientation and gender identity. Outcome measures were dissatisfaction with life, lack of emotional support, social isolation, employment loss in the past 12 months, Supplementary Nutrition Assistance Program participation in the past 12 months, insufficient food, inability to pay bills, inability to pay utilities, lack of transportation, and stress. Survey weights were applied. Multivariable linear regression models were used to measure the association between sexual orientation and gender identity for each outcome. The study sample comparing outcomes by sexual orientation included 178 803 individuals: 84 881 men (48.5%; 92.9% heterosexual; 7.1% sexual minority) and 93 922 women (51.5%; 89.4% heterosexual; 10.6% sexual minority). The study sample comparing outcomes by gender identity included 182 690 adults (99.2% cisgender; 0.8% gender minority). Of sexual minority women, 58.1% reported at least 1 SRF compared with 36.5% of heterosexual women. Sexual minority women were significantly more likely to report social isolation (difference, 7.4 percentage points [PP]; 95% CI, 4.9-10.0 PP) and stress (difference, 12.2 PP; 95% CI, 9.8-14.7 PP) compared with heterosexual women. A greater proportion of sexual minority men (51.1%) reported at least 1 SRF than heterosexual men (34.0%); the largest magnitudes of inequity were in dissatisfaction with life (difference, 7.9 PP; 95% CI, 5.8-10.1 PP) and stress (difference, 6.7 PP; 95% CI, 4.5-8.9 PP). Of gender minority adults, 64.1% reported at least 1 SRF compared with cisgender adults (37.1%). Gender minority adults were significantly more likely to report social isolation (difference, 14.8 PP; 95% CI, 9.9-19.7 PP) and stress (difference, 17.0 PP; 95% CI, 11.9-22.1 PP). In this cross-sectional study, sexual and gender minority adults were significantly more likely to report multiple SRFs. These findings suggest that policies and community-based systems to advance socioeconomic equity among sexual and gender minority adults are critical.

"Caught between two worlds": Managing identity in bisexual fatherhood.

Bisexuality in fatherhood is largely invisible, with very little known about the experiences of bisexual fathers. Conducted by researchers in the United Kingdom, this study is one of the first to explore the experiences of bisexual fathers, and, using an identify-focused approach, it aims to understand bisexual fathers' experiences of managing their bisexuality and role as a father. Twenty-four bisexual fathers in Europe and North America took part in qualitative, semistructured interviews that focused on their bisexual identity, becoming a parent, experiences of family life, and community involvement. Reflexive thematic analysis was conducted, and four themes were identified: valuing different types of authenticity, seeking safety in the community, reconciling bisexuality with the traditional family, and sharing and learning across age groups. Despite describing their identity as often invisible, fathers indicated that their personal identity had a significant impact on their social interactions as well as their individual parenting and family practices. Findings contrast stage models of LGBTQ+ identity development, as fathers' identity work practices were often more important for their identity development and integration than aspiring for full "outness." Findings expand our scholarly understanding of the role of identity in parenting and highlight the need to improve representation and support for bisexual fathers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Equity and Inclusion for LGBTQ+ Residents: Lessons Learned from the Initial Long-Term Care Equality Index (LEI)

ObjectivesMost older adults with lesbian, gay, bisexual, queer, questioning, transgender, and related identities (LGBTQ+) are concerned about receiving lower-quality care and/or being mistreated in nursing homes. Older LGBTQ+ veterans may have additional reservations about care in Department of Veterans Affairs (VA) nursing homes (Community Living Centers [CLCs]) because of experience with past discriminatory military policies (eg, bans on participating in military service, Don't Ask Don't Tell). This article describes one of the first VA CLCs to participate in the Human Rights Campaign–developed Long-Term Care Equality Index (LEI). DesignA single-site formative evaluation was completed to support quality improvement and identify opportunities for growth using the LEI. The LEI is a facility benchmarking tool to support more inclusive environments for LGBTQ+ residents and employees. The LEI offers 4 evaluation criteria: (1) Non-Discrimination and Staff Training; (2) LGBTQ+ Resident Services and Support; (3) Employee Benefits and Policies; and (4) Resident and Community Engagement. Facilities receive ratings based on the number of requirements achieved in each category. Participants and Methods: Older LGBTQ+ veterans, current CLC residents, interdisciplinary CLC providers and leadership, and national Geriatrics and Extended Care program managers collaborated to pilot the LEI and develop tools and materials to support other VA facilities' participation in the LEI. ResultsQualitative interviews with veterans and CLC residents supported inclusion of gender identity and sexual orientation in resident handbooks, discussions about person-centered care, and opportunities for additional staff training and community engagement (eg, observing Pride Month in June). Resources to support VA long-term care facilities' participation in the LEI were developed. Conclusions and ImplicationsThe LEI offers a structured approach to identifying areas for improvement in providing high-quality and equitable care in long-term care settings. Practical suggestions for CLCs and other nursing home settings considering the LEI for the first time are discussed.

Sexual Identity Development, Psychiatric Risk, and Protective Factors Among Bisexual People in Mainland China, Hong Kong, and Taiwan.

Purpose: This study aimed to uncover sexual identity development and investigate the psychiatric risks for bisexual people across mainland China, Hong Kong, and Taiwan by examining ecologically informed factors at the individual, family, and community levels. Methods: An internet-based survey was administered to 685 respondents, from June to August 2021, reached primarily through lesbian, gay, bisexual, transgender, and queer community organizations and professional networks. Participants reported their demographics, identity milestones, and psychiatric symptoms. Results: Significant birth cohort and regional differences were observed regarding bisexual identity milestones. Individuals who were older, transgender and/or nonbinary, and based in Taiwan disclosed their sexual identity more. All respondents reported clinically elevated depression and anxiety symptoms, with a majority experiencing moderately severe depression (60%) and moderate or severe anxiety (80%). Approximately half of respondents contemplated suicide in the past year. Compared with cisgender women, identifying as transgender and nonbinary assigned female at birth was significantly associated with increased depression and higher odds of suicidal ideation in the past year. Enhanced self-esteem was associated with greater well-being and decreased psychiatric symptoms. Experiencing family shame was associated with increased anxiety and depression. At the community level, living in Hong Kong was linked to lower depression and suicidal ideation compared to mainland China. The presence of an LGBT group correlated with improved psychological well-being. Conclusions: Chinese bisexual people face substantial risks for depression, anxiety, and suicidal ideation, influenced by factors including self-esteem, transgender and nonbinary gender identity, family dynamics, and community context. Significant birth cohort and regional differences in bisexual identity development exist.

The Impact of Stigma and Sexual Identity on PrEP Awareness and Use Among At-Risk Men Who Have Sex With Men in Four U.S. Cities (HPTN 078).

Persistent pre-exposure prophylaxis (PrEP) use reduces the risk of HIV infection, yet uptake lags among those with the greatest need. Sexual identity stigma may be a significant barrier to PrEP awareness and use among high-risk communities. The primary aim of this study was to determine whether sexual identity was related to PrEP awareness and use. This multi-site HIV Prevention Trials Network (HPTN) study (HPTN 078) focuses on men who have sex with men (MSM) (n=335) who were HIV-negative at screening. The majority of participants were non-white (62.1%), younger than 35 (57.9%), single (79.1%), and aware of PrEP, yet had never taken PrEP (52.5%). Participants completed questionnaires including sexual history and identity; lesbian, gay, bisexual, transgender, queer (LGBTQ) community engagement; PrEP awareness and use; and several measures of sexual identity stigma including family and friend stigma, general societal stigma, and anticipated healthcare stigma. Univariate and multinomial logistic regression models helped to determine factors associated with PrEP awareness and use. There were stark disparities in PrEP awareness comparing Black and White participants; 50% of Black participants reported being PrEP unaware vs 11.8% of White participants. In this sample, gay sexual identity (compared to bisexual identity) was associated with increased PrEP awareness (AOR 6.66) and use (AOR 16.9). Additionally, 29% of the association between sexual orientation and PrEP use was mediated through internalized stigma. Given low PrEP uptake among MSM, interventions that address sexual identity stigma may motivate greater PrEP uptake.

Bisexual Identity in a Religious Environment in Christina Lauren’s Autoboyography

This study focuses on analyzing the representation of bisexual identity in Christina Lauren’s novel "Autoboyography." Through qualitative research, the aim is to reveal the discourse of bisexuality constructed by the acts and behaviors of other characters toward the male main characters using Stuart Hall’s theory of representation, with a particular focus on Michel Foucault’s discursive approach. Another objective of this study is to examine the critical position of Christina Lauren as the novel’s author towards the issue of bisexuality. The findings reveal that the author created characters who both oppose and support bisexuality, thereby highlighting the issue of bisexuality in the 21st century. Through their narrative, the author sheds light on the challenges faced by male individuals living as bisexuals in a religiously conservative environment. By doing so, Christina Lauren not only addresses social issues surrounding bisexuality but also illustrates the main character's struggles in accepting a bisexual identity in an environment influenced by religious beliefs.

Internalized Homonegativity is Indirectly Associated with Smoking Status through Somatic Anxiety.

In this study, we examined how internalized homonegativity (IH), a non-adaptive cognitive response to lesbian, gay, and bisexual (LGB) minority stressors, related to the manifestation of somatic anxiety symptoms and reduced the likelihood of being a former smoker. Participants (N = 77) smoked ≥ 100 cigarettes in their lifetime, some of whom successfully quit their use (N = 23 former smokers). The Lesbian, Gay, and Bisexual Identity Scale and the State-Trait Inventory for Cognitive and Somatic Anxiety were used to assess IH and somatic anxiety. Current smokers experienced higher IH rates than former smokers (former = 0, current = 1; b = .65, p < .05). IH was positively associated with somatic anxiety (b = .17, p < .001), and the association between IH and smoking status was mediated through somatic anxiety (b = .17; CI = [.0002, .6539]). One's experience with IH may be a risk factor for psychological distress and continued smoking. Current findings can aid in the development of future longitudinal or experimental studies to examine the causality between IH and somatic anxiety and include confounding variables.

Pretty Bi for an Ally: A Critical Autoethnography

Bisexual people experience negative messaging about their identity from broader society, as well as from within the LGBTIQA + community. The period of adolescence can be particularly tumultuous for those navigating their identity amongst this messaging. Drawing on Ozalas’s (2020) and Suarez’s (2022) studies, this study utilizes a critical autoethnographic approach and aims to explore cis-normative and heteronormative perspectives that were dominant within Australian society between the years of 2004 and 2016 from my bisexual lens. Employing McInnis’s (2022) notion of belonging and Warren’s (2023) use of allyship, this study describes the journey of discovering my bisexual identity and belonging during adolescence and understanding trans allyship through sibship. It also explores how certain social and environmental events can contribute to a sense of belonging or exclusion. The study documents how bisexuality evolves from the unknown, to the hidden, to the visible in a parallel process to supporting a trans sibling’s identity.

Leadership and bisexuality: Dually occurring processes of identity development.

With the growing importance of identity development, it is important to see the intersections that occur with one's identity as both a leader and as bisexual. Leader identity and bisexual identity development can occur in tandem, with critical moments influencing both dually occurring identity development processes. By understanding the need that the field of leadership education has to explore the development of bisexual leaders and leadership educators, the authors discuss the need to center minoritized identities in our scholarship and practice within the field.

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

Disparities in Mortality by Sexual Orientation in a Large, Prospective Cohort of Female Nurses

Extensive evidence documents health disparities for lesbian, gay, and bisexual (LGB) women, including worse physical, mental, and behavioral health than heterosexual women. These factors have been linked to premature mortality, yet few studies have investigated premature mortality disparities among LGB women and whether they differ by lesbian or bisexual identity. To examine differences in mortality by sexual orientation. This prospective cohort study examined differences in time to mortality across sexual orientation, adjusting for birth cohort. Participants were female nurses born between 1945 and 1964, initially recruited in the US in 1989 for the Nurses' Health Study II, and followed up through April 2022. Sexual orientation (lesbian, bisexual, or heterosexual) assessed in 1995. Time to all-cause mortality from assessment of exposure analyzed using accelerated failure time models. Among 116 149 eligible participants, 90 833 (78%) had valid sexual orientation data. Of these 90 833 participants, 89 821 (98.9%) identified as heterosexual, 694 (0.8%) identified as lesbian, and 318 (0.4%) identified as bisexual. Of the 4227 deaths reported, the majority were among heterosexual participants (n = 4146; cumulative mortality of 4.6%), followed by lesbian participants (n = 49; cumulative mortality of 7.0%) and bisexual participants (n = 32; cumulative mortality of 10.1%). Compared with heterosexual participants, LGB participants had earlier mortality (adjusted acceleration factor, 0.74 [95% CI, 0.64-0.84]). These differences were greatest among bisexual participants (adjusted acceleration factor, 0.63 [95% CI, 0.51-0.78]) followed by lesbian participants (adjusted acceleration factor, 0.80 [95% CI, 0.68-0.95]). In an otherwise largely homogeneous sample of female nurses, participants identifying as lesbian or bisexual had markedly earlier mortality during the study period compared with heterosexual women. These differences in mortality timing highlight the urgency of addressing modifiable risks and upstream social forces that propagate and perpetuate disparities.

IJCM_54A: Medical curriculum and published literature with focus on usage of appropriate LGBTQIA+ language: A situational analysis

Background: A sensitive language usage is important in scientific literature when reporting “lesbian, gay, bisexual, transgender, queer, intersex, asexual and other identities” (LGBTQIA+) and medical education can play an important role towards early sensitization of future professionals. Objective: To evaluate the competency based undergraduate curriculum (CBME) guidelines by National Medical Council and to conduct a content analysis of published medical education articles related to LGBTQIA+. Methodology: We reviewed the CBME guidelines for competencies pertaining to sensitization of medical students regarding LGBTQIA+. For content analysis, we searched PubMed using the MeSH terms “”Sexual and Gender Minorities”” AND “”Education, Medical”, restricting our search to English language. The Press Council of India (PCI) guidelines were used as reference for preferred and non-preferred terms. Results: At present, NMC has not brought about any teaching modules or sensitization on LGBTQIA+ for the undergraduate curriculum. However, the related competencies were psychosexual and gender identity disorders in Psychiatry (PS 13.1-13.7) and gender issues and women empowerment in community medicine (CM 10.9). A total of 177 articles were retrieved from PubMed. We selected 30 relevant articles, of which12 (40%) were from India. Majority of them (94%) complied to the PCI guidelines on LGBTQIA+, with respect to terms such as ‘transgender’, ‘transman’, ‘transwoman’ and ‘LGBTQ’. One Indian article used the term ‘transgenders. There was no usage of derogatory terms such as ‘eunuch’ and ‘victims’. Terms such as ‘Gender Non-conforming’ and ‘Gender affirming surgery’ were used in some surgery articles (6%) with no use of avoidable terms like ‘sex change surgery’ and ‘sex reassignment surgery’. Conclusion: The CBME needs to add specific LGBTQIA+ related competencies in the curriculum. The language in the medical education articles reviewed largely conformed with the PCI guidelines on LGBTQIA+ reporting with a fair, respectful, and informative coverage.

Toward inclusive health care: Pharmacists’ perceptions on academic preparedness and health care provision for the LGBTQIA+ community

BackgroundThe community of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identities (LGBTQIA+), comprising sexual and gender minorities, frequently encounters violence, discrimination, and numerous obstacles in accessing health care services. Pharmacists have the potential to significantly contribute to the health care provision for this community. ObjectiveTo assess pharmacists’ perceptions regarding academic preparedness and health care provision for the LGBTQIA+ community in Brazil. MethodsAn online cross-sectional survey was conducted from August 2022 to February 2023, focusing on the academic training of pharmacists and the provision of health care to the LGBTQIA+ community in Brazil. Data collection was achieved through a 28-question online questionnaire, comprising both closed-ended questions, and Likert-type items. The study variables were subjected to an exploratory descriptive analysis. ResultsWe received 261 complete and valid responses. A majority of pharmacists indicated that they provided health care to the LGBTQIA+ community (n = 161, 61.7%); however, they lacked formal education on LGBTQIA+ health care during their pharmacy program (n = 256, 98.1%). Most participants strongly agreed that pharmacists play a crucial role in promoting health care for this community (n = 213, 81.6%). However, only a small percentage felt confident in addressing issues related to the effectiveness and safety of hormone use for transgender patients (n = 38, 14.6%). Furthermore, less than a third believed that the health care provided by pharmacists should be differentiated for patients within and outside of the LGBTQIA+ community (n = 76, 29.1%). ConclusionThe results of this study underscore the necessity and significance of incorporating this topic both in pharmacy training and continuing education. This approach is crucial to enhance and bolster the clinical practice of pharmacists.

Lesbian, gay, bisexual, transgender, and nonbinary representation on Australian scripted television in the 2000s and 2010s

Over the past few decades, there has been significant industry and scholarly interest in diversity, equity, and inclusion in television. Alongside this, attention has been paid to the politics of queer representation in screen and media contexts. Providing much-needed data on these issues, this article catalogues the representation of gay, lesbian, bisexual, transgender, and nonbinary characters in Australian scripted television since 2000. We highlight the inclusion of more queer characters onscreen and situate this in the context of two significant decades of change in the Australian television industry and the broader socio-political context. In teasing out recent trends around gender and sexually diverse representation, we identify shifts toward representing more complex and inclusive queer story worlds on Australian television. We also note significant tensions in these representations, highlighting how Australian television remains quite conservative in depicting queer sex, intersections between sexualities and gender identities, and bisexual identities.