Sexual Minority Women's Health Research Articles

Discrimination experiences, resilience, and cardiovascular disease risk factors among sexual minority women.

Resilience, or the process of adapting to adversity, may protect against the harmful effects of minority-related stressors on the cardiovascular health of sexual minority women (SMW). An online survey was conducted in a sample of cisgender, non-heterosexual women to evaluate resilience as a moderator of the association between discrimination experiences and key cardiovascular disease (CVD) risk factors: stress, tobacco-smoking, hazardous alcohol consumption, poor diet quality, physical inactivity, and sedentary behaviors. Overall, 191 women (mean age = 29.34, SD = 6.92; 84.5% White) completed the survey and met eligibility to be included in the data analysis. White race (b = - 6.71, SE = 2.49) and education (b = - 3.36, SE = 0.56) were each independently associated with fewer discrimination experiences. Latinx ethnicity was associated with more discrimination experiences (b = 9.34, SE = 2.61). Education was associated with greater resilience (b = 4.57, SE = 0.83). Multivariable regression models were adjusted for race, ethnicity, and education. Discrimination was associated with a higher likelihood of smoking in the past month (b = 0.04, SE = 0.02) and drinking at hazardous levels (b = 0.09, SE = 0.02). Resilience was associated with less stress (b = - 0.15, SE = 0.02), a lower likelihood of hazardous alcohol consumption (b = - 0.02, SE = 0.01) and less time spent engaging in sedentary behaviors (b = - 0.02, SE = 0.01). One moderation emerged, such that discrimination was negatively associated with stress for those low in resilience (b = - 1.75, SE = 0.58), and not associated with stress for those high in resilience. These findings may inform the development of CVD-risk reduction interventions for SMW, which could include both strategies to mitigate the effects of discrimination on substance use and coping skills to promote resilience.

Internalized homophobia, self-esteem, social support and depressive symptoms among sexual and gender minority women in Taiwan: An online survey.

WHAT IS KNOWN ON THE SUBJECT?: Sexual minority individuals are more likely to experience depressive disorders than heterosexual individuals. Factors associated with depressive symptoms among sexual minority individuals have been explored and examined; however, there is a limited evidence to understand the factors among sexual minority women in non-western countries. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: To the best our knowledge, this is the first study examining internalized homophobia, self-esteem, social support and depressive symptoms among sexual minority women in Taiwan. Sexual minority women at risk of having depressive symptoms had a higher level of internalized homophobia, lower self-esteem and fewer support from partners, friends, and families. Specifically, being single, being a student and having a higher personal income increased the risk of having depressive symptoms among sexual minority women. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health practitioners and nurses should be aware of and assess sexual minority women's level of internalized homophobia, self-esteem, and received social support to reduce the risk of depressive symptoms and thus help prevent suicidal ideation. LGBT sex education and government involvement are essential to buffer the negative influences of a homophobic society on the mental health of sexual minority women. ABSTRACT: Introduction Sexual minority women are more likely to report depressive symptoms than sexual minority men. However, there is a lack of evidence to understand factors associated with depressive symptoms among sexual minority women in non-western countries. Aim This study examined internalized homophobia, self-esteem, social support and depressive symptoms among Taiwanese sexual minority women. Method A total of 581 Taiwanese sexual minority women (Age range 20-48years old, Mean 26.96, SD 5.718) completed an online survey. Results Taiwanese sexual minority women at risk of having depressive symptoms had a higher level of internalized homophobia and lower self-esteem. Perceived support from participants' partners, friends and families was related to lower risk of depressive symptoms. Being single, being a student and having a higher personal income were also found to increase the risk of having depressive symptoms among the women. Discussion Mental health interventions are essential for sexual minority women with internalized homophobia and low self-esteem. Implications for Practice Mental health practitioners and nurses should be aware of and assess the concerns that sexual minority women have regarding healthcare services and provide culturally competent care to reduce the risk of depressive symptoms.

First comes marriage, then comes the election: Macro-level event impacts on African-American, Latina/x, and White sexual minority women.

Sexual minority women (SMW) may have different experiences of macro-level events, such as changes in marriage laws or election outcomes, related to their multiple identities. African American, Latina/x, and White identities intersect with gender/sex and sexual identity to influence experiences at the intrapersonal, interpersonal, social, and political levels of the socio-ecological environment. Participants include 100 African American, 35 Latina/x, and 164 White SMW (N = 299) in Wave 4 (2017-2019) of a longitudinal study of SMW's health conducted in the United States (Chicago Health and Life Experiences of Women Study). Responses to nine open-ended survey questions about marriage equality and the 2016 Presidential election were examined. Thematic analysis noted similarities across groups and focused on group differences in four areas: 1) personal well-being (including fear and anxiety about discrimination; risk associated with masculine presentation; and religion as stress and support); 2) interpersonal relationships (including relationships with partners, family, and in a community); 3) societal discrimination and prejudice (including harassment in public spaces and concerns about travel); and 4) civil rights, government harassment, and police-state violence. Emerging differences emphasized the impact of race/ethnicity and the intersection of race/ethnicity and gender on experiences of marriage equality and the 2016 election. Findings suggest that a more nuanced understanding of the experiences of individuals with different racial/racialized identities and the intersection of race/ethnicity with sexual identities is essential to creating culturally competent and effective supports for SMW.

The Gendered Self of Chinese Lesbians: Self-Esteem as a Mediator Between Gender Roles and Depression.

Sexual minority women are at an elevated risk for depression compared to heterosexual women, yet less is known about how gender roles affect the mental health of sexual minority women. Existing studies examining the role of self-esteem in the relationship between gender roles and depression are scarce and have predominantly focused on heterosexual populations. Using a cross-sectional survey of Chinese lesbians in Hong Kong (N = 438), the study tested the direct and indirect effects of different types of gender roles (masculine, feminine, and androgynous) on depression through the mediating factor of self-esteem. We found that masculinity and androgyny were positively associated with self-esteem, while femininity was negatively associated with self-esteem. More importantly, self-esteem fully mediated the inverse relationship between masculinity and depression and that between androgyny and depression. The positive relationship between femininity and depression was also fully mediated by self-esteem. By examining different types of gender roles and incorporating gender roles, self-esteem, and depression into a unified framework, the research highlighted the particularly protective effect of androgyny, which had the strongest positive direct effect on self-esteem and indirect effect on depression through the mediation of self-esteem compared to the effects of other types of gender roles. Our results illuminate the importance of understanding how individual differences in gender roles relate to the mental health of sexual minority women in future research and interventions. Implications for interventions that help Chinese lesbians cope with gender expectations and improve their mental health are discussed.

Sexual Minority Women's Experiences With Sexual Identity Disclosure in Contraceptive Care.

To describe a group of young sexual minority women's experiences with and preferences for sexual identity disclosure in the context of contraceptive care. In Chicago, Illinois, Salt Lake City, Utah, and Madison, Wisconsin, investigators conducted five focus groups (n=22) and 11 interviews with women aged 20-30 years who identified as something other than heterosexual. Focus groups explored social norms regarding contraceptive care; interviews documented individual experiences with contraceptive care. Using a qualitative descriptive approach and combined deductive and inductive content analysis, investigators coded transcripts for themes related to disclosing sexual orientation to contraceptive providers. Participants described the process of sexual identity disclosure in contraceptive care in three stages: 1) listening for whether, when, and how health care providers asked about sexual orientation, 2) deciding whether or not to disclose sexual identity to providers, and 3) evaluating responses from providers after disclosure. Participants wanted providers to: avoid assumptions and ask about both sexual identity and sexual behaviors, signal their openness and competence around the health of sexual minority women during contraceptive encounters, and focus discussions on the individual patient's priorities and needs for contraceptive care. Decisions made by sexual minority women about sexual identity disclosure in contraceptive contexts are influenced by previous and current interactions with health care providers. Contraceptive providers should ask all patients about sexual identity and sexual behavior, avoid assumptions about use of and need for contraception, and acknowledge the prevalence of marginalization, discrimination, and stigma experienced by sexual minority women and their communities in health care contexts.

Depression and Victimization in a Community Sample of Bisexual and Lesbian Women: An Intersectional Approach.

Mental health inequities among bisexual and lesbian women are well-documented. Compared to heterosexual women, both bisexual and lesbian women are more likely to report lifetime depressive disorders, with bisexual women often faring the worst on mental health outcomes. Risk factors for depression, such as victimization in childhood and adulthood, are also more prevalent among bisexual women. Less is known about the intersection of racial/ethnic and sexual minority identities, and how depression and victimization may differ across these multiple, co-occurring identities. Data were from Wave 3 of the Chicago Health and Life Experiences of Women study, an 18-year, community-based longitudinal study of sexual minority women's health. We constructed a six-category "intersection" variable based on sexual identity and race/ethnicity to examine group differences in lifetime depression and victimization. We tested childhood and adult victimization as moderators of lifetime depression (n = 600). A majority (58.2%) of the total sample met criteria for lifetime depression. When considering the intersection of race/ethnicity and sexual identity, Black bisexual and Black lesbian women had significantly lower odds of depression than White lesbian women, despite their higher reports of victimization. Latina bisexual and lesbian women did not differ from White lesbians on depression. Victimization did not moderate the association between the intersection variable and depression. More research is needed to better understand risk and protective factors for depression among racially/ethnically diverse sexual minority women (SWM). We highlight the need to deliberately oversample SWM of color to accomplish this goal.

The Impact of Marriage Equality on Sexual Minority Women’s Relationships With Their Families of Origin

ABSTRACTSupport from family of origin is important to the health and wellbeing of sexual minority women (SMW) and structural stigma may impact that support. The recent extension of marriage rights to same-sex couples in all U.S. states provided an opportunity to examine whether this change in law would impact the relationship of SMW with their families of origin regarding their same-sex relationships, including marriage. Interviews with 20 SMW were conducted to learn about their perceptions of how support from families of origin had been impacted by or changed since the U.S. Supreme Court decision (Obergefell v. Hodges, 135 S. Ct. 2584, 2015). Thematic analysis of the narrative responses revealed stories of continued family support; increases in acceptance or support; mixed support/rejection or unclear messages; “don’t ask, don’t tell” or silence; and continued or increased family rejection. Most participant narratives included more than one theme. Implications for SMW's health and relationships are discussed.

The Sexual Health of Women in Lebanon: Are There Differences by Sexual Orientation?

From studies conducted in Western countries (United States, United Kingdom, and Australia), we know that the sexual health of sexual minority women (SMW) differs in key ways from that of heterosexual women (HSW). To date, the sexual health of SMW living in the Middle East and North Africa region has not been studied. The purpose of this study was to compare the sexual health of SMW and HSW living in Lebanon. SMW and HSW living in Lebanon (N = 95) completed an anonymous, self-administered survey. SMW's risk perceptions and health promoting and sexual behaviors were compared to those of HSW. We examined differences by sexual orientation by using t tests and Fisher's exact tests. The 45 SMW and 50 HSW had similar demographic characteristics. Significantly more SMW had heard of human papillomavirus, but only 22% of women from both groups knew of its association with abnormal Papanicolaou tests. Cervical cancer screening rates were similar in SMW and HSW, although remarkably low (42%) compared with rates in Western countries. Significantly more SMW (18%) reported difficulty with access to care than HSW (0%). Forty-four percent of SMW reported discomfort in disclosing their sexual orientation to their healthcare provider and 61% reported that healthcare providers lacked sensitivity toward lesbian, gay, bisexual, and transgender needs. Unwanted sexual contact occurred more frequently in SMW (53%) than HSW (23%). The sexual health of women is affected by sociocultural factors. SMW living in Lebanon have unique health needs that should be addressed within their sociocultural context.

The Effects of Sexual Orientation on the Relationship Between Victimization Experiences and Smoking Status Among US Women.

This study examined the relationships between experiences of childhood and adulthood victimization and current smoking among heterosexual and sexual minority women. The main hypothesis was that victimization experiences would predict current smoking status. Further, we hypothesized that the effect of childhood victimization on self-reported smoker status would be mediated by adult victimization. Data are from two studies conducted in the United States that used similar methods and questionnaires in order to conduct a comparative analysis of women based on sexual orientation. Data from Wave 1 (2000-2001) of the Chicago Health and Life Experiences of Women (CHLEW) study and from Wave 5 (2001) of the National Study of Health and Life Experiences of Women (NSHLEW) study were used in these analyses. Twenty-eight percent of the sample reported current smoking. Victimization experiences were common, with 63.4% of participants reporting at least one type of victimization in childhood and 40.2% reporting at least one type in adulthood. Women who identified as heterosexual were less likely to be victimized during childhood than were women who identified as lesbian or bisexual. Adult victimization had a significant effect on current smoker status, and the effect of childhood victimization on smoker status was mediated by adult victimization. When examined by sexual orientation, this indirect relationship remained significant only among bisexual women in the sample. Study findings make a valuable contribution to the literature on victimization and health risk behaviors such as smoking. Given the negative and long-term impact of victimization on women, strategies are needed that reduce the likelihood of victimization and subsequent engagement in health risk behaviors such as smoking. The study findings make a valuable contribution to the literature on sexual minority women's health on the influence of victimization on health risk behaviors. With the goal of reducing the likelihood of adult victimization and subsequent engagement in health risk behaviors, programs and policies aimed at preventing victimization of women are warranted. Providers and community health agencies should assess and target physically and sexually abused sexual minority youth for mental health intervention with the goal of interrupting the progression from childhood victimization to adult victimization and subsequent engagement in health risk behaviors.

Sexual Minority Women's Satisfaction with Health Care Providers and State-level Structural Support: Investigating the Impact of Lesbian, Gay, Bisexual, and Transgender Nondiscrimination Legislation

PurposeStructural discrimination is associated with negative health outcomes among sexual minority populations. Recent changes to state-level and national legislation provide both the opportunity and the need to further explore the impact of legislation on the health indicators of sexual minorities. Using an ecosocial theory lens, the present research addresses the relationship between structural support or discrimination and satisfaction with one's health care provider among sexual minority women. MethodsData were drawn from an online survey of sexual minority women's health care experiences. Using the Andersen Behavioral Model of Health Services Utilization to operationalize the variables in our model, we examined the relationship between state-level nondiscrimination legislation and satisfaction with provider—a widely used measure of health care quality—through regression analysis. FindingsParticipants in structurally supportive states (i.e., those with nondiscrimination legislation) were more likely to disclose their sexual identity to their providers and to report higher satisfaction with their providers. The absence of nondiscrimination legislation was associated negatively with satisfaction with providers. ConclusionsResults of our study show that the external environment in which sexual minority women seek health care, characterized by structural support or lack thereof, is related to perceived quality of health care.

Consequences of runaway and thrownaway experiences for sexual minority health during the transition to adulthood

ABSTRACTSexual minority youth are more likely to run away from home or experience homelessness, leaving them at increased risk of victimization and negative health outcomes. In this study, the authors use a developmental perspective that considers both vulnerable beginnings in families and the risky trajectories that follow to explore the connections between running away or being thrown out by parents and sexual minority women's and men's health in adulthood. Using four waves of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), the authors consider multiple dimensions of health and several potential intervening mechanisms. Findings suggest that runaway and thrownaway experiences have persistent negative effects on health into adulthood, in part because of their association with sexual victimization, educational attainment, and relationships with parents. Sexual minority men who have been thrown out by parents report a greater likelihood of suicidal ideation, smoking, and substance use into adulthood. Sexual minority women with runaway experiences have poorer health and increased depressive symptoms, while women with thrownaway experiences engage in more health risk behaviors. Sexual victimization stands out as a key mechanism for sexual minority women's health, as more than half of these young women report experiences of sexual victimization.

We're Here and We're Queer: Sexual Orientation and Sexual Fluidity Differences Between Bisexual and Queer Women

ABSTRACTTheorists and researchers have noted an overlap between individuals who are bisexually-identified and queer-identified. Although early definitions of bisexuality may have been predominantly binary (i.e., attracted to women and men), in recent years there has been a move toward a more “queer” understanding of bisexuality (e.g., attraction to more than one gender beyond women and men). The purpose of this study was to examine similarities and differences between adult women who were bisexually-identified and those who were queer-identified, ages 18 to 66 years, on sociodemographic characteristics, two dimensions of sexual orientation (sexual behaviors and attractions), fluidity in attractions and sexual orientation identity, and identity centrality and affirmation in an online sample (N = 489), which was mostly from the United States (73.5%). Results indicated that women who are bisexual and queer were similar in terms of sociodemographic characteristics, with the exception of education; women identifying as queer were more educated than women identifying as bisexual. Women identifying as queer were also more likely than women identifying as bisexual to report variability in their sexual behaviors and attractions and more fluidity in their sexual orientation identity. Additionally, women identifying as queer reported higher levels of identity centrality and affirmation than women identifying as bisexual. Considerations for sexual minority women's health research are discussed.

Sexual Orientation and Sexual and Reproductive Health among African American Sexual Minority Women in the U.S. South

BackgroundResearch on the sexual and reproductive health of sexual minority women, especially those of color, is limited. MethodsUsing multivariable Poisson regression, we estimated risk ratios for the association between two dimensions of sexual orientation (sexual identity and sexual behavior) and five sexual and reproductive health indicators (pregnancy, contraceptive use, human immunodeficiency virus [HIV] testing, Pap test use, and sexual assault) among African American sexual minority women in the U.S. South (n = 165). ResultsLesbians were less likely than bisexual women to have ever been pregnant (risk ratio [RR], 0.64; 95% confidence interval [CI], 0.48–0.85), ever received an HIV test (RR, 0.88; 95% CI, 0.80–0.96), obtained a Pap test in the last 3 years (RR, 0.75; 95% CI, 0.61–0.91), and had an abnormal Pap test result in their lifetime (RR, 0.42; 95% CI, 0.24–0.75). Women with only female past-year sexual partners were less likely than women with male and female past-year sexual partners to have ever been pregnant (RR, 0.58; 95% CI, 0.43–0.78), ever received an HIV test (RR, 0.87; 95% CI, 0.79–0.96), obtained a Pap test in the last 3 years (RR, 0.82; 95% CI, 0.67–0.99), and had an abnormal Pap test result in their lifetime (RR, 0.55; 95% CI, 0.32–0.94). Contraceptive use, receiving an abnormal Pap test result at the time of the study visit, and experiencing sexual assault did not differ by sexual identity or behavior. ConclusionsSeveral sexual and reproductive health indicators varied in relation to sexual identity and sexual behavior among Southern African American sexual minority women. Interventions that facilitate access to sexual and reproductive health services and are tailored to the unique needs of sexual orientation subgroups of sexual minority women are needed.

Making the invisible visible: a systematic review of sexual minority women's health in Southern Africa.

BackgroundOver the past two decades research on sexual and gender minority (lesbian, gay, bisexual and transgender; LGBT) health has highlighted substantial health disparities based on sexual orientation and gender identity in many parts of the world. We systematically reviewed the literature on sexual minority women’s (SMW) health in Southern Africa, with the objective of identifying existing evidence and pointing out knowledge gaps around the health of this vulnerable group in this region.MethodsA systematic review of publications in English, French, Portuguese or German, indexed in PubMed or MEDLINE between the years 2000 and 2015, following PRISMA guidelines. Additional studies were identified by searching bibliographies of identified studies. Search terms included (Lesbian OR bisexual OR “women who have sex with women”), (HIV OR depression OR “substance use” OR “substance abuse” OR “mental health” OR suicide OR anxiety OR cancer), and geographical specification. All empirical studies that used quantitative or qualitative methods, which contributed to evidence for SMW’s health in one, a few or all of the countries, were included. Theoretical and review articles were excluded. Data were extracted independently by 2 researchers using predefined data fields, which included a risk of bias/quality assessment.ResultsOf 315 hits, 9 articles were selected for review and a further 6 were identified through bibliography searches. Most studies were conducted with small sample sizes in South Africa and focused on sexual health. SMW included in the studies were racially and socio-economically heterogeneous. Studies focused predominately on young populations, and highlighted substance use and violence as key health issues for SMW in Southern Africa.ConclusionsAlthough there are large gaps in the literature, the review highlighted substantial sexual-orientation-related health disparities among women in Southern Africa. The findings have important implications for public health policy and research, highlighting the lack of population-level evidence on the one hand, and the impact of criminalizing laws around homosexuality on the other hand.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2980-6) contains supplementary material, which is available to authorized users.

College status, perceived drinking norms, and alcohol use among sexual minority women.

Lesbian, gay, and bisexual young adults are at elevated risk for drinking compared to heterosexual young adults, and this discrepancy is particularly striking for sexual minority women (SMW). Perceived social norms are strong predictors of young adult alcohol use, especially among college students. The college environment is often one where increases in alcohol use are seen, but the impact of college status on SMW's drinking has been understudied. The present study explored patterns of alcohol use and consequences among SMW and the extent to which social norms relate to use and consequences. Participants were recruited via social networking sites for a larger national study on SMW's health behaviors. Present analyses focused on 875 SMW between 18 and 25 who were categorized as either a 2-year college student (n = 196), 4-year college student (n = 418), or non-student (n = 261). Several differences emerged between college and non-college SMW, with non-college women reporting higher alcohol use and social norms compared to 4-year college women. In terms of alcohol-related consequences, students in both 2-year and 4-year colleges reported a higher likelihood of any consequences. There was some evidence that perceived norms partially explained differences in typical drinking among the college status groups. The present findings suggest that college may play a protective role against heavy drinking for this population of young women, however, the results are not straightforward and additional research is warranted.

Sexual Minority Women's Health Behaviors and Outcomes After Breast Cancer.

Sexual minority women (e.g., lesbians, bisexual women, and women who prefer a female partner) are a known risk population for overweight, obesity, and mental health problems. Our objective is to compare sexual minority women with breast cancer to a control sample of sexual minority women without cancer to identify differences in healthful lifestyle practices, weight, well-being and mental health. This is a cross-sectional study of 85 sexual minority women with a breast cancer history (cases) matched by age and partner status to 85 sexual minority controls without cancer. We compared self-reported physical activity, fruit and vegetable intake, weight, quality of life, anxiety, and depression. Cases and controls had similar health behaviors, BMI, quality of life, anxiety, and depression. Of the weight-related behaviors, meeting the recommended guidelines of physical activity was significantly associated with lower likelihood of being overweight or obese, less depression, and better mental quality of life. Sexual minority women with breast cancer are similar to sexual minority women without cancer with respect to healthful behaviors, body weight, anxiety, depression, and quality of life. Lifestyle interventions to reduce the risk of poor outcomes after cancer should be implemented in this population as well as in sexual minority women without cancer.

Health Behavior, Status, and Outcomes Among a Community-Based Sample of Lesbian and Bisexual Women.

To compare health behaviors, and physical and mental health outcomes in a community-based sample of bisexual and lesbian women. The Chicago Health and Life Experiences of Women (CHLEW) study is a longitudinal study of sexual minority women's health. Wave 3 of the CHLEW used a modified version of respondent-driven sampling to recruit a supplemental sample of bisexual-identified women into the study, with an additional focus on younger women, and Black and Latina women. Face-to-face interviews were conducted and data were captured using computer-assisted interviews. Data from the supplemental Wave 3 sample are reported here. Bisexual (n=139) and lesbian women (n=227) did not differ on most health outcomes, either in terms of prevalence or adjusted odds. Bisexual women were at higher risk of ever being diagnosed with a sexually transmitted infection (STI) (AOR=3.01) and scoring 10 or more on the Center for Epidemiologic Studies Depression Scale (CES-D) (AOR=1.73) compared to lesbian women. In contrast to the prevailing view of bisexual women as being at higher risk for many/most negative health outcomes, we found relatively few differences between bisexual and lesbian women in the current study. Additional research is needed to better understand risk and resilience factors among bisexual women specifically, and sexual minority women more broadly.

Disability Among Sexual Minority Women: Descriptive Data from an Invisible Population.

To assess the health and well-being of sexual minority women (SMW) with disabilities. A survey assessing physical and mental health and quality of life was administered to a convenience sample of 52 women with disabilities and 74 without disabilities. All had been recruited for an SMW's health intervention targeting women over 40 with potential for weight-related health problems. Women with disabilities experienced more discrimination, had more posttraumatic stress disorder and anxiety disorders, were less connected to SMW's communities, had more physical health limitations, and reported poorer quality of life, mostly related to physical factors such as energy level and pain. SMW with disabilities have rarely been studied, and may have significant challenges with health, including greater need for community support. Studies are needed to further explore the influences on the health and well-being of SMW with disabilities.

Abstract B25: The role of psychosocial clusters in explaining disparities among sexual minority women

Abstract Introduction: Sexual minority women (SMW) are a group that experience health disparities, including disparities in cancer risk, according to the recent Institute of Medicine report on Lesbian, Gay, Bisexual and Transgender health. Differences in SMW's psychosocial functioning, and an examination of how psychosocial concepts cluster in this group, could inform us about their health disparities. Individual psychosocial concepts can be clustered to represent underlying factors that function as health indicators. Cluster patterns and function could differ among disparities groups like SMW due to exposures to minority stress. Minority stress is germane here because it influences the individual concepts that comprise clusters. SMW's exposure to minority stressors such homophobia, and prejudice and discrimination, may influence self esteem, stress, happiness, and social functioning. A first step in understanding the health disparities among SMW, could be to examine psychosocial clustering patterns and cluster associations with health outcomes, among this group. The current study sought to investigate the form and function of psychosocial clusters among SMW and heterosexual women (HW) participating in a population-based study of health and aging. The first objective was to explore and compare how psychosocial concepts cluster among these two groups of women. The second objective was to test for associations between clusters and SMW's physical and mental health compared to HW. Methods: This study used data from the National Social Life Health and Aging Project, a U.S., population-based, sample of 1550 women, aged 57–89. This included 1369 HW and 62 SMW. Hierarchical cluster analysis was used to identify the existence of clusters from nine psychosocial concepts: happiness, self esteem, stress, loneliness, emotional support from family, emotional support from friends, number of close relatives, number of close friends, number of social connections on a social network roster. Multivariate linear regression was used to test for significant associations between clusters and physical health, measured with a chronic disease comorbidity index, and mental health, measured with the, Center for Epidemiological Studies—Depression, scale. Results: Hierarchical cluster analysis revealed differences according to sexual orientation. Among HW, a two-cluster solution emerged: A Well-being Cluster, comprised of happiness, stress, loneliness, and self esteem; and a Social Cluster, comprised of all five of the social concepts. Among SMW, a three-cluster solution emerged: a Stress Cluster, comprised of, loneliness, self esteem and stress; a Social Cluster comprised of, number of close relatives, number of social connections on a social network roster, number of close friends, and emotional support from family; and a Friendship Cluster, comprised of happiness and emotional support provided by friends. Among HW, the Well-being Cluster was significantly associated with physical health (p < .001) and mental health (p < .001). Among SMW, the Stress Cluster was significantly associated with physical health (p = .04) and mental health (p< .001). Conclusion: Hierarchical cluster analysis made it possible to consider how psychosocial concepts cluster empirically and relate to health. We identified differences in psychosocial clusters among HW and SMW and determined significant associations between clusters and health among both groups. These results extend our understanding about SMW health by finding evidence for differences in psychosocial clustering patterns and by relating these differences to health outcomes. These findings are significant as they may highlight the most important components for enhancing SMW's health and reducing health and cancer disparities. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B25.

Comparing Sexual Minority Status Across Sampling Methods and Populations

SUMMARY The health of sexual minority women (SMW) has recently received research attention. Previous research into the health of SMW (e.g., lesbians, bisexuals, transgendered women) used a mixture of sampling methods, many of which were poorly documented and difficult to understand. The results of these previous studies do not present a consistent pattern of findings, possibly due to differences in sampling methods. The present study compared the characteristics of SMW across four survey sampling methods, three in the same geographic area. Differences were found among groups of SMW by sampling method, including in demographic data (e.g., level of education) and personal health data (e.g., rates of regular mammography screening). These findings provided a possible explanation for the variety of findings in the published literature and identified rigorous sampling methods that can be used in future research.