Heterosexual Controls Research Articles

A case-control study of healthcare disparities in sex and gender minority patients with breast cancer.

6517 Background: Disparities in the quality of diagnosis and treatment of breast cancer in sex and gender minority (SGM) populations are largely undefined. Only 24% of studies funded by the National Cancer Institute capture data on sexual orientation, while only 10% capture data on gender identity. To address this gap, the National Academies 2020 Report calls for adding sexual orientation and gender identity (SOGI) to ongoing data collection efforts. This case-control study matching SGM patients with breast cancer to cisgender heterosexual controls is the result of linking SOGI data to the Stanford University Healthcare (SHC) Oncoshare breast cancer database, which integrates data from the electronic medical record (EMR) and California Cancer Registry. Methods: An initial database query across the SHC EMR was performed for charts containing SOGI terms in patients with breast cancer seen in SHC Oncology. 686 charts were identified for manual review and after eliminating false positives, the sample was reduced to 92 SGM patients, who were then matched by year of diagnosis, age, stage, ER-status, and HER-2 status to cisgender heterosexual controls within Oncoshare. Additional data on demographics, diagnosis, treatment, and relapse were then manually abstracted from the EMR. Results: The SGM cohort was comprised of 80% lesbians, 13% bisexuals and 6% transgender men. The median age at diagnosis across both groups was 49. SGM patients were 72% white, 4% Asian, 12% Black or Latinx 6% other compared to 63% white, 24% Asian, 6% Black or Latinx, 6% other in the controls (p = 0.0006). Thirteen percent and 32% of SGM patients engaged in risky alcohol and illicit drug use respectively, compared to 3% and 6% of controls (p = 0.028; p < 0.0001). Estrogen exposure risk factors including median age of menarche, first delivery, menopause, and use of exogenous estrogens were balanced between the two groups, but SGM patients had fewer children (median 0 vs 2, p < 0.0001). There was a delay in time to diagnosis from symptom onset in SGM patients versus controls (median 64 days vs 37 days, p = 0.043). There was no difference in surgical approach, use of post-lumpectomy radiation, or use of neoadjuvant chemotherapy for stage III disease. However, SGM patients were less likely to undergo chest reconstruction (55% vs 82%, p = 0.0098) and if ER+, to complete ≥5 years of ER-directed therapy (53% vs 72%, p = 0.048). SGM patients used more alternative medicine (46% vs 29%, p = 0.033) and had a higher rate of documented refusal of recommended oncologic treatments (38% vs 21%, p = 0.0088). Correspondingly, SGM patients experienced a higher recurrence rate (31% vs 14%, p = 0.0124). Conclusions: To our knowledge, this is the first study to examine quality of diagnosis and treatment of breast cancer in SGM patients. Several novel potential healthcare disparities are identified, which should be further evaluated in population-based studies to inform interventions.

2D:4D Digit Ratios in Adults with Gender Dysphoria: A Comparison to Their Unaffected Same-Sex Heterosexual Siblings, Cisgender Heterosexual Men, and Cisgender Heterosexual Women.

We compared gender dysphoria (GD) patients and their same-sex siblings in terms of their 2D:4D ratios, which may reflect prenatal exposure to androgen, one of the possible etiological mechanisms underlying GD. Sixty-eight GD patients (46 Female-to-Male [FtM]; 22 Male-to-Female [MtF]), 68 siblings (46 sisters of FtMs; 22 brothers of MtFs), and 118 heterosexual controls (62 female; 56 male) were included in the study. FtMs were gynephilic and MtFs were androphilic. We found that 2D:4D ratios in the both right hand (p < .001) and the left hand (p = .003) were lower in male controls than in female controls. Regarding right hands, FtM GD patients had lower 2D:4D ratios than female controls (p < .001) but their ratios did not differ from those of their sisters or male controls. FtM GD patients had no significant difference in their left-hand 2D:4D ratios compared to their sisters or female and male controls. While there was no significant difference in right hands between FtM's sisters and male controls, left-hand 2D:4D ratios were significantly higher in FtM's sisters (p = .017). MtF GD patients had lower right-hand 2D:4D ratios than female controls (p <.001), but their right-hand ratios did not differ from those of their brothers and male controls. There was no significant difference in left-hand 2D:4D ratios between MtF GD patients, and their brothers, or female and male controls. FtM GD patients showed significantly masculinized right-hand 2D:4D ratios, while there was no evidence of feminization in MtF GD patients.

Predicting transphobia among cisgender women and men: The roles of feminist identification and gender conformity

Introduction This study examined feminist identification and conformity to traditional gender norms as predictors of transphobic attitudes. Method Data was collected among an online, MTurk sample of 290 adult cisgender women and men. Results: Feminist beliefs and self-labeling were independently associated with decreased transphobia among cisgender women, but not among cisgender men. Conformity to the masculine norms of heterosexual self-presentation and emotional control were significantly, independently associated with increased transphobia, whereas risk-taking was associated with decreased transphobia. Conformity to the traditional feminine norm of Sexual Fidelity was significantly associated with increased transphobia. Conclusions Practical and policy implications are discussed.

Health Disparities, Inpatient Stays, and Emergency Room Visits Among Lesbian, Gay, and Bisexual People: Evidence From a Mental Health System

This study examined differences in health outcomes and acute service use between lesbian, gay, and bisexual (LGB) individuals and a matched heterosexual control group. Individuals ages 18 to 85 whose electronic health records indicated a sexual orientation as LGB and who were included in the 2015 New York State Office of Mental Health Patient Characteristics Survey (N=5,775) were matched with heterosexuals (N=5,775) by sex assigned at birth, age, race, Hispanic ethnicity, and county of residence and compared on health status indicators, conditions and behaviors, and acute service use. Generalized estimating equation models were used to estimate the odds and rates of acute service use. LGB individuals appeared to have more chronic general medical conditions and physical disabilities and tended to use fewer acute services compared with heterosexuals. Gay men and lesbians were significantly less likely than heterosexuals to have used a mental health-related inpatient service (adjusted odds ratio [AOR]=0.69, 95% confidence interval [CI]=0.57-0.85; and AOR=0.73, 95% CI=0.59-0.89 [respectively]) or emergency room (ER) service in the past 12 months (AOR=0.63, 95% CI=0.53-0.76; and AOR=0.79, 95% CI=0.66-0.94 [respectively]). Bisexual men and women were more likely than heterosexuals to have shorter substance use-related inpatient stays (rate ratio [RR]=0.65, 95% CI=0.47-0.90; and RR=0.66, 95% CI=0.51-0.86 [respectively]) and to have fewer substance use-related ER visits (RR=0.69, 95% CI=0.48-0.99; and RR=0.55, 95% CI=0.43-0.69 [respectively]). The health care system needs strategies in LGB-centered care, research, medical education, health policy, and evidence-based practices to engage sexual minority groups in mental health and general medical care.

Sexual behaviour of rams: male orientation and its endocrine correlates

The components of heterosexual behaviour in rams are reviewed as a basis for understanding partner preference behaviour. A small percentage of rams will not mate with oestrous females and if given a choice will display courtship behaviour towards another ram in preference to a female. Some of the endocrine profiles of these male-oriented rams differ from those of heterosexual controls. These differences include reduced serum concentrations of testosterone, oestradiol and oestrone, reduced capacity to produce testosterone in vitro, and reduced capacity to aromatize androgens in the preoptic-anterior hypothalamus of the brain. Our observation that aromatase activity is significantly lower in the preoptic-anterior hypothalamic area of male-oriented rams than in female-oriented rams may indicate an important neurochemical link to sexual behaviour that should be investigated. The defect in steroid hormone production by the adult testes of the male-oriented ram may represent a defect that can be traced to the fetal testes. If this contention is correct, partner preference behaviour of rams may also be traceable to fetal development and represent a phenomenon of sexual differentiation.

Structural connections in the brain in relation to gender identity and sexual orientation

Both transgenderism and homosexuality are facets of human biology, believed to derive from different sexual differentiation of the brain. The two phenomena are, however, fundamentally unalike, despite an increased prevalence of homosexuality among transgender populations. Transgenderism is associated with strong feelings of incongruence between one's physical sex and experienced gender, not reported in homosexual persons. The present study searches to find neural correlates for the respective conditions, using fractional anisotropy (FA) as a measure of white matter connections that has consistently shown sex differences. We compared FA in 40 transgender men (female birth-assigned sex) and 27 transgender women (male birth-assigned sex), with both homosexual (29 male, 30 female) and heterosexual (40 male, 40 female) cisgender controls. Previously reported sex differences in FA were reproduced in cis-heterosexual groups, but were not found among the cis-homosexual groups. After controlling for sexual orientation, the transgender groups showed sex-typical FA-values. The only exception was the right inferior fronto-occipital tract, connecting parietal and frontal brain areas that mediate own body perception. Our findings suggest that the neuroanatomical signature of transgenderism is related to brain areas processing the perception of self and body ownership, whereas homosexuality seems to be associated with less cerebral sexual differentiation.

‘Male Gaze’ in Malayalam Cinema: a reading of K.G. George's ‘Adaminte Variyellu’

The theory of male gaze was first introduced by British film maker, scholar and theorist, Laura Mulvey in her 1975 essay ‘Visual Pleasure and Narrative Cinema.’1 According to Mulvey, cinema reflects the oblivion of patriarchal society and reinforces the notion that women are the subject of heterosexual male control and desire.2 Mulvey states that most of the popular Hollywood films respond to number of pleasures offered by cinema, particularly known as scopophilia. This process of gaining pleasure by taking people as objects and subjecting them to a domineering gaze is gendered and eventually establishes women as objects of scopophilia and men as bearers of the look. The function of the cinema, according to Laura Mulvey, is to serve as a voyeuristic medium that encourages the audience to take pleasure from looking upon. Many Hollywood movies, especially the ones of Hitchcock and Stemberg were widely studied on the basis of this version of psychoanalytic theory. The purpose of this paper is to analyse the Malayalam movie, ‘Adaminte Variyellu (Adam's Rib) directed by the veteran film maker, K.G.George in the light of Laura Mulvey's essay. Adaminte Variyellu, the 1983 movie, talks about the travails of three women from different socio-economic sections of the society. Content analysis was used to determine whether Mulvey's argument of ‘male gaze and female spectatorship’ was applicable to Malayalam films of the 80’s. This papertakes as its starting-point the way a Malayalam movie reflects, reveals and works on the socially established notions of sexual difference which apparently controls images, erotic ways of looking and spectacle.

Cerebral sex dimorphism and sexual orientation.

The neurobiology of sexual orientation is frequently discussed in terms of cerebral sex dimorphism (defining both functional and structural sex differences). Yet, the information about possible cerebral differences between sex-matched homo and heterosexual persons is limited, particularly among women. In this multimodal MRI study, we addressed these issues by investigating possible cerebral differences between homo and heterosexual persons, and by asking whether there is any sex difference in this aspect. Measurements of cortical thickness (Cth), subcortical volumes, and functional and structural resting-state connections among 40 heterosexual males (HeM) and 40 heterosexual females (HeF) were compared with those of 30 homosexual males (HoM) and 30 homosexual females (HoF). Congruent with previous reports, sex differences were detected in heterosexual controls with regard to fractional anisotropy (FA), Cth, and several subcortical volumes. Homosexual groups did not display any sex differences in FA values. Furthermore, their functional connectivity was significantly less pronounced in the mesial prefrontal and precuneus regions. In these two particular regions, HoM also displayed thicker cerebral cortex than other groups, whereas HoF did not differ from HeF. In addition, in HoM the parietal Cth showed "sex-reversed" values, not observed in HoF. Homosexual orientation seems associated with a less pronounced sexual differentiation of white matter tracts and a less pronounced functional connectivity of the self-referential networks compared to heterosexual orientation. Analyses of Cth suggest that male and female homosexuality are not simple analogues of each other and that differences from heterosexual controls are more pronounced in HoM.

Psychosocial factors and ageing in older lesbian, gay and bisexual people: a systematic review of the literature.

To synthesise and evaluate the extant literature investigating the psychosocial influences on ageing as a lesbian, gay or bisexual person, to develop understanding about these influences and guide future research in the area. Research suggests there may be specific psychological and social factors relevant to ageing for individuals with a nonheterosexual identity. A systematic review was conducted on empirical research involving lesbian, gay and bisexual individuals aged 60 or above. The Cochrane Database, PsychINFO, MEDLINE, Web of Science and Google Scholar were searched and 41 studies met inclusion criteria. The majority had not been reviewed in earlier review articles. Findings were within two domains: psychological, consisting of sub-themes relating to identity, mental health and body image; and social, consisting of relationships, social support, discrimination, caregiving and receiving, community, accessing services and housing. The results suggest lesbian, gay and bisexual individuals mostly adjust well to ageing identities, with mediating influences including self-acceptance and connection with peers. Challenges experienced included ageism and heteronormative health and social care services; intimate friendships, social support and respectful professionals mitigated such threats and facilitated successful ageing. Methodological issues related to sampling procedures, such as purposive sampling through the gay community and limited generalisability due to the homogeneity of participants. Additionally, there was a widespread lack of heterosexual control groups. However, most studies used appropriate measures and acknowledged inherent limitations. Psychosocial influences included the challenge of societal stigma, but also resilience individuals demonstrate through a positive attitude. These factors must continue to be investigated for services to best meet the needs of this population. Clinicians are well placed to assist individuals draw on resilience when facing ageing challenges. Also, clinicians should be aware older people may have prior negative experiences of accessing services and try to involve 'families of choice' in care planning.

Homosexuality and Anorexia Nervosa: An Explorative Study on Personality Traits

Background: The relationship between anorexia nervosa in males and homosexuality is debated. A higher rate of Eating Disorders (EDs) was found in homosexual than in heterosexual men population. Since anorexia nervosa in men relates with a specific personality profile, homosexual men may share personality features with men affected with anorexia nervosa which may represent risk factors for the ED's outburst. Nevertheless, they have never been compared with the same instrument. The Temperament and Character Inventory (TCI) was widely applied in the study of EDs. Methods: This study compares personality traits, assessed with the TCI in a group of males with anorexia nervosa (n=21) with two control groups; heterosexual (n=51) and homosexual (n=23). A discriminant analysis was performed. Results: Men with anorexia nervosa and homosexual controls display a higher harm avoidance and a lower self-directedness compared with heterosexual controls. Men with anorexia nervosa also display a lower reward dependence compared with homosexual controls and a lower cooperativeness compared with both control groups. Conclusions: A relationship between the personality traits of men with anorexia nervosa and homosexual orientation may exist. Nevertheless, the low reward dependence and the low cooperativeness, which are the most specific characteristics of men with anorexia nervosa, are not linked to the homosexual orientation. Homosexual controls share with men with anorexia nervosa nonspecific personality traits that may indicate a common susceptibility to body's dissatisfaction, depression and stress.

Housing for ageing LGBTQ people in Sweden: a descriptive study of needs, preferences, and concerns

Background/aim: With an increasing number of ageing people who identify themselves as lesbian, gay, bisexual, transgender, or queer (LGBTQ), there is a risk that traditional housing for older people fails to meet the needs of these people. The aim of this study was to describe LGBTQ people’s needs, preferences, and concerns according to ageing and housing.Materials and methods: Based on a survey (n = 487), and six focus-group discussions (n = 30), with LGBTQ persons, quantitative and qualitative approaches were used to analyse the findings.Results: When comparing the ranking of preferences (in terms of activity options, environmental features, and staff competence) in a senior housing setting between the LGBTQ people (n = 200) and heterosexual matched controls (n = 198), only minor differences were detected. The findings from the focus groups included: (1) a dilemma between segregation and openness, (2) the importance of safety associated with ageing together with persons with similar experiences, and (3) networks of persons at different ages connected through close friendship supported participation in activities in LGBTQ-profiled senior housing.Conclusion and significance: The findings provide knowledge to improve awareness of sexual orientation when it comes to needs and preferences in relation to ageing and housing in a Swedish context.

Analysis of the Association between Catechol-O-Methyltransferase Val158Met and Male Sexual Orientation

Male sexual orientation is thought to have a genetic component. However, previous studies have failed to generate positive results from among candidate genes. Catechol-O-methyltransferase (COMT), located on chromosome 22, has six exons, spans 27 kb, and encodes a protein of 271 amino acids. COMT has an important role in regulating the embryonic levels of catecholamine neurotransmitters (such as dopamine, norepinephrine, and epinephrine) and estrogens. COMT is also thought to be related to sexual orientation. This study aimed to investigate the relationship between the COMT Val158Met variant and male sexual orientation. We performed association analysis of the COMT gene single nucleotide polymorphism, Val158Met, in 409 homosexual cases and 387 heterosexual control Chinese men. COMT polymorphism status was determined using a polymerase chain reaction-based assay. Polymerase chain reaction was performed to genotype the COMT Val158Met polymorphism. The frequency differences of the genotype and alleles distribution between the male homosexual and control groups. Significant differences, both in genotype and alleles, between male homosexual individuals and controls indicated a genetic component related to male homosexuality. The Val allele recessive model could be an interrelated genetic model of the cause of male homosexuality. The COMT Val158Met variant might be associated with male sexual orientation and a recessive model was suggested.

Life Satisfaction, Self-Esteem, and Loneliness Among LGB Adults and Heterosexual Adults in China

ABSTRACTLow levels of life satisfaction have been linked to low self-esteem and loneliness, but this association has never been tested directly in LGB (lesbian/gay/bisexual) populations. We compared 275 Chinese LGB adults to 275 demographic-matched Chinese heterosexual controls on life satisfaction, self-esteem, and loneliness. LGB adults reported lower levels of self-esteem and higher levels of loneliness than heterosexuals, but similar levels of overall life satisfaction. Self-esteem partially mediated (but did not moderate) the relationship between loneliness and life satisfaction in both groups. Hierarchical regressions indicated that demographic variables, loneliness, and self-esteem can predict life satisfaction in both LGB and heterosexual adults, but explained more variance of life satisfaction in the LGB group. Thus self-esteem and loneliness play a more important role in life satisfaction for LGB rather than heterosexual Chinese adults.

Childhood and adolescent sexual behaviors predict adult sexual orientations

AbstractAnonymous retrospective data were provided by 3,443 adult participants via computer-assisted self-interview. This was the first study focused on determinants of adult sexual orientation to adjust for the effects of same-sex sibling incest. Five measures of adult sexual orientations (ASOs) provided evidence consistent with the theory that ASOs result from early sex-specific romantic attachment, conditioning caused by early sexual experiences with partners, and other experiences, such as early masturbation using human images, acting synergistically with critical period learning, and sexual imprinting. Early same-sex crushes were the most powerful predictor of ASOs, and they also increased the likelihood of engaging in early same-sex partnered and masturbation behaviors. Incestuous experiences with same-sex siblings affected the ASOs of the incest participants. And, lesbian, gay, and bisexual participants tended to have an earlier onset of puberty than heterosexual controls within sexes. However, sta...

Masculinity, health behavior, and age: An examination of Hong Kong Chinese men.

Men suffer more severe chronic health conditions and have higher mortality for all leading causes of death. Research suggests that men who endorse more traditional constructions of masculinity are less likely to engage in health protective behavior. However, less attention has been paid to non-Western societies. Using a sample of Hong Kong Chinese men (N 220), the present study sought to examine the relationship between age, conformity to masculine norms, and health behavior. Younger age was associated with adaptive dietary behavior, greater engagement in preventive care behavior, and higher levels of social support. Playboy behavior was predictive of engagement with substance use, while heterosexual presentation, self-reliance, and emotional control were all positively associated with preventive care. These findings are discussed in relation to the Chinese cultural influence on masculinity, such as the importance of filial piety. The clinical implications of the findings are also discussed with suggestions for improving the health behavior and habits of older men in Hong Kong.

Birth Order and Sibling Sex Ratio in a Population with High Fertility: Are Turkish Male to Female Transsexuals Different?

Western studies have consistently found that androphilic (sexually attracted to men) male-to-female transsexuals have a later birth order and a relative excess of brothers compared with appropriate control participants. However, non-Western studies on birth order and sibling sex ratio in androphilic males (transsexual or non-transsexual) are rare. The objective of the study was to test the hypothesis that androphilic male-to-female transsexuals have a late birth order and a relative excess of brothers in a non-Western culture with a higher fertility rate. The participants were 60 androphilic male-to-female transsexuals and 61 male heterosexual controls. The transsexual participants had significantly more older brothers than the control participants, but the groups did not differ in their numbers of older sisters, younger brothers, or younger sisters. The foregoing pattern is usually referred to as the "fraternal birth order effect." Slater's and Berglin's Indexes both showed that the mean birth order of the control participants was very close to that expected from a random sample drawn from a demographically stable population whereas the mean birth order of the transsexual participants was later. A measure of sibship composition, brothers/all siblings, showed that the transsexual group had a higher proportion of male siblings compared with the control group. In conclusion, the present study found that Turkish androphilic male-to-female transsexuals show the same high fraternal birth order that has been found in comparable androphilic samples in Western Europe, North America, and the South Pacific, which suggests a common underlying biological causal mechanism.

Assessment of Implicit Sexual Associations in Non-Incarcerated Pedophiles

Offences committed by pedophiles are crimes that evoke serious public concern and outrage. Although recent research using implicit measures has shown promise in detecting deviant sexual associations, the discriminatory and predictive quality of implicit tasks has not yet surpassed traditional assessment methods such as questionnaires and phallometry. The current research extended previous findings by examining whether a combination of two implicit tasks, the Implicit Association Task (IAT) and the Picture Association Task (PAT), was capable of differentiating pedophiles from non-pedophiles, and whether the PAT, which allows separate analysis for male, female, boy and girl stimulus categories, was more sensitive to specific sexual associations in pedophiles than the IAT. A total of 20 male self-reported pedophiles (10 offender and 10 non-offenders) and 20 male self-reported heterosexual controls completed the two implicit measures. Results indicated that the combination of both tasks produced the strongest results to date in detecting implicit pedophilic preferences (AUC = .97). Additionally, the PAT showed promise in decomposing the sexual associations in pedophiles. Interestingly, as there was an equal distribution of offenders and non-offenders in the pedophile group, it was possible to test for implicit association differences between these groups. This comparison showed no clear link between having these implicit sexual associations and actual offending.

Association Analysis Between the Tag SNP for Sonic Hedgehog rs9333613 Polymorphism and Male Sexual Orientation

Male sexual orientation has been proposed to have genetic components, but previously suggested candidate genes have all received negative results. The human sonic hedgehog (SHH) gene is located in the 7q36 region, which was linked to male sexual orientation in a previous genome-wide association study. SHH is known to play an important role in embryo patterning, and there is evidence connecting it to sexual orientation. In this study, we performed an association analysis of the SHH tag single nucleotide polymorphism rs9333613 in 361 subjects and 319 Chinese male controls. We find a significant difference in genotype and allele distribution between identified homosexuals and heterosexual control subjects, suggesting that the SHH gene could potentially be associated with male sexual orientation.

International Differences in Alcohol Use According to Sexual Orientation

ABSTRACT Most research on sexual orientation and alcohol use in the United States has found higher rates of alcohol use and abuse among gay men and lesbians. Studies from other countries have found smaller or no differences between sexual minority and heterosexual women and men. The present study used general population survey data from 14 countries to examine high-volume and risky single-occasion drinking by sexual orientation. Data from 248 gay men and lesbians and 3720 heterosexuals were analyzed in a case-control design. In several countries partnered or recently partnered gay men and lesbians had no greater risk of heavy drinking or engaging in heavy drinking than heterosexual controls. Only lesbians in North America showed higher risk for both indicators. Future general population health research should include larger samples of gays and lesbians and use more comprehensive measures of sexual orientation for investigating the prevalence of health risk factors.

Mental Health Among Israeli Homosexual Adolescents and Young Adults

This study examines the mental health status of Israeli homosexuals in adolescence and early adulthood in comparison to heterosexual controls. We compared 219 homosexuals (136 gay men and 83 lesbian women) with 219 individually matched heterosexuals on indices of depression and subjective well being. In line with the study hypothesis, the results indicated that the homosexual participants reported more depressive symptoms and more negative affect than matched heterosexuals. However, the homosexuals were also found to report a higher level of positive affect. This study suggests that co-activated systems of negative and positive emotions facilitate adaptation among young homosexuals.