Lesbian Adults Research Articles

Predictors of new-onset suicide risk and persistent suicide risk among young adult lesbian, gay and bisexual individuals experiencing the COVID-19 pandemic: a follow-up study.

The aim of this 4-year follow-up study was to examine the predictive effects of demographics, three types of sexual stigma, three types of self-identity confusion, anxiety, depression, family support and problematic Internet use before the coronavirus disease 2019 (COVID-19) pandemic on new-onset suicide risk and persistent suicide risk in young adult lesbian, gay and bisexual individuals who experienced the COVID-19 pandemic in Taiwan. Baseline data were collected from 1,000 lesbian, gay and bisexual individuals in 2018 and 2019. Outcome data on suicide risk were collected again in 2023. The suicide module of the Mini International Neuropsychiatric Interview was used to assess suicide risk in terms of thoughts of death, desire to self-harm, thoughts of suicide, plans for suicide and suicide attempts in the preceding month at the initial and follow-up assessments. Baseline three types of sexual stigma, self-identity disturbance, depression, anxiety and problematic Internet use were used to examine their prediction of new-onset suicide risk and persistent suicide risk at follow-up. In total, 673 individuals participated in the follow-up survey. Notably, 16.5% of the participants who had no suicide risk at baseline had new-onset suicide risk at follow-up; 46.4% of the participants who had suicide risk at baseline also had suicide risk at follow-up. Participants who were transgender (p=.003), who perceived greater levels of microaggression (p<.001), and who had greater levels of problematic Internet use at baseline (p=.024) were more likely to have new-onset suicide risk at follow-up. Participants who had greater levels of self-identity confusion were more likely to have persistent suicide risk at follow-up (p=.023). Intervention strategies for reducing suicide risk in lesbian, gay and bisexual individuals should be developed with consideration of the predictors identified in this study.

SOCIODEMOGRAPHIC DIFFERENCES IN ADVANCE CARE PLANNING AMONG OLDER LESBIAN AND GAY ADULTS

Abstract Advance care planning (ACP) is a process that supports adults at any stage of health in ensuring that their values, goals, and wishes are met regarding future medical care. Factors associated with completing ACP include older age, being White, higher education, and higher socioeconomic status. However, scant research has investigated if these same characteristics are associated with ACP among lesbian and gay adults. Using data from an online survey (N=139), bivariate analyses were conducted to investigate predictors of ACP outcome measures. Being White (p&amp;lt;.01), older (p&amp;lt;.01), and employed (p&amp;lt;.05) were associated with having a higher level of comfort with medical decision making. Having a higher income (p&amp;lt;.01), being employed (p&amp;lt;.01), and having a health condition (p&amp;lt;.05) were associated with having completed a living will. Having a higher income (p&amp;lt;.01) and being employed (p&amp;lt;.05) were associated with having a durable power of attorney for healthcare. These outcomes demonstrate that while some variables were similar to previous findings, additional sociodemographic characteristics were found to have an influence on ACP among older lesbian and gay adults. Given that completing ACP has shown to improve quality of care at end of life, it is imperative to understand what factors influence ACP for older lesbian and gay adults. Understanding these within group differences will lead to future research and outreach efforts developed to inform and equip healthcare workers and community organizations with the means to better serve older gay and lesbian adults, a group that has been historically discriminated against by the healthcare system.

Predictors of problematic smartphone use among young adult lesbian, gay and bisexual individuals during the COVID-19 pandemic: a four-year follow-up study

BackgroundThis 4-year follow-up study was conducted to evaluate the predictive effects of prepandemic individual and environmental factors on problematic smartphone use (PSU) among young adult lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic.MethodsData on prepandemic PSU, demographics, sexual stigma (e.g., perceived sexual stigma from family members, internalized sexual stigma, and sexual microaggression), self-identity confusion (e.g., disturbed identity, unconsolidated identity, and lack of identity), anxiety, depression, and family support were collected from 1,000 LGB individuals between August 2018 and June 2019. The participants’ PSU was surveyed again after 4 years (between August 2022 and June 2023). The associations of prepandemic individual and environmental factors with PSU at follow-up were analyzed through linear regression.ResultsIn total, 673 (67.3%) participants completed the follow-up assessment. The severity of PSU significantly decreased after 4 years (p = .001). Before the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels depressive symptoms (p < .001), disturbed identity (p < .001), and perceived sexual stigma from family members (p = .025) at baseline were significantly associated with PSU at follow-up. After the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels PSU (p < .001) and depressive symptoms (p = .002) at baseline were significantly associated with PSU at follow-up.ConclusionInterventions aimed at reducing the severity of PSU among LGB individuals should be designed considering the predictors identified in our study.

Absolute and relative e-cigarette harm perceptions among young adult lesbian and bisexual women and nonbinary people assigned female at birth

PurposeYoung adult lesbian and bisexual women report considerable e-cigarette disparities, which may be attributed to low harm perceptions. No studies have assessed differences in e-cigarette harm perceptions in this group, nor which factors might be intervention targets to influence harm perceptions. Materials and methodsWe investigated differences in and modifiable correlates of e-cigarette harm perceptions among young adult lesbian and bisexual women and non-binary people assigned female at birth. Young adult women and non-binary people assigned female at birth, aged 18–30 years old, and who self-identified as lesbian or bisexual (N = 471) reported absolute and relative harm perceptions of e-cigarettes to health in an online survey. We modeled associations between harm perceptions and individual, interpersonal, and contextual factors. ResultsBisexual (vs. lesbian) participants perceived higher absolute harm of e-cigarettes (Mean (M) = 7.61 vs M = 7.09, p = .03). Participants rated e-cigarettes as slightly less harmful than cigarettes, and there was no statistically significant difference by sexual orientation (Bisexual: M = 4.84 vs Lesbian: M = 4.36). In multivariable models, bisexual (vs. lesbian) participants and Hispanic/Latinx and Other race (vs. non-Hispanic White) participants reported higher absolute and relative e-cigarette harm perceptions. Greater sexual identify affirmation and greater perceived stress were associated with higher absolute and relative e-cigarette harm perceptions. ConclusionsE-cigarette harm perceptions vary vis-à-vis individual-level factors. Self-identification as bisexual or minoritized race/ethnicity, greater sexual identity affirmation, and greater perceived stress was associated with increased harm perceptions. Understanding variations may inform targeted health communications to reduce e-cigarette use disparities.

Endocrine Health and Health Care Disparities in the Pediatric and Sexual and Gender Minority Populations: An Endocrine Society Scientific Statement.

Endocrine care of pediatric and adult patients continues to be plagued by health and health care disparities that are perpetuated by the basic structures of our health systems and research modalities, as well as policies that impact access to care and social determinants of health. This scientific statement expands the Society's 2012 statement by focusing on endocrine disease disparities in the pediatric population and sexual and gender minority populations. These include pediatric and adult lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) persons. The writing group focused on highly prevalent conditions-growth disorders, puberty, metabolic bone disease, type 1 (T1D) and type 2 (T2D) diabetes mellitus, prediabetes, and obesity. Several important findings emerged. Compared with females and non-White children, non-Hispanic White males are more likely to come to medical attention for short stature. Racially and ethnically diverse populations and males are underrepresented in studies of pubertal development and attainment of peak bone mass, with current norms based on European populations. Like adults, racial and ethnic minority youth suffer a higher burden of disease from obesity, T1D and T2D, and have less access to diabetes treatment technologies and bariatric surgery. LGBTQIA youth and adults also face discrimination and multiple barriers to endocrine care due to pathologizing sexual orientation and gender identity, lack of culturally competent care providers, and policies. Multilevel interventions to address these disparities are required. Inclusion of racial, ethnic, and LGBTQIA populations in longitudinal life course studies is needed to assess growth, puberty, and attainment of peak bone mass. Growth and development charts may need to be adapted to non-European populations. In addition, extension of these studies will be required to understand the clinical and physiologic consequences of interventions to address abnormal development in these populations. Health policies should be recrafted to remove barriers in care for children with obesity and/or diabetes and for LGBTQIA children and adults to facilitate comprehensive access to care, therapeutics, and technological advances. Public health interventions encompassing collection of accurate demographic and social needs data, including the intersection of social determinants of health with health outcomes, and enactment of population health level interventions will be essential tools.

Prospective Predictors of Work Limitations in Young Adult Lesbian and Bisexual Women: An Examination of Minority Stress, Trauma Exposure, and Mental Health.

Trauma exposure and mental health problems adversely affect work functioning. Sexual minority women are at increased risk for trauma exposure, depression, and PTSD. Sexual minority women also experience unique stressors related to their sexual orientation, which can directly impact work functioning. However, little research to date has examined the impact of trauma exposure and mental health problems among sexual minority women on their occupational outcomes. The goal of the current study was to examine whether trauma exposure, mental health problems, and minority stressors were associated with occupational functioning one year later in a large sample of young adult lesbian and bisexual women. The study utilized a subset of data (N = 304) from a larger longitudinal study on health risk behaviors among young adult lesbian and bisexual women. Results indicated that trauma exposure, posttraumatic stress, depression, and perceived heterosexism were each associated with subsequent work limitations, but after accounting for shared variance between predictors, only perceived heterosexism and depression were uniquely associated with subsequent work functioning. These findings highlight the roles of mental health and sexual orientation-related stress in the challenges that lesbian and bisexual women experience at work and point to a need for additional research to better understand risk and protective factors related to negative employment outcomes among lesbian and bisexual women.

NAVIGATING DEMENTIA DURING COVID-19: THE EXPERIENCES OF GAY AND LESBIAN OLDER ADULTS

Abstract By 2030, it is estimated that 30 million individuals worldwide will have Alzheimer’s disease or related-dementias (hereafter dementia). Described as a “modern epidemic of later life,” dementia research has begun to reflect the diversity of our aging society with greater attention to minority populations. Nonetheless, some marginalized dementia-affected populations remain understudied. Estimates suggest more than 1 million lesbian, gay, bisexual, and transgender older adults will have dementia by 2030. Despite sizeable predictions, dementia-affected gay and lesbian populations remain critically understudied particularly in relation to COVID-19. To date, there is scarce literature focusing on how community-dwelling gay and lesbian adults with dementia navigate the management of their condition during the COVID-19 pandemic. In order to identify how community-dwelling gay and lesbian adults manage their dementia during the COVID-19 pandemic, data were combined from two interview-based studies. Content analysis was conducted on the interview narrative of the subset of individuals with dementia identifying as gay or lesbian and their study partner(n=18). Thematic findings include: 1.triple marginalization (age, sexual orientation, cognitive status), 2.social isolation, 3.programming effects (e.g., adult day programming, ADRD support groups), 4.informal and formal care interruptions, and 5.symptom acceleration. While all members of the public have experienced difficulties since the onset of COVID-19, health threats vary depending on social circumstances and vulnerabilities. Analyses indicate community-dwelling gay and lesbians with dementia are uniquely impacted by COVID-19 and face unique challenges. Attunement to such issues are of special interest to community-level policy makers, health providers, and older LGBTQ adults themselves, requiring further attention.

Healthcare satisfaction at the intersections of sexual orientation and race/ethnicity

ABSTRACT Objectives: Existing scholarship has consistently demonstrated disparities in healthcare experience based on sexual identity. However, relatively little research has considered intersections with race/ethnicity, despite that intersection with other characteristics may complicate healthcare experiences and satisfaction among sexual minorities. This study aims to address such a gap by examining healthcare satisfaction across the intersections of sexual and racial/ethnic identity. Design: Utilizing data on U.S. adults included in the 2013–2018 Behavioral Risk Factor Surveillance System (BRFSS) (n = 372,766), we investigate levels of satisfaction with care among a range of groups simultaneously embodying two identities. Results: Findings from ordered logistic regression models show that among adults who identify as heterosexual, the odds of reporting high satisfaction with care are lower among Blacks, Asians, and Native Americans. Among sexual minority adults, the likelihood of reporting high satisfaction with care is consistently lower among Native American gay and lesbian adults compared to gays and lesbians of other race/ethnicity or Native American and White heterosexuals, indicating heightened vulnerability to poorer healthcare experience among this multiple minority group. Conclusion: While levels of satisfaction with care tend to be generally high across groups, future research should endeavor to investigate the driving factors that lower the odds of high healthcare satisfaction among those with intersecting minority identities.

Proportion of ALGBT adult Brazilians, sociodemographic characteristics, and self-reported violence

Asexual, lesbian, gay, bisexual, and trans (ALGBT) individuals face worse life conditions and violence rates than their heterosexual cisgender counterparts. Brazil is often highlighted for having one of the highest rates of hate-related homicides against ALGBTs in the world. However, to date, Brazil’s ALGBT population has not been investigated with a representative sample, and basic information such as population size or sociodemographic characteristics are mostly based in non-systematic data. We aimed to assess the proportion of asexual, lesbian, gay, bisexual, trans and non-binary adults in Brazil, their sociodemographic characteristics, and self-reported violence rates. In 2018, a sample (n = 6000) of the Brazilian adult population answered a face-to-face survey assessing sociodemographic characteristics, gender identity, sexual orientation, and self-reported psychological, physical, verbal, and sexual violence. Among Brazilian adults, 12.04% are ALGBT: 5.76% asexual, 0.93% lesbian, 1.37% gay, 2.12% bisexual, 0.68 trans, and 1.18% non-binary. Compared to heterosexual cisgender men, most ALGBT individuals have worse socioeconomic indicators and higher rates of self-reported psychological and verbal violence. All ALGBT groups and heterosexual cisgender women reported sexual violence more often than heterosexual cisgender men. It was reported between 4 up to 25 times more often by heterosexual cisgender women and trans individuals, respectively. The rates of the other ALGBT groups sit among the two. Our findings provide evidence of the important size of the ALGBT Brazilian population, as well as their socioeconomic vulnerability, and concerning violence levels experienced by the group. Policy makers may refer to the present article in order to mitigate this population’s vulnerability and to better understand its sociodemographic characteristics.

"No one size fits all" A Multi-Method Survey of Oncology Allied Health Professionals Experiences with Lesbian, Gay, Bisexual, Transgender/Queer Questioning Adolescent, and Young Adult Patients with Cancer and Reproductive and Sexual Health".

Objectives: To assess training needs for providers who care for adolescent and young adult (AYA) lesbian, gay, bisexual, transgender/queer questioning (LGBTQ) cancer patients, we conducted a mixed-method survey. During their cancer care experience, AYA cancer patients experience physical, psychosocial, and reproductive health challenges. In addition to these challenges, AYA LGBTQ individuals are a diverse and medically underserved population who experience unique challenges and disparities in medical care. Methods: Health care providers (n = 351) who participated in our reproductive health in cancer training program completed a survey with 28 quantitative items and 4 open-ended items assessing knowledge, confidence discussing reproductive health, and confidence in knowledge specific to reproductive needs and general health needs among AYA LGBTQ patients. Results: Confidence discussing and confidence in knowledge of reproductive and general health needs are lower regarding transgender and nonbinary patients. Nearly half of providers (45%) demonstrated low knowledge, while 38% and 17% demonstrated moderate and high knowledge, respectively. Open comments indicated providers desired more training around the needs of Trans and nonbinary patients, and creating welcoming environments. Conclusions: The majority of our participants demonstrate low or moderate knowledge regarding factors that can influence AYA LGBTQ patient care, suggesting that this is a key area for improvement. Furthermore, improving provider knowledge may subsequently improve confidence in general and reproductive needs of LGBTQ patients, resulting in improved patient-centered care. Improving provider knowledge and confidence may then ultimately help reduce disparities in cancer care among this patient population.

‘I somehow had the Feeling that I did not belong there’—Experiences of Gay and Lesbian Recreational Athletes in German Sports Clubs

There is little empirical research on the sport experiences of gay and lesbian recreational athletes in Germany and their existence and needs within organized, non-professional sports have largely been ignored. Based on twelve in-depth interviews with self-identified male gay and female lesbian adults, this paper explores how queer recreational athletes experience sport in German sports clubs and which particular challenges or discriminatory situations they are confronted with. Findings show that study participants do not experience much discrimination on an explicit level in the sports clubs. Nevertheless, many respondents try to hide their sexuality in the sports context to prevent possible discrimination and questions about their sexuality. After all, it is mainly the discussion about and reduction of their sexuality that is being experienced as problematic. Five main stressors have been identified: (1) the necessity of an outing, (2) the sports club typical mode of communication, (3) the heteronormative pre-structuring of the sports, (4) the feeling of otherness and the assigned special role, (5) the implicit fear of discrimination. The findings point to the need for increased reflection on and reduction of heteronormative structures in German sports clubs.

Problematic Smartphone Use and Its Associations with Sexual Minority Stressors, Gender Nonconformity, and Mental Health Problems among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan.

Smartphones are a necessity for many people; however, problematic smartphone use (PSU) may negatively influence people’s mental health. Using multivariate linear regression analysis, the study examined the associations of sexual minority stressors [namely perceived sexual stigma from family members, sexual orientation microaggressions (SOMs), and internalized sexual stigma] and gender nonconformity with PSU severity as well as the associations of PSU with depression and anxiety in young adult lesbian, gay, and bisexual (LGB) individuals. This cross-sectional survey study recruited 1000 young adult LGB individuals (500 men and 500 women). PSU severity was assessed using the Smartphone Addiction Inventory. The experiences of perceived sexual stigma from family members, SOMs, and internalized sexual stigma and the levels of gender nonconformity, depression, and anxiety were assessed. The results indicated that perceived sexual stigma from family members, SOMs, internalized sexual stigma in the dimensions of social discomfort and identity and gender nonconformity were significantly associated with PSU severity in LGB individuals. Moreover, PSU was significantly associated with depression and anxiety in LGB individuals. The findings highlight the significance of developing strategies for the prevention and early detection of PSU and sexual minority stress in LGB individuals.

Prevalence and Sociodemographic and Behavioral Correlates of Psychological Distress among Lesbian, Gay, and Bisexual Adults in the United States, 2013-2018

Background: The lesbian, gay, bisexual, and transgender (LGBT) population comprises approximately 5.6% of the total US population. Levels and patterns of psychological distress in the LGBT population are less well known compared with the general population. This study examines the prevalence and sociodemographic and behavioral correlates of psychological distress among lesbian, gay, and bisexual (LGB) adults in the United States. Methods: Using the pooled cross-sectional data from the 2013-2018 National Health Interview Surveys (N=183,020), differentials in serious psychological distress (SPD) and factor-based psychological distress scores were analyzed by multivariate linear and logistic regression. Results: The prevalence of SPD was 8.0% for the LGB population aged ≥18, 7.0% for gay and bisexual males, and 8.9% for LGB females, compared with 3.4% for the total straight/heterosexual population, 2.7% for straight males, and 4.0% for straight females. Mean psychological distress index scores were highest among LGB females (109.8), followed by gay and bisexual males (105.8), straight females (100.6), and straight males (97.7). Compared with the straight population, LGB adults had higher education, unemployment, and poverty levels and were more likely to be non-Hispanic White and single. LGB adults were more likely to smoke and drink alcohol and more likely to be physically active than straight adults. LGB females had higher obesity but gay and bisexual males had lower obesity rates than their straight counterparts. After controlling for covariates, LGB adults had 89% higher odds of SPD and significantly higher distress levels than straight adults. Younger age, lower-income, divorce/separation, lack of health insurance, functional limitation, smoking, physical inactivity, and obesity were significant predictors of SPD and higher psychological distress levels in LGB adults. Conclusion and Implications for Translation: Significant disparities in mental health exist, with LGB adults at substantially increased risk of psychological distress and likely in greater need of appropriate social and mental health services. Health policies aimed at improving the material conditions and social environments may lead to improved mental health outcomes among LGB adults and the general population. Copyright © 2022 Singh, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Expectation of Rejection and Its Association with Health Care Avoidance and Delay Among 2175 Korean Lesbian, Gay, and Bisexual Adults: A Nationwide Cross-Sectional Survey.

Purpose: The study examined an association between expectation of rejection and health care avoidance and delay (HAD) among lesbian, gay, and bisexual (LGB) adults in South Korea. Methods: We analyzed data from a nationwide cross-sectional survey of 2175 South Korean LGB adults, which was approved by the Korea University Institutional Review Board. We categorized expectation of rejection into tertiles ("low," "medium," and "high" levels) and investigated its association with past 12-month HAD using multivariate modified Poisson regression. Results: After adjusting for covariates, including experiences of discrimination, participants with high levels of expectation of rejection had 1.38-times (95% confidence interval: 1.16-1.65) higher prevalence of HAD compared with those with low levels. Conclusion: Living in anticipation of rejection can negatively impact LGB adults' health care utilization.

Leaving a Mark and Passing the Torch: Intended Legacies of Older Lesbian and Gay Spanish Activists

ABSTRACT Aging paradigms should entail all individuals. More research on older LGBT+ adults is needed since the literature has been mainly built on heteronormative and cisgender standards. The creation and shaping of the kind of legacy an individual would like to leave behind when he/she dies is key in aging well. This study explores the intended legacies of older lesbian and gay adults (50+ years old) who were activists in social movements in Spain. Eighteen participants (12 gay men) participated in a semi-structured interview on their intended legacies. Thematic analysis was used to analyze the interviews. The main findings showed that all participants reported intended legacies: i) personal, to transmit their lived knowledge and to be remembered as good and committed persons; ii) broader, to contribute to LGBT+ rights, and to a better society; iii) composite, the desire that younger generations recognize their contributions, and to know they helped to protect new generations. The participants in this study lived a life of intense involvement in social movements, and currently their intended legacies involve leaving a mark and passing the torch to younger generations. This understanding will help us to develop adequate practices that promote well-being in older LGBT+ adults.

Internalized Sexual Stigma among Lesbian, Gay, and Bisexual Individuals in Taiwan: Its Related Factors and Association with Mental Health Problems.

Internalized sexual stigma (ISS) is one of the major issues that can compromise the health of sexual minority populations. This quantitative study aimed to examine: (1) the relationships of individual factors (gender, age, education level, sexual orientation, and age of identification of sexual orientation) and perceived family support with ISS; and (2) the associations of ISS with mood problems and the moderating effects of gender on the associations among Taiwanese young adult lesbian, gay, and bisexual (LGB) individuals. In total, 500 male and 500 female young adult LGB individuals aged between 20 and 30 years participated in this study. The experience of ISS, individual (e.g., gender, age, education level, sexual orientation, and age of identification of sexual orientation) and environmental factors (perceived family), mood problems (e.g., anxiety and depression) were collected. The individual and environmental factors related to ISS and the associations of ISS with mood problems were examined using multivariate linear regression analysis. The results indicated that gender, sexual orientation, age of identification of sexual orientation, and perceived family support were significantly associated with all or some dimensions of ISS in LGB individuals. Various dimensions of ISS had different relationships with anxiety and depression. Gender had moderating effects on the association between the identity dimension of ISS and sexual orientation as well as between the social discomfort dimension of ISS and anxiety. Various dimensions of ISS among LGB individuals should be routinely assessed by mental health service units. Intervention programs should be provided for LGB individuals, especially those with factors related to ISS.

Intersectional Activism Among Black Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning Young Adults: The Roles of Intragroup Marginalization, Identity, and Community

Research around the importance of activism for positive development has been primarily focused on a single identity, missing the ways in which race and sexual orientation intersect to influence the communities young adults advocate for. The current study assesses how Black lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) young adults’ experiences of discrimination, identity, and community predict involvement in intersectional activism (e.g., activism for LGBTQ communities of color). With a sample of 216 Black LGBTQ young adults from the Social Justice Sexuality project, we used hierarchical linear regression to examine relationships between intragroup marginalization, identity, community involvement, and intersectional activism. While all three constructs explained a significant variance in intersectional activism, only racial marginalization within the LGBTQ community and involvement in LGBTQ communities of color were positively associated with intersectional activism. These findings demonstrate that experiences of intragroup marginalization and connection to communities that center both race and sexual orientation may be important in fostering activism among Black LGBTQ young adults.

"It's Kind of Complicated": A Qualitative Exploration of Perceived Social Support in Young Adult and Young Adult Lesbian, Gay, Bisexual, Transgender, and/or Queer Cancer Survivors.

Purpose: This qualitative secondary analysis describes the perceived importance of familial, peer, and health system social support for an understudied group of cancer survivors: young adults (YAs), including those who are lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). Methods: Semistructured interviews were conducted with YA cancer survivors as part of a study of social support networks and interactions. Team members conducted content analysis of interview transcripts; coding decisions were reviewed and discussed among the research team. Descriptions of social support were ultimately organized around family, peer, and health care system support. Results: Twelve YA survivors recruited using two National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and social media participated between August 2019 and May 2020. Survivors averaged 28.2 years old. Half of survivors self-identified as female; four survivors were LGBTQ. Participants described both the positives of social support, as well as barriers to meeting support needs, within the following three levels: familial, peer, and health care providers or system. Conclusion: YA survivors have needs that are often addressed by their families, peers, and the health care system. However, barriers such as complex relationship history and lack of targeted/tailored support programs can prevent survivors from receiving adequate support. The growing diversity and intersectionality represented in the YA population call for targeted support and training by the health care system to sufficiently support this population.

COVID-19 Vaccination Coverage and Vaccine Confidence by Sexual Orientation and Gender Identity - United States, August 29-October 30, 2021.

Lesbian, gay, bisexual, and transgender (LGBT) populations have higher prevalences of health conditions associated with severe COVID-19 illness compared with non-LGBT populations (1). The potential for low vaccine confidence and coverage among LGBT populations is of concern because these persons historically experience challenges accessing, trusting, and receiving health care services (2). Data on COVID-19 vaccination among LGBT persons are limited, in part because of the lack of routine data collection on sexual orientation and gender identity at the national and state levels. During August 29-October 30, 2021, data from the National Immunization Survey Adult COVID Module (NIS-ACM) were analyzed to assess COVID-19 vaccination coverage and confidence in COVID-19 vaccines among LGBT adults aged ≥18 years. By sexual orientation, gay or lesbian adults reported higher vaccination coverage overall (85.4%) than did heterosexual adults (76.3%). By race/ethnicity, adult gay or lesbian non-Hispanic White men (94.1%) and women (88.5%), and Hispanic men (82.5%) reported higher vaccination coverage than that reported by non-Hispanic White heterosexual men (74.2%) and women (78. 6%). Among non-Hispanic Black adults, vaccination coverage was lower among gay or lesbian women (57.9%) and bisexual women (62.1%) than among heterosexual women (75.6%). Vaccination coverage was lowest among non-Hispanic Black LGBT persons across all categories of sexual orientation and gender identity. Among gay or lesbian adults and bisexual adults, vaccination coverage was lower among women (80.5% and 74.2%, respectively) than among men (88.9% and 81.7%, respectively). By gender identity, similar percentages of adults who identified as transgender or nonbinary and those who did not identify as transgender or nonbinary were vaccinated. Gay or lesbian adults and bisexual adults were more confident than were heterosexual adults in COVID-19 vaccine safety and protection; transgender or nonbinary adults were more confident in COVID-19 vaccine protection, but not safety, than were adults who did not identify as transgender or nonbinary. To prevent serious illness and death, it is important that all persons in the United States, including those in the LGBT community, stay up to date with recommended COVID-19 vaccinations.

Validation of the Orgasm Rating Scale in Context of Sexual Relationships of Gay and Lesbian Adults.

Currently, no validated instrument exists for assessing the subjective experience of orgasm in the gay population. The Orgasm Rating Scale (ORS), previously validated in the heterosexual population, comprises four dimensions: Affective, Sensory, Intimacy, and Rewards. This study validated it for sexual relationships in the gay population by obtaining its factorial invariance by sexual orientation and sex, its internal consistency reliability, and evidence of validity in its relationship with other variables. We assessed 1600 cisgender Spanish adults–heterosexuals, gays, and lesbians–divided into 4, sex-based groups of 400 each, according to the Kinsey scale scores. Participants reported recent experiences of orgasm in the context of sexual relationships and responded to the ORS and other scales assessing attitude toward sexual fantasies and sexual functioning. The ORS structure showed a strict multigroup-level invariance by sexual orientation and sex, confirming its four-dimensional structure. The subjective orgasm intensity was associated with a positive attitude toward sexual fantasies and sexual functioning. Scores obtained on the Affective, Intimacy, and Rewards dimensions confirmed the ability to discriminate between gay people with and without orgasmic difficulties. The ORS’s Spanish version presents good psychometric properties as a validated scale to evaluate the subjective experience of orgasm in the gay population.