Lesbian, Gay, Bisexual Research Articles

Medical student clinical cultural awareness in cancer care of sexual gender minority patients

ObjectiveHealth disparities in lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+), or sexual and gender minority (SGM) people are known. SGM people have higher cancer risk, but lower rates of screenings, resulting in a higher likelihood of late-stage disease. This study evaluates medical students’ clinical cultural awareness in cancer care of SGM patients to identify gaps in education. MethodsThis was a cross-sectional survey distributed to medical students at a academic center. There were 38 questions on demographics, attitudes, and knowledge of SGM topics. Descriptive statistics were used for demographic information and stratified analyses assessed responses by demographic subgroups. ResultsThere were 238 responses from 1145 students (response rate = 20.7 %). Of the responders, 91.2 % and 79 % were comfortable treating lesbian, gay, bisexual (LGB) and transgender patients respectively. Only 28.6 % and 21.8 % were confident treating LGB and transgender patients respectively after taking the survey. 91.2 % of students were interested receiving education regarding SGM health needs. ConclusionWhile most medical students are comfortable treating LGBTQ+ patients, most are not confident in their knowledge. This difference is most profound in knowledge of transgender patients. Practice implicationsSchools must provide more education in SGM topics to improve student knowledge to produce competent providers.

Z-Drug Use and Benzodiazepine Use and Misuse Among LGB Populations: The Role of Psychological Distress.

Z-drugs (hypnotics such as zolpidem, zopiclone, and zaleplon) and benzodiazepines (BZDs) are sedative medications with misuse liability. The goals of this study are to report the (1) prevalence of past-year any Z-drug use, any BZD use, and any BZD misuse by sexual identity category and psychological distress; (2) associations among these 3 categories between sexual identity and past-year psychological distress; (3) associations among these 3 categories with sexual identity by past-year psychological distress status. Data were collected from the National Survey on Drug Use and Health (years 2015-2019 [n = 210,392]), a yearly representative national household survey of the American population. We report prevalences of any Z-drug use, any BZD use, and any BZD misuse by sexual identity and past-year psychological distress status. We ran logistic regressions with complex survey design with the 3 dichotomous variables described above as the dependent variables, stratified and not-stratified by psychological distress. Prevalence of any Z-drug an BZD use and any BZD misuse were higher among LGB (lesbian/gay/bisexual) populations, especially gay men and bisexual women. Psychological distress was positively associated with any Z-drug and BZD use and any BZD misuse. Women were at higher risk of Z-drug (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.18-1.37) and BZD use (OR, 1.64; 95% CI, 1.55-1.73), but lower risk of BZD misuse (OR, 0.82; 95% CI, 0.76-0.88). When stratifying by psychological distress, differences between LGB and heterosexuals were more pronounced among those without past-year psychological distress, especially gay men and bisexual women. The presence of psychological distress attenuates the disparities between LGB and heterosexual individuals in Z-drug use and BZD use and misuse.

Mentorship for young gay men in Hong Kong: A pilot mixed-methods randomized controlled trial.

This study examined whether mentorship could promote young gay men's identities and well-being, and whether a mentor's sexual orientation matters. A randomized control trial compared outcomes across three conditions: Arm A (a mentee matched with a sexual minority mentor), Arm B (a mentee matched with a heterosexual mentor), and a control arm receiving psychoeducation only. A community sample of 60 mentees aged 18-25 years was randomly allocated to the three arms and completed questionnaires at baseline, 3 months into the intervention, and at the end of the 6-month program. Fifteen mentees recounted their mentoring experiences through in-depth interviews. Linear mixed effects models showed that for both intervention and control conditions, internalized homonegativity declined while resilience, loneliness, and body acceptance improved over time. No time and group interactions were found. Meanwhile, a mentor's sexual orientation did not drive differential quality and outcomes of mentorship. Interviewees cited various benefits of mentorship, including providing companionship, enriching connection with lesbian, gay, bisexual (LGB) communities, and adding knowledge and perspectives of LGB lives and identities. Although quantitative data did not support any exclusive benefits of mentorship, most mentees recognized mentorship as a vital source of affirmation and companionship. Implications for research and mentoring programs are discussed.

Multiple risk factors of substance use among lesbian, gay, bisexual (LGB) adults: A comparison study

ABSTRACT The aim of this study was to identify and compare risk factors of substance use between heterosexual and LGB adults. Using data from the 2020 National Survey on Drug Use and Health (NSDUH), Chi-square, t-test, and standard multiple regressions were employed to analyze the data. The findings showed that LGB participants had significantly higher experiences with substances and initiated substance use earlier than heterosexual participants. Some risk factors were related to experiences with substance use for both groups (i.e. depression, emotional distress, age of first alcohol and marijuana use), but these factors accounted for more of the variance for LGB participants. Additionally, overall health was uniquely associated with experiences with substance use for LGB participants. These results have important implications for the design of culturally appropriate substance use prevention and intervention services for LGB individuals.

Sociodemographic factors associated with major depressive episodes and suicidal ideation among emerging adults with diabetes in the U.S.

Research focused on disparities related to mental health comorbidities, especially among emerging adults with diabetes, is limited. Identifying associated factors of disparities could inform policy decisions to make diabetes-related interdisciplinary care more accessible for vulnerable groups. Using data from the National Survey on Drug Use and Health (2015-2019), we examined disparities in presence of major depressive episode (MDE) and suicidal ideation among emerging adults with diabetes. Survey design-adjusted bivariate and multivariable logistic regression models were used for statistical analyses. The study included 1,125 emerging adults (18-25 years old), with a history of type 1 diabetes (T1D) or type 2 diabetes (T2D). After controlling for sociodemographic and health-related characteristics, we found lower odds of having past-year major MDE for non-Hispanic Black (AOR, 0.42, p=0.032) compared to their non-Hispanic White counterparts. Females were 3.02 times more likely to have past-year MDE than males (AOR, 3.02, p=0.004). The odds of having past-year MDE were 1.96 times higher among individuals who identified as LGB (lesbian, gay, bisexual) (AOR, 1.96, P=0.038). There were no statistically significant disparities in suicidal ideation related to race/ethnicity, sex, education, and family income. However, individuals who identified as LGB had significantly higher likelihood of suicidal ideation than their heterosexual counterparts (AOR, 2.47, P=0.004). Significant disparities related to MDE and suicidal ideation exist based on race/ethnicity, gender, and sexual orientation. Integration of a mental health professional into the multidisciplinary diabetes care team is critical for effective management of comorbid mental health conditions in younger patients with diabetes.

Making the invisible, visible: older lesbian, gay and bisexual victim-survivors’ “lived experiences” of domestic abuse

PurposeThis paper aims to examine the use of coproduction to create a film “Do You See Me?”, to amplify the voices of a “hard to reach” group: older lesbian, gay, bisexual (LGB) victim-survivors of domestic abuse (DA).Design/methodology/approachQualitative methods were used as part of the co-production, which included two practitioner focus groups and 14 narrative interviews with lesbian, gay, bisexual, transgender, queer or questioning persons or the community (LGBTQ+) victim-survivors.FindingsDespite differences in gender, sexualities, roles and “lived experiences” across stakeholders, there was a shared aim to ensure victim-survivors had a sense of ownership in this endeavour. Consequently, a positive reciprocity existed that helped to foster effective communication, allow for capacity building and subsequent knowledge exchange. The collaboration produced a nuanced meta-narrative making visible the “lived experiences” of LGB victim-survivors’ perceptions of perpetrator behaviours.Originality/valueTo the best of the authors’ knowledge, this paper is original in two ways, firstly, providing insights into the “lived experiences” of an invisible group; older LGBTQ+ victim-survivors, and secondly, in involving them in the co-production of a film. The paper aims to reveal how interdependencies that developed between stakeholders helped to disrupt understandings, develop new ways of knowing and build levels of trust. Group interactions helped to dismantle hierarchies, so those with experiential knowledge: the survivors, had greater control throughout the research process. The paper is significant in providing a critical reflection on the ethical, methodological and resource challenges involved in co-production. It also makes recommendations for researchers and funders about the value of using co-production as a method to engage with hard-to-reach groups.

Intersectional examination of travel well-being and activities of LGB travellers

Lesbian, Gay, Bisexual (LGB) people can experience discrimination because of their minoritized status, which can be exacerbated when they come from a less privileged group or background compared to the rest of society. Travel can play a unique role in their lives by providing an opportunity to escape the constrictors of how one is defined and positioned in their home environment. The experiences enabled through travel can help build capacities that enhance well-being and the ability to cope with prejudice at home. This paper explores how LGB people with intersectional identities perceive the role of travel in contributing to their well-being and the activities they participate in while travelling. We frame intersectionality as one’s sexual orientation and the differences arising from one’s relative socioeconomic status. Through an online survey of 473 Australian LGB people, we identify five well-being segments, which differed on their socioeconomic status, travel activity choices, and sexual orientation. The results have implications for how travel is a well-being tool that supports different segments of LGB people through the provision of pleasure activities while also facilitating self-development, social contribution, and minimizing the impact of negative experiences on day-to-day life.

HEALTHCARE NEEDS AND PERCEPTION OF HEALTH SYSTEM RESPONSIVENESS IN LGBTQIA+ COMMUNITY IN INDIA: A SURVEY BASED CROSS SECTIONAL STUDY

Background: Lesbian Gay Bisexual Transgender Queer Intersex Asexual+ (LGBTQIA+) community faces health disparities because of social stigma, discrimination, denial of civil and human rights. On the basis of their sexual orientation and/or gender identity, they face barriers to healthcare access. Healthcare professionals who have little knowledge about the LGBT community can lead to poor health care of the community. The discrimination faced by them increases the risk of poor mental and physical health. Thus, a 'queer-friendly healthcare for all' is the need of the hour. Objectives: The objective of this study was to evaluate distinct healthcare needs and barriers to healthcare among LGBTQIA+ community and analyse the perceived health system responsiveness in the LGBTQIA+ community. Materials and methods: Using social media, crosssectional survey was conducted. Respondents were directed to an online questionnaire-based Google form. Respondents 18 years of age or older who self-identied to belong to LGBTQIA+ community participated in this study. Results: A total of 253 participants were involved in the study. We found out barriers to come out, and unique healthcare problems affecting mental health, sexual health and physical health among LGBTQIA+ community. We also found that there were barriers to access healthcare and according to them, health system is unresponsive towards the LGBTQIA+ community and there face signicant health disparities. Conclusion: There is a need for sensitization of the healthcare providers towards the needs of LGBT community. The study also identies the rst step ( identication ) on the long path to acceptance of the diversity and variegated hues that nature has created. Progressive and inclusive realization of social rights and right to privacy embracing all and to start a dialogue is necessary for ensuring equal rights and opportunities for “less than equal” sections of the society

현대사진에 나타난 가족의 개념을 통한 트라우마(상실의 기억)의 극복에 관한 고찰

Creative activities often act as a tool to overcome trauma for artists. Nan Goldin is an American photographer who was first introduced in New York in the 1970s and 1980s for documenting intimate daily life of herself and friends who were part of bohemian and LGBTQ(Lesbian Gay Bisexual Transgender Queer) minority cultures. Nan started photography to overcome the trauma caused by her sister’s death. Leaving home, she formed a new concept of family and recorded their daily life in the form of a diary. Through understanding Nan Goldin's childhood and concept of family, the thesis analyzes narrative techniques, subject matters, and colors used in work. Viewers gain sympathy and comfort in an unfamiliar way through Nan Goldin’s daily record.

Help me to come out gracefully! Working with lesbian, gay, and bisexual, people affected by cancer to develop a national practitioner guide supporting inclusive care

IntroductionThe healthcare support needs of the lesbian, gay, bisexual (LGB) and transgender community are becoming an emerging area of healthcare research. Providing person-centred care is World Health Organisation policy and as such it is important that Radiography services can demonstrate areas in which they are working with people to design, develop and feedback on the services that they receive. This research aimed to establish how cancer treatment impacted on the identities of LGB people, their experiences of care, and their engagement with developing a practitioner guide. MethodsThis cooperative inquiry is underpinned by person-centred philosophy and participatory research principles. Participants were nine lesbian, gay, and bisexual people affected by cancer. Each engaged in two facilitated, audio-recorded conversations to explore their experiences of cancer care. An analytical framework based on Mezirow's Transformational Theory was used to organise the data, followed by detailed content analysis to develop themes. ResultsParticipants included men and women, aged 45–68, who had experienced different cancers. They explored how cancer treatment had impacted on them, and worked with the researcher and stakeholders to establish a seven-recommendation practitioner guide aimed at improving LGB people's care experiences. Their accounts revealed a broad range of issues that both corroborate and build on existing evidence. Themes highlighted expectations and experiences of both assumptions and prejudice in healthcare interactions. These experiences, along with misinterpretation of relationships with significant others, led to feelings of discomfort and reserve about self-expression. Findings of the research are presented in the following key areas: Dilemmas of attending oncology appointments; Inclusive experiences of care; and Formulation of the practitioner guide. ConclusionThe research findings enabled development of a national practitioner guide with the participants and key stakeholders to raise awareness of the needs of LGB persons affected by cancer and support better care. Implications for practiceBy providing real-life accounts this research adds to understanding of how LGB persons interact with services, developing evidence to support cultural competence within the profession of Radiography and oncology services more broadly.

Effects of School Policies and Programs on Violence Among All High School Students and Sexual and Gender Minority Students.

Youth identifying as lesbian, gay, bisexual (LGB) and/or transgender/gender nonconforming (TGNC) are at increased risk of violence. School policies and practices may mitigate this risk. Researchers merged data from the 2016 New Mexico School Health Profiles and the 2017 New Mexico Youth Risk and Resiliency Survey. Researchers employed multivariable logistic regression to test the associations between school-level measures and violence outcomes. Genders and sexualities alliances (GSAs) were associated with reduced odds of lifetime forced sex among all, heterosexual cisgender, and LGB students, reduced odds of sexual violence among heterosexual cisgender students, and reduced odds of dating violence among LGB students. Inclusive sexual health education was associated with reduced odds of lifetime forced sex among LGB and TGNC students, reduced odds of sexual violence among LGB students, and increased odds of dating violence among heterosexual cisgender students. Inclusive teacher training was associated with increased odds of lifetime forced sex among TGNC students. Inclusive sexual health education and the presence of active GSAs may have the greatest potential for reducing violence, especially among LGB and TGNC students. Findings highlight the important role of school policies and practices in addressing violence.

Black Transnational Resistance

Look Back at It (2016) is a cutting-edge interpretation of Pablo Picasso’s Les Demoiselles d’Avignon (1907) by African American multidisciplinary artist Rashaad Newsome. The work is a collage of magazine cuttings. The action is set in the vogue ballroom scene, a counterculture sparked in the 1970s by the Black and Latinx Lesbian Gay Bisexual Transgender Queer/Questioning (LGBTQ+) communities in New York. The muses are disenfranchised African American trans women who have faced a long-standing subjugation anchored in America’s history of racial slavery and classed transphobic capitalism. Their bodies are made of a collage of dazzling jewels cut from glossy magazines that have rendered them invisible. Drawing on beauty politics, this article maps the visual repertoire of Newsome’s aesthetic and its geopolitical implications. A formal and contextual analysis highlights how the use of high jewelry alludes to the global trade in minerals—most specifically, the diamond industry’s spoliation of South Africa’s natural resources, pionered by British imperialist Cecil Rhodes. Special attention is paid to the way Newsome’s subversion of the codes of high jewelry visually and conceptually echoes voguers’ transgression of high fashion in dance competitions. Newsome stages a transnational and transhistorical dialogue between two distinct but interconnected systems of oppression, imperialism and global capitalism, thus sketching a collective history of Black pain and of creative resilience, guided by trans women, that is essential at the time of the resurgence of global populist nationalistic discourses.

Lesbian Gay Bisexual Transgender Questioning/Queer Two- Spirit Adolescents and Suicidality

Background: At a time when suicides are increasing throughout the United States, lesbian, gay, bisexual, transgender, and two spirit (LGBTQ2S) adolescents are at especially high risk for suicidal ideation, attempts, and completed suicide. Objectives: To 1) provide an overview and clinical perspective on LGBTQ2S suicidal ideation, attempts, and completed suicide; 2) discuss how the literature maps on to theories of suicide, and also points the way to clinical recommendations; and 3) give recommendations for clinical care based on this evidence. Method: This article uses a narrative review style to discuss the current concerns around LGBTQ2S adolescent suicide. The Social Ecological Model, the Interpersonal Psychological Theory of Suicide, and Minority Stress Theory are used describe the manner in which risks are acquired. Results: Emerging research demonstrates risks and protective factors in the lives of LGBTQ2S adolescents. The social context of LGBTQ2S adolescents puts them at risk for internalizing the experiences of discrimination evident in our society, In addition, there are other risk factors frequently associated with their LGBTQ2S status, such as substance misuse, homelessness, and lack of social support . Adolescents of color are especially vulnerable as they experience multiple marginalizations, often living in under resourced communities with poor access to health care. Support to families can be provided in the form of psychoeducation based on research findings. Social support is crucial and can be effectively provided in schools. Access to mental health care needs to be increased and barriers reduced. Conclusion: There is a need for more research, especially prospective study designs and research that centers adolescents of color and homeless adolescents. While there may be barriers to addressing the current rate of suicidality in this population, clinicians who work with adolescents can use a range of therapies to support their LGBTQ2S adolescent patients and their families, decreasing risk of suicidality.

The Influence of Social Media Social Support on the Flourishing Homosexual Identity: A Case Study of the Lesbian Gay Bisexual Transgender Queer (LGBTQ) Community in Accra-Ghana

The aim of the study was to explore the influence of social media and social support on the flourishing homosexual identity in Accra, Ghana. The objectives were to determine the extent to which social support influence’s homosexual identity, the correlation between homosexual identity and flourishing levels among homosexuals, to ascertain the extent to which media, emotional, and social support predicts how homosexuals flourish, and finally to as certain how differences in the level of education predict how homosexuals flourish in Accra, Ghana. A case study design was employed. The population for this study was associates of the homosexual Community in Accra-Ghana. Using a purposive sampling technique, 142 homosexual respondents answered a standard questionnaire. Berlin Social Support scale (BSSS), Diener Flourishing scale Lesbian, Gay, and Bisexual Identity Scale were used on demographics, social support, flourishing, and lesbian, gay, bisexual identity. Data was analysed using simple linear regression, Pearson product-moment correlation coefficient, and one-way analysis of variance. Results obtained indicated that social support does not predict homosexual identity among homosexuals in Accra. As an individual homosexual identity increases so does the level with which the individual flourishes. Thirdly, social media emotional, and social support was found to be a predictor of flourishing among homosexuals in Accra. Finally, the results also indicated that differences in the level of education do not predict how homosexuals flourish in Accra. The conclusion indicates that study has shown that differences in the level of education among homosexuals do not influence the extent to which homosexuals flourish.

State-Level Regulations Regarding the Protection of Sexual Minorities and Birth Outcomes: Results From a Population-Based Cohort Study.

We leverage state-level variability in social policies that confer legal protections for sexual minorities (e.g., employment nondiscrimination acts) and examine their association with birth outcomes among sexual minority women. We link measures of structural protections (i.e., social policies) to a prospective, population-based cohort of US adults-the National Longitudinal Study of Adolescent to Adult Health ( n = 7913 total singleton births, n = 274 singleton births to bisexual women, n = 53 singleton births to lesbian women)-which includes measurement of key risk factors for birth outcomes over the life course. Lesbian, gay, bisexual (LGB) policy protections were associated with better birth outcomes for lesbian women. For example, among lesbian women, the predicted birth weight for infants in states with no policy protections was 3.01 kg (95% confidence interval = 2.71-3.30) but was 3.71 kg (95% confidence interval = 3.46-3.96) in states with three or four policy protections. In negative control analyses, there was no association between LGB policy protections and birth outcomes among the nonstigmatized group (i.e., heterosexual women), providing evidence of specificity. Furthermore, in states with the most LGB policy protections, lesbian women were at lower risk for preterm births and had infants with higher birth weights than heterosexual and bisexual women. These associations remained robust after adjusting for 13 risk factors, including demographics, prior and current indicators of socioeconomic status, preconception and perinatal risk factors, and neighborhood characteristics. These results provide novel evidence that sexual orientation-related policy protections, measured at the state level, are associated with a decreased risk for adverse birth outcomes among lesbian women.

Repetitive transcranial magnetic stimulation for generalized anxiety and panic disorders: A systematic review and meta-analysis.

Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved, noninvasive modality for treating major depressive disorder and obsessive-compulsive disorder. Earlier studies evaluating therapeutic effects of rTMS on symptom scores of patients with generalized anxiety disorder (GAD) and panic disorder (PD) have yielded inconsistent findings. We performed a systematic review and meta-analysis of interventional studies assessing the effect of rTMS on symptom scores in patients with GAD or PD with or without psychiatric comorbidities using studies published up to April 2021. We used DerSimonian-Laird random effects models to obtain pooled standardized mean difference (SMD) and 95% CI. A total of 13 studies consisting of 677 participants (404 treated with rTMS and 273 without rTMS) were included in this meta-analysis. In GAD patients with or without any comorbidities, rTMS therapy demonstrated significant improvements in anxiety (SMD = 1.45; P < .001) and depression (SMD = 1.65; P < .001) scores regardless of rTMS parameters. Overall anxiety (SMD = 0.24; P = .48) and panic severity (SMD = 1.19; P = .054) scores did not significantly improve after rTMS therapy in patients with PD. rTMS is safe and improves anxiety and depression scores only in GAD patients, regardless of underlying comorbidities or rTMS parameters.

Gender differences in the association of sexual orientation with depressive symptoms: A national cross-sectional study among Chinese college students

BackgroundDepressive symptoms among the lesbian, gay, bisexual (LGB) in college students have generated worldwide concern in recent decades. This study aimed to estimate the associations between sexual orientation and depressive symptoms among Chinese college students, with a focus on gender differences. MethodsA total of 30,733 college students were recruited from 10 Chinese province-level regions with a multistage, stratified cluster, random sampling method between March and June 2019. The 20-item Center for Epidemiologic Studies Depression Scale (CESD-20) was used to measure the depressive symptoms. Sexual orientation was assessed by asking the question, “Which of the following options best describes you?” The responses were categorized as heterosexual, gay/lesbian, bisexual, and unsure. ResultsIn our sample (N = 30,733), the prevalence of depressive symptoms was 6.1%. Among the surveyed Chinese college students, 3.7% self-reported as LGB, and 7.2% were unsure. LGB (gay/lesbian: 14.9% for males and 6.8% for females; bisexual: 9.3% for males and 16.4% for females) had a higher risk of depressive symptoms than heterosexuals. After adjusting for control variables, LGB and unsure college students were more likely to have depressive symptoms than their heterosexual peers. For males, unsure college students reported the highest risk of depressive symptoms; for females, lesbian and bisexual college students reported the highest risk of depressive symptoms. LimitationsThe cross-sectional study design and self-reported depressive symptoms and sexual orientation. ConclusionLGB was associated with increased depressive symptoms among Chinese college students. Furthermore, the associations of LGB sexual orientation with depressive symptoms were more robust for females than males.

Well-Being of Lesbian, Gay, Bisexual Youth: The Influence of Rural and Urban Contexts on the Process of Building Identity and Disclosure.

The study investigates how the territorial community can influence the individual and social well-being of lesbian, gay, bisexual (LGB) youth and especially the recognition of their feelings and the construction of their own identity as well as their needs to be socially recognized. This research focuses on the experiences of 30 LGB individuals (23 males and 7 females), with a mean age of 25.07 years (SD = 4,578), living in urban and rural areas of Southern Italy. Focalized open interviews were conducted, and the Grounded Theory Methodology, supported by the Atlas.ti 8.0 software, was used for data analysis. The textual material was first coded, and then codes were grouped into five macro-categories: Freedom of identity expression in the urban and rural context, identity construction and acceptance process, need of aggregation and identification with the LGB community, role of the interpersonal relationship in the process of identity acceptance, socio-cultural context, and LGB psychological well-being. The results showed a condition common to the two contexts that we can define as “ghettoization.” The young LGB is alone in the rural area due to a lack of places and people to identify with and greater social isolation. On the contrary, although there are more opportunities in the urban area, young people feel stigmatized and ghettoized because “their places” are frequented exclusively by the lesbian, gay, bisexual, transexual, queer (LGBTQ) community. The work will extensively discuss the limitations of the research, future proposals, and the practical implications of the results.

Lesbian Gay Bisexual Transgender and Queer Health-Care Experiences in a Military Population

ABTRACT This study aimed to understand the experiences of lesbian, gay, bisexual, transgender, and queer of former military service members. Data for this analysis was collected from the two open-ended survey questions as part of a larger online survey. The analysis was performed using the web-based data analysis application Dedoose. Eighty-eight qualitative responses were used. Analysis of the responses revealed five main themes: (1) identity, (2) negative experiences, (3) impact of experiences, (4) policy, and (5) positive experiences. These findings can influence future military research by focusing on the effects of the Don’t Ask Don’t Tell policy, negative and positive experiences, and the impact of those experiences.

Examining the Relationship Between LGBTQ-Supportive School Health Policies and Practices and Psychosocial Health Outcomes of Lesbian, Gay, Bisexual, and Heterosexual Students.

Purpose: We examined the association of lesbian, gay, bisexual, transgender, and questioning (LGBTQ)-supportive school policies and practices with psychosocial health outcomes among lesbian, gay, bisexual (LGB), and heterosexual students. Methods: The 2014 and 2016 School Health Profiles data from principals and health educators from 117 schools assessed LGBTQ-supportive school policies and practices. We computed the sum of school policies and practices, indicating the number available for each student. The 2015 and 2017 Youth Risk Behavior Survey data from 75,638 students from the same schools measured psychosocial health outcomes. We conducted multilevel cross-sectional logistic regressions of the associations of school-level policies and practices with student-level health outcomes by sexual identity while controlling for sex, grade, race/ethnicity, and school priority. Results: Several LGBTQ-supportive school policies and practices were significantly associated with lower odds of feeling threatened at school, suicide-related behaviors, and illicit drug use among LGB students. For heterosexual students, having a gay-straight alliance or similar club was linked to multiple health outcomes, whereas other policies and practices were significantly associated with lower odds of safety concerns at school, forced sexual intercourse, feeling sad or hopeless, and illicit drug use. Increasing the sum of policies and practices was linked to lower odds of suicide-related behaviors among LGB students and safety concerns and illicit drug use among heterosexual students. Conclusion: These findings suggest that LGBTQ-supportive school policies and practices are significantly associated with improved psychosocial health outcomes among both LGB and heterosexual students, although more research is needed to better understand these relationships.