LGB Men Research Articles

And how do LGB adults rate their orgasms in a relational context?

Subjective orgasm experience (SOE) refers to the perception, assessment, and/or sensation of orgasm on a psychological level, with the particularity that the study of SOE in nonheterosexual populations is currently very scarce. The study sought to analyze differences in SOE dimensions, comparing the intensity of each adjective of the Orgasm Rating Scale (ORS) and creating a ranking of the adjectives that better represent it in LGB men and women. In a sample of 1475 adults organized into 4 groups according to the type of sexual relationships reported, comparisons were made using multivariate analysis of variance and chi-square tests. Differences were obtained in the intensity of all the SOE dimensions, and in 23 of the 25 ORS adjectives. Lesbians and bisexual women reported higher intensity in SOE compared with bisexual and gay men. Because the ORS has been established as a good tool for detecting orgasmic difficulties in nonheterosexual populations, this study could provide LGBT affirmative psychotherapy with evidence on how these individuals evaluate their orgasms in a relational context. This study extends prior limited knowledge about how LGB people evaluate their orgasmic experiences in the context of sexual relationships. Despite this, the study poses limitations such as nonprobability sampling or the inclusion of exclusively cisgender and young individuals, making it difficult to generalize the results. Although significant differences were found between LGB men and women, all groups agree on the adjectives they use to describe the subjective experience of orgasm in the context of sexual relationships; therefore, evidence is provided about how LGB people evaluate their orgasmic experiences in this context.

Abstract P188: Diabetes Prevalence and its Risk Factors Among Veterans by Sexual Orientation

Introduction: There is evidence that lesbian, gay, and bisexual (LGB) adults have poorer cardiovascular health than their heterosexual peers, but studies of the association between sexual orientation (SO) and diabetes mellitus (DM) have been few. Prior studies have largely been cross-sectional, rely on self-reported data, and have small sample size; findings have been mixed. To further investigate this association, large nationwide cohorts with objective data capture are needed. Methods and Results: We used data from the Veterans Healthcare Administration Lesbian, Gay, Bisexual, Transgender EHR cohort which includes veterans with ≥2 encounters October 1, 2009-September 30, 2019. The first clinic visit in this window was the index date with the baseline date one year later; the subsequent year served as a baseline period for observation of prevalent disease and comorbidities. We did not include transgender veterans in this analysis in order to focus on SO rather than on the intersection of SO with gender identity. The SO of 1,108,990 veterans was identified using a natural language processing tool; 185,788 veterans were classified as LGB. Prevalent DM (ICD-9/10 codes or HbA1c≥6.5%) was present among 193,330 veterans (32,986 LGB). We first examined sample characteristics by sex and SO. Mean age (years) and BMI (kg/m 2 ) were similar across SO in women (age: 41, BMI: 29) and men (age: 53, BMI: 30). Although the distribution of race was similar across groups, LGB men and women were more likely to be of Hispanic ethnicity (11%, both sexes) than non-LGB men and women (6% and 8%, respectively). Current smoking was more prevalent among LGB (44% men, 39% women) than among non-LGB veterans (40% men, 30% women). We used logistic regression to assess the association between SO and DM. Adjusting for age, sex, race, Hispanic ethnicity, BMI, smoking status, health insurance, marital status, and enrollment priority group (based on military service history, disability and income), LGB veterans had 1.12 [1.10, 1.13] times the odds of DM versus non-LGB veterans. Among women, those classified as bisexual (0.87 [0.74, 1.01]) or lesbian (1.03 [0.97, 1.10]) did not have significantly different odds of DM than non-LGB women. Among men, bisexual men had lower odds of DM (0.86 [0.80, 0.93]) while gay men had higher odds (1.04 [1.01, 1.06]) than non-LGB men. In both men and women, sexual minority individuals whose SO could not be classified had greater odds of DM than their non-LGB peers (women: 1.15 [1.08, 1.23]; men: 1.25 [1.22, 1.28]). Conclusion: This is one of the first studies to examine DM in a veteran population stratified by SO. Our sex-specific findings highlight the importance of examining each SO group separately, in addition to jointly, as to further elucidate the association between SO, cardiovascular risk factors, and general cardiovascular health. Future work will examine the intersection of SO with gender identity.

Causes of alcohol-attributable death and associated years of potential life lost among LGB and non-LGB veteran men and women in Veterans Health Administration

BackgroundAlcohol use is a significant concern nationally and research now highlights higher rates of alcohol attributable death (AAD) and years of potential life lost (YPLL) among lesbian, gay, and bisexual (LGB) veterans compared to non-LGB veterans. In this study, we examined specific causes of AAD and associated YPLL between LGB and non-LGB veteran men and women to highlight needed outreach, prevention, and treatment strategies. MethodsUsing data from the nationwide Veterans Health Administration electronic health record and National Death Index from 2014 to 2018, we examined the top ten ranked causes of AAD among LGB (n = 102,085) and non-LGB veteran (n = 5,300,521) men and women, as well as associated YPLL per AAD. ResultsWe observed higher rates of AAD among men than women, but higher rates among LGB veterans relative to their same-sex non-LGB counterparts. We noted greater YPLL per AAD among LGB men and all women compared to non-LGB men, even when of similar or same rank in cause of death. Acute-cause AAD death (e.g., alcohol-related suicide, poisonings) was ranked higher among LGB men and all women. YPLL was greater for both acute- and chronic-cause AAD (e.g., liver disease) among LGB men and all women compared to non-LGB men. ConclusionsCauses of AAD differ between LGB and non-LGB men and women. The differences observed highlight disparities in acute- and chronic-cause AAD between groups help explain the higher number of YPLL per AAD that disfavor LGB men and women veterans, and essential next steps in primary and secondary prevention of hazardous drinking and mortality risk.

Circumstances of Suicide Among Lesbian, Gay, Bisexual and Transgender Individuals

Suicide rates for sexual minorities are higher than the heterosexual population. The purpose of this study is to explore circumstances surrounding suicide completion to inform future intervention strategies for suicide among lesbian, gay, bisexual and transgender (LGBT) individuals. We completed a retrospective analysis of data from the National Violent Death Reporting System (NVDRS) from 2013-2017. Victims identified as transgender were considered separately. We stratified analysis by identified sex of the victim for the LGB population. Of the 16,831 victims whose sexual orientation or transgender status was known: 3886 (23.1%) were identified as female, 12,945 (76.9%) were identified as male. 479 (2.8%) were identified as LGBT; of these, 53 (11%) were transgender. LGBT victims were younger than non-LGBT victims. Male LGB victims were more likely to have a history of prior suicide attempts, past or current mental illness diagnosis, and were less likely to use firearms than male heterosexual victims. Female LGB victims were more likely to have problems in an intimate partner relationship than heterosexual women, while LGB men were more likely to have problems in family or other relationships. Transgender victims were again more likely to have mental health problems and a history of prior attempts, but less likely to have intimate partner problems and more likely to have a history of child abuse. These results highlight the importance of promoting suicide interventions that recognize the complex intersection between stated gender, sex, and sexuality and the different cultural impacts these identities can have.

The association of sexual orientation with prostate, breast, and cervical cancer screening and diagnosis.

129 Background: Data on heterogeneity in cancer screening and diagnosis rates among lesbians/gays and bisexuals is lacking. Recent studies showed that lesbians/gays and bisexuals have decreased healthcare utilization compared to heterosexual counterparts and continue to experience discrimination in healthcare. Few studies have examined how sexual orientation impacts cancer screening and prevalence. We, therefore, investigated the association between sexual orientation and prevalent sex-specific cancer including prostate, breast, and cervical cancer. Methods: This was a cross-sectional survey-based US study, including men and women aged 18+ from the Health Information National Trends Survey (HINTS) database between 2017-2019. The primary endpoint was individual-reported prostate, breast, and cervical cancer screening and prevalence rates among heterosexual and LGB men and women. Multivariable logistic regression analyses assessed association of various covariates with undergoing screening and diagnosis of these cancers. Results: Overall, 4,441 and 6,333 heterosexual men and women, respectively, were compared to 225 and 213 lesbian/gay and bisexual men and women, respectively. Lesbians/gays and bisexuals were younger and less likely to be screened for prostate, breast, and cervical cancer than heterosexuals. A higher proportion of heterosexual women than lesbian and bisexual women were screened for cervical cancer with pap smears (95.36% vs. 90.48% and 86.11%, p = < 0.001) and breast cancer with mammograms (80.74% vs. 63.81% and 45.37%, p = < 0.001). Similarly, a higher proportion of heterosexual men than gay and bisexual men were screened for prostate cancer with PSA blood tests (41.27% vs. 30.53% and 27.58%, p = < 0.001). Conclusions: Lesbians/gays and bisexuals in the US may be less likely to undergo screening of sex-specific prevalent malignancies, including prostate, breast, and cervical cancer. Healthcare professionals should be encouraged to improve cancer screening among lesbians/gays and bisexuals.

Elevated risk of substance use disorder and suicidal ideation among Black and Hispanic lesbian, gay, and bisexual adults

ObjectiveBlack and Hispanic persons who identify as lesbian, gay, or bisexual (LGB) experience health disparities relative to non-Hispanic White and heterosexual groups respectively, including higher rates of suicidal ideation (SI) and substance use disorder (SUD). To elucidate intersectional risk, we used a large national sample to examine rates of SI, SUD, and their co-occurrence (SI + SUD) at the intersection of sexual identity and race/ethnicity. MethodData were from five years (2015–2019) of the National Survey of Drug Use and Heath (unweighted N = 189,127). Multinomial logistic regressions with persons without SI and SUD as references were stratified by gender and controlled for survey year, age, education, marital status, and income. ResultsCompared to same-race and same-gender heterosexual adults, White, Black, and Hispanic LGB men and women showed higher odds of SI (AOR = 2.86–4.45), SUD (AOR = 1.23–3.01), and SI + SUD (AOR = 2.72–6.85). Compared to same-gender White heterosexual adults, Black and Latinx heterosexual men and women showed lower odds of SI (AORs = .54–.65), SUD (AORs = .52–.78) and SI + SUD (AORs = .41–.57). Compared to same-gender White LGB adults, Black and Hispanic women, but not men, showed lower SI odds (AORs = .58–.72). Compared to same-gender White heterosexual adults, Black and Hispanic LGB men and women showed higher odds of SI (AORs = 1.71–2.51) and SI + SUD (AORs = 1.91–2.97). ConclusionsConsistent with research showing effects of multiple minority stress on behavioral health, adults with intersecting racial/ethnic and sexual minority identities showed increased odds of SI, SUD, and SI + SUD relative to Non-Hispanic White heterosexual peers. Black, Hispanic, and White LGB adults may benefit from screening and intervention for SI and SUD.

Substance use and sexuality: Comparing sexual identity and attraction using a multilevel multivariate model

Previous research has found that sexual minority individuals are more likely than heterosexual individuals to engage in substance use behaviours such as the consumption of illicit drugs, heavy drinking and tobacco smoking. This study innovates by comparing the association of different measures of sexuality with substance use behaviours and exploring whether this association varies by place. We exploit multivariate multilevel models with sexual attraction and sexual identity as exposure measures and Great Britain Local Authorities (LA) as places. This study compares multivariate models for men and women, comparing measures of sexuality using sexual attraction and sexual identity to look simultaneously at cannabis use, current smoking and alcohol use, and variance across LAs. Sexual attraction was a stronger predictor of engaging in substance use behaviours compared to sexual identity for men and women, and LGB women experienced greater odds of engaging in all substance use behaviours than LGB men. After controlling for relevant covariates, there was residual LA level variation only for women cannabis users, although it was not significant. These findings highlight the importance of using different measures of sexuality, and that LGB women are more vulnerable to engaging in risky health behaviours. LGB women in particular may require sexuality-specific interventions, support and policies in LAs with greater cannabis use.

Too Many Boxes, or Not Enough? Preferences for How We Ask About Gender in Cisgender, LGB, and Gender-Diverse Samples

As U.S. society has become more aware of gender identity issues, there has been a push for more inclusive demographic categories that go beyond the traditional gender binary of male/female. In three studies, we assessed the attitudes of U.S. cisgender men and women across sexual orientations (Study 1), heterosexual cisgender men and women (Study 2), cisgender LGB men and women (Study 3), and transgender and gender non-binary individuals across sexual orientations (Study 3) regarding different formats of gender questionnaires. Studies 2 and 3 showed a strong overall preference for the non-binary formats. Across all three studies, preferences for the binary format and objections to the non-binary formats were related to gender-binary beliefs, distinctiveness threat, cisgender and mostly heterosexual male participants, conservative political orientation, and religiosity. These findings suggest that general opposition to utilizing non-binary formats may be influenced by institutionalized binary gender norms and heteronormativity. Across both cisgender and gender-diverse samples, most participants preferred a non-binary gender question format, and gender-diverse individuals overwhelmingly preferred the expanded format. We suggest that those who collect gender data use the expanded format in order to be more inclusive and allow gender-diverse individuals to identify themselves if they choose to do so.

Sexual Trajectories of Lesbian, Gay, and Bisexual Adults in the Netherlands.

Studies on sexual trajectories of lesbian, gay, and bisexual (LGB) people generally focus on the first same-sex attraction and sexual experience, and their relation to self-identification and coming out as LGB. Relational and opposite-sex experiences are generally not taken into account. The aim of this study was to provide a more comprehensive overview of LGBs' sexual trajectories and to distinguish subsamples with different trajectories. A sample of same-sex attracted members of an online research panel (N=3054) completed a sexual health questionnaire, including items about the timing of sexual and relational milestones. Results showed that the majority of gay men and lesbian women had same-sex sexual and relational experiences, whereas most bisexual men and women had had experiences with the opposite sex. Among gay men and lesbian women, two trajectories emerged, differing mainly on whether people had been sexually or romantically involved with opposite-sex partners, and on age of first same-sex attraction. Among those who were not exclusively attracted to the same sex, six patterns emerged, which differed especially with regard to the nature and comprehensiveness of their same-sex experiences. Within the exclusively same-sex attracted group, the trajectory with no heterosexual experiences related to higher levels of psychological adjustment. For non-exclusive sexually attracted people, trajectories including experience of same-sex relationships seem to be most beneficial. In conclusion, both relational and opposite-sex experiences proved to be important elements of LGB men and women's sexual trajectories.

Substance use among lesbian, gay, and bisexual clients entering substance abuse treatment: Comparisons to heterosexual clients.

This study evaluated whether sexual orientation-specific differences in substance use behaviors exist among adults entering substance abuse treatment. Admissions records (July 2007-December 2009) were examined for treatment programs in San Francisco, California receiving government funding. Lesbian, gay, and bisexual (LGB) persons (n = 1,441) were compared to heterosexual persons (n = 11,770) separately by sex, examining primary problem substance of abuse, route of administration, age of first use, and frequency of use prior to treatment. Regarding bisexual males, the only significant finding of note was greater prevalence of methamphetamine as the primary substance of abuse. When compared to heterosexual men, gay and bisexual men evidenced greater rates of primary problem methamphetamine use (44.5% and 21.8%, respectively, vs. 7.7%, adjusted odds ratios [ORs] 6.43 and 2.94), and there was lower primary heroin use among gay men (9.3% vs. 25.8%, OR 0.35). Among LGB individuals, race and ethnicity did not predict primary problem substance, except that among LGB men and women, a non-White race predicted cocaine use (OR 4.83 and 6.40, respectively), and among lesbian and bisexual women, Hispanic ethnicity predicted lower odds of primary cocaine use (OR 0.24). When compared to heterosexual men, gay men were more likely to smoke their primary problem substance (OR 1.61), first used this substance at an older age (M = 23.16 vs. M = 18.55, p < .001), and used this substance fewer days prior to treatment (M = 8.75 vs. M = 11.41, p < .001). There were no differences between heterosexual and lesbian or bisexual women. There were unique patterns of substance use for gay and bisexual men entering substance abuse treatment, but women did not evidence differences. Gay men evidenced unique factors that may reflect less severity of use when entering treatment including fewer days of use and a later age of initiation of their primary problem substances. The results underscore the importance of being sensitive to differences between gay, bisexual, and heterosexual males when considering substance use disorders. (PsycINFO Database Record

Sexual orientation and sex differences in adult chronic conditions, health risk factors, and protective health practices, Oregon, 2005-2008.

IntroductionResearch on lesbian, gay, and bisexual (LGB) individuals’ health and health practices has primarily consisted of convenience studies focused on HIV/AIDS, substance use, or mental illness. We examined health-related disparities among Oregon LGB men and women compared with heterosexual men and women using data from a population-based survey.MethodsData from the 2005 through 2008 Oregon Behavioral Risk Factor Surveillance System were used to examine associations between sexual orientation and chronic conditions, health limitations, health risk factors, and protective health practices.ResultsCompared with heterosexual women, lesbian and bisexual women were significantly more likely to smoke cigarettes, be obese, binge drink, and have chronic conditions, and less likely to engage in protective health practices. Compared with heterosexual men, gay men were significantly less likely to be obese, more likely to binge drink, and more likely to engage in protective health practices. Compared with heterosexual men, bisexual men were significantly more likely to have a physical disability, smoke cigarettes, binge drink, and more likely to get an HIV test.ConclusionsHealth disparities among Oregon LGB individuals were most prominent among lesbian and bisexual women. Gay men had the most protective health practices, but they were more likely than heterosexual men to engage in risky behaviors that lead to chronic diseases later in life. Targeted public health interventions should be provided in environments that avoid stigmatizing and discriminating against LGB individuals where they live, work, learn, and socialize.

Comorbidity and age of onset of eating disorders in gay men, lesbians, and bisexuals

This study examines the prevalence of psychiatric disorders among lesbian, gay, and bisexual (LGB) men with eating disorders. A total of 388 white, black, and Latino LGB men and women were sampled from community venues. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. Gay and bisexual men with eating disorders were more likely to have an anxiety or substance abuse disorder than gay and bisexual men without eating disorders, whereas lesbian and bisexual women with eating disorders were more likely to have a mood disorder than lesbian and bisexual women without an eating disorder. For individuals diagnosed with an eating and anxiety or major depressive disorder, the onset of the psychiatric disorder was more likely to precede the onset of the eating disorder. Researchers should study potential explanations of the relationship between eating and psychiatric disorders among LGB men and women.

Eating disorders in diverse lesbian, gay, and bisexual populations.

This study estimates the prevalence of eating disorders in lesbian, gay, and bisexual (LGB) men and women, and examines the association between participation in the gay community and eating disorder prevalence in gay and bisexual men. One hundred and twenty six white heterosexuals and 388 white, black, Latino LGB men and women were sampled from community venues. DSM-IV diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. Gay and bisexual men had significantly higher prevalence estimates of eating disorders than heterosexual men. There were no differences in eating disorder prevalence between lesbian and bisexual women and heterosexual women, or across gender or racial groups. Attending a gay recreational group was significantly related to eating disorder prevalence in gay and bisexual men. Researchers should study the causes of the high prevalence of eating disorders among gay and bisexual men.