LGBTQ Adults Research Articles

Effects of Unequal Treatment, Verbal Harassment, and Physical Violence on Subjective Cognitive Health Among Middle-Aged and Older LGBTQ Adults: Variation by Type and Basis of Victimization

This study investigated how different forms of victimization influence subjective cognitive health among middle-aged and older LGBTQ adults. Using data from the Vanderbilt University Social Networks, Aging, and Policy Study, we applied Poisson regression models to examine the effects of victimization experiences, including variation by type and basis of victimization, on the number of self-reported cognitive difficulties. Regarding victimization type, we tested the effects of experiencing unequal treatment, verbal harassment, and physical attack in the last year on the number of self-reported cognitive difficulties. We also examined the effects of experiencing victimization based on sexual orientation, gender identity or expression, age, and race or ethnicity on the number of self-reported cognitive difficulties. Respondents who experienced victimization in the past year reported higher rates of cognitive difficulties than respondents who did not experience victimization. These results varied by victimization type. Experiencing unequal treatment and verbal harassment in the last year was associated with higher rates of self-reported cognitive difficulties. Experiencing physical attack did not significantly predict higher rates of self-reported cognitive difficulties. Finally, victimization experiences based on sexual orientation, gender identity or expression, race or ethnicity, and age all predicted higher rates of self-reported cognitive difficulties. Taken together, these results demonstrate how different forms of victimization could harm cognitive health among LGBTQ populations and generate cognitive health disparities.

‘Because it’s who I am’: self-determination of LGBTQ adults with intellectual disability

Lesbian, Gay, Bisexual, Transgender, Intersex, Queer and Asexual (LGBTIQA+) people with intellectual disability face unique challenges in asserting their identities. We aim to understand how Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals with intellectual disability exercise self-determination within disability services. Eight LGBTQ adults with intellectual disability who used disability services participated in qualitative interviews. Fifteen key informants, representing government policy makers, disability service organisations, gender and sexuality educators, and senior leaders of LGBTQ organisations were also interviewed. We found that LGBTQ people with intellectual disability navigate barriers to self-determination: making autonomous decisions about their sexualities or gender identities; coming out and being recognised as LGBTQ; and gaining a sense of belonging in both disability and LGBTQ spaces. We suggest organisational-level actions including: (1) building organisational awareness; (2) including sexuality and gender identities in person centred support planning; and (3) increasing access to positive visual representations and experiences of pride.

LGBTQ Mental Health Peer Support: A Descriptive Survey

BackgroundGender and sexual minority adults have significant unmet mental health care needs and are often faced with barriers to accessing appropriate services. In this context, LGBTQ individuals often turn to each other for mental health support.MethodsIn a sample of 326 LGBTQ adults (M age = 37.64) who were providing mental health support to their LGBTQ peers, we examined the nature of LGBTQ peer support, including who provides peer support, to whom, and for what issues. We also examined the experiences of those providing LGBTQ peer support, and the role of mental health training. Data were collected in 2020.ResultsParticipants provided support to a range of individuals, including close friends, colleagues, and those who were previously strangers. The types of concerns they supported their peers with varied greatly, though depression, anxiety, suicidality, and coping with discrimination were common concerns. Participants were often managing multiple competing demands, and many appeared to be managing their own mental health concerns. Those who had received at least some mental health training appeared to fare better in their experiences of providing peer support compared to those without such training.Policy ImplicationsFindings illustrate the importance of increasing access to LGBTQ-affirmative mental health services. We also highlight the importance of developing and disseminating initiatives designed to support those providing LGBTQ peer support, both to increase the effectiveness of peer support and to help manage the impact of providing LGBTQ peer support.

COVID-19, lockdowns, and the mental wellbeing of LGBTQ people in Australia

LGBTQ communities around the world entered the COVID-19 pandemic with generally high rates of poor mental health and faced additional challenges including stigma, discrimination, and barriers to care. This study sample was drawn from a survey of 3135 LGBTQ adults residing in Australia during the pandemic. Regression analysis was used to explore individual differences in psychological distress and perceived change in mental wellbeing since the onset of the pandemic as well as the impact of lockdowns, by taking advantage of a natural experiment comparing the states that experienced more extensive lockdowns (Victoria and New South Wales) to the rest of Australia. The burden of mental health was found to vary across gender, sexual orientation, age, and area of residence. While no impact of lockdowns on psychological distress was observed, participants living in the states of Victoria (β = −0.15; 95% CI = −0.23, −0.07) and New South Wales (β = −0.13; 95% CI = −0.21, −0.05) self-reported a more negative impact of the pandemic on their mental wellbeing compared to the rest of the country. The findings suggest that the COVID-19 pandemic had a negative impact on the mental wellbeing of LGBTQ populations, particularly among those who experienced extensive lockdowns and highlight the need for increased efforts to enable access to mental health supports during times of crisis.

Queer representation in children’s books beyond two moms or two dads

PurposeThis article aims to help educators provide a holistic view of the LGBTQ community by highlighting children’s books that include non-parental LGBTQ characters.Design/methodology/approachThe author selected over 80 children’s books honored by the American Library Association’s Rainbow Book List. Twenty-two books were analyzed that contain examples of LGBTQ adults existing beyond the homonormative nuclear family, e.g. two same-sex parents raising children.FindingsThe author discusses various ways of living represented in these books, such as chosen families, extended families, romantic partnerships and singlehood.Originality/valueWith the increased number of high-quality LGBTQ-inclusive children’s books published in the past decade, this study provides the foundation for educators to select various texts that reveal diverse representations of LGBTQ individuals.

Gay & Gray XI: Somewhere Over the Rainbow - Aging with Pride!

Having previously tackled topics such as LGBTQ military sexual trauma, revisiting aging populations and HIV, and the intersectional experience of black queer older adults, Gay & Gray this year will focus on the transitional process of aging itself. While seniors cope with life changes as they grow older, LGBTQ seniors face specific challenges that may be especially burdensome. Often, older LGBTQ adults “have to make a hard choice at the end of their lives: Go ‘back into the closet’ or accept inferior care and discrimination” (CBC). This predicament embodies “a fear of loss of autonomy, identity, and freedom of sexual expression,” and often results in compromise “in order to feel safe during a period in which they anticipate… being vulnerable and lacking in power” (Wilson, et al.).In this session, we will discuss powerful issues including the threat of isolation while aging, healthcare access, and moving to long-term housing through the lens of gender and sexual minorities. First, we will explore how older LGBTQ adults are often more isolated than their heterosexual counterparts, with higher rates of living alone, fewer sources of family and social supports, and greater stigma among their peers (SAGE “US Army Vet”, Progress Lifeline). We will also consider reasons why LGBTQ adults may be hesitant to disclose their sexual orientation and gender identity to healthcare providers, fearing inadequate care and even outright discrimination. Afterwards, we will discuss how LGBTQ adults’ transitions from independent living into assisted living and nursing homes are further complicated by concerns about experiencing physical and verbal harassment, as more and more LGBTQ individuals fear “being forced back into the closet” and “conceal… their true selves” in order to access services and avoid harassment (Wilson, et al.). Lastly, we will evaluate potential solutions to promote community and enhance access to safe housing for aging LGBTQ individuals.

Predictors of Religious and Spiritual Identities in a Nationwide Sample of Black LGBTQ Adults in the United States

LGBTQ people have a complex history with religion and spirituality in the United States. This dynamic is likely to be complicated for black LGBTQ people given the intersection of their LGBTQ identity with their racial identity, both of which are marginalized in U.S. society. There is, however, a paucity of quantitative research that examines significant predictors of religious and spiritual identities among black LGBTQ adults. To address this gap in the literature, we use a 2020 nationwide survey of black LGBTQ adults to examine the significance of gender, religious upbringing, and attendance at religious services on the likelihood that black LGBTQ people identify as religious and/or spiritual. The results of our exploratory study indicate that, compared to black LGBTQ men, black LGBTQ women are less likely to identify as religious, but more likely to identify as spiritual. Additionally, black LGBTQ adults who grew up in a religious family are more likely to identify as religious, and those who attend religious services are more likely to identify as religious and/or spiritual.

Medicine, access, spirit, and survival: An intersectional look at concepts of health among a diverse sample of LGBTQ adults

Research on lesbian, gay, bisexual, transgender/gender expansive, and queer (LGBTQ) health is dominated by disparities in disease, access, and risk behaviors. Such research is critical for examining the myriad factors that limit the lives of gender and sexual minorities. Few studies, however, have explored LGBTQ people's concepts of health. People's accounts of health are important, as they reveal insights into a person's relationship to the social world and are fundamental to accessing care. Semi-structured, in-depth individual interviews were conducted with a diverse sample of 40 LGBTQ-identified adults living in New York City, aiming to explore (a) how LGBTQ people conceptualize health, and (b) how participant constructions of health reflect personal, social, cultural, and political subjectivities as well as institutionalized discourses of health and illness. Through framework analysis, four primary themes were identified: (1) health as medicine; (2) health as mind-body-spirit; (3) health as survival; and (4) health as access. Implications for the health professions, including patient-centered care, shared decision-making, and provider training, are discussed.

An Analysis of Tobacco and Marijuana Use by Middle School and High School Bisexual and Homosexual Students Surveyed by the National Youth Tobacco Survey From 2020 to 2022.

This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors. Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups. Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students. The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents.

Out in Suburbia: Associations between residential location, mental health, and community connectedness among LGBTQ Australians

ABSTRACT This article critically examines the contemporary applicability of homonormativity in understanding LGBTQ experiences in outer suburban Australia. Representing a departure from urban-rural dichotomies in queer geographical research, this study enriches our understanding of LGBTQ life in suburban areas. Drawing on a comprehensive national survey encompassing 6835 LGBTQ adults in Australia, the research provides novel quantitative insights into the geographic distribution of LGBTQ mental health and wellbeing outcomes. Contrary to assumptions of suburban privilege, the article challenges the notion of homonormativity in the suburbs, shedding light on the unique challenges faced by LGBTQ people in these areas. Findings reveal that LGBTQ people in outer suburban Australia experience higher psychological distress and suicidal ideation compared to their inner suburban and rural counterparts. Additionally, they report lower levels of connection with LGBTQ communities, indicating a dearth of supportive resources in these areas. These insights have crucial policy implications, advocating for changes that foster diversity and inclusion in outer suburban areas. By emphasizing the distinct experiences of LGBTQ individuals in these settings, the research underscores the necessity for targeted interventions and support. This work extends beyond conventional urban-centric studies, offering valuable insights to inform policies, advocacy efforts, and community support initiatives for LGBTQ people in suburban environments.

LGBTQ-RELATED DISCRIMINATION REDUCES SLEEP QUALITY IN OLDER ADULTS: EVIDENCE FROM VUSNAPS AND UCNETS

Abstract Sleep is a critical protective factor for health outcomes with low-quality sleep linked to increased risk of diabetes, cardiovascular disease, and cognitive decline. Theoretical work proposes that minority stress may negatively affect sleep quality for LGBTQ and other minoritized populations. We examine differences in sleep quality across sexual orientation and gender identity and test the relationship between minority stress and sleep quality for LGBTQ adults. Data come from 1) UC Berkeley Social Networks Study (UCNets), a panel study of 50–70-year-olds with an oversample of older LGBTQ adults and 2) the Vanderbilt University Social Networks, Aging, and Policy Study (VUSNAPS), a panel study of older LGBTQ adults aged 50-76. LGBTQ identity includes participants who are transgender and/or gay, lesbian, bisexual, or something else. We estimate Poisson models predicting sleep quality as a function of LGBTQ identity and exposure to LGBTQ-related discrimination. Sleep quality is measured using three items available in both studies: 1) the number of nights per week trouble falling asleep, 2) number of nights per week trouble staying asleep, and 3) number of mornings per week waking well rested. Experiences of LGBTQ-related discrimination in the last year were measured using the Daily Heterosexist Experiences Questionnaire. We find that LGBTQ identity is significantly associated with poorer sleep quality compared to non-LGBTQ peers. Among LGBTQ adults, sleep quality declines as the number and intensity of recent experiences of LGBTQ-related discrimination increases. Poorer sleep quality may be an underlying mechanism exacerbating health disparities across sexual orientation and gender identity.

Cervical screening among LGBTQ people: how affirming services may aid in achieving cervical cancer elimination targets

ABSTRACT To reach cervical cancer elimination targets it is necessary to increase screening rates among underserved populations such as LGBTQ communities. This paper examines rates of attendance and associated factors of cervical screening in LGBTQ communities. Data from 2,424 people aged 25 to 74 years and assigned female at birth were drawn from an online national Australian survey of LGBTQ adults. Over half of the sample had accessed cervical screening in the past 2 years. Using a multivariable logistic regression analysis, significant associations were found between screening, sociodemographic traits and health-care access. Trans men were least likely to access cervical screening, while bisexual, pansexual and queer identified participants were most likely to access screening. People who lived outside inner-suburban areas and those who had a disability were less likely to have had screening. Evidence of trusting relationships with a general practitioner (having a regular GP and GP’s knowledge of the individual’s LGBTQ identity) increased the likelihood that participants had screened, as did recent access to a medical service that was LGBTQ-inclusive or catered specifically to LGBTQ communities. The findings suggest the importance of training health providers, as well as targeted public health messaging for increasing uptake of cervical screening among LGBTQ people.

Correction to: The Impact of Community Belongingness on Mental Health and Well‑Being Among Black LGBTQ Adults

Correction to: The Impact of Community Belongingness on Mental Health and Well‑Being Among Black LGBTQ Adults

The Impact of Community Belongingness on Mental Health and Well-Being Among Black LGBTQ Adults

The Impact of Community Belongingness on Mental Health and Well-Being Among Black LGBTQ Adults

Older LGBTQ Adults and Sexual Health

Older LGBTQ Adults and Sexual Health

Interruption of Biomedical Interventions Among LGBTQ Individuals in the United States at the Onset of the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted healthcare access in the United States. This study sought to explore LGBTQ adults’ changes in access and adherence to preexposure prophylaxis (PrEP), human immunodeficiency virus (HIV) treatment, hormone replacement therapy (HRT), and contraception. This study employs data from a cross-sectional internet survey conducted between May and July 2020. The analysis was stratified by medications: PrEP (n = 147), HIV treatment (n = 78), HRT (n = 86), and contraception (n = 185). For people using PrEP, those between the ages of 18–29 and 30–39 and those with insurance did not report having difficulty accessing their medications; however, people between the ages of 30 and 39 did report that they had missed doses of this medication. For people using antiretroviral therapy (ART), cisgender (cis) gay men did not report trouble accessing medications, whereas lesbian cis women, respondents between the ages of 18–29 and 30–39, did report trouble accessing medications. For those using HRT, white non-Hispanic, black, and Latinx individuals did not have trouble accessing medication; however, Asian, Native American, Pacific Islander, and Middle Eastern participants did experience trouble accessing medication. Finally, contraceptive users with insurance did not experience difficulty in accessing medication and did not miss doses of this medication. Changes to medication access and adherence during the COVID-19 pandemic can be used to develop new protocols to help meet the needs of vulnerable populations such as the LGBTQ community. New protocols that may ensure access, as well as privacy around access to medications, are insurance coverage for telehealth.

Family Violence Within LGBTQ Communities in Australia: Intersectional Experiences and Associations with Mental Health Outcomes

BackgroundWhile prior research has documented intimate partner violence (IPV) and family of origin violence (FOV) experienced by LGBTQ communities at rates at least comparable to heterosexual and/or cisgender populations, little knowledge exists of how this experience occurs within intersections of these communities and who is most at risk.MethodsThis study utilised data from a from a large nationwide Australian survey of the health and wellbeing of 6835 LGBTQ adults aged 18 + years. Multivariable logistic regression analyses were conducted to identify individual factors associated with reporting ever having experienced FOV or IPV.ResultsIn total, 2675 (43.18%) participants reported ever experiencing FOV and 3716 (60.7%) reported ever experiencing IPV. Non-binary people, cisgender women, and trans men were most likely to have experienced FOV. Non-binary people and cisgender women were most likely to experience IPV. Participants aged 55 + years (compared to 18–24 years) were less likely to have experienced FOV, while the likelihood of experiencing IPV increased with age. Education was associated with both FOV and IPV (highest among the non-university tertiary educated). Having a moderate or severe disability and ever experiencing homelessness were associated with a greater likelihood of experiencing FOV and IPV. Recent experiences of suicidal ideation, suicide attempt and high/very high psychological distress were associated with experiences of FOV and IPV.ConclusionsThis new knowledge regarding the factors that identify LGBTQ people at greater risk of family or intimate partner violence can ensure the tailoring of family violence practice and policy to those most in need.

Preferences for Types of Inclusive Family Violence Services Among LGBTQ People in Australia

PurposeLGBTQ people are less likely to seek support and face significant barriers in accessing affirmative family violence support services. Efforts to improve family violence service access must be grounded in the preferences of LGBTQ people themselves.MethodData from a large nationwide Australian survey of the health and wellbeing of LGBTQ adults were analysed. 4,148 participants expressed a preference for family violence service provision. Multivariable logistic regressions were used to identify factors associated with preferences for family violence service provision, comparing mainstream services that are not known to be inclusive, mainstream services that are known to be LGBTQ-inclusive, and LGBTQ-specific services.ResultsIn total, 8.8% (n = 363) of participants indicated a preference for mainstream services, 57.5% (n = 2,383) for mainstream services that are known to be LGBTQ-inclusive and 33.8% (n = 1,402) for LGBTQ-specific services. Trans and non-binary identified people were more likely to prefer LGBTQ-specific services than cisgender participants, while bisexual, pansexual and asexual people were more likely to prefer mainstream LGBTQ-inclusive services. Participants with a regular general practitioner were more likely to prefer LGBTQ-inclusive services. Participants who had not felt supported the most recent time they reported an experience of family violence were more likely to prefer LGBTQ-specific services.ConclusionFamily violence and healthcare services require training in LGBTQ issues to provide inclusive and affirming care. The findings have implications for policy and practice in family violence care and illustrate an urgent need to reform the current narrative of family violence, which frequently excludes LGBTQ communities.

Blurred border or safe harbor? Emotional well-being among sexual and gender minority adults working from home during COVID-19

During the COVID-19 pandemic, lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults have experienced pronounced declines in well-being. However, less is known about how changes to daily routines and settings, such as the shift to remote work within many occupations, may be playing a role in well-being outcomes. Drawing on a unique time diary data source (N = 3515 respondents and 7650 episodes) collected between April 2020–July 2021 through online crowdsourcing platforms, we conducted random effects analyses to examine how working from home has been associated with experienced well-being among LGBTQ and cisgender heterosexual workers in the United States during the pandemic. Findings indicate LGBTQ adults felt significantly less stressed and tired while doing paid work at home than while working at a workplace. In addition, working at a workplace, rather than working from home, appeared to be more detrimental to LGBTQ adults’ well-being compared to their non-LGBTQ counterparts. Adjusting for work characteristics explained some of the difference, whereas adjusting for family characteristics had little impact on the results. It is possible that for LGBTQ employees, working from home mitigates some of the minority stressors experienced during paid work.

Anticipatory Economic Stressors: Perceived and Potential Sources of Economic Disadvantage for LGBTQ Adults

This article examines anticipatory economic stress—or the stress of future economic crises or events that may negatively impact material well‐being—for LGBTQ adults. Using qualitative interview data from 76 LGBTQ adults, three main sources of anticipatory economic stress emerged: the family, the workplace, and health care. Following an intersectionality framework, these anticipatory economic stressors are experienced differently across gender and racial lines, heightening anticipatory economic stress for LGBTQ people of color and transgender respondents. This article has significant implications for understanding the role of future economic stress in the present and provides important insight into what specific forms of anticipatory economic stress that shape the lives of LGBTQ individuals.