Non-heterosexual Sexual Orientation Research Articles

Exploring sexual and reproductive health among adolescent and young adult patients with cancer: A patient-oriented qualitative study using novel, serial focus groups.

e23080 Background: While treatment advances for adolescent and young adult (AYA, ages 15 - 39) cancers are improving survival, there is a lack of information and support regarding impacts of AYA cancer on sexual and reproductive health (SRH) during and after treatment. Our study explored SRH experiences of AYA cancer patients using novel, serial focus groups. Methods: With online and in-person approaches, we recruited folks who: 1) Were diagnosed with cancer at age 15 – 39; 2) Reside in Canada; and 3) Are over 18. Participants were grouped into cohorts based on akin characteristics (e.g., sex, stage). Each cohort engaged in three focus groups, mimicking support groups, to foster community and trust. An interview guide was iteratively developed with patient research partners. We used framework analysis to identify recurring themes and patterns, offering full insight of participants’ SRH perspectives and experiences from deductive and inductive views. Results: We recruited 4 focus group cohorts, with 6–10 participants each (N = 24 females, 6 males), representing various cancer types (e.g., pelvic, hematologic) and stages (1–4). Cohorts had representation of transgender (n = 1) and gender diverse folks (n = 3), non-heterosexual sexual orientation (n = 11), and racial diversity (n = 9). We identified three themes describing participants’ experiences: 1) internally (“looking inwards”) – impact of AYA cancer on SRH; 2) externally (“looking outwards”) – impact of cancer on interpersonal relationships; and 3) role of the healthcare system. Internally, folks described complex impacts of AYA cancer on themselves, revealing shifting definitions, perspectives, expectations, and goals of SRH over time. Dynamic interplays of AYA cancer also surfaced, unveiling mental, physical, and financial health changes that positively or negatively impacted participants’ SRH and influenced short and long-term well-being. Externally, changes in romantic relationships and family planning underscored the complex interplay of societal pressures on SRH and reproductive choices. Regarding the healthcare system, findings highlight facilitators (i.e., self-advocacy, nurses, recent pregnancy, provider with similar identity, etc.) and barriers (i.e., gender, SRH stigma, age, fertility treatment costs, heteronormativity, SRH deprioritization, etc.) that influence access to appropriate and available SRH resources and support. Conclusions: SRH challenges have significant internal and external impacts among AYA cancer patients and their interpersonal relationships during and after treatment. By understanding their SRH experiences throughout their cancer care, providers and the healthcare system can identify opportunities to implement SRH care more effectively into the cancer care continuum, significantly improving health outcomes for AYA cancer patients.

Development of Gender Non-Contentedness During Adolescence and Early Adulthood

Adolescence is an important period for the development of gender identity. We studied the development of gender non-contentedness, i.e., unhappiness with being the gender aligned with one’s sex, from early adolescence to young adulthood, and its association with self-concept, behavioral and emotional problems, and adult sexual orientation. Participants were 2772 adolescents (53% male) from the Tracking Adolescents’ Individual Lives Survey population and clinical cohort. Data from six waves were included (ages 11–26). Gender non-contentedness was assessed with the item “I wish to be of the opposite sex” from the Youth and Adult Self-Report at all six waves. Behavioral and emotional problems were measured by total scores of these scales at all six waves. Self-concept was assessed at age 11 using the Global Self-Worth and Physical Appearance subscales of the Self-Perception Profile for Children. Sexual orientation was assessed at age 22 by self-report. In early adolescence, 11% of participants reported gender non-contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26). Three developmental trajectories of gender non-contentedness were identified: no gender non-contentedness (78%), decreasing gender non-contentedness (19%), and increasing gender non-contentedness (2%). Individuals with an increasing gender non-contentedness more often were female and both an increasing and decreasing trajectory were associated with a lower global self-worth, more behavioral and emotional problems, and a non-heterosexual sexual orientation. Gender non-contentedness, while being relatively common during early adolescence, in general decreases with age and appears to be associated with a poorer self-concept and mental health throughout development.

Experiences of Interpersonal Violence in Sport and Perceived Coaching Style Among College Athletes

Concern about interpersonal violence (IV) in sport is increasing, yet its implications remain poorly understood, particularly among currently competing college athletes. To document the self-reported prevalence of IV in college sports; identify associated risk factors; examine potential consequences associated with athletes' psychosocial well-being, emotional connection to their sport, and willingness to seek help; and explore the associations between IV reporting and perceived variations in coaching styles. This survey study analyzes results of the 2021 to 2022 National Collegiate Athletic Association (NCAA) myPlaybook survey, which was administered from July to December 2021 to 123 colleges and universities across the US. Participants were NCAA athletes aged 18 to 25 years who were current players on an NCAA-sanctioned team. Self-reported demographic characteristics (eg, athlete gender identity and sexual orientation) and perceived differences in supportive vs abusive coaching styles (eg, athlete autonomy, team culture, and extent of abusive supervision). The primary outcome was self-reported experiences of IV in sport during the college sports career of currently competing college athletes. Types of IV considered were physical abuse, financial abuse, sexual abuse, psychological or emotional abuse, and neglect or abandonment. Outcomes potentially affected by IV were assessed with 4 questionnaires. A total of 4119 athletes (mean [SD] age, 19.3 [1.5] years; 2302 males [55.9%]) completed the survey (response rate, 21.2%). One in 10 athletes (404 of 4119 [9.8%]) reported experiencing at least 1 type of IV during their college sports career, of whom two-thirds (267 [6.5%]) experienced IV within the past 6 weeks. On multivariable analysis, female gender identity (odds ratio [OR], 2.14; 95% CI, 1.46-3.13), nonheterosexual sexual orientation (OR, 1.56; 95% CI, 1.01-2.42), increasing age beyond 18 years (OR, 1.13; 95% CI, 1.01-1.30), increasing year of NCAA eligibility beyond the first year (OR, 1.19; 95% CI, 1.02-1.39), and participation in select sports (eg, volleyball: OR, 2.77 [95% CI, 1.34-5.72]; ice hockey: OR, 2.86 [95% CI, 1.17-6.95]) were independently associated with IV. When exposed to IV, college athletes reported experiencing consistently worse psychosocial outcomes, including increased burnout (mean difference on a 5-point Likert scale, 0.75; 95% CI, 0.63-0.86; P < .001) and an expressed desire to consider quitting their sport (mean difference, 0.81; 95% CI, 0.70-0.92; P < .001). They were not, however, less willing to seek help. Differences in coaching style were associated with differences in IV reporting. In risk-adjusted linear regression models, having a more supportive coach was associated with a 7.4 (95% CI, 6.4-8.4) absolute percentage point decrease in athletes' probability of reporting experiencing IV. In contrast, having a more abusive coach was associated with up to a 15.4 (95% CI, 13.8-17.1) absolute percentage point increase in athletes' probability of reporting experiencing IV. Results of this survey study suggest that IV is associated with marked changes in the psychosocial health and emotional well-being of college athletes, particularly those who identify as female and with nonheterosexual sexual orientations. Variations in coaching style have the potential to alter these associations. Ongoing efforts are needed to leverage the unique position that coaches hold to help reduce IV and create safe places where all college athletes can thrive.

Gay Men's Gender Experiences in Police Academy

&lt;p&gt;本研究探討警校男同志在學期間所經驗到校園中性別相關的文化，以及這些經驗對他們產生的影響和相對應之因應與調適。研究以女性主義觀點的敘事研究方法，招募四位正在就學或畢業三年內之警校男同志進行半結構式訪談，採「類別-內容」分析法處理資料。研究結果包含四大部分：（1）警校文化可歸類成三部分:官僚體系、傳統封閉、訓練因素；（2）警校男同志除了受其所身處警校文化影響外，也經驗到警校中的性別文化:反女權、異性戀霸權、陽剛文化；（3）在這些多元因素與壓迫相互交織下，警校男同志在校多數時間經歷來自不同對象（老師、隊部師長、同儕）的恐同與歧視；（4）前述經驗使警校男同志感受到身為校內性少數的孤單感及內化恐同所帶來的不舒適感，同時也發展出不同的因應與調適（直接回應、間接調適、尋求支持）。結論:置身於一個父權、官僚體系、結構性的文化脈絡與體制下，警校男同志確實經驗到歧視與恐同，雖然有發展出一些因應策略以利在此環境中生存下來，但還是感受到很深的孤單感。根據研究結果，本文在教育與輔導實務上，建議警校教師、隊部師長及諮商輔導中心進行性平友善校園活動之推展、相關法規與制度之修訂，並期待校方領導階層能有效帶領警校體制與系統進行相關倡議活動；此外，也建議未來研究可更聚焦多元及性少數學生在警校之處境，以促進多元性別相關議題在這些單位受到重視。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This study aimed to investigate gay men&amp;rsquo;s gender experiences, their ways of coping, and what strategies they arm themselves with to fight sexual prejudices at the Taiwan Police Academy. This qualitative study used narrative inquiry, based on feminist perspectives, for data analysis. Four gay men who were currently attending the Taiwan Police Academy or had graduated within three years participated in semi-structured interviews. The analysis of their stories revealed the following: (1) The cultural environment of the Taiwan Police Academy is (a) a bureaucracy that is not conducive to promoting the visibility of gender equality issues, (b) traditional closures that cannot keep up with the evolution of the times, and (c) de-gendered collective life management and training. (2) Gender-related cultures are (a) threatened men&amp;rsquo;s right and anti-feminism, (b) heterosexual hegemony of lecture arrangement, and (c) masculinity of femininity-rejection. (3) Participants reported experiencing homophobia and discrimination from faculty and peers, as well as the intersectionality of multiple oppression. Homophobia and discrimination can be divided into three categories based on the following three topics: (a) Non-heterosexual sexual orientation, (b) atypical gender expression, and (c) gender difference. The first topic of discrimination can be divided into three subcategories: implicit discrimination, personally experienced discrimination, and common ubiquitous discrimination in everyday life. Discrimination against atypical gender expression was targeted toward men who spoke more feminine. The third type of discrimination against gender differences occurs in gender stereotypes and the misogyny or objectification of women. (4) With respect to impact, there are two phenomena from the finding: (a) Feeling alone was the shared experience of the participants in the homophobic and oppressive environment. They all consistently mentioned that they had few gay friends in police academies. (b) The participants experienced different degrees of internalized homophobia; some said that an unfriendly environment made them less self-accepting because of their gay status, whereas others said they would never want to be gay again in life. Additionally, regarding coping strategies, the participants developed different strategies to deal with the discrimination, isolation, and microaggressions they encountered in schools. These strategies included three types: (1) direct responses (self-deprecating, counterattack, and education in an opportune time); (2) indirect self-regulation (pretending to be heterosexual, intentionally ignoring unfriendly comments, assuming that it can divert attention if viewed from a different respective, and choosing an identity with advantageous attributes); and (3) seeking support from friendly peers, professors, and faculty of student corps (especially Captain, Associate Captain, and Lieutenant); furthermore, some participants availed themselves for counseling and guidance resources. Surrounded by a patriarchal, bureaucratic, and heteronormative system with restrictive structures, gay men at the Taiwan Police Academy had indeed experienced real discrimination and homophobia. Although they had developed different coping strategies to survive in the environment, they still needed to protect their educational status and safety by hiding their sexual minority identity. Implications and recommendations for faculty and counselors to reduce oppression or discrimination against LGBTQIA and students studying at the Taiwan Police Academy were provided based on the findings of this study. In future studies, researchers can explore other sexual minorities in police academies, such as lesbians, bisexuals, and transgenders. Suggestions for Police Academy teaching and team management can be summarized as follows: (1) School leaders take the lead in promoting gender equity education; (2) Implementing gender-related regulations and laws in traditional closures; (3) Create a gender-equal and friendly life management and training space; (4) Create a learning environment free from gender bias and discrimination. Additionally, practical advice to the Counseling Center in the police academy includes how to reduce the stigma associated with counseling and how to explicitly take a gender-friendly stance. This is the first study to investigate the educational experience of sexual minority students, especially gender experiences, at the Taiwan Police Academy. More research on sexual orientation and gender identity experiences at the Taiwan Police Academy is needed to promote an understanding of gender equity in masculine-dominant educational systems.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

SAT414 Gender Identity And Sexual Orientation Among Patients Evaluated By Psychiatric In A Pediatric ED

Abstract Disclosure: D. Alejandro: None. A. Martinez: None. C. Escudero: None. G. Rieger: None. Background: Over the two decades the number of transgender and Gender Non-Conforming (GNC) youth has increased significantly. The prevalence of depression, anxiety, and other psychiatric conditions has been reported to be high among this population. In this report we explore gender identity and sexual orientation among patients evaluated by psychiatry in an emergency room of a pediatric hospital. Methods: We reviewed the charts of 220 patients who were evaluated by a psychiatric social worker in the emergency department between August and October 2022. Gender identity and sexual orientation were documented in 118 of these patients. Results: Of 118 patients, ranging in age from 10 to 21 years, whose gender identity and sexual orientation were evaluated, 78 (66%) were Assigned Female at Birth (AFAB) and 40 (33%) were Assigned Male at Birth (AMAB). Hispanic ethnicity was represented in 78% (93) of our population followed by Non-Hispanic White in 13% (16).Of AFAB, 12 patients (15%) identified as trans-male and 10 (13%) identified as non-binary. Of AMAB, one (2.5%) was identified as non-binary and three (7%) were unsure. Regarding sexual orientation, 26 (33%) of AFAB reported being heterosexual, 23(29%) bisexual, 5 (6.4%) pansexual and 9 (11.5%) were unsure/exploring. Among trans-males, 4(33%) identified as bisexual, 3 (25%) as gay, 2(16%) as pansexual, 2(16%) were unsure and one (8%) did not respond. Twenty-eight (70%) of AMAB reported to be heterosexual, 4 (10%) bisexual, one (2.5%) gay, 4 (10%) were unsure/exploring. The only trans-female reported to be bisexual. Regarding identified psychiatric diagnoses, major depressive disorder was reported in 83% of our population, being AFAB the most affected in 67%. Conclusions: The prevalence of transgender/GNC among pediatric patients evaluated by a psychiatric social worker at a children’s hospital emergency department is significantly higher than in the general population. Non-heterosexual sexual orientation is also higher than in the cisgender population. Emergency department providers in pediatric emergency facilities should receive formal training in the evaluation and management of LGBTQ youth. Presentation: Saturday, June 17, 2023

Gender Typicality, Social Self-Efficacy, and Adjustment in Italian Sexual Minority Young Adults

The present study focuses on the relationship between gender typicality, social self-efficacy, and adjustment in a sample of 522 lesbian women, gay men, bisexual, and other non-heterosexual sexual orientation participants. Participants (78.2% women; Mage = 23.8, SD = 3.63) reported their similarity to same- and other-gender peers as a way to assess their gender typicality, social self-efficacy, satisfaction with life, and perceived social safeness. The Path Analysis model showed that - controlling for participants’ gender and sexual orientation- higher same- and other-gender typicality was associated with higher perceived social safeness and higher satisfaction with life, both directly and indirectly through social self-efficacy. The present study contributed to the debate on gender studies by testing same and other gender typicality as independent dimensions of gender typicality in sexual minority young adults, focusing on positive adjustment. Furthermore, the results suggested the role of social self-efficacy as a critical mechanism in the association between gender typicality and sexual minority psychosocial adjustment.

The experience of forced sexual intercourse among undergraduate students: associated factors and possible consequences

The scope of this article is to investigate the prevalence of the experience of forced sexual intercourse on life and its possible consequences on mental and sexual health among undergraduate students at a public university in Brazil. It is a quantitative cross-sectional study with 996 undergraduate students. Sampling was carried out systematically by single-stage clusters. Descriptive, bivariate and multivariate analyses were performed using the Poisson Regression model, and the etiological fractions of the consequences of forced sexual intercourse were calculated. The lifetime prevalence of forced sexual intercourse was 12.1%. Female sex, non-heterosexual sexual orientation, first sexual intercourse before the age of 14, child food insecurity and domestic violence were associated with a higher prevalence of the outcome. Individuals who experienced forced sexual intercourse were more likely to be diagnosed with sexually transmitted infections and to represent a potential suicide risk. The study revealed the problems of sexual violence in the university context.

Analysis of Sexual Orientation in Adolescents at Junior High School Jakarta

Background: In adolescence, sexual urges will appear more easily, there is a possibility of choosing a non-heterosexual sexual orientation. To prevent this, it is necessary to be identified in early adolescence. Purpose: to determine the sexual orientation of adolescents at SMP 1 Barunawati Jakarta and to analyze the relationship between perceptions, attitudes, parenting styles, intensity of access to pornography, environment and trauma to sexual orientation using the Chi Square statistical test. Methods: This research is a descriptive study with a cross-sectional research design with a research instrument using a questionnaire. The population in this study were all students of class VII and VIII at SMP 1 Barunawati Jakarta with a total sample of 139 people. Results: Based on the results of univariate analysis, it was found that 67.6% of adolescents were heterosexual and 32.4% were at risk of non-heterosexuality. Meanwhile, the results of the bivariate analysis showed that the variables of perception, attitude and intensity of access to pornography had a significant relationship to sexual orientation with P values of 0.000, 0.009 and 0.003. Conclusions: Students at SMP 1 Barunawati Jakarta have a sexual orientation that is in accordance with societal norms. Perceptions, attitudes and intensity of access to pornography have a significant relationship to the formation of sexual orientation. It is hoped that midwives can detect changes in sexual orientation in adolescents from an early age so that they can be treated immediately.

SENTIMENT ANALYSIS ON LGBT ISSUES IN INDONESIA WITH LEXICON-BASED AND SUPPORT VECTOR MACHINE ALGORITHMS

Non-heterosexual sexual orientation (LGBT) behavior today is one of the most pervasive issues in Indonesian culture. Because of its domino effect on social stability and physical and mental health, the phenomenon known as lesbian, gay, bisexual, and transgender (LGBT) has always been under scrutiny. The development of LGBT people in Indonesia reflects cultural changes that concern many people. Freedom of speech for LGBT people on social media has many public implications. Observation of this phenomenon gives rise to views of anomalies and discrepancies that have drawn criticism. Various attempts have been made to prevent the movement of LGBT people. However, until now, many still debate the pros and cons of this LGBT movement. The lexicon-based method uses a support vector machine to classify public opinion in TikTok video comments about LGBT issues. The lexicon-based method is used as a weighting method, and the support vector machine method is used as a classification method. The results show that the highest gain in sentiment is neutral, with percentage values of 61%, 56%, 68%, 69%, and 63%. The second is positive sentiment, with percentage values of 27%, 27%, 20%, 20%, and 29%. The rest have negative sentiments. With a relatively high accuracy of the five data sets sequentially at 93%, 89%, 95%, 97%, and 91%. This shows that the majority of Indonesians prefer to ignore the issue.

Disclosing One’s Non-Heterosexual Sexual Orientation at Work in 2020: A Survey of Quebec LGBQ Workers

ABSTRACT Concealing one’s non-heterosexual orientation (NHO) remains a protection strategy against workplace discrimination used by many lesbian, gay, bisexual, and queer (LGBQ+) individuals. This article explores four sets of correlates (identity and individual trajectory, social support, professional position, and structural and cultural work context) relative to three levels of outness (total, partial, and null). Online cross-sectional data of 2,106 LGBQ+ participants from Quebec (Canada) showed that 27% reported total outness, while 64% reported partial outness, and 9%, null outness. Multinomial hierarchical regression analyses revealed that each set of correlates significantly contributed to levels of workplace NHO outness. The two sets of variables making the largest contributions to levels of outness were those pertaining to identity and individual trajectory (14% of the variance) and structural and cultural work context (9%). Compared to partial outness, null outness was associated with an unaccepting work climate, while total outness was more likely in contexts with organizational support (e.g., with the presence of an inclusivity policy). Without trivializing the influence of non-workplace factors on outness levels, the present findings support the need to develop an inclusive and accepting work climate for LGBQ+ individuals.

Sexually transmissible infections (STI) and HIV testing and diagnosis among Aboriginal and non-Aboriginal adolescents in contact with the Australian justice system: a cross-sectional study.

It is unclear what factors are associated with sexually transmissible infections (STI) and HIV testing and diagnosis among justice-involved adolescents, and if these differ for Aboriginal or Torres Strait Islander peoples. A cross-sectional survey of 465 justice-involved adolescents (aged 14-17years) from Australia was conducted between 2016 and 2018. Participants were asked about sexual behaviours, STI/HIV knowledge, and prior STI diagnoses and testing. Approximately 38% (n =130) of those sexually active had ever been screened for STI/HIV and 17.8% (n =23) had been diagnosed with an STI. No participant reported living with HIV. For Aboriginal participants, being male (aOR 3.6, 95% CI 1.3-10.1) and having under three sexual partners in the past 12months (aOR 3.1, 95% CI 1.2-8.0) was associated with never having had an STI/HIV test. For non-Aboriginal participants, being male (aOR 2.7, 95%CI 1.2-5.7), single (aOR 2.4, 95% CI 1.2-4.9), attending school (aOR 2.4, 95% CI 1.1-5.1), not having sought sexual health information (aOR 2.8, 95% CI 1.4-5.8), and having a lower STI/HIV knowledge score (aOR 2.3, 95% CI 1.1-5.0) were associated with never having had an STI/HIV test. Factors associated with STI diagnosis were non-heterosexual sexual orientation (aOR 5.6, 95% CI 1.1-28.2), transactional sex (aOR 11.2, 95% CI 3.0-41.3), and having sought sexual health information (aOR 3.5, 95% CI 1.0-12.5). Males, particularly Aboriginal male adolescents, should be engaged with sexual health promotion and testing services as soon as they come into contact with the justice system. Approaches should consider different cultural, gender and sexual orientations.

Cognitive Subjective Well-Being during the Second Lockdown in Portugal: The Predictive Role of Sociodemographic and Psychopathological Dimensions

The negative impact of the COVID-19 pandemic on well-being has been widely described. However, studies on how country-specific characteristics influenced the impacts of the pandemic experience on cognitive subjective well-being are still needed. This study examined the predictive role of sociodemographic characteristics and psychopathological dimensions on cognitive subjective well-being during the second lockdown period in Portugal. An online sample of 332 adults completed a series of self-report instruments between April and July 2021, covering the period from 15 January to 15 March 2021. Hierarchical regression analysis revealed that being married or living in a civil union, not having/or living with children, not living with/or caring for an elderly person, and not being infected with the SARS-CoV-2 were significant and positive predictors of higher cognitive subjective well-being. In contrast, a non-heterosexual sexual orientation; isolation due to COVID-19; and higher levels of depression, anxiety, and stress, along with repetitive negative thinking, were significant predictors of negative cognitive subjective well-being during the second lockdown in Portugal. The importance of developing promotional, preventive, and remedial interventions focused on specific country and individual characteristics for poor cognitive subjective well-being for promoting mental health and well-being during this critical period and similar future crisis events is discussed.

Medical avoidance among marginalized groups: the impact of the COVID-19 pandemic.

Medical avoidance is common among U.S. adults, and may be emphasized among members of marginalized communities due to discrimination concerns. In the current study, we investigated whether this disparity in avoidance was maintained or exacerbated during the onset of the COVID-19 pandemic. We assessed the likelihood of avoiding medical care due to general-, discrimination-, and COVID-19-related concerns in an online sample (N = 471). As hypothesized, marginalized groups (i.e., non-White race, Latinx/e ethnicity, non-heterosexual sexual orientation, high BMI) endorsed more general- and discrimination-related medical avoidance than majoritized groups. However, marginalized groups were equally likely to seek COVID-19 treatment as majoritized groups. Implications for reducing medical avoidance among marginalized groups are discussed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10865-022-00332-3.

Violencia obstétrica en Chile: percepción de las mujeres y diferencias entre centros de salud

RESUMENObjetivo.El objetivo del presente artículo es reportar los resultados de la primera encuesta sobre violencia obstétrica en Chile, de modo de hacer visible una realidad más frecuente de lo que creemos y comparar su ocurrencia según tipo de servicio (público o privado) en que se ha atendido el parto.Métodos.Se trata de un estudio descriptivo y de tipo transversal conducido entre los meses de diciembre de 2019 y mayo de 2020. La muestra quedó compuesta por 2105 mujeres de todas las regiones de Chile.Resultados.Los análisis de los datos indican que un 79,3% de las mujeres cree haber experimentado alguna forma de violencia obstétrica. A pesar de la gran cantidad de informes de violencia en centros de salud públicos y privados, se detectan diferencias estadísticas significativas entre ambos, y son más frecuentes en los centros públicos. Del mismo modo, se detectan más informes de violencia obstétrica en mujeres jóvenes (18-29 años), en quienes se identifican con pueblos originarios y entre quienes tienen una orientación sexual no heterosexual.Conclusiones.La violencia obstétrica es parte del continuo de violencia hacia las mujeres e informada de modo sistemático por quienes atienden sus partos tanto en servicios públicos como privados de salud. Es una forma de violencia tiene graves consecuencias en las mujeres debido tanto a la posición del equipo médico y a la relevancia del evento de parto en la vida de cualquier mujer.

Sexual violence in older adults: a Belgian prevalence study

BackgroundSexual violence (SV) is an important public health problem which may cause long-lasting health problems. SV in older adults remains neglected in research, policies and practices. Valid SV prevalence estimates and associated risk factors in older adults are currently unavailable. In this study we measured lifetime and past 12-months sexual victimisation in older adults living in Belgium, its correlates, assailant characteristics and the way that victims framed their SV experiences.MethodsSV was measured using behaviourally specific questions based on a broad definition of SV. Participants were selected via a cluster random probability sampling with a random route finding approach. Information on sexual victimisation, correlates, assailant characteristics and framing was collected via structured face-to-face interviews with adults aged 70 years and older living in Belgium (community-dwelling, assisted living and nursing homes).ResultsAmong the 513 participants, the lifetime SV prevalence was 44% (55% F, 29% M). Past 12-months prevalence was 8% (9% F, 8% M). Female sex and a higher number of sexual partners were associated with lifetime SV (p < .05), non-heterosexual sexual orientation with past 12-months SV (p < .05). Correlates identified to be linked to elder abuse and neglect in previous studies were not linked with SV in our sample. ‘Someone unknown’ was identified as most common assailant.ConclusionsSexual victimisation appears to be common in older adults in Belgium. Both correlates and assailant characteristics seem to differ from previous studies on elder abuse and neglect. Recognizing older adults as a risk group for sexual victimisation in research, policies and practices is of the utmost importance.

Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality

BackgroundIndividuals with histories of sexual abuse may be more likely to experience sexual-related problems including hypersexuality, but gender-related differences remain unclear. AimThis online study examined sexual abuse history and hypersexuality by gender among 16,823 Hungarian adults, adjusting for age, sexual orientation, relationship status, education, employment status, and residence. MethodsAn online questionnaire on one of the largest Hungarian news portals advertised this study examining sexual activities in January 2017. 3 categorizations of age-related sexual abuse were examined: child sexual abuse (CSA) occurring at age 13 and earlier (compared to no abuse), adolescent/adult sexual abuse (AASA; compared to no abuse), and CSA and AASA (CSA/AASA; compared to one age-related category of abuse or the other). OutcomesThe outcome variable, hypersexuality, was examined as a continuous variable due to the low prevalence of clinical hypersexuality in this sample. 3 multivariate linear regression analyses adjusting for covariates aimed to predict hypersexuality from each category of abuse, along with gender and its interaction with each category. ResultsIn all models, younger age, non-heterosexual sexual orientation, male gender, single relationship status, less than full-time work, and living in a capital city were associated with hypersexuality, and education was not a significant predictor. CSA, AASA, and CSA/AASA predicted hypersexuality in both men and women. There was a significant interaction between CSA/AASA and gender, such that the relationship between CSA/AASA and hypersexuality was stronger in men than in women. Clinical TranslationSexual abuse at each developmental time-point may influence hypersexuality among men and women, although the cumulative impact of CSA and AASA on hypersexuality may be particularly relevant among men. Strengths & LimitationsThis is one of the largest studies to examine gender-related differences in the relationship between sexual abuse and hypersexuality. Nevertheless, our study is cross-sectional, and longitudinal work is needed to determine how sexual abuse affects children, adolescents, and adults throughout their lives. ConclusionDevelopmental impacts of sexual abuse may be considered in a gender-informed fashion in order to develop and optimize effective prevention and treatment strategies for hypersexuality.Slavin MN, Blycker GR, Potenza MN, et al. Gender-Related Differences in Associations Between Sexual Abuse and Hypersexuality. J Sex Med 2020;17:2029–2038.

Gender identity, sexual orientation and adverse sexual experiences in autistic females

BackgroundThere is growing recognition that autistic females present with more diverse gender and sexual identities than their non-autistic counterparts. Likewise, autistic females are also at an increased risk of adverse sexual experiences. As higher rates of sexual victimisation are observed in individuals with diverse sexual identities in the broader population, rates of negative sexual experiences among autistic females remain unclear. This study aimed to investigate the representation of gender and sexual diversity within autistic females and examine their rates of regretted, and unwanted, sexual encounters among females with a transgender gender identity and non-heterosexual sexual orientation.MethodsTwo hundred and ninety-five females completed the Sexual Behaviour Scale-III (SBS-III) online. Self-reported gender identity and sexual orientation were compared between 134 autistic (Mage= 26.2 years, SD = 8.7) and 161 non-autistic females (Mage = 22.0 years, SD = 4.6). Differences in the prevalence of negative sexual experiences were compared across diagnosis and each gender identity and sexual orientation label.ResultsAutistic females were more likely to identify with a transgender gender identity (p < .05) and non-heterosexual sexual orientation (p < .007) compared to non-autistic females. Autistic homosexual females were more likely to have experienced a range of negative sexual experiences than autistic heterosexual females (OR ≥ 3.29; p < .01) and were more likely to have experienced unwanted sexual experiences than non-autistic females regardless of sexual orientation (OR ≥ 2.38; p < .05). There were no differences in rates of negative sexual experiences between autistic bisexual and both autistic heterosexual and non-autistic bisexual females. Non-autistic bisexual females (OR = 0.24; p = .018) presented with a reduced risk of regretted sexual experiences than non-autistic heterosexual peers. There were no differences in negative sexual experiences across gender identity in the autistic sample.LimitationsThe use of fixed format response items may have restricted participants’ abilities to provide rich responses pertaining to their sexual identities and nature of negative sexual experiences. The small number of participants who identified as transgender (n = 40) limits the reliability of results pertaining to sexual experiences across gender identity. Moreover, although multiple recruitment methods were used in this study, non-representative may bias estimates of prevalence rates. Thus, the data may not be representative of the broader population.ConclusionsResults indicate that autistic females present with greater diversity in their sexual identities than individuals without autism, with those with a homosexual sexual orientation being at greater risk of experiencing adverse sexual encounters. Findings suggest the importance of increased clinical attention to this diversity and the need to provide support to facilitate the development of a healthy sexual identity and reduce the risks identified in this study.

Gender Identity and Sexual Orientation Identity in Women and Men Prenatally Exposed to Diethylstilbestrol

We assessed the associations of prenatal diethylstilbestrol (DES) exposure, a potent estrogen, with sexual orientation and gender identity in 3306 women and 1848 men who participated in a study of prenatal DES exposure. Odds ratios (OR) and 95% confidence intervals (CI) were derived from logistic regression models adjusted for birth year, study cohort, and education. Among women, the OR for DES in relation to reporting sexual orientation identity as nonheterosexual was 0.61 (95% CI 0.40–0.92) primarily due to a strong inverse association with a lesbian identity (OR 0.44, 95% CI 0.25–0.76). Among men, the OR for DES in relation to reporting a nonheterosexual sexual orientation identity was 1.4 (95% CI 0.82–2.4), and ORs were similar for having a gay identity (1.4, 95% CI 0.72–2.85) and bisexual identity (1.4, 95% CI 0.57–3.5). Only five individuals reported a gender identity not conforming to that assigned at birth, preventing meaningful analysis. Women who were prenatally exposed to DES were less likely to have a lesbian or bisexual orientation, while DES-exposed men were somewhat more likely to report being gay or bisexual, but estimates were imprecise.

Advancing Equity in Nephrology: Enhancing Care for LGBTQ+ Patients and Our Workforce.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face social, economic, legal, health, and health care–related disparities amid evolving threats to sociopolitical advances made in the last decade ([1][1],[2][2]). In response, organizations, including the National Institutes of

Formal comment on: Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria.

Purpose In on-line forums, parents have reported that their children seemed to experience a sudden or rapid onset of gender dysphoria, appearing for the first time during puberty or even after its completion. Parents describe that the onset of gender dysphoria seemed to occur in the context of belonging to a peer group where one, multiple, or even all of the friends have become gender dysphoric and transgender-identified during the same timeframe. Parents also report that their children exhibited an increase in social media/internet use prior to disclosure of a transgender identity. Recently, clinicians have reported that post-puberty presentations of gender dysphoria in natal females that appear to be rapid in onset is a phenomenon that they are seeing more and more in their clinic. Academics have raised questions about the role of social media in the development of gender dysphoria. The purpose of this study was to collect data about parents’ observations, experiences, and perspectives about their adolescent and young adult (AYA) children showing signs of an apparent sudden or rapid onset of gender dysphoria that began during or after puberty, and develop hypotheses about factors that may contribute to the onset and/or expression of gender dysphoria among this demographic group. Methods For this descriptive, exploratory study, recruitment information with a link to a 90-question survey, consisting of multiple-choice, Likert-type and open-ended questions was placed on three websites where parents had reported sudden or rapid onsets of gender dysphoria occurring in their teen or young adult children. The study’s eligibility criteria included parental response that their child had a sudden or rapid onset of gender dysphoria and parental indication that their child’s gender dysphoria began during or after puberty. To maximize the chances of finding cases meeting eligibility criteria, the three websites (4thwavenow, transgender trend, and youthtranscriticalprofessionals) were selected for targeted recruitment. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques. Data were collected anonymously via SurveyMonkey. Quantitative findings are presented as frequencies, percentages, ranges, means and/or medians. Open-ended responses from two questions were targeted for qualitative analysis of themes. Results There were 256 parent-completed surveys that met study criteria. The AYA children described were predominantly natal female (82.8%) with a mean age of 16.4 years at the time of survey completion and a mean age of 15.2 when they announced a transgender-identification. Per parent report, 41% of the AYAs had expressed a non-heterosexual sexual orientation before identifying as transgender. Many (62.5%) of the AYAs had reportedly been diagnosed with at least one mental health disorder or neurodevelopmental disability prior to the onset of their gender dysphoria (range of the number of pre-existing diagnoses 0–7). In 36.8% of the friendship groups described, parent participants indicated that the majority of the members became transgender-identified. Parents reported subjective declines in their AYAs’ mental health (47.2%) and in parent-child relationships (57.3%) since the AYA “came out” and that AYAs expressed a range of behaviors that included: expressing distrust of non-transgender people (22.7%); stopping spending time with non-transgender friends (25.0%); trying to isolate themselves from their families (49.4%), and only trusting information about gender dysphoria from transgender sources (46.6%). Most (86.7%) of the parents reported that, along with the sudden or rapid onset of gender dysphoria, their child either had an increase in their social media/internet use, belonged to a friend group in which one or multiple friends became transgender-identified during a similar timeframe, or both Conclusion This descriptive, exploratory study of parent reports provides valuable detailed information that allows for the generation of hypotheses about factors that may contribute to the onset and/or expression of gender dysphoria among AYAs. Emerging hypotheses include the possibility of a potential new subcategory of gender dysphoria (referred to as rapid-onset gender dysphoria) that has not yet been clinically validated and the possibility of social influences and maladaptive coping mechanisms. Parent-child conflict may also explain some of the findings. More research that includes data collection from AYAs, parents, clinicians and third party informants is needed to further explore the roles of social influence, maladaptive coping mechanisms, parental approaches, and family dynamics in the development and duration of gender dysphoria in adolescents and young adults.