Sexual Minority Identity Research Articles

Mental health outcomes, associated factors, and coping strategies among LGBTQ adolescent and young adults during the COVID-19 pandemic: A systematic review.

LGBTQ adolescents and young adults have been disproportionately affected by the COVID-19 pandemic. This review aims to describe the impact of the COVID-19 crisis on mental health among LGBTQ adolescents and young adults, identify associated factors, and summarize coping strategies. A systematic review was conducted by searching six databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, MEDLINE). Eligibility criteria included (1) reported mental health outcomes, (2) conducted among LGBTQ adolescents and young adults, and (3) data collection occurred since January 2020. All studies were screened independently, and relevant data were synthesized following PRISMA guidelines. Of 395 records, 67 articles were screened for eligibility. Among these, 39 studies met the inclusion criteria. LGBTQ adolescents and young adults reported substantial mental health burdens, including depression, anxiety, stress, and loneliness during the pandemic. A pooled prevalence of depressive symptoms with a combined sample size of 7326 LGBTQ adolescents and young adults was 59% (95%CI: 0.48-0.70), (I2=98.95%, p<0.001). Among anxiety outcomes, the pooled prevalence with a sample size of 3258 LGBTQ adolescents and young adults was 55% (95% CI: 0.46-0.63), (I2=95.70%, p<0.001). Individual factors associated with mental distress included age, gender, and history of mental health disorders. Interpersonal and community-level factors included loss of safe spaces, family support, and discrimination on sexual and gender minority identity. Strategies to cope with distress include the use of social media and increased use of alcohol, tobacco, and other drugs. The pandemic has had a substantial negative impact on psychological distress among LGBTQ adolescents and young adults. Results substantiate the need for further research into social media as a coping instrument and the expansion of telehealth mental health services.

P-1440. Are Veterans Willing to Complete Sexual Health Screening In Primary Care?: Lessons Learned from a Population Level Sexual Health Questionnaire

Abstract Background The CDC recommends routine sexual histories (SH), yet they are rarely completed in primary care (PC) due to barriers ranging from patient discomfort to provider time constraints. We implemented a system wide nurse-led sexual health screening tool at a large VA hospital. Here we report on patient acceptability of sexual histories and sexual behaviors of Veterans at a population level.Table 1Demographics, Overall by Question 1 ResponseThis table describes demographics of those who agreed to discuss their sexual health, ie said Yes to Question 1 Methods We deployed a short SH screening questionnaire to be conducted during PC visits. Administered mostly by nurses, the questionnaire began with a consent question. Those with an affirmative response proceeded to answer additional questions. We queried the VA’s electronic database to ascertain patient demographics including age, birth sex, sexual orientation, gender identity, race/ethnicity, Rural-Urban Commuting Area codes. We describe the population as medians and proportions.Table 2Demographics, Overall by Question 2 ResponseThis table describes demographics of those who agreed to discuss about sexual health and have more than one sexual partner, ie said Yes to Question 2 Results Over 2-years (April 14, 2022-24) 130,986 SH screening questionnaires were offered to 95,490 unique Veterans, with 83,510 (87%) agreed at least once (Table 1). Birth sex females were more likely than males to agree to SH (91% vs. 87%). Most 65 and older agreed to the screening (85%). Supermajority of Veterans who have recorded a sexual identity as LGBQ+ agreed to SH (1688/1798, 94%). Similarly, 96% of those who have recorded self-identified gender as transgender man, transgender woman, or non-binary also agreed to SH. Racial or ethnic minority patients were more likely to agree to SH than Whites: 90% Black vs. 87% White; 91% vs. 87% non-Hispanic. Of 83,510 patients who agreed, 2754 (3%) had more than 1 sexual partner in the last 6 months, with younger age, LGBQ+ identity, Black race and Hispanic ethnicity associated with likelihood of more than 1 sexual partner (Table 2). Of these, 4% reported sexual partners of more than 1 gender, and 21% of this subset had a self-described sexual orientation as straight or heterosexual. Sexual Health Questions Conclusion A brief SH screening questionnaire administered by nurses in PC settings is feasible and highly acceptable to patients. Patients who identify as minority racial, ethnic, sexual or gender identity groups are very willing to provide SH, in some cases at much higher rates than non-minority peers. Other healthcare systems can implement similar nurse-led screening tools to improve SH taking in PC settings Age Breakdown for Question 1 This table describes the age breakdown for those who said Yes to Question 1, indicating both young and old population agree to discuss about sex. Disclosures All Authors: No reported disclosures

Sexual Minority Stress: Preliminary Evidence of Accelerated Pubertal Development in Early Adolescence.

Societal stressors place a tremendous burden on individuals who identify with a sexual minority identity. While minority stress experienced by racial/ethnic minority groups has been linked to accelerated aging, this link has yet to be examined among sexual minority youth. This study explores whether sexual minority youth who indicate experiencing stress at home or school (Minority Stress) due to their identity show evidence of accelerated aging (pubertal status or tempo) compared to those who do not report such experiences (No Minority Stress). Data are from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were approximately 9-10 years old at baseline, 10-11 years old at Time 1, and 11-12 years old at Time 2. Measures included child-reports of sexual minority identity and stressors, and parent-reports of adolescent pubertal development. Among 432 included participants who identified with a sexual minority identity, 83.6% were assigned female at birth and 24.8% were in the Minority Stress group. There were consistent results showing that sexual minority youth in the Minority Stress group showed accelerated pubertal status over time compared to those in the No Minority Stress group. Pubertal tempo (i.e., slope) was only accelerated for those who first identified as sexual minority at Time 2. Our findings underscore that minority stress experienced by sexual minority youth may be linked to differences in pubertal development among these youth. The developmental and clinical implications of these patterns present critical lines for future research concerned with the wellbeing of sexual minority youth.

Which comes first, puberty or identity? The longitudinal interrelations between pubertal timing and sexual minority self-identification among early adolescents.

Sexual minority adolescents experience puberty earlier than their heterosexual peers. Early puberty is an indicator of premature aging and can be partly driven by chronic stress linked to discrimination. Nonetheless, the neural, cognitive, and social development linked to puberty enables adolescents to explore and understand their sexual identities. For sexual minority youth, does the stress from identity-based discrimination make them more likely to experience advanced pubertal timing, or is early pubertal timing the impetus for their self-identification with a sexual minority identity? To answer this research question, the present study leveraged longitudinal and national data to test the temporal ordering between sexual minority self-identification and pubertal timing among one sample of 7,818 unrelated adolescents and another sample of 4,050 adolescent siblings nested across 1,989 households in the United States. Across both samples, results illustrated significant bidirectional relations between pubertal timing and sexual minority self-identification. Adolescents who self-identified as sexual minorities experienced more advanced pubertal timing 1 year later, and adolescents who experienced more advanced pubertal timing were more likely to identify as sexual minorities 1 year later. While the longitudinal link between pubertal timing and later sexual minority self-identification may be a normal developmental process, the longitudinal link between sexual minority self-identification and subsequent advanced pubertal timing may be attributable to heterosexist stigma. The present findings underscore the need to mitigate prejudice so that all adolescents have the freedom to explore their identities without risks to their development. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Health Care Stereotype Threat During the COVID-19 Pandemic Among Sexual and Gender Minority Individuals.

Objectives. To determine the levels and differentials in health care stereotype threat experienced during the COVID-19 pandemic by individuals with sexual or gender minority identities. Methods. The National Couples' Health and Time Use Study is a national cross-sectional US population‒ based sample of partnered individuals interviewed during the pandemic between September 2020 and April 2021 with oversamples of sexual and gender minority individuals. The analytic sample consisted of 3614 individuals (n = 2043 heterosexual and n = 1571 sexual minority individuals along with 3489 cisgender and 125 noncisgender people). Results. Individuals with sexual minority identities experienced significantly more health care stereotype threat than heterosexual people. Cisgender women and those with another gender identity experienced significantly more health care stereotype threat than cisgender men. These results persisted after the inclusion of indicators of health conditions, insurance, COVID-19 experience, and sociodemographic factors. Conclusions. Gender and sexual minority‒identifying people reported high levels of worries about health discrimination. Our work suggests that providing positive health care experiences may reduce these worries and offer a potential antidote to sexual and gender minority health disparities that are driven by structural and interpersonal discrimination. These findings support calls for the further education and transformation of health care provision and systems. (Am J Public Health. Published online ahead of print January 16, 2025:e1-e9. https://doi.org/10.2105/AJPH.2024.307926).

“Encouraged to be Your True Self”: An Interpretative Phenomenological Study of Medical Students’ Experiences of Role Models in Shaping Sexual Minority Identity in Medical School

Phenomenon: Sexual and gender minority (SGM) identifying individuals experience worse health outcomes compared to non-SGM identifying counterparts. Representation of SGM individuals within medical schools may improve the delivery of more equitable healthcare through reducing biases and normalizing SGM presence within healthcare spaces. Approach: Our initial aim was to explore the extent to which role models may influence personal SGM identities within medical schools in the United Kingdom, using an interpretative phenomenological approach. This methodology allowed us to develop meaning from, and give voice to participants’ relationship with their bespoke experiences, respecting differing narratives within the broad ‘SGM’ umbrella, rather than attempting to establish commonalities. Semi-structured interviews were conducted with five medical students and three medical school faculty within three medical schools, who identified as SGM. Due to a lack of gender minority identifying participants, we unfortunately could not adequately speak to their experiences, and therefore narrowed our eventual focus to sexual minority (SM) individuals. Findings: The developed themes followed a cyclical process of: (1) role model identification; (2) role model selection, influenced by matched wider identities including generation, hierarchy and power; (3) trait assimilation, particularly where identity deficits were perceived; and (4) identity projection, where students used role models to both emulate comfortable SM identity projection, and become advocatory role models themselves. Throughout, participants described role models as multifaceted in their direction (vertical and horizontal), influence (positive and negative) and locus of effect (as individuals, and as part of a collective). Unexpectedly, identity, power, and hierarchy-matching meant peer-to-peer role modeling was often experienced more positively than vertical faculty-to-student role modeling. However, as expected, heteronormativity exerted an inhibitory effect on this process. Insights: We built upon existing social cognitive paradigms to develop a ‘double-funnel’ model to represent how social contexts can map onto individual SM identities and vice versa, mediated by role models. The triangulation of these three aspects in relation to medical education presents novel understandings to the field. Greater explicit institutional support of student-led SM societies, and facilitation of the presence and discussion of SM symbols and personal identities within professional spaces, may go a long way in redefining ‘normativity’ in medical schools.

Mental Health Disparities by Sexual Orientation and Gender Identity in the All of Us Research Program.

Limited research explores mental health disparities between individuals in sexual and gender minority (SGM) populations and cisgender heterosexual (non-SGM) populations using national-level data. To explore mental health disparities between SGM and non-SGM populations across sexual orientation, sex assigned at birth, and gender identity within the All of Us Research Program. This cross-sectional study used survey data and linked electronic health records of eligible All of Us Research Program participants from May 31, 2017, to June 30, 2022. Self-identified SGM status. Prevalence of common mental health conditions identified from linked electronic health records. Logistic regression adjusted for age, race and ethnicity, educational level, income, employment status, and geographic region was used to assess the association between SGM status and mental health conditions. Among 413 457 participants, 269 947 (65.3%) were included in the analysis (median age, 59 [IQR, 43-70] years), with 22 189 (8.2%) self-identified as SGM. Men with cisgender sexual minority identity had higher odds of bipolar disorder (adjusted odds ratio [AOR], 1.87; 95% CI, 1.70-2.56) compared with cisgender heterosexual men. Women with cisgender sexual minority identity had higher odds of bipolar disorder (AOR, 2.09; 95% CI, 1.95-2.25) compared with cisgender heterosexual women. Gender diverse people assigned female sex at birth had higher odds of posttraumatic stress disorder (PTSD) compared with both cisgender heterosexual men (AOR, 3.67; 95% CI, 2.99-4.50) and cisgender heterosexual women (AOR, 2.77; 95% CI, 2.26-3.40). Gender diverse individuals assigned male sex at birth had higher odds of bipolar disorder (AOR, 2.35; 95% CI, 1.66-3.33) compared with cisgender heterosexual men and higher odds of attention-deficit/hyperactivity disorder (AOR, 2.19; 95% CI, 1.48-3.23) compared with cisgender heterosexual women. Transgender men had higher odds of depression (AOR, 2.11; 95% CI, 1.80-2.49) compared with cisgender heterosexual men, while transgender women had higher odds of any personality disorder (AOR, 2.71; 95% CI, 1.84-3.99) compared with cisgender heterosexual women. In this cross-sectional study of participants in the All of Us Research Program, there were significant mental health disparities between participants in SGM and non-SGM groups. These findings underscore the need for tailored mental health interventions to improve the well-being of SGM populations, while noting that the associations do not imply causality but reflect the stigma and minority stress experienced by these individuals.

Future time perspectives and concerns among adolescents in 2022

Future time perspectives (FTP) and future-related concerns in adolescence remain underexplored. We aimed to identify factors associated with limited FTP and describe future-related concerns. Data were drawn from a population-based...

Sexual identity-related inequalities in associations between adverse childhood experiences and health in late adolescence-A national cohort study.

This study examined associations between adverse childhood experiences (ACEs) and mental health and health-risk behaviours, including differences by sexual minority (SM) identity. We included 8,686 adolescents (males = 50.7%, SM = 10.3%) from the UK-wide Millennium Cohort Study with data on eight ACEs (e.g., domestic violence, parental psychological distress, bullying) recorded between ages 3-14 and a wide-range of health indicators and health-risk behaviours at age 17. Associations between 1) Sexual identity and ACEs were analysed using multinomial logistic regression and 2) Cumulative ACE scores and all outcomes were analysed using linear/logistic regression (with appropriate interactions assessing differences in ACE-outcome associations by sexual identity and adjusted for sex, ethnicity, and parental income). Results showed SM individuals had a higher prevalence of bullying (33.9% vs. 20.3%) and experiencing ≥3ACEs [Bisexual: RRR 1.87 (95% CI 1.35, 2.57), Gay/Lesbian RRR 2.08 (1.24, 3.48)]. The number of individuals experiencing adverse mental health outcomes increased in relation to greater ACE exposure with evidence for effect-moderation by sexual identity in certain outcomes. For example, among individuals with 0 ACEs, 8% of heterosexual adolescents reported psychological distress vs. 22% in bisexual and 17% in gay/lesbian peers, increasing to 16% in heterosexual vs. 41% in bisexual and 45% in gay/lesbian adolescents with ≥3 ACEs. Similar patterns were observed for other health indicators (e.g., self-harm, suicidality, sleep quality) and health-risk behaviours (e.g., risky sex). Our findings indicate that ACEs are associated (with a gradient) with worse mental health and well-being, and higher risk of some health-risk behaviours. However, the detrimental effect of ACEs on health is worse in SM adolescents compared to heterosexual peers.

"I find value in myself": Queer Asian American men's self-love and resistance in the face of White supremacy.

Queer (i.e., gay, bisexual, or another sexual minority identity) Asian American men experience unique challenges and strengths related to their social identities at the intersection of race and sexual orientation. While a sizable body of research has shown how this population faces racism within the broader queer community, there is little research that specifically examines the strengths of this population, including how they cultivate self-love in the face of White supremacy. Thus, the purpose of this study was to examine how queer Asian American men who endorse self-love regardless of what queer white men think of them cultivate that self-love, as well as to understand the benefits of this self-love. Using a qualitative, grounded theory approach with 20 queer Asian American men who endorsed self-love regardless of what queer White men think of them, results indicated the core category of facilitating forces of self-love. Within this overarching category, results highlighted four key categories: location (i.e., predominantly White area, racially diverse area, and transition from one area to another), social support (i.e., processing experiences and challenging the status quo), self-reflection (i.e., journaling, therapy, and increasing critical consciousness/viewing the self-in-context), and active resistance (i.e., externalizing racism, distancing from Whiteness, seeking representation, engaging in activism or advocacy, and cultivating self-worth). This study highlights the specific mechanisms by which queer Asian American men love themselves regardless of queer white men's views of them, posing larger implications for how marginalized groups can resist and thrive in the face of societal oppression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-compassion as a mediator of the relationship between social support and identity affirmation in sexual minority adults

ABSTRACT Identity affirmation refers to comfort and pride in sexual minority identity, and consideration of this as a positive facet of one’s identity. Evidence demonstrates that identity affirmation is beneficial for sexual minority individuals, yet little is known about factors predicting identity affirmation. The current research examines social support as a predictor of identity affirmation in lesbian, gay, bisexual, and queer (LGBQ) adults, and tests whether self-compassion mediates this. A sample of 597 LGBQ adults (M age = 40.48 years, SD = 14.62) completed an online anonymous survey assessing demographic characteristics, self-compassion, social support, and identity affirmation. Social support predicted identity affirmation both directly, and indirectly via self-compassion, though sexual identity moderated these effects. Specifically, social support predicted greater identity affirmation via self-compassion among gay, lesbian, and bisexual individuals. However, among queer-identified individuals, there were no direct or indirect effects found. Results suggest that social connection may help to foster identity affirmation by enhancing attitudes of acceptance and kindness towards oneself, at least among gay, lesbian, and bisexual individuals. Findings also suggest there may be unique predictors of identity affirmation for queer-identified individuals, and further research is needed to identify these predictors. Interventions targeting social factors and self-compassion may warrant further investigation to assess whether they can help to cultivate identity affirmation in LGBQ adults.

"I have some people who actually really care:" Young sexual minority women's lived experiences of non-suicidal self-injury disclosure.

Sexual minority youth are more likely to engage in Non-Suicidal Self-Injury (NSSI) than their heterosexual peers, and sexual minority women demonstrate greater risk of NSSI than their sexual minority male counterparts. However, a lack of research exists on NSSI among young sexual minority women, particularly their NSSI disclosure experiences. We used a descriptive-interpretive, qualitative design with semi-structured interviews to examine young sexual minority women's lived experiences disclosing NSSI and of others' responses to these disclosures. The sample included 65 sexual minority women aged 14-30 recruited via paid social media advertising from across the U.S. We performed an inductive thematic analysis of transcripts from 58 participants (89%) who reported a history of NSSI. Participants shared reasons for disclosure (wanting help, communicating distress) or nondisclosure (cultural stigmas), types of disclosure (accidental/involuntary, and direct/voluntary), and recipients of a disclosure (friends, partners, mental health providers, and parents). They also described responses to, and feelings after, NSSI disclosure, revealing two themes: i) Unhelpful/stigmatizing responses (based on fear, anger, and apathy) and ii) Helpful/destigmatizing responses (expressions of concern, emotional support, and alternative coping strategies). Overall, young sexual minority women's disclosure experiences were consistent with those of other populations, highlighting the need to further reduce stigma about NSSI, as well as sexual minority identities, and provide universal education promoting helpful responses to NSSI disclosure.

11.O. Scientific session: Mental Health Among Sexual and Gender Minority Populations in Diverse Structural Stigma Environments

Abstract Research conducted across numerous countries finds that sexual minority (e.g., lesbian, gay, and bisexual [LGB]) and gender minority (e.g., transgender [T]) individuals represent high-risk populations for poor mental health and suicidality. These disparities are believed to be a consequence of a stigmatizing environment and sexual and gender minority individuals’ disproportionate exposure to stigma-based stress compared to cisgender (i.e., non-transgender) heterosexuals. Stigma occurs at multiple levels to compromise LGBT individuals’ health. At the structural level, stigma manifests as unjust laws, policies, and cultural norms that deny, or fail to protect, the equal rights of LGBT individuals. At the interpersonal level, stigma manifests as discrimination in social interactions, social exclusion, and outright victimization. At the individual level, stigma can tax LGBT individuals’ coping resources by requiring costly behavioral strategies such as concealment of one’s LGBT identity. In this workshop, four studies from different regional environment with varying degree of structural stigma will be presented, i.e., the USA, Switzerland, Rwanda, and Kenya. They resent novel findings on the processes and mechanism underlying LGBT populations increased risk of mental health and links between stigma experiences at different levels. Dr. Clark will present a study of how negative news media coverage influence suicidality among LGBT young adults in the USA using intensive longitudinal assessments. Dr. Pfister will present findings from in-depth interviews concerning suicidality with individuals representing a wide variety of sexual and gender minority identities in Switzerland. Dr. van der Star will present a study exploring how structural stigma environments are linked to interpersonal and individuals level stigma experiences in sexual minorities representing different generations of LGBT populations. Dr. Stojanovski will present data from surveys and interviews of LGBT populations in Kenya and Rwanda focusing on experiences of discrimination and mental health. Key messages • Negative media reporting, discrimination, and barriers to health care can influence mental health and suicidality among LGBT individuals. • Identity concealment may represent a mechanism through which sexual minorities navigate structurally stigmatizing climates.

Stressors and symptoms explaining sexual orientation inequalities in mental health services usage: A longitudinal study with young adults

Abstract Background Sexual minority (i.e., lesbian, gay, and bisexual [LGB], and other non-heterosexual) individuals are more likely to use mental health services than heterosexuals; however, evidence is scarce about factors contributing to this difference. Methods This study uses longitudinal data from a population-based sample of young adults (aged 18- 36) in Sweden (N = 1,137). We use mediation analysis to examine whether common mental health symptoms (i.e., depressive, anxiety and social anxiety symptoms, suicidality, and alcohol use) mediate sexual orientation differences in mental health services use; and to understand whether adding general stressors (i.e., low social support, loneliness, and perceived stress) to these models increases the total effect explained. Afterwards, we use logistic regression models to understand how minority-specific stressors (e.g., family reaction and dimensions of sexual minority identity) predict mental health service use among sexual minority individuals (N = 498), adjusting for common mental health symptoms. Results Common mental health symptoms only partially mediate the associations and the direct effect for sexual orientation remain significant (β = 0.11, p &amp;lt; 0.01). Adding general stressors to these models only slightly increase the total effect explained and the direct effect remained significant (β = 0.11, p &amp;lt; 0.01). Among sexual minority individuals, after adjusting for common mental health symptoms, a difficult process of coming out (β = 0.12, p &amp;lt; 0.05) and negative family reaction towards one’s sexual orientation (β = 0.15, p &amp;lt; 0.05) predicted use of mental health services. Conclusions Overall, these results show that minority-specific stressors contribute to help-seeking behaviours among sexual minority individuals, regardless of psychiatric morbidity, highlighting the potential role of mental health services empowering sexual minority individuals to cope with minority stress.

Experiences of LGBTQ+ graduate students in research-focused doctoral programs: a scoping review

Students of sexual and gender minority (SGM) identities have long been underserved in higher education, and the limited research thus far has focused on undergraduates. There is a large gap in understanding the outcomes and experiences of LGBTQ+ graduate students, particularly in STEM. We undertook the first scoping review to examine the available literature on LGBTQ+ student experiences in research-focused doctoral programs. A scoping review methodology was utilized to compile a broad set of publications for a narrative review of emergent themes. A comprehensive search of 5 bibliographic databases yielded 1,971 unique studies, which were screened by two independent reviewers for data on LGBTQ+ doctoral students in non-clinical fields. Eighty-two publications were included in the analysis, over half of which were published in the past 5 years. Thirteen themes emerged from analyzing the included publications. LGBTQ+ ientities can continue evolving during graduate school, and some students incorporated SGM identities in their research (“mesearch”). Though students expected academia to be welcoming, many encountered repeated anti-LGBTQ+ bias that impacted their perceived safety for coming out. Nearly half of the studies mentioned intersectionality with other marginalized identities, including race/ethnicity, religion, disability, and others. Based on the information presented, we outline recommendations for practitioners to improve doctoral education, such as preparing teaching assistants to manage discriminatory classroom conduct.

Associations Between Sexual Orientation Dimensions and Cardiometabolic Diseases: Data From the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).

Sexual orientation can be measured across identity, attraction, and behavior. Sexual minorities are at increased risk of cardiovascular disease (CVD) and diabetes; however, it is not known whether cardiometabolic disease risk varies across these dimensions. We analyzed cross-sectional data from 36,309 adults who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Participants were categorized as heterosexual (reference), lesbian/gay, or bisexual across identity, attraction, and behavior using structured clinical interview data. Prevalent CVD (myocardial infarction, stroke, angina, or arteriosclerosis) and diabetes were assessed by self-report. Demographics (age, sex, race/ethnicity, education, and income) adjusted logistic regression models revealed bisexual behavior (i.e., people reporting sexual activity with both man- and woman-identifying individuals), but not lesbian/gay behavior (i.e., people reporting sexual activity exclusively with same-sex individuals), was associated with an increased odds of prevalent CVD (OR = 1.44, 95% CI = 1.08-1.91, p = .013) and prevalent diabetes (OR = 1.39, 95% CI = 1.09-1.77, p = .007). Contrastingly, sexual minority identity (i.e., self-concept) and attraction (i.e., one's sexual/romantic feelings) were not associated with prevalent CVD or diabetes. Our results in a nationally representative sample indicate that the sexual orientation dimension of behavior is linked with prevalent CVD and diabetes. This finding suggests that assessing multiple sexual orientation dimensions may aid in identifying sexual minority subgroups in greatest need of cardiometabolic disease prevention efforts. Although mechanisms such as stigma and minority stress have been proposed, future studies are required to elucidate mechanisms underlying the bisexual behavior-cardiometabolic disease relationship.

Rainbow owls: A phenomenological analysis of LGBTQ+ agriscience teachers’ experiences

The purpose of this study was to collaborate with School-Based Agriscience Education (SBAE) teachers who identify as LGBTQ+ to examine the unique interactions between their chosen career and their sexual and/or gender minority identities. This phenomenology utilized queer theory to analyze data from semi-structured interviews with individuals who had taught at least one year in the SBAE classroom, identified as LGBTQ+, and were employed to teach SBAE or professionally supervise an SBAE teacher. Participants consisted of six gay men, one lesbian woman, and one transgender man from eight different states across the U.S. Findings indicated three themes: 1) the three-hurdle race from closeted to proud, 2) Taking the elevator to avoid the “state” SBAE level, and 3) Affirmation and representation - the importance of being out. While the findings in this study are not generalizable, we begin to uncover the hurdles that our LGBTQ+ SBAE teachers face. Findings from this study have the potential to inform policy and culture reform to create more inclusive and equitable spaces for SBAE teachers from underserved communities. Of note, individual state SBAE associations should be particularly prompt in assessing these issues since these spaces have been identified by participants as particularly egregious when it comes to a lack of inclusion.

The Developmental Collision Hypothesis: An Empirical Test With Three Generations of Sexual Minority Youth.

Sexual minority youth experience disproportionate rates of mental health symptomatology relative to their heterosexual peers. Less is known about why these disparities have persisted despite growing public awareness of sexual diversity. The developmental collision hypothesis states that increased cultural visibility of sexual diversity has accelerated the developmental timing of sexual minority identity formation processes such that they collide with early adolescence, a uniquely sensitive period for experiencing identity-based stigma and associated mental health vulnerability. To test this hypothesis, levels and relations between ages of sexual minority identity development milestones, frequency of LGBT-related victimization, and depressive symptoms were examined across three age-matched but cohort-distinct samples of sexual minority adolescents. Data come from three secondary datasets of sexual minority youth who were adolescents in the 1990s, 2000s, and 2010s, respectively: the Challenges and Coping Study, the Victimization and Mental Health among High Risk Youths Study, and the Risk and Protective Factors for Suicide among Sexual Minority Youth Study (n = 1312; Mage = 17.34, SD = 1.30; 52% female). Adolescents from more recent cohorts reported earlier mean ages of several milestones but similar frequencies of LGBT-related victimization relative to those from less recent cohorts. Path analysis models showed that earlier milestones were associated indirectly with more depressive symptoms through LGBT-related victimization. Notably, earlier ages of self-identification and disclosure of a sexual minority identity were also directly related to less depressive symptoms. Few generational differences in relations between constructs emerged. Findings garner initial support for the developmental collision hypothesis and suggest that LGBT-related victimization, rather than earlier milestones themselves, increases mental health vulnerability.

Levels and outcomes of 12-step participation among sexual and gender minority subgroups

IntroductionSexual minority (e.g., bisexual, gay, lesbian, queer) and gender minority (e.g., transgender, non-binary, gender expansive) individuals (SGMI) experience higher rates of alcohol and other substance use disorders than their heterosexual and cisgender (i.e., non-transgender) counterparts. 12-Step programs are currently the most common source of support for alcohol and other substance use-related problems in the United States. Little is known about rates and levels of participation and outcomes of SGMI in 12-Step programs. Examining SGMI with a lifetime alcohol or other substance use disorder, this study aims to: 1) describe lifetime attendance rates (any vs. none) and levels of participation (number of program activities) in 12-Step groups among SGMI overall and compare rates of attendance and levels of participation across sexual and gender minority identities and 2) determine how lifetime level of participation in 12-Step programs relates to past-year alcohol and other substance use outcomes. MethodsWe used data collected through The PRIDE Study, a national, large-scale, longitudinal health study of adult SGMI, administering supplemental questions to assess alcohol and other substance use disorders and 12-step participation. Zero-Inflated Negative Binomial models (N = 1353) run with sexual and gender identities as predictors of lifetime 12-step attendance (yes/no) and level of 12-Step participation determine if greater levels of 12-Step participation were associated with lower levels of past-year Alcohol and Substance Use Disorder (AUD & SUD) symptoms. The study ran models for those with lifetime AUD (n = 1074) and SUD (n = 659) separately. ResultsParticipants who engaged in greater levels of 12-Step participation had lower levels of past-year AUD and SUD symptoms. Gay and queer respondents with AUD were more likely and lesbian respondents with SUD were less likely than other participants to have ever participated in 12-Step programs. All other associations between sexual/gender identities and 12-Step participation disappeared when age was added to the model. ConclusionsThis study provides preliminary evidence that 12-Step participation may be an effective resource for reducing AUD and SUD symptoms among SGMI. Younger SGMI and SGMI holding sexual/gender identities other than gay and queer may require additional support to initiate participation in 12-Step programs.

Mental health help-seeking willingness among U.S. college students: A resilience factor associated with many sexual minority identities

BackgroundFor populations with elevated mental health risks such as college students and minority groups, understanding openness to seeking professional help can inform ways to improve service engagement. This study explores help-seeking willingness among U.S. college students by sexual orientation. MethodsData were drawn from the 2021 National College Health Assessment (N = 64,079). The main outcome of interest was help-seeking willingness (i.e., reported openness to seeking professional mental health help when needed). A secondary outcome was help-seeking history (i.e., past mental health service utilization). Logistic regression analyses were conducted using R version 4.0.5. ResultsIncreased help-seeking willingness was detected among students with a help-seeking history, whether within the past 12 months (OR=7.40, 99%CI: 6.78–9.08) or beyond (OR=2.26, 99%CI: 2.11–2.42). Even after controlling for various covariates including help-seeking history, elevated odds of help-seeking willingness persisted for gay (AOR=2.01, 99%CI: 1.63–2.49), bisexual (AOR=1.35, 99%CI: 1.23–1.49), questioning (AOR=1.22, 99%CI: 1.04–1.45), pansexual (AOR=1.31, 99%CI: 1.06–1.63), and queer (AOR=1.78, 99%CI: 1.35–2.38), relative to heterosexual students. ConclusionsHelp-seeking willingness is a mental health resilience factor unique to several sexual minority groups. Examining what yields greater help-seeking willingness for these sexual minority student groups may inform interventions that enable all college students to seek help when they are in distress.