Sexual Minority Individuals Research Articles

Intersectionality and Adverse Childhood Experiences: Comparing Subgroups of Sex, Race/Ethnicity, and Sexual Orientation

This study investigated the intersectionality of adverse childhood experiences (ACEs) among subgroups of sex, race/ethnicity, and sexual orientation. Using data from the Behavioral Risk Factor Surveillance Survey across 34 states (N=116,712) from 2009 to 2018, authors stratified subgroups of sex (male/female), race/ethnicity (White/Hispanic/Black/multiracial/other), and sexual orientation (heterosexual/bisexual/gay) to investigate the number of ACEs across groups. Analyses were conducted in 2022. Stratification resulted in 30 distinct subgroups (e.g., bisexual Black females, straight multiracial males) with significant post hoc differences per group. Generally, those identifying as sexual minority individuals had the highest number of ACEs (the top 14 of 30 subgroups), whereas seven of the top ten subgroups were female. Surprisingly, no clear patterns emerged by race/ethnicity, although the two largest groups (straight White females and straight White males) were 27th and 28th of 30, respectively. Although studies have examined ACEs by individual demographic variables, less is known about the extent to which ACEs are present in stratified subgroups. Sexual minority subgroups (particularly female bisexual subgroups) trend toward a higher number of ACEs, whereas heterosexual subgroups (regardless of sex) comprised the lowest 6 groups with respect to ACEs. Implications include further examination of bisexual and female subgroups (including specific ACE domain investigations) to identify the vulnerable population.

Associations between the Self-Reported Likelihood of Receiving the COVID-19 Vaccine, Likelihood of Contracting COVID-19, Discrimination, and Anxiety/Depression by Sexual Orientation.

There is limited evolving literature on COVID-19 vaccine uptake and its barriers among sexual minority populations (lesbian, gay, bisexual, transgender, and queer [LGBTQ]), despite their increased COVID-19 risk factors. We assessed the differences in intention to receive the COVID-19 vaccine by self-reported likelihood of contracting COVID-19, anxiety/depression, discrimination frequency, social distancing stress, and sociodemographic factors across sexual orientation. An online national cross-sectional survey was conducted in the United States between 13 May 2021, and 9 January 2022, among adults aged ≥18 (n = 5404). Sexual minority individuals had a lower intention of receiving the COVID-19 vaccine (65.62%) than heterosexual individuals (67.56%). Disaggregation by sexual orientation, however, showed that gay participants had a higher intention of COVID-19 vaccination (80.41%) and lesbian (62.63%), bisexual (64.08%), and non-heterosexual, non-LGB sexual minority (56.34%) respondents had lower intentions of receiving the COVID-19 vaccine than heterosexual respondents. Sexual orientation significantly moderated the association between the perceived likelihood of receiving the COVID-19 vaccine and the self-reported likelihood of contracting COVID-19, anxiety/depression symptoms, and discrimination. Our findings further underline the importance of improving vaccination efforts and access among sexual minority individuals and other vulnerable groups.

Barriers to Mental Health Care Identified by Sexual and Gender Minority Individuals in Georgia and South Carolina.

Geographic location can affect access to appropriate, affirming mental health care for sexual and gender minority (SGM) individuals, especially for those living in rural settings. Minimal research has examined barriers to mental health care for SGM communities in the southeastern United States. The objective of this study was to identify and characterize perceived barriers to obtaining mental health care for SGM individuals living in an underserved geographic area. Drawing from a health needs survey of SGM communities in Georgia and South Carolina, 62 participants provided qualitative responses describing barriers they encountered to accessing mental health care when needed in the previous year. Four coders used a grounded theory approach to identify themes and summarize the data. Three themes of barriers to care emerged: personal resource barriers, personal intrinsic factors, and healthcare system barriers. Participants described barriers that can inhibit access to mental health care regardless of one's sexual orientation or gender identity, such as finances or lack of knowledge about services, but several of the identified barriers intersect with SGM-related stigma or may be magnified by participants' location in an underserved region of the southeastern United States. SGM individuals living in Georgia and South Carolina endorsed several barriers to receiving mental health services. Personal resource and intrinsic barriers were the most common, but healthcare system barriers were present as well. Some participants described simultaneously encountering multiple barriers, illustrating that these factors can interact in complex ways to affect SGM individuals' mental health help seeking.

"We don't have a template to follow": Sexual identity development and its facilitative factors among sexual minority men in the context of China.

Extant research on sexual identity development among sexual minority individuals has been predominantly conducted in Western contexts and focused on factors that hinder identity development processes. Using thematic analysis, this qualitative study sought to explore the experiences of sexual identity development among Chinese sexual minority men as well as the facilitative factors in China that positively influence this developmental process. The sample comprised 24 participants who self-identified as Chinese sexual minority men. The analysis yielded five overarching themes: awareness of one's attraction and corresponding reactions, identity exploration, moving toward identity acceptance and commitment, acceptance and support from others, and environmental support. The first three themes described the processes of sexual identity development among Chinese sexual minority men, whereas the latter two themes centered on the related facilitative factors in the context of China. The results highlight the importance of understanding the identity development process within Chinese minority men's unique sociocultural contexts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Shame Experiences And Psychopathology: The Mediating Role Of Self-compassion And Social Support In Sexual Minority Individuals

Sexual Minority (SM) individuals who are victims of stigma have reported higher levels of traumatic shame experiences and psychopathology symptoms (depression and social anxiety) when compared to heterosexual individuals. Self-compassion and social support have been described as protective factors. This study aimed to explore the mediating role of self-compassion and social support in the relationship between shame felt in traumatic experiences and psychopathology symptoms in a sample of SM individuals. The sample was composed of 264 adult SM individuals who reported traumatic shame experiences (56% men, 36% women, and 8% nonbinary). Correlations between variables were significant and ranged from very weak to moderate. Two models were performed, one for each dependent variable (depression and social anxiety symptoms). The mediating models revealed different results: compassionate actions was a significant mediator in the relationship of shame in traumatic experiences with depression symptoms and social anxiety symptoms, social support from friends had the same role on the prediction of depression, and social support from the family was a significant mediator on the prediction of social anxiety symptoms. These results suggest the importance of cultivating compassionate actions and promoting social support in intervention programs with SM individuals with early traumatic shame experiences, to target depression and social anxiety symptoms.

Prevalence of Substance Use Among Asian Sexual Minority Individuals in the United States, 2015-2020

ABSTRACT Asian sexual minorities (SMs) are an under-researched population. SMs are at higher risk for substance use problems than heterosexuals, but little research exists specifically on Asians who are SM. This study compared the prevalence of substance use among Asian SMs and among adults by race/ethnicity and sexual identity in the US. Data were analyzed from participants in the 2015–2020 National Survey on Drug Use and Health, a nationally representative cross-sectional survey of non-institutionalized adults. Controlling for demographic characteristics, logistic regression models were used to estimate odds of substance use 1) among Asian adults by sexual identity (N = 11,079) and 2) all adults by race/ethnicity and sexual minority status (N = 223,971). Among Asians, compared to heterosexuals, identifying as gay/lesbian was associated with higher odds of past-month use of marijuana. Bisexual Asians were at higher odds of engaging in past-year prescription opioid misuse and having past-year alcohol use disorder (AUD). Compared to White heterosexuals, Asian SMs were at lower odds for past-month binge drinking and cocaine use, but not for past-month marijuana use and past-year AUD, marijuana use disorder, and prescription opioid misuse. More research is needed to understand these disparities and address sexual identity’s role in substance use among Asians.

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

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

Eating disorders in sexual minority adolescents and young adults: examining clinical characteristics and psychiatric co-morbidities in an inpatient medical setting

BackgroundSexual minority adolescents and young adults are at higher risk of eating disorders compared to heterosexual peers. However, little is known about the clinical and psychiatric presentation of this population requiring inpatient medical stabilization. Given the increased risk for eating disorder behaviors in sexual minority individuals amidst increased rates of medical hospitalizations secondary to eating disorders, it is important to understand presenting characteristics of this population. The objectives of this study were to (1) describe the clinical characteristics of sexual minority adolescents and young adults with eating disorders admitted for medical instability and (2) compare psychiatric co-morbidities and suicidality of sexual minority adolescents and young adults to heterosexual peers.MethodsA retrospective chart review was conducted of 601 patients admitted to a large inpatient eating disorders medical stabilization unit between 2012 and 2020. Data collected included demographics, medical data including vital signs, and psychiatric characteristics. Chi square or t-tests were used to examine potential differences in clinical characteristics and psychiatric co-morbidities between groups. Modified Poisson regression was used to assess associations between sexual orientation and psychiatric co-morbidities.ResultsOver one fifth (21.1%, n = 103) of our inpatient sample identified as a sexual minority individual. The average age of participants was 15.6 years (2.7). Sexual minority adolescents and young adults had higher percent median body mass index compared to heterosexual peers and yet equally severe vital sign instability on admission. Sexual minority adolescents and young adults were almost 1.5 times more likely to have a psychiatric comorbidity with higher rates of depression, anxiety, and post-traumatic stress disorder. Sexual minority adolescents and young adults were approximately two times more likely to have a history of self-injurious behaviors and/or suicidality.ConclusionsSexual minority adolescents and young adults with eating disorders have equally severe vital sign instability despite higher percent median body mass index on admission for medical stabilization. Sexual minority adolescents and young adults hospitalized for medical complications of eating disorders are far more likely to have an additional mental health disorder and a history of self-harm and/or suicidality, which may portend a less favorable long-term prognosis.

Abstract P190: Social Determinants of Cardiovascular Health in Sexual Minority Adults: A Systematic Review

Introduction: Sexual minority (e.g., lesbian, gay, bisexual, queer) adults appear to be at higher risk of cardiovascular disease (CVD) than heterosexual adults. Although social determinants of health have been shown to contribute to cardiovascular health (CVH) disparities in the general population, there is a dearth of research examining these determinants in sexual minority adults. Objective: Using the World Health Organization’s definition of social determinants of health, we conducted a systematic literature review to synthesize and critique existing evidence on social determinants of CVH among sexual minority adults. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and performed a comprehensive search of literature published between January 2011 and March 2022. Studies were included if they were peer-reviewed, English-language, and examined associations between social determinants of health and CVH outcomes among sexual minority individuals 18 years old or older. CVH outcomes were CVD risk factors (including diabetes, hypertension, hyperlipidemia, and obesity) and CVD conditions (such as stroke, heart attack, and coronary artery disease). We performed quality appraisal using the Joanna Briggs Institute Critical Appraisal Checklists for Analytical Cross-Sectional Studies and Cohort Studies. Results: Our search retrieved 2,133 studies, of which 18 met the inclusion criteria. Of these, 16 were cross-sectional and two used longitudinal designs. All 18 studies had a low risk of bias. The majority (n = 17) included predominantly White samples. Overall, the findings were mixed. Stressful life events were associated with elevated CVD risk. Individuals who reported living in more supportive environments had lower odds of being overweight; however, greater disclosure of sexual minority status was associated with higher odds of being overweight. Living in rural settings was associated with higher odds of obesity and hypertension. Experiences of discrimination were not associated with any CVH outcomes. Findings for interpersonal trauma (e.g., adulthood trauma, childhood trauma), education, religious activity, and relationship status were mixed. No studies examined social determinants at the structural level. Conclusions/Implications: Findings highlight social determinants that may serve as targets of clinical and public health interventions to improve the CVH of sexual minority adults. Future longitudinal research is needed that includes more diverse samples and examines multi-level social determinants of CVH, including at the social and structural levels.

Social Anxiety Across Sexual and Gender Identity Subpopulations

Recent research indicates that gay/lesbian identified sexual minority individuals report lower social anxiety than their counterparts who identify as bisexual or indicate an emerging identity label (e.g., queer, pansexual, or asexual). The current study advances the knowledge base by comparing levels of social anxiety across both sexualandgender identity subpopulations in a sexual minority sample residing in the Republic of Ireland. Six hundred two sexual minority adults participated in an online survey in which they completed measures of sociodemographic variables (including sexual and gender identity) and social anxiety. Across gender identity subpopulations, transgender/non-binary individuals were more likely to report elevated social anxiety symptoms than both cisgender men and cisgender women; further, cisgender women were more likely to report elevated social anxiety symptoms than cisgender men. Within each of these gender identity groups, there was no significant difference in odds of elevated social anxiety symptoms across sexual identity subgroups (gay/lesbian, bisexual, and emerging identity) when adjusted for sociodemographic variables. Results highlight the necessity to represent the mental health experiences of diverse sexual minority subpopulations, especially in population-based studies of sexual minority mental health. Additionally, future studies should aim to explore the potentially distinctive and complex social stressors encountered by the diverse groups within the sexual and gender minority population.

Associations between body image patterns and body image-related pathology in sexual minority individuals: A mixture-modeling approach

Body image concerns are associated with disordered eating, body dysmorphic disorder (BDD), and illicit appearance and performance enhancing drug (APED) misuse. Sexual minority individuals are a vulnerable population for body image concerns. Latent profile analyses were used to identify body image patterns in sexual minority men (n = 479) and women (n = 483) and to investigate associations between latent profiles and body image-related pathology. A 5-profile solution demonstrated best fit for men and a 4-profile solution for women. Among women, co-occurring high thinness/muscularity concerns had higher probability of vomiting and dietary restriction than the high thinness/low muscularity concerns profile. The probability of driven exercise did not differ across latent profiles for men and only differed between low thinness/low muscularity and high thinness/high muscularity concerns profiles in women. Men with low thinness/high muscularity concerns had significantly lower probability of vomiting and laxative misuse than all other profiles but did not significantly differ from co-occurring high or moderate thinness/muscularity concerns profiles in binge eating and illicit APED misuse. This study may have implications for future research, treatment, and prevention of body image-related pathology in sexual minority individuals.

The Mediating Role of Insecure Attachment in the Gap in Parenthood Desire between Lesbian and Gay Individuals and Their Heterosexual Counterparts

Previous studies have shown that lesbian and gay (LG) individuals, in comparison to their heterosexual counterparts, tend to report lower levels of parenthood desire. While numerous variables have been suggested to explain this gap in parenthood aspirations, no study has investigated the mediating role of avoidant attachment in the association between sexual orientation and parenthood desire. For that purpose, a sample of 790 cisgender Israelis aged 18-49 years (M = 28.27, SD = 4.76) was recruited using convenience sampling. Among the participants, 345 self-reported as predominantly or exclusively lesbian or gay and 445 self-reported as exclusively heterosexual. Participants completed online questionnaires assessing their sociodemographic characteristics, parenthood desire, and avoidant and anxious attachment styles. Mediation analyses were performed using the PROCESS macro, and the results revealed that LG individuals reported lower parenthood desire, higher avoidant attachment, and higher anxious attachment compared to heterosexual individuals. Moreover, avoidant attachment had a significant mediation effect in the association between sexual orientation and parenthood desire. The findings suggest that LG individuals are more likely to report higher avoidant attachment due to possible rejection and discrimination from family members and peers, and this may be associated with lower parenthood desire. The results contribute to the growing body of research on family formation and parenthood aspirations among LG individuals, and specifically studies aimed at delineating the factors that contribute to the gap in parenthood aspirations between sexual minority individuals and their heterosexual counterparts.

Mental Health Disparities Between Lesbian Mothers and Heterosexual Parents: the Mediating Role of Positivity.

Previous evidence has shown better mental health outcomes for lesbian mothers, in comparison with heterosexual parents. The present study explored the mediating role of positivity (i.e., the tendency to view life with a positive outlook) in determining these mental health differences. Seventy-two Israeli lesbian mothers by donor insemination (from 36 families) were compared with 72 Israeli heterosexual parents by assisted reproduction (without donated gametes; from 36 families) on positivity, life satisfaction, and depressive symptomatology. All parents were cisgender and had at least one child born through assisted reproduction, aged 3-10years. Data were collected between December 2019 and February 2021. Mediational analyses indicated that lesbian mothers reported greater positivity, which was, in turn, associated with greater life satisfaction and less depressive symptomatology. The results pinpoint the possible protective and strengthening role of positivity for lesbian mothers in the pronatalist and familistic environment of Israel. The research contributes to the literature on the mental health of parents with diverse sexual orientations living outside of the USA and Europe. Policy Implications Policymakers and mental health professional should be knowledgeable about the importance of improving positivity as a strategy for reducing depressive symptomatology and promoting life satisfaction among lesbian mothers. Moreover, policy makers and legislators are called to ease the access of sexual minority individuals to parenthood, as in this population parenthood associates with heightened mental health outcomes.

Sexual Identity Differences in Tobacco (Re)Uptake: Testing Mediation by Internalizing and Externalizing Symptoms

Tobacco use among gay, lesbian, and bisexual individuals is disproportionately higher than among heterosexual individuals. Identifying the mechanisms behind these differences can inform prevention and cessation efforts aimed at advancing health equity. Internalizing and externalizing symptoms as mediators of tobacco (re)uptake among sexual minority individuals was examined. Waves 4 and 5 of the Population Assessment of Tobacco and Health (2016-2019) study were analyzed in 2022. Adolescents aged ≥14 and adults years not using tobacco at Wave 4 (n=21,676) were included. Wave 4 sexual identity was categorized as heterosexual, gay/lesbian, bisexual, or something else. Associations of sexual identity with (re)uptake of cigarette use, E-cigarette use, and polytobacco use at Wave 5 were assessed, along with possible mediation of these associations by Wave 4‒internalizing and ‒externalizing symptoms. Internalizing and externalizing symptoms predicted tobacco (re)uptake regardless of sexual identity, particularly for female individuals. Gay/lesbian females (AOR=2.26; 95% CI=1.14, 4.48) and bisexual females (AOR=1.36; 95% CI=1.06, 1.74) had greater odds of E-cigarette (re)uptake than heterosexual females. High internalizing and externalizing symptoms accounted for over one third of the difference in E-cigarette (re)uptake among bisexual compared with that among heterosexual females. Males who reported sexual identity as something-else had lower odds of cigarette (re)uptake than heterosexual males (AOR=0.19; 95% CI=0.06, 0.66); this association was not mediated by internalizing and externalizing symptoms. Internalizing and externalizing symptoms uniquely contribute to E-cigarette (re)uptake among bisexual females. Strategies that reduce sexual minority stressors and resulting psychological distress may help to reduce tobacco use disparities.

Lesbian, gay, bisexual, transgender and or queer patient experiences in Canadian primary care and emergency departments: a literature review

This literature review synthesises existing evidence and offers a thematic analysis of primary care and emergency department experiences of lesbian, gay, bisexual, transgender, queer and/or any other sexual or gender minority (LGBTQ+) individuals in Canada. Articles detailing first-person primary or emergency care experiences of LGBTQ + patients were included from EMBASE, MEDLINE, PsycINFO and CINHAL. Studies published before 2011, focused on the COVID-19 pandemic, unavailable in English, non-Canadian, specific to other healthcare settings, and/or only discussing healthcare provider experiences were excluded. Critical appraisal was performed following title/abstract screening and full-text review by three reviewers. Of sixteen articles, half were classified as general LGBTQ + experiences and half as trans-specific experiences. Three overarching themes were identified: discomfort/disclosure concerns, lack of positive space signalling, and lack of healthcare provider knowledge. Heteronormative assumptions were a key theme among general LGBTQ + experiences. Trans-specific themes included barriers to accessing care, the need for self-advocacy, care avoidance, and disrespectful communication. Only one study reported positive interactions. LGBTQ + patients continue to have negative experiences within Canadian primary and emergency care – at the provider level and due to system constraints. Increasing culturally competent care, healthcare provider knowledge, positive space signals, and decreasing barriers to care can improve LGBTQ + experiences.

Sexual orientation and cannabis outcomes among Black Individuals: The role of cannabis use motives

Sexual minority individuals report greater cannabis use and cannabis use related problems relative to straight individuals. Although sociocultural models suggest that sexual minority individuals may be especially vulnerable to using cannabis for high-risk motives such as coping motives, little attention has been paid to the role of cannabis use motives among sexual minority relative to straight individuals. Thus, the current study examined the role of cannabis use motives and cannabis-related problems among Black sexual minority and straight individuals that reported current (past 3-month) cannabis use (N = 137, 28.5 % of whom identify as sexual minority). Sexual minority participants endorsed more frequent cannabis use, and social, coping, enhancement, and expansion motives than straight participants. Conformity motives were not significantly related to sexual minority status. Multiple mediation model with all relevant motives included as putative mediators indicated that sexual minority status was related to cannabis problems indirectly via the effects of coping and expansion motives. Alternative models strengthen confidence in the directionality of these effects, although future prospective research will be an important next step. Findings may help inform treatment efforts among sexual minority individuals to reduce risk of negative cannabis outcomes.

An exploratory study of the coming out road drawing: A novel growth promoting intervention for sexual and gender minority individuals

Despite the shift in acceptance of sexual and gender minority (SGM) individuals in the United States, heterosexism continues to endure, including a recent swathe of legislative attempts to restrict LGBTQ+ rights. The experience of heterosexism, and resultant minority stress, places SGM individuals at greater risk for negative mental health outcomes, demanding a need for culturally responsive therapeutic interventions. The use of Hanes’ (1995) road drawing, modified as a directive to depict one’s coming out story, was examined as such an intervention. We hypothesized that participants would experience a significant increase in positive affect and decrease in negative affect after they created a road drawing of their coming out story. While findings reflected a trend for an increase in positive affect following the art making directive, t(39) = 1.92, p = .062, statistical significance was only found for those who experienced themselves to be “more out,” t(31) = 2.74, p = .01. No significance was observed for negative affect. Findings support the coming out road drawing as a growth promoting intervention. Examples of participant artwork are provided to highlight the narrative and symbolic quality of the coming out road drawing. Application and direction for future research are discussed.

LGBTQ+ Perspective in Hand Surgery: Surgeon and Patient.

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+)individuals and patients face high levels of discrimination both in the workplace and in the clinic setting, with more than 25% of LGBTQ+people experiencing discrimination in the workplace due to their sexual orientation. Hand Surgery stands to continue to advance by encouraging the brightest students into the field no matter their background. LGBTQ+patients also have specific needs within the field of Hand Surgery, where we are uniquely positioned to treat them or guide them by being well versed in the needs of the community.

Estimated likelihood of parenthood among sexual minority individuals associates with interpersonal vulnerability and traumatic outlook

ABSTRACT Background Lesbian women and gay men (LG) tend to report lower levels of parenthood aspiration than their heterosexual counterparts. While several variables have been suggested to explain this phenomenon, no study has investigated the potential mediating role of interpersonal vulnerability and subjective traumatic outlook in the association between sexual orientation and the estimated likelihood of parenthood. Objective To investigate whether interpersonal vulnerability and subjective traumatic outlook mediate the association between sexual orientation and a lower estimated likelihood of parenthood. Methods A sample of 435 childfree, cisgender Israeli participants, aged 18–49 years (M = 27.82, SD = 4.47), were recruited through convenience sampling. 192 participants self-reported as LG (64 lesbian women and 128 gay men). Participants completed online questionnaires assessing their estimated likelihood of parenthood, interpersonal vulnerability, and subjective traumatic outlook. Mediation analyses were performed using the PROCESS macro. Results LG individuals reported a lower estimated likelihood of parenthood than their heterosexual counterparts. Interpersonal vulnerability and subjective traumatic outlook significantly mediated the association between sexual orientation and a lower estimated likelihood of parenthood. Conclusions Despite improvement in the socio-political climate relating to sexual minority rights and access to fertility technologies, LG individuals are still more likely to report a lower estimated likelihood of parenthood in comparison to heterosexual individuals. Moreover, this gap appears to be partially mediated by interpersonal vulnerability and subjective traumatic outlook. The results contribute to the growing body of international research exploring family formation among sexual minority individuals and are relevant for researchers, clinicians, and policymakers.

Queer in the Latter Days: An Integrated Model of Sexual and Religious Identity Development Among Former Mormon Sexual Minority Adults

ABSTRACT Sexual minority individuals often have complicated relationships with conservative religion, including conflicts between their sexual and religious identities. Sexual minority members of the Church of Jesus Christ of Latter-Day Saints (CJCLDS) experience unique struggles, given the policies and doctrine of the CJCLDS and its commitment to heteronormative family structures and gender roles. A better understanding of the identity development trajectory for sexual minority individuals formerly involved in the church can deepens our understanding of sexual identity development in constrained contexts and help promote successful identity integration within this subpopulation. Transcripts from semi-structured interviews with thirty-four sexual minority individuals who identified as former members of the CJCLDS were analyzed using an inductive thematic approach, followed by a deductive theory-building process in which Cass’s Homosexual Identity Formation Model and Genia’s Religious Identity Development Model were overlaid on themes. We present a model that captures the trajectory of sexual and religious identity development that captures the experiences of sexual minority adults within the constraints of the CJCLDS, a non-affirming religious denomination.