Structural Stigma and Disparities in Long-Term Health Conditions Among Australians in Same-Sex Relationships: 2021 Australian Census

Objectives.  To explore the extent to which structural stigma (sociocultural and institutional constraining factors) is associated with sexual orientation disparities in long-term health conditions. Methods.  We measured structural stigma using the regional percentage of votes against same-sex marriage from Australia's 2017 Marriage Equality Survey and mapped this to the 2021 Census survey of 10 093 399 and 136 988 individuals in different-sex and same-sex relationships, respectively. Controlling for individual and area-level confounders, we used logistic regression analyses to examine the association between quartiles of structural stigma and sexual orientation disparities in long-term health conditions (e.g., any, mental health, asthma, cardiovascular). Results.  In the lowest stigma quartile, individuals in same-sex relationships had 56% higher odds of reporting any long-term health condition (odds ratio [OR] = 1.56; 95% confidence interval [CI] = 1.53, 1.59) and this increased to 63% in the highest stigma quartile (OR = 1.63; 95% CI = 1.58, 1.68). Effects were particularly pronounced for cardiovascular, respiratory, and mental health conditions as well as for men, younger populations, and those living in socioeconomically deprived regions. Conclusions.  Living in stigmatizing environments may have deleterious health effects for sexual minorities in Australia. Policy action and enhanced protections for sexual minorities are urgently required. (Am J Public Health. 2024;114(10):1110-1122. https://doi.org/10.2105/AJPH.2024.307759).

The Promise of Double Living. Understanding Young People with Same-Sex Desires in Contemporary Kampala

Ugandan urban same-sex desiring individuals frequently encounter and navigate competing understandings of sexuality and sexual identity. Western essentialist understanding of sexual identity introduced by international development partners and transnational LGBT+ (Lesbian, Gay, Bi- and Transsexual) activism, as well as media, offer an alternative to Ugandan non-essentialist and fluid subject positions. This article seeks to understand how young individuals with same-sex -desires in Kampala navigate tensions between Western and local understandings concerning sexuality. We have interviewed 24 young individuals with same-sex desires (unaffiliated and individuals working in LGBT+ organizations) and asked how they approach their sexuality and experiences living with same-sex desires in contemporary Kampala. The results reveal how interview participants engaged in a complex navigation between local community expectations, their own same-sex desires, and embeddedness in a global LGBT+ culture. Although the participants engaged in what Westerners would label as a "double life," the article problematizes the prescriptive norms of authenticity and "coming out." The conclusion is that the fluid vs essentialist dichotomy is too simplistic to be helpful when trying to understand the lives and aspirations of young people with same-sex desires.

Divergence in Chinese Sexual Attitudes: An Age-Period-Cohort Analysis

A crucial component of comprehending societal change is understanding how sexual attitudes have evolved over time. The substantial and typical changes in China have created an ideal quasi-experimental design and a wealth of empirical data for tracking the evolution of sexual attitudes. However, existing research has failed to adequately analyze the temporal trends in Chinese sexual attitudes. This study employed an age-period-cohort framework to investigate changes in public sexual attitudes, including premarital sex, extramarital sex, and homosexuality. And it further delved into these attitudes in light of two unique aspects of Chinese society: urban-rural divide and political status. It explored the contributing elements and potential processes of changing public sexual attitudes in China using data from seven waves of national social survey conducted from 2010 to 2021. The findings indicated that public sexual attitudes became more conservative with age; the period effect exhibited a fluctuating upward trend, indicating a general increase in acceptance of the three sexual attitudes; notable differences in sexual attitudes among cohorts were identified. The divergence in sexual attitudes was significantly influenced by urban-rural divide and political status.

Sexual Attraction and Non-Suicidal Self-Harm: The Role of Stressors and Psychological Mediators

Non-suicidal self-harm (NSSH) is a serious concern for the well-being of youth. Stressors relate to greater NSSH risk, such as being non-heterosexual in a heteronormative society. Other stressors may include traumatic experiences. These relationships may be mediated by psychological factors (depressed mood, anxiety, anger, and self-esteem) as well as contextual factors (support from parents and peers). The purpose of this study was to examine NSHH ideation and behavior among Icelandic youth, as well as relationships with stressors and mediators. Students in Icelandic high schools (N = 8921, 50.8% female) completed an in-class survey in the year 2016. Results showed an elevated risk of NSSH ideation and behavior among bisexual and homosexual youth. Mediation analyses showed that, for girls, being bisexual related to greater NSSH ideation and behavior, and these relationships were mediated by depressed mood, anger, and self-esteem, as well as by support from parents and peers. For boys, however, both homosexual and bisexual attraction related to greater risk for NSSH ideation and behavior, which was mediated by depressed mood, anger, and self-esteem. These results suggest that NSSH risk factors vary by gender and, therefore, they may benefit from different interventions to stop and prevent this behavior. This is the first study of its kind in Iceland, where sexual minority stress may need further study within the Nordic context.

The Third Backdoor: How the DSM Casebooks Pathologized Homosexuality

This study argues that institutional psychiatry's pathologizing stance on homosexuality persisted after 1973, when the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. It persisted not only through the well-known diagnoses of "ego-dystonic homosexuality" and "gender identity disorder of childhood," but also through case studies published in four editions of the DSM Casebooks (1981, 1989, 1994, 2002), the APA publications advertised as a "learning companion to the Diagnostic and Statistical Manual." These publications contained harmful and false homosexual stereotypes, associating gay men with child abuse, violence, and sexual sadism; associating homosexuality with mental disturbance while failing to similarly mark heterosexuality or bisexuality; associating psychopathology with gay social contexts while failing to similarly mark non-gay social contexts. This study provides evidence that the DSM Casebooks portrayed homosexual women and bisexuals as invisible, and homosexual men as narcissistic, predatory, and dangerous.

Gender Identity in the Contemporary Age: It Is Often a Suffered Conquest

Gender identity is strictly connected to biological sex, but it is not determined by it. The sex-gender distinction made it possible to challenge biological determinism, which had historically claimed to provide a scientific foundation for gender differences. Gender does not have a biological origin, but a sociocultural one; it is the centennial conditioning that has determined gender differences, making them perceive as natural rather than culturally learned dispositions. In the last few years homosexuality, and the various characteristics that distinguish it, is becoming an increasingly visible and relevant reality both in sociocultural and the scientific fields, also and above all within clinical psychology and mental health.

Queering the (Ab)Normalization of Gender, (Hetero)Sexuality and Schooling in South Africa

Schools are places where youth do work on the construction of their sexual identities which is intimately connected with issues around gender. Using one-on-one in-depth interviews, this article addresses how queer youth navigate dominant understandings of gender and sexuality in the context of their identity and practice. Cognizant of how gender remains a significant force in organizing social relations in schools, the youth parody and abnormalize heteronormativity calling into question the fragility of hegemonic heterosexuality. Moreover, the findings demonstrate that despite evidence that associates schooling with social exclusion, the queer youth's accounts highlight, strikingly, that queer identity and inclusion are not necessarily separate storylines. Offering an alternative view of the schooling experiences of queer youth, the paper motivates that within exclusion, in a matter of speaking with all its unduly assemblages, is inclusion.

Queer Students, International Service-Learning, and Inclusivity: Insights into Identity, Activism, and Learning

This qualitative study examines the experiences of LGBTQ students involved in international service-learning, exploring the possibilities, positive impacts, and complexities of navigating LGBTQ identities while participating in international service-learning. Analysis of their experiences yielded three themes that played an important role shaping their experiences: balancing their stance as learners and as activists, viewing their LGBTQ identities as assets as well as objects of structural barriers, and navigating language to make sense of their context and make themselves understood. These findings have implications for how universities and community partners prepare, train, and support students before, during and after their experiences abroad.

Protester, Partygoer, or Simply Playing It Down? The Impact of Crowd Affiliations on LGBT Emerging Adults' Socioemotional and Academic Adjustment to College

Although peer crowd affiliations have been studied among emerging adults in college, this work has yet to focus in on LGBT-identifying students. Accordingly, the current study a) surveyed the peer crowd landscape using a sample of 234 LGBT students (M_age = 19.89, SD = 1.55; 70.51% female, 18.38% male, 11.11% other) at a small, private, liberal arts college in Southern California, and b) explored the relationships between self-reported peer crowd affiliations and LGBT students' adjustment (i.e., loneliness, belongingness, and academic-, alcohol-, drug-, and sex-risk behaviors). Results point to the existence of four underlying peer crowd dimensions among LGBT students: protester, nonvocal, social, and athletic. Furthermore, affiliation with these peer crowds was found to relate to students' self-reported loneliness and academic-, drug-, and sex-risk behaviors.

Meta-Analyses of Fraternal and Sororal Birth Order Effects in Homosexual Pedophiles, Hebephiles, and Teleiophiles

This study investigated the relations between numbers of older brothers, numbers of older sisters, and the odds of homosexuality in later-born males, including males who are most attracted sexually to prepubescent or early pubescent children (pedohebephiles) and males who are most attracted sexually to adults (teleiophiles). The authors meta-analyzed data from 24 samples of homosexual and heterosexual men, originally reported in 18 studies, and totaling 18,213 subjects. The results confirmed that older brothers increase the odds of same-sex preference in pedohebephiles as they do in teleiophiles. They also replicated the recent finding that older sisters have a similar but weaker statistical association with the odds of homosexuality. These findings have two theoretical implications. First, the findings for older brothers and older sisters indicate some commonality in the factors that influence sexual preference in teleiophiles and those that influence sexual preference in pedohebephiles. Second, the finding for older sisters confirms a prediction stemming from the hypothesis that male fetuses stimulate maternal antibodies that increase the odds of homosexuality in later-born males. Such immunization could result from miscarried as well as full-term fetuses, and number of older sisters should correlate with number of male fetuses miscarried before gestation of the subject.

Sexual minority status, social adversity and risk for psychotic disorders-results from the GROUP study

BACKGROUND

Lesbian, bisexual, or gay individuals (LBGs) have an increased risk for mental health problems compared to heterosexuals, but this association has sparsely been investigated for psychotic disorders. The aim of this study was: (1) to examine whether LBG sexual orientation is more prevalent in individuals with a non-affective psychotic disorder (NAPD) than in people without a psychotic disorder; and if so, (2) to explore possible mediating pathways.

METHODS

Sexual orientation was assessed in the 6-year follow-up assessment of the Dutch Genetic Risk and Outcome of Psychosis study (GROUP), a case-control study with 1547 participants (582 patients with psychotic disorder, 604 siblings, and 361 controls). Binary logistic regression analyses were used to calculate the risk of patients with a psychotic disorder being LBG, compared to siblings and controls. Perceived discrimination, history of bullying, childhood trauma (CT), and sexual identity disclosure were investigated as potential mediating variables.

RESULTS

The proportion of individuals with LBG orientation was 6.8% in patients (n = 40), 4.3% in siblings (n = 26), and 2.5% in controls (n = 10). The age- and gender-adjusted odds ratio of LBG for patients was 1.57 (95% CI 1.08-2.27; p = 0.019), compared to siblings and controls. Discrimination, bullying, and CT all partially mediated this association.

CONCLUSIONS

Adverse social experiences related to sexual minority status may increase the risk for NAPD. Sexual identity, behavior, and difficulties need more attention in everyday clinical practice.

Heteronormativity in the Lives of Lesbian, Gay, Bisexual, and Queer Young People

Heteronormativity, as defined in queer theory, is the presumption and privileging of heterosexuality. Research on how young people make sense of and narrate heteronormativity in their own lives is needed to inform theories of heteronormativity. Using queer and intersectional frameworks, we conducted semi-structured interviews with 14 sexual and gender minority young people (ages 18 to 24), analyzed using thematic analysis, to examine how young adults make sense of heteronormativity. Participants discussed how gender expression informed both sexuality and sexual attraction. Participants prioritized biological parenthood over other family constructions but rarely discussed marriage. Gender, sexuality, and race contributed important contexts for how participants described heteronormativity in their lives and should be the focus of future research. Finally, binaries of gender, sexuality, and family intersected in participants' lives and their narrative constructions.

The Mediating Role of Attachment Avoidance in the Association between Sexual Orientation and Mental Health

The current study examined whether attachment avoidance mediates the association between being a sexual minority (gay men or lesbian women) and poorer mental health outcomes. For this purpose a community-dwelling sample of 350 gay men and lesbian women (M = 30.39, SD = 6.82) and 445 heterosexual men and women (M = 26.95, SD = 3.11) completed measures of attachment avoidance, depressive symptoms, anxiety symptoms and life satisfaction. Results showed that gay men and lesbians reported poorer mental health. Moreover, attachment avoidance had a mediating effect on the association between being a sexual minority and depressive symptoms, anxiety symptoms and life satisfaction. These findings are some of the first to suggest empirical support for the role of attachment avoidance in accounting for the mental health vulnerability of gay men and lesbians. The results contribute to a better understanding of the minority stress model and should be addressed by practitioners.

Same-Sex Sexuality and the Risk of Divorce: Findings from Two National Studies

Despite symbolic linkages between heterosexuality and marriage, and a pervasive heteronormative ideology of romantic love, little population-representative research examines whether same-sex sexuality - desire/attraction, behavior, and gay, lesbian, or bisexual identity - increases the likelihood of divorce from an different-sex spouse. We examine this association using data from the 1992 National Health and Social Life Survey and the 2011-2013 National Survey of Family Growth. In both sub-studies, multivariate logistic regression analyses indicate that same-sex sexuality reduces the odds of ever marrying. However, among the once-married, same-sex desire/attraction, sexual behavior, and gay, lesbian, or bisexual identity respectively increase the odds of different-sex divorce net of demographic and early-life factors. Same-sex sexuality puts a brake on divorce by preventing some different-sex marriages that would ultimately end in divorce, but is associated with an increase risk of different-sex divorce among once-married individuals.

Smoking and Quitting Behavior by Sexual Orientation: A Cross-Sectional Survey of Adults in England

OBJECTIVE

To assess associations between sexual orientation and smoking and quitting behavior among adults in England.

METHODS

Data were collected from 112 537 adults (≥16 years) participating in a nationally representative monthly cross-sectional survey between July 2013 and February 2019. Sexual orientation was self-reported as heterosexual, bisexual, lesbian/gay, or prefer-not-to-say. Main outcomes were smoking status, e-cigarette use, cigarettes per day, time to first cigarette, motivation to stop smoking, motives for quitting, use of cessation support, and past-year quit attempts. Associations were analyzed separately for men and women using multivariable regression models adjusted for relevant covariates.

RESULTS

Smoking prevalence is now similar between gay (21.6%), prefer-not-to-say (20.5%) and heterosexual men (20.0%), and lesbian (18.3%) and heterosexual women (16.9%), but remains higher among bisexual men (28.2%, adjusted odds ratio [ORadj] = 1.41, 95% confidence interval [CI] = 1.11 to 1.79) and bisexual women (29.8%, ORadj = 1.64, 95% CI = 1.33 to 2.03) and lower among prefer-not-to-say women (14.5%, ORadj = 0.85, 95% CI = 0.72 to 0.99). Among smokers, bisexuals were less addicted than heterosexuals, with bisexual men smoking fewer cigarettes per day (Badj = -2.41, 95% CI = -4.06 to -0.75) and bisexual women less likely to start smoking within 30 min of waking (ORadj = 0.66, 95% CI = 0.45 to 0.95) than heterosexuals. However, motivation to stop smoking and quit attempts did not differ significantly.

CONCLUSIONS

In England, differences in smoking prevalence among people with different sexual orientations have narrowed, primarily driven by a larger decline in smoking rates among sexual minority groups than heterosexuals. Bisexual men and women remain more likely to smoke but have lower levels of addiction while being no less likely to try to quit.

IMPLICATIONS

This population-based study provides an up-to-date picture of smoking and quitting behavior in relation to sexual orientation among adults in England. Findings suggest that widely documented disparities in smoking prevalence have narrowed over recent years, with gay men and lesbian women no longer significantly more likely to smoke than heterosexuals, although smoking remains more common among bisexual men and women. Insights into differences in level of addiction, use of cessation support, and motives for quitting may help inform the development of targeted interventions to further reduce smoking among sexual minority groups.

Association between Discrimination and Depressive Symptoms Among 2,162 Lesbian, Gay, and Bisexual Adults in South Korea: Does Community Connectedness Modify the Association?

This study investigated the association between perceived discrimination and depressive symptoms among Korean lesbian, gay, and bisexual (LGB) individuals and explored the role of community connectedness in that association. We analyzed a nationwide cross-sectional survey of 2,162 LGB adults in Korea. Discrimination based on its types, including sexual orientation, over the past 12 months was classified into four categories: (1) 'never experienced discrimination,' experienced (2) 'only sexual orientation discrimination,' (3) 'any of the other types of discrimination,' and (4) 'both sexual orientation discrimination and any of the other types of discrimination.' Our findings suggest that there was a statistically significant association between 'only sexual orientation discrimination' and depressive symptoms among LGB individuals with a low-level of community connectedness, but not among those with a high-level. In the other two categories of discrimination, which included the other types of discrimination, the associations were statistically significant, regardless of the level of community connectedness.

Association of Coming Out as Lesbian, Gay, and Bisexual+ and Risk of Cigarette Smoking in a Nationally Representative Sample of Youth and Young Adults

Importance

Coming out as lesbian, gay, bisexual, or other identities besides heterosexual (LGB+) may represent a susceptible period for cigarette smoking initiation in youth and young adults.

Objective

To assess whether young people who change their sexual identity have higher risk of cigarette smoking initiation and current smoking compared with those with consistent sexual identities.

Design, Setting, and Participants

This cohort study used data from the nationally representative Population Assessment of Tobacco and Health study (wave 1, 2013-2014; wave 2, 2014-2015; wave 3, 2015-2016; wave 4, 2016-2018). Youth and young adults aged 14 to 29 years who were never smokers at wave 1 were included in this study. Analysis began October 2018 and ended June 2020.

Exposures

Consistent sexual identity (consistently heterosexual, consistently LGB+) vs changing sexual identity (coming out as LGB+, other LGB+ patterns) based on 4 waves of sexual identity data. Identities were further classified by distinguishing between bisexual and lesbian, gay, and other nonheterosexual identities.

Main Outcomes and Measures

Smoking initiation and current cigarette smoking at wave 4.

Results

Among 7843 individuals who never smoked at wave 1, 6991 (90.7%) reported a consistent sexual identity, and 852 (9.3%) changed sexual identity across waves. The mean (SE) baseline age of participants who reported consistent heterosexuality was 20.1 (0.8) years; consistently LGB+, 20.0 (3.7) years; coming out as LGB+, 18.0 (2.9) years, and other LGB+ pattern, 20.3 (3.8) years. A total of 14.1% (weighted) initiated smoking, and 6.3% were current smokers at wave 4. Compared with consistently heterosexual identities, coming out as LGB+ (23% vs 13%; odds ratio [OR], 1.72; 95% CI, 1.34-2.20), consistently LGB+ identities (17% vs 13%; OR, 1.45; 95% CI, 1.03-2.04), and other LGB+ patterns (17% vs 13%; OR, 1.47; 95% CI, 1.04-2.08) were positively associated with smoking initiation by wave 4. Compared with consistently heterosexual identities, ORs for smoking initiation were 2.24 (28% vs 13%; 95% CI, 1.72-2.92) for coming out as bisexual, 1.99 (23% vs 13%; 95% CI, 1.20-3.29) for consistently LGB+ with change to/from bisexual, and 2.20 (23% vs 13%; 95% CI, 1.40-3.46) for other LGB+ patterns with change to/from bisexual identity. Current smoking estimates were similar to those for smoking initiation.

Conclusions and Relevance

Compared with consistently heterosexual identities, changing sexual identity over follow-up was associated with smoking initiation and current smoking. The risk associated with changing sexual identities was concentrated among participants coming out as bisexual or reporting other changes in their identity to/from being bisexual. More research is needed on mechanisms underlying the association between changing sexual identity and smoking initiation to inform tailored prevention programs and tobacco regulations.

Correlates and Predictors of Sexual Satisfaction for Older Adults in Same-Sex Relationships

Study explored correlates and predictors of sexual satisfaction among older adults in same-sex relationships by examining internalized homophobia, resilience, sexual communication, and relationship satisfaction. Online survey elicited 265 participants (54% female, 46% male), aged 60-75, in same-sex relationships from 1 to 47 years. Participants reported high levels of relationship satisfaction and resilience, moderate levels of sexual communication and sexual satisfaction, and low levels of internalized homophobia. Stepwise multiple regression analysis indicated relationship satisfaction contributed uniquely to the prediction of sexual satisfaction. Relationship satisfaction was positively correlated with sexual satisfaction and resilience and negatively correlated with internalized homophobia. Internalized homophobia was also negatively correlated with resilience. Recent estimates indicate there are over three million U.S. citizens over 65 who consider themselves LGBTQ, many of whom are in same-sex relationships. Therefore, given the paucity of research and misconceptions about this population, findings, and recommendations are of value to educators, clinicians, and policymakers.

Self-Imposed Exile, Marginality, and Homosexuality in the Novels of Abdellah Taïa, Rachid O., and Eyet-Chékib Djaziri

A burgeoning canon of Maghrebian writers in self-imposed exiled in France has in the last decade begun to openly broach the subject of homosexuality in Arab-Muslim communities of the Maghreb. Novels of writers like Abdellah Taïa, Rachid O. and Eyet-Chékib Djaziri reflect a fascinating trans-Mediterranean construction of homosexual identity. Drawing on Svetlana Boym's critical work, particularly her observation that nostalgia "charts an affective geography of the native land that often mirrors the melancholic landscapes" of the exiled, this paper analyzes the construction of homosexuality against the notions of exile, nostalgia, and marginality. The novels of these Maghrebian writers highlight nostalgia as both cathartic and paralyzing for "gay" migrant protagonists who find themselves trapped in the subtle seam between a cherished Maghreb that is framed as homophobic in the sexual clash of civilizations and a more liberal yet inauspicious France. The nostalgic contemplation of the constitution of a homosexual subjectivity is read as a critical performance and mainstreaming of hitherto marginalized voices that now subvert and fight back against normalizing discourses of ethnicity, sexual and gender identity as well as nationality.

"I'm Not like That, So Am I Gay?" The Use of Queer-Spectrum Identity Labels Among Minor-Attracted People

Largely based on an erroneous belief that individuals who are preferentially attracted to minors are necessarily sex offenders, queer communities have distanced themselves from this population over the past several decades. There are now those who object to the use of labels such as "gay" and "queer" by minor-attracted people (MAPs), raising the question, "to whom do queer-spectrum identity labels belong?" I engage with this question using data from my research with 42 MAPs, exploring their uses of queer-spectrum identity labels and the conflicts they have encountered regarding their use of these terms. I then discuss the potential consequences of accepting the use of these labels by MAPs.

Playing Recognition Politics: Queer Theoretical Reflections on Lesbian, Gay, and Queer Youth Social Policy in Australia in the 1980s and 1990s

This article provides a queer theoretical reflection on the emergence of lesbian, gay, and queer (LGQ) youth as subjects of policy attention in Australia in the late twentieth century. In particular, it focuses on the ways in which specific forms of social, bureaucratic, and organizational recognition have given shape to LGQ youth as categorical policy objects. To this end, this article critically interrogates social policy related to the provision of funding for LGQ youth support during the 1980s and 1990s in two Australian states: New South Wales and Western Australia. More specifically, it focuses on some of the ways in which LGQ youth have been discursively shaped and materially supported in three different organizations, two of which continue to be strongly associated with support of LGQ youth in Australia. This study of the emergence of these organizations, resourced by three different sectors-the state, the church, and the LGQ community itself-necessarily draws on ephemeral resources, reflecting the conditions of possibility in which this work was being enacted. We conclude with an analysis of the necessity for situating policy recognitions within specific contexts to examine the implications for LGQ youth as the subjects such recognitions simultaneously seek to constitute and serve.

Does the Spiritual Values/Religion Subscale of the Self-Description Questionnaire III Function Differentially Across Heterosexual and Non-Heterosexual Young Adults? A Measurement Invariance Study

We evaluated the dimensionality and measurement invariance of the Spiritual Values/Religion (SVR) subscale from the Self-Description Questionnaire III across heterosexual and non-heterosexual young adults. We found a one-factor model provided adequate fit to the data for each group, with the SVR items exhibiting configural, metric, and scalar invariance across the two groups. Given that we established measurement invariance, we examined the latent mean difference on the construct and found the heterosexual group reported significantly higher levels of spiritual value/religion than the non-heterosexual group. Our results provided empirical support for the theorized factor structure of the SVR items and the use of the SVR subscale across heterosexual and non-heterosexual young adults, making the scale a viable option for researchers studying religiosity in these specific subpopulations.

Stressors Based on Sexual Orientation and Mental Health Among Lesbian, Gay, and Bisexual Individuals in China: Minority Stress and Perceived Pressure to Get Married

Chinese Confucian filial piety posits that getting married and having children to maintain family bloodlines is a fundamental duty of children to their parents. Chinese lesbian, gay, and bisexual (LGB) individuals experience added stresses because of the pressure to get married from parents, social environments, and themselves. However, no research thus far has examined the influence of this added stressor, called "pressure to get married," on the mental health of LGB individuals in China. This study examined the influence of sexual orientation-based stresses (i.e., LGB minority stress and perceived pressure to get married) on mental health among 543 Chinese single LGB individuals (259 gay men, 161 lesbians, 68 bisexual men, and 55 bisexual women). We developed a new measure of stress based on perceived pressure to get married and found three factors based on pressure sources: social pressure, parental pressure, and internalized pressure. Both minority stress and perceived pressure to get married were associated with worse mental health. Minority stress and perceived external pressure (i.e., perceived social and parental pressure) were found to be components of a second-order latent variable, called sexual orientation-based stress, which was associated with worse mental health. Sexual orientation-based stress is associated with mental health through coping/emotion and cognitive, but not social, processes. The results indicate that the pressure to get married experienced by Chinese LGB individuals need to be examined further. The findings indicated that the perceived pressure to get married was another significant stressor based on sexual orientation and minority stress, and was associated with mental health among Chinese LGB individuals.

Assessment of Couple Relationships Standards in Same-Sex Attracted Adults

Relationship standards are beliefs about what makes a good romantic relationship. To date, no research on relationship standards in same-sex relationships has been conducted. This paper describes development of the Rainbow Couples Relationship Standards Scale (Rainbow CRSS). In common with measures of relationship standards developed with heterosexuals, the Rainbow CRSS assesses the importance people attach to Couple Bond standards (expression of love, caring, intimacy), Family Responsibility standards (extended family relations, maintenance of face and harmony), Religion, and Relationship Effort standards. The Rainbow CRSS also assesses three standards hypothesized to be of particular importance to same-sex couples: Relationship Outness (public disclosure of the relationship), Sexual Openness (acceptance of open sexual relationship), and Dyadic Coping with Homophobic discrimination. Participants were 414 same-sex attracted men and women who completed the Rainbow CRSS online, plus some validation scales. The Rainbow CRSS showed a coherent two-level factor structure that was similar to that in heterosexual couples for the Couple Bond and Family Responsibility Scales. Same-sex attracted people's standards were similar for men and women, and for singles versus those in a relationship. Same-sex attracted people's standards were very similar in endorsement of Couple Bond, Family Responsibility, Religion, and Relationship Effort standards to those of heterosexuals. The Relationship Outness and Dyadic Coping with Homophobia scales assessed potentially important standards that reflect some distinctive challenges for same-sex couple relationships.