Comparing National Probability and Community-Based Samples of Sexual Minority Adults: Implications and Recommendations for Sampling and Measurement

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

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.

Differences in Minority Stress Experiences, Mental Health, and Relationship Quality Outcomes Among Bisexual, Pansexual, and Queer Women

The majority of sexual minority women in the United States today identify as bi+. Recent research suggests that "non-traditional" bi+ labels such as pansexual and queer are being adopted more frequently than ever before, making it increasingly important to evaluate whether these women have unique needs. In the current study, we explored differences in minority stress experiences, mental health, and relationship quality outcomes by sexual identity label among women who identify with the most common bi+ labels: bisexual, pansexual, and queer. Participants were 285 bi+ cisgender women in romantic relationships. They completed online measures of minority stress (antibisexual experiences, identity concealment, disconnection from the sexual and gender minority (SGM) community, and internalized stigma), mental health (depression and anxiety), and relationship quality (satisfaction and commitment). Overall, participants reported similar experiences of minority stress and few differences in their mental health outcomes. However, there were differences in antibisexual experiences by sexual identity label, such that pansexual women reported more frequent antibisexual experiences than bisexual and queer women. There were also differences in relationship quality by sexual identity label, such that bisexual women reported higher satisfaction than pansexual women and higher commitment than both pansexual and queer women. Findings suggest that pansexual and queer women may be facing their own unique challenges, even compared to bisexual women. Clinical prevention and intervention efforts can be tailored for these women to include strategies to cope with more frequent exposure to antibisexual experiences, as well as relationship education and skill-building to promote healthy romantic relationships.

The City Clinic Cohort Study: Hepatitis B, HTLV-III/LAV, and CDC AIDS Project 24

Anticipating the availability of a safe vaccine, scientists at the Center for Disease Control (CDC) planned for a multicenter study of the prevalence, incidence, and efficacy of an experimental vaccine for hepatitis B in 1977, conducted the study among homosexual male volunteers in five collaborating sexually transmitted infection (STI) clinics in the United States from April 1978 through 1980, and concluded that the candidate vaccine was highly efficacious in preventing infections with the hepatitis B virus. Then something completely unexpected and portentous happened. Some successfully vaccinated as well as other homosexual and bisexual men began to show signs and symptoms of a rare cancer, Kaposi's sarcoma, and opportunistic infections typically associated with severe immunodeficiency. As early as October 1983, members of the Hepatitis B study cohort in San Francisco were invited to return to the city STI clinic for further examinations, testing, and confidential interviews about their sexual and other practices. CDC AIDS Project 24 was designed to help describe the natural history of AIDS, define risk factors, and predict future trends. It produced some of the earliest and most convincing scientific evidence about the seriousness and extent of the AIDS epidemic among homosexual and bisexual men in the United States. How the City Clinic Cohort Study came about and evolved is the focus of this commentary.

Sexual Minority Identity Development: Latent Profiles of Developmental Milestones in a National Probability Sample

Sexual identity development milestones mark the ages at which sexual minority people first experience key developmental events including same-sex attraction, self-realization of a sexual minority identity, same-sex sexual behavior and romantic relationships, and sexual identity disclosure. Most studies of milestones use variable-centered, rather than person-centered approaches, potentially obscuring diversity in patterns across milestones. Using data from The Generations Study, the first national probability sample of White, Black, and Latinx sexual minority adults in the United States (n = 1,492), we examined variability in milestone timing and patterning using a latent profile analysis approach. We identified four distinct profiles, characterized by variability in milestone mean ages, pacing, and sequences: an early adolescence profile (22.9%), a middle adolescence profile (33.6%), a late adolescence profile (27.6%), and an adulthood profile (15.9%). Profiles were demographically distinct, varying by birth cohort, sexual identity, race/ethnicity, gender identity, and childhood gender nonconformity. Results suggest developmental and demographic diversity in the emergence of sexual identity development across the life course, with implications for sexual minority health and thriving.

Recruiting and retaining sexual and gender minority couples in intervention research: Lessons learned from trials of tailored relationship education programs

Relationship interventions, including healthy relationship education, couple therapy, and dyadic approaches to treating mental and physical health issues, hold promise for promoting relationship and individual health among sexual and gender minority (SGM) populations. Because SGM couples live within a context of societal stigma against their minority identities and relationships, they are likely to be best served by targeted, culturally sensitive relationship interventions that are affirming, free of hetero- and cis-normativity, and address the unique stigma-based challenges that they face. Therefore, a key goal for the field today is to conduct research evaluating and refining newly developed relationship interventions designed specifically for SGM couples. In this paper, we offer recommendations for effectively recruiting and retaining large, diverse samples of SGM couples for clinical trials of tailored relationship interventions, grounded in guidelines for psychological practice and conducting research with SGM populations. Throughout, we offer examples and lessons learned from our experiences conducting clinical trials of tailored SGM relationship education programs. We encourage the use of recruitment and retention strategies that involve members of the target SGM community from the outset, are informed by knowledge about SGM individuals and relationships, use currently preferred language for individual identities and relationships, attend to issues of confidentiality regarding sexual/gender identity or relationship involvement, and adhere to the norms of the particular community and recruitment venue.

Incorporating macro-social contexts into emotion research: Longitudinal associations between structural stigma and emotion processes among gay and bisexual men

Research into correlates and predictors of emotion regulation has focused almost exclusively on individual differences and the immediate situation. Here, we consider whether features of macro-social contexts may also shape emotion regulation. To test this hypothesis, we conducted a longitudinal study of 502 gay and bisexual men living in 269 U.S. counties that varied in the level of stigma surrounding sexual minorities. We find that gay and bisexual men living in higher- (vs. lower-) stigma counties consistently reported more suppression, which consequently explained longitudinal increases (vs. decreases) in their lack of emotional clarity over 24 months. Results were robust to demographic characteristics, stigma at the interpersonal level (i.e., sexual orientation-related discrimination), and another form of social inequality (i.e., county-level income inequality). These findings suggest that broadening the lens of emotion regulation research to include characteristics of the macro-social environment may yield new insights into determinants of emotion regulation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-schemas and information processing biases as mechanisms underlying sexual orientation disparities in depressive symptoms: Results from a longitudinal, population-based study

Sexual minority individuals experience higher prevalence of major depression and more frequent depressive symptoms compared to heterosexual individuals. Although existing theories have suggested cognitive mechanisms that may explain these disparities, empirical tests are limited by a reliance on cross-sectional designs, self-reported measures, and nonprobability samples. We analyzed data from a longitudinal, population-based study of young adults (N = 1,065; n = 497 sexual minority) who completed validated measures of depressive symptoms over a 3-year period; at Wave 2, participants completed the self-referent encoding task, a behavioral task assessing self-schemas and information processing biases. Self-schemas were measured with the drift rate, which was estimated via the composite of endorsement of positive or negative words as self-referential (or not) and the reaction time for these decisions. Information processing biases were operationalized as the total number of negative words that were both endorsed as self-referential and recalled after the task, divided by the total number of words endorsed and recalled. Compared to heterosexuals, sexual minorities displayed significantly higher negative self-schemas and recalled a significantly higher proportion of negative words endorsed as self-referential, relative to total number of words. In turn, these differences in self-schemas and information processing biases mediated the sexual orientation disparity in depressive symptoms. Moreover, among sexual minorities, perceived discrimination predicted greater negative self-schemas and information processing biases, which mediated the prospective association between discrimination and depressive symptoms. These findings provide the strongest evidence to date for cognitive risk factors that underlie sexual orientation disparities in depression, highlighting potential intervention targets. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"I Know Myself Again, Which Makes Me Motivated for Life": Feasibility and Acceptability of Using Experience Sampling Methods With Trauma-Exposed Sexual Minority Women

Intensive longitudinal designs (e.g., experience sampling methods [ESMs]) hold promise for examining the dynamic interplay between daily adversity, coping strategies, and behavioral and mental health issues among marginalized populations. However, few studies have used intensive longitudinal designs with sexual minority women (SMW), an understudied and at-risk population. We assessed feasibility and acceptability of using once-daily, interval-contingent ESM with 161 trauma-exposed SMW (Mage = 29.1, SD = 7.57); 20.5% nonbinary; 32.3% queer; 52.2% people of color; 14.3% with annual incomes ≤$9,999; and 30.4% in Southern United States (U.S.). SMW completed one comprehensive online baseline assessment and once-daily brief online assessments for 14 days. Daily surveys assessed past-24-hour stressors, stress responses, and behavioral and mental health symptoms. At the end of the 14-day ESM period, SMW answered three open-ended questions about participating in this study and about research with SMW. Regarding feasibility, 151 participants (94.0%) initiated the post-baseline ESM study portion and 72 (45.0%) completed all 14 daily surveys. An average of 11.70 (median = 13, SD = 3.31) daily surveys (83.5%) were completed by those who initiated the ESM. ESM completion level varied by race/ethnicity and U.S. region. Qualitative acceptability data revealed several themes, namely that SMW (1) enjoyed participating and felt positively about the ESM experience, (2) felt supported to reflect on impacts of early and ongoing stressors, (3) appreciated the chance to self-reflect and challenge existing thought patterns and coping behaviors, (4) recognized their capacity to tolerate trauma-related distress, (5) recommended that researchers focus on SMW's diverse stressors and daily experiences, (6) wanted a rationale for providing sensitive information and more space to narrate their experiences, and (7) recognized the need for affirmative treatment and policies. Findings could inform modifications to ESM protocols to improve their feasibility and acceptability among trauma-exposed SMW and promote ongoing utility of this valuable method.

Stratified Simple Random Sampling Versus Volunteer Community-Wide Sampling for Estimates of COVID-19 Prevalence

Objectives. To evaluate community-wide prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using stratified simple random sampling. Methods. We obtained data for the prevalence of SARS-CoV-2 in Jefferson County, Kentucky, from adult random (n = 7296) and volunteer (n = 7919) sampling over 8 waves from June 2020 through August 2021. We compared results with administratively reported rates of COVID-19. Results. Randomized and volunteer samples produced equivalent prevalence estimates (P < .001), which exceeded the administratively reported rates of prevalence. Differences between them decreased as time passed, likely because of seroprevalence temporal detection limitations. Conclusions. Structured targeted sampling for seropositivity against SARS-CoV-2, randomized or voluntary, provided better estimates of prevalence than administrative estimates based on incident disease. A low response rate to stratified simple random sampling may produce quantified disease prevalence estimates similar to a volunteer sample. Public Health Implications. Randomized targeted and invited sampling approaches provided better estimates of disease prevalence than administratively reported data. Cost and time permitting, targeted sampling is a superior modality for estimating community-wide prevalence of infectious disease, especially among Black individuals and those living in disadvantaged neighborhoods. (Am J Public Health. 2023;113(7):768-777. https://doi.org/10.2105/AJPH.2023.307303).

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

Introduction

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.

Methods

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 3-10 years. Data were collected between December 2019 and February 2021.

Results

Mediational analyses indicated that lesbian mothers reported greater positivity, which was, in turn, associated with greater life satisfaction and less depressive symptomatology.

Conclusions

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.

Assisted Conception Socialization Self-Efficacy Among Israeli Lesbian, Gay, and Heterosexual Parent Families and its Association with Child Externalizing Problems

This questionnaire-based study compared 36 Israeli lesbian mother families (n = 72 lesbian mothers) formed by donor insemination, 39 Israeli gay father families (n = 78 gay fathers) formed by gestational surrogacy, and 36 Israeli heterosexual parent families (n = 72 heterosexual parents) formed by assisted reproduction (without donated gametes), all with a target child aged 3-10 years. The families were examined for parents' assisted conception socialization self-efficacy, depression, negative and positive affect, life satisfaction, positivity, resilience, social support, and child externalizing problems. Multiple factors associated with child externalizing problems were also examined. Multilevel modeling analyses indicated that parents' assisted conception socialization self-efficacy did not differ between family groups; however, lesbian mothers and gay fathers reported fewer child externalizing problems and greater social support, relative to heterosexual parents. Also, lesbian mothers-but not gay fathers-reported lower levels of depression, greater life satisfaction, and more positivity than did heterosexual parents. Finally, irrespective of family type, greater assisted conception socialization self-efficacy was associated with fewer parent-reported child externalizing problems. Findings are interpreted in light of the cultural socialization framework and Israel's familistic and pronatalist environment. Implications for health professionals, educators, and policymakers working with diverse family forms are discussed.

Polydrug Use, Sexual Risk, and HIV Testing Among Cisgender Gay, Bisexual, and Other Men and Transgender and Nonbinary Individuals Who Have Sex With Men in Kazakhstan

This study examined substance use and sexual risk correlates of HIV testing among cisgender gay, bisexual, and other men (MSM) and transgender and nonbinary individuals (TSM) who have sex with men in Kazakhstan. We analyzed baseline data from an HIV prevention trial collected prior to intervention deployment (N = 304). Multivariable logistic regression analyses revealed that lifetime HIV testing was positively associated with poly-drug use (AOR = 4.4, 95% CI [2.0, 9.9]) and negatively with sexual risk (AOR = 0.4, 95% CI [0.2, 1.0]). Similarly, recent HIV testing was positively associated with polydrug use (AOR = 2.7, 95% CI [1.4, 5.2]) and negatively with sexual risk (AOR = 0.5, 95% CI [0.3, 0.9]). Current HIV testing was negatively associated with sexual risk (AOR = 0.6, 95% CI [0.3. 0.9]). Findings support the value of integrating drug treatment with HIV testing among MSM and TSM in Kazakhstan.

Future parenting aspirations and minority stress in U.S. sexual minority adults

Parenthood is an aspiration shared by a majority of U.S. adults. However, previous research has found that sexual minority adults (e.g., lesbian, gay, bisexual [LGB]) are less likely than heterosexual counterparts to be parents or desire to become parents in the future. To date, few studies have examined how minority stress (i.e., everyday discrimination [ED], felt stigma [FS], and internalized homophobia [IH]) influences parenting desire, parenting likelihood, and expectation a gap between the two. Even fewer studies have examined the parenting aspirations of sexual minority individuals following nationwide legalization of same-sex marriage in the United States. We analyzed data from 487 childfree lesbian, gay, bisexual, and queer participants from two cohorts ("equality cohort": ages 18-25; "visibility" cohort: ages 34-41) from the Generations study, a national probability sample of sexual minority adults in the United States. As expected, we found that the visibility cohort adults had significantly lower parenting desire and parenting likelihood, and a greater parenting expectation gap than the equality cohort adults. Additionally, while everyday discrimination (ED) did not predict parenting aspirations, IH and FS predicted higher parenting desire and lower parenting likelihood, respectively. We found a cohort by FS interaction such that FS predicted even lower parenting likelihood in the visibility cohort adults. Our findings contribute to a growing body of research on sexual minority parenthood and may inform community practice and clinical support for sexual minority adults who pursue parenthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comparing substance use outcomes by sexual identity among women: Differences using propensity score methods

BACKGROUND

Differences in alcohol, tobacco, and other drug (ATOD) use by sexual identity vary across samples of women recruited using different sampling methods. We used propensity score (PS) weighting methods to address two methodological questions: (1) Do disparities between sexual minority women (SMW) and heterosexual women persist when differences in risk and protective factors are similarly distributed between groups, and (2) Does accounting for SMW-specific resiliency factors impact differences between non-probability samples of SMW?

METHODS

Four samples included SMW from a longitudinal study with a nonprobability sample (n = 373), a national general population panel sample (n = 373), and a national LGBTQ-specific panel sample (n = 311), as well as a national probability sample of heterosexual women (n = 446). Between-groups analyses using double-robust PS weighted models estimated differences in ATOD use under hypothetical conditions in which samples have similar risk and protective factors.

RESULTS

After PS weighting, imbalance in confounders between SMW and heterosexual samples was substantially reduced, but not eliminated. In double-robust PS weighted models, SMW samples consistently had significantly greater odds of drug use than heterosexuals, with odds from 8.8 to 5.6 times greater for frequent marijuana use and 4.8-3.2 greater for other drug use. Few differences between SMW samples in ATOD outcomes or other variables remained after PS weighting.

CONCLUSION

Relative to heterosexual women, disparities in marijuana and other drug use among SMW are evident regardless of sampling strategy. The results provide some reassurance about the validity of large nonprobability samples, which remain an important recruitment strategy in research with SMW.

Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women

Informed by minority stress and intersectionality frameworks, we examined: 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g., lesbian, bisexual); and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness, and internalized homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. Data come from a large and diverse community sample of SMW (N = 662; age range: 18-82; M = 40.0, SD = 14.0). The sample included 35.8% Black, 23.4% Latinx, and 37.2% White participants. Logistic regressions tested associations of sexual identity and race/ethnicity, minority stressors, and PTEs with PTSD-PD. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness, and internalized homonegativity were each associated with higher odds of PTSD-PD, but only internalized homonegativity was additively associated with PTSD-PD in mutually adjusted models above and beyond effects of PTEs. No evidence for interactive effects between PTEs and minority stressors was found. In a diverse community sample of sexual minority women, PTSD is strongly associated with potentially traumatic childhood events and with minority stressors above and beyond the associations with other potentially traumatic events and stressors in adulthood. Our findings suggest a strong need for therapists to address the effects of stigma and homophobia in treatment for PTSD, as these minority stressors likely maintain and exacerbate the effects of past traumas.

"I Was Always Trying to Figure It Out… on My Own Terms": Structural Barriers, the Internet, and Sexual Identity Development among Lesbian, Gay, Bisexual, and Queer People of Different Generations

Recognizing the historical grounding of sexual identity development, we examined the spontaneous narration of the internet's significance among a diverse sample of three distinct birth cohorts of sexual minority adults (n = 36, ages 18-59) in the United States. Thematic analysis revealed two structural barriers and four roles of the internet in sexual identity development. Structural barriers were being in a heterosexual marriage (exclusive to members of the older cohort), and (2) growing up in a conservative family, religion, or community (which cut across cohorts). Roles of the internet included: learning about LGBQ+ identities and sex; watching pornography (which appeared only in narratives of the younger cohort); finding affirming community; and facilitating initial LGBQ+ romantic and sexual experiences (which appeared mostly in narratives of the younger cohort). Most participants who described the internet as playing a role in sexual identity development were members of the younger (ages 18-25) and middle (ages 34-41) cohorts. We discuss how the internet has assumed a unique role in history in the development of sexual minority people. Further, our findings highlight that sexual identity development occurs across the lifespan, and how that process and the roles of the internet vary by generation and structural realities.

Challenges of virtual RDS for recruitment of sexual minority women for a behavioral health study

Respondent driven sampling (RDS) is an approach commonly used to recruit nonprobability samples of rare and hard-to-find populations. The purpose of this study was to explore the utility of phone and web-based RDS methodology to sample sexual minority women (SMW) for participation in a telephone survey. Key features included 1) utilizing a national probability survey sample to select seeds; 2) web-based recruitment with emailed coupons; and 3) virtual processes for orienting, screening and scheduling potential participants for computer-assisted telephone interviews. Rather than resulting in a large diverse sample of SMW, only a small group of randomly selected women completed the survey and agreed to recruit their peers, and very few women recruited even one participant. Only seeds from the most recent of two waves of the probability study generated new SMW recruits. Three RDS attempts to recruit SMW over several years and findings from brief qualitative interviews revealed four key challenges to successful phone and web-based RDS with this population. First, population-based sampling precludes sampling based on participant characteristics that are often used in RDS. Second, methods that distance prospective participants from the research team may impede development of relationships, investment in the study, and motivation to participate. Third, recruitment for telephone surveys may be impeded by multiple burdens on seeds and recruits (e.g., survey length, understanding the study and RDS process). Finally, many seeds from a population-based sample may be needed, which is not generally feasible when working with a limited pool of potential seeds. This method may yield short recruitment chains, which would not meet key RDS assumptions for approximation of a probability sample. In conclusion, potential challenges to using RDS in studies with SMW, particularly those using virtual approaches, should be considered.

Minority Stress and Suicidal Ideation and Suicide Attempts Among LGBT Adolescents and Young Adults: A Meta-Analysis

Purpose: This meta-analytic study examined associations between minority stressors and suicidal ideation and suicide attempts among LGBT adolescents and young adults (aged 12-25 years). Methods: Identified studies were screened using the inclusion and exclusion criteria. Studies had to include an association between a minority stressor and a suicidality outcome and were categorized into 10 meta-analyses. Overall effect sizes were calculated using three-level meta-analyses. In addition, moderation by sampling strategy was examined. Results: A total of 44 studies were included. Overall, LGBT bias-based victimization, general victimization, bullying, and negative family treatment were significantly associated with suicidal ideation and/or suicide attempts. Associations of discrimination and internalized homophobia and transphobia with suicidal ideation and/or suicide attempts were not significant. No moderation effects were found for sampling strategy. Conclusion: Although overall effect sizes were small, our meta-analytic study shows a clear link between various types of minority stressors and suicidal ideation and suicide attempts among LGBT adolescents and young adults.

Gender and Sexual Identity in Adolescence: A Mixed-Methods Study of Labeling in Diverse Community Settings

Understandings of sexual and gender identity have expanded beyond traditional binaries, yet we know little about adolescents’ appropriation of identity labels across diverse communities. In a mixed-methods study of adolescents recruited from lesbian, gay, bisexual, transgender, and queer (LGBTQ+) spaces in communities differing in support of sexual and gender diversity, seven patterns emerged: (a) frequent use of nonbinary gender identity labels (23.9% of survey sample), especially in high-support communities; (b) greater comfort among adolescents assigned female at birth (AFAB) with diverse gender expression, which informants attributed to pressures to conform to compulsive masculinity for boys; (c) frequent use of plurisexual (60.8%) and asexual (9.9%) labels, especially among those AFAB, and discussion of online settings as a resource; (d) intersectional patterning of “queer” to describe sexual identity (12.4% of survey sample), with White youth in high-support communities signifying an intellectual/political stance and non-White youth in low-support communities using queer as an umbrella term; (e) resistance to labeling and ambivalence about labels due to intra-community dynamics; (f) labeling challenges among boys of color; and (g) challenges with stigma, sexualization, and violence for transgender and nonbinary youth. Findings highlight how contemporary adolescents engage with and challenge received conceptions of gender and sexuality and how this process is shaped by intersectional identities.