Poor mental health among Taiwanese people experiencing the public debates on and referendums for same-sex marriage: A Facebook online survey

Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan

The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State–Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants’ sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.

Associations among Perceived Sexual Stigma from Family and Peers, Internalized Homonegativity, Loneliness, Depression, and Anxiety among Gay and Bisexual Men in Taiwan

This study aimed to examine the moderating factors of the association between perceived sexual stigma from family and peers and internalized homonegativity, as well as to compare the effects of perceived sexual stigma from family and peers and internalized homonegativity on loneliness, depression, and anxiety in gay and bisexual men. In total, 400 gay and bisexual men participated in this study. The experiences of perceived sexual stigma from family and peers on the Homosexuality subscale of the HIV and Homosexuality Related Stigma Scale, internalized homonegativity on the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, loneliness on the UCLA Loneliness Scale (Version 3), depression on the Center for Epidemiological Studies-Depression Scale, and anxiety on the State subscale of the State-Trait Anxiety Inventory were collected. The results indicated that perceived sexual stigma from family and peers was significantly associated with internalized homonegativity in both gay and bisexual men, and that sexual orientation moderated the association. Moreover, the association between internalized homonegativity and loneliness was significantly greater than that between perceived sexual stigma from family and peers and loneliness, although no significant differences were observed in their associations with depression and anxiety. Intervention programs that promote changes in the attitudes toward gay and bisexual men among the general population are needed to help prevent the development of internalized homonegativity and further loneliness, depression and anxiety.

"Strong Together": Minority Stress, Internalized Homophobia, Relationship Satisfaction, and Depressive Symptoms among Taiwanese Young Gay Men

Taiwan's legalization of same-sex marriage affords legal status for romantic relationships between sexual minority individuals. Yet, little is known about the role of intimate relationships in the experiences of minority stress and mental health among gay men. This study tested a model where internalized homophobia mediated the association between distal minority stress and depressive symptoms and relationship satisfaction was posited as a moderator. Data came from a sample (n = 557) of Taiwanese young gay men who were in a romantic relationship. Respondents completed the scales of distal minority stress, internalized homophobia, relationship satisfaction, and depressive symptoms. Mediation and moderation analyses were performed on the macro PROCESS. The Johnson-Neyman (J-N) technique was used to interpret the moderating effect of relationship satisfaction. Results show that both distal minority stress and internalized homophobia were positively associated with depressive symptoms. Internalized homophobia partially mediated the association between distal minority stress and depressive symptoms. Relationship satisfaction had a moderating effect. The effect of distal minority stress was lower among those who reported high satisfaction in their current romantic relationship. This study suggested that a satisfying relationship provides protection for gay men's mental health. Clinicians should attend to relationship issues when working with sexual minority clients.

Relationships of Homophobic Bullying Victimization during Childhood with Borderline Personality Disorder Symptoms in Early Adulthood among Gay and Bisexual Men: Mediating Effect of Depressive Symptoms and Moderating Effect of Family Support

This study investigated (1) the associations of homophobic bullying victimization in childhood with borderline personality disorder (BPD) symptoms in early adulthood among gay and bisexual men; (2) the mediating effect of depressive symptoms on the association between homophobic bullying victimization and BPD symptoms, and (3) the moderating effects of perceived family support on the association between homophobic bullying victimization and BPD symptoms. A total of 500 gay or bisexual men aged between 20 and 25 years were recruited into this study. The experiences of physical, verbal and social relationship bullying victimization during childhood were evaluated using the Mandarin Chinese version of the School Bullying Experience Questionnaire. The experiences of cyberbullying victimization during childhood were evaluated using the Cyberbullying Experiences Questionnaire. BPD symptoms were assessed using the Borderline Symptom List. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale. Perceived family support was evaluated using the Family Adaptation, Partnership, Growth, Affection, and Resolve index. The results of mediation analyses demonstrated that all the types of homophobic bullying victimization in childhood were directly associated with BDP symptoms in young adulthood as well as indirectly associated with BPD symptoms through the mediation of depressive symptoms. The results of moderation analyses demonstrated that the association between homophobic bullying victimization and BPD symptoms decreased when the individuals had more family support. Intervention programs to reduce homophobic bullying victimization and enhance family support for gay and bisexual men and their families are necessary. Interventions to improve depressive and BPD symptoms among gay and bisexual men are also necessary, especially for those who experienced homophobic bullying victimization during childhood.

Effects of Same-Sex Marriage Legalization for Sexual Minority Men in Taiwan: Findings From a Prospective Study

Objective: On May 24, 2019, same-sex marriage (SSM) was legalized in Taiwan. Increasing research in western countries has yielded longitudinal evidence about the psychosocial benefits of SSM for sexual minority individuals, but they have rarely included sexual minority-specific measures or considered participants’ relationship status. This study aimed to examine the short-term effects associated with the legalization of SSM for gay and bisexual men in Taiwan.

Methods: A panel sample of 731 gay and 132 bisexual men participated in baseline (May 2019) and follow-up (October 2020) online surveys to report their depressive symptoms, distal sexual minority stress, internalized homophobia, and outness status.

Results: The results demonstrated significant reductions in depressive symptoms and distal sexual minority stress along with increased rates of coming out to friends, family, and parents. These changes were similar for partnered and un-partnered individuals. Fixed-effect regression analysis indicated that the decline in distal sexual minority stress and internalized homophobia contributed to the decline in depressive symptoms.

Conclusion: This study preliminarily supports the positive effects of SSM in promoting sexual minority men’s mental health and disclosure in Taiwan.

Suicide attempts among Taiwanese lesbian, gay, bisexual, and transgender adults during the 2018 Taiwan referendum on same-sex issues

Purpose

To examine suicide attempts and the influencing factors among Taiwanese lesbian, gay, bisexual, and transgender (LGBT) adults during the 2018 Taiwanese referendum on same‐sex issues.

Research design and methods

The 2018 Taiwanese referendum was held on November 24. A cross‐sectional online survey was conducted between October 2018 and February 2019. A total of 1012 self‐identified LGBT adults were included in the final sample.

Results

Among the 1012 Taiwanese LGBT adults, the rates of suicide attempts ranged from 9.1% to 24.4%. A younger age, being a student, having low income, having mental health issues, and having a high level of depressive symptoms were associated with a significantly higher risk of suicide attempts in the participants. Conversely, having a postgraduate degree, having high self‐esteem, and perceiving support from friends and family were associated with a lower risk of suicide attempts.

Conclusion

This is the first study to investigate suicide attempts among LGBT individuals and the influencing factors within the context of a same‐sex marriage referendum in an Asian country. The results of this study demonstrate the importance of suicide prevention measures for the LGBT community, particularly during times of increased social stress and conflict between social groups with diverse sexual and gender identities.

Clinical relevance

The results of this study suggest that nurses’ and health‐care providers’ sensitivity toward LGBT patients and their knowledge and skills in providing culturally competent care are key factors in suicide prevention for LGBT adults. Therefore, nurses and health‐care providers must be provided with training courses on culturally competent care.