Exploring the Q in LGBTQ: Demographic characteristic and sexuality of Queer people in a U.S. representative sample of sexual minorities

Caring for the LGBTQIA+ Patient: A Best-Practices Primer on Language, Sexual Function Considerations, and Health Disparities in Gynecologic Care

Despite representing a growing percentage of the global population, queer patients (i.e., lesbian, gay, bisexual, transgender, intersex, and/or asexual; LGBTQIA+) continue to experience significant disparities in gynecologic healthcare. Common barriers to inclusive care include discriminatory healthcare experiences, difficulty finding identity-affirming providers, and systemic lack of competency in addressing queer-specific medical needs. Such barriers arise out of heteronormative assumptions, limited provider training, and insufficient understanding of diverse sexual and gender identities. This narrative review examines gynecologic care considerations for lesbian, gay, bisexual/pansexual, asexual, intersex, and transgender patients. We review research documenting how queer patients delay or avoid healthcare due to fear of judgment, discrimination, and inadequate provider understanding. Our review highlights unique healthcare needs across different queer identities, including inclusive and culturally-sensitive sexual health screening that includes (but is not centered solely on) queer-specific sexual practices; considerations for transgender patients undergoing gender-affirming care; and incorporating intersectionality into assessment, treatment planning, and delivery. Finally, we make direct recommendations for caring for queer patients, including developing inclusive intake processes; training healthcare teams in affirming, non-discriminatory practices; using gender-neutral language; recognizing the diversity of sexual and gender identities; and addressing minority stress and its impacts on health.

"Lesbian", a Term in Dispute: A Scoping Review

This scoping review sought to explore the evolving landscape of lesbian identities and communities from 2013 to 2023. It addresses the debate over the relevance of the term "lesbian" in contemporary academia, highlighting contrasting viewpoints on its significance. Through thematic analysis of 12 selected articles, the study elucidates tensions surrounding lesbian identities, including stigmatization, generational divides, and the move toward "queer." It also examines shifts within lesbian communities, particularly concerning trans inclusion/exclusion, and the emergence of post-lesbian discourses. Key findings reveal a complex interplay between identity politics, queer politics, and generational differences. While some argue for lesbian specificity and cohesive communities, others strive for more fluid and inclusive identities. The study also underscores the ongoing importance of lesbian communities, despite challenges posed by changing societal norms and evolving politics. Overall, this research contributes to a nuanced understanding of lesbian identities, emphasizing the need for inclusive dialogues and bridging generational divides within the LGBTQIA+ community.

Minority stress and psychological well-being in queer populations

Queer individuals experience unique stressors related to their minority status, negatively impacting their mental health. One factor contributing to these disparities is exposure to minority stress, which involves social stressors related to minority status. Previous research has focused on the negative impacts of minority stress, with less attention to its impact on positive psychological functioning. This study explored the relationship between minority stress and psychological well-being among 270 queer individuals in German-speaking countries. Participants completed an online survey assessing minority stress and psychological well-being. Analyses of Covariance indicated that proximal factors of minority stress-such as self-stigma, concealment, and expectations of rejection-had a particularly negative impact on psychological well-being, but no effects could be found for gender and sexual orientation. Additionally, gender identity but not sexual orientation had a significant effect on minority stress, with non-binary and other gender identities reporting higher minority stress compared to females. Thematic analysis revealed concerns about survey inclusivity, gender identity challenges, and intersectionality of minority identities. Our findings emphasize the significant impact of minority stress on the psychological well-being of queer individuals, particularly non-binary people and those with diverse gender identities, while demonstrating the need for inclusive research methodologies, tailored interventions, and policies addressing the diverse experiences within the queer community.

Measurement opportunities for studying sexual and gender diverse partnerships in population-based surveys

Objective

This article outlines for family scholars and researchers designing surveys or searching for data on sexual and gender-diverse (SGD) families the latest methodological advancements in United States population-based surveys for studying SGD partnerships by reviewing five recently collected, publicly available, population-representative data sets.

Background

LGBTQIA+ adults and SGD partnerships are an expanding demographic group in the United States. Yet, measurement limitations have restricted studies of these partnerships that use population-based studies. To address this issue, researchers designing population-representative data collections have adopted new strategies to measure SGD partnerships accurately. However, most population representative surveys continue to lack data on growing segments of the LGBTQIA+ population by relying solely on the sex of partners or limited sexual and gender identity measures.

Conclusion

We recommend expanding population-based surveys to incorporate inclusive measures of sexual and gender identity, directly asking about the gender composition of a couple and measurement of cohabiting and other nonmarital relationships. These approaches are especially important for understanding relationships among younger populations who do not follow heteronormative relationship trajectories and hold diverse gender and sexual identities.

Implications

Although the research opportunities on SGD individuals and partnerships are expanding; researchers must remain mindful of the limitations of current data sets and advocate for updates to the United States population data infrastructure.

Global prevalence of major depressive disorder in LGBTQ+ samples: A systematic review and meta-analysis of epidemiological studies

BACKGROUND

LGBTQ+ populations have been reported to have higher rates of depression compared with their heterosexual peers. Such data provided us the impetus to conduct a meta-analysis on the worldwide prevalence of major depressive disorder (MDD) in LGBTQ+ populations and moderating factors that contributed to differences in prevalence estimates between studies.

METHODS

A systematic literature search was performed in major international (PubMed, PsycINFO, Web of Science, EMBASE) and Chinese (Chinese Nation Knowledge Infrastructure (CNKI) and WANFANG) databases from dates of inception to 10 December 2021.

RESULTS

48 articles comprising 4,616,903 individuals were included in the meta-analysis. The overall prevalence of MDD was 32.2 % (95%CI: 30.8-33.6 %, I2 = 99.6 %, τ2 = 0.284). MDD prevalence was higher in the LGBTQ+ samples from the United States than other countries, though the difference was not significant in moderator analyses. Moderator analyses indicated point and lifetime prevalence of MDD were significantly higher than estimates based on the past year (Q = 6.270, p = 0.043). Furthermore, studies that relied on convenience sampling had a higher prevalence of MDD than those based on other sampling methods (Q = 8.159, p = 0.017). In meta-regression analyses, mean age (B = 0.03, z = 9.54, p < 0.001) and study quality assessment score (B = 0.24, z = 67.64, p < 0.001) were positively associated with pooled prevalence of MDD while mediation data of year of study (B = -0.08, z = -72.55, p < 0.001) and sample size (B = -1.46, z = -37.83, p < 0.001) were negatively associated with pooled prevalence of MDD in LGBTQ+ samples.

CONCLUSIONS

MDD is common among in LGBTQ+ individuals. Considering the negative consequences MDD has on daily life and well-being, appropriate prevention and treatment measures should be provided to vulnerable members of these populations. The findings of this meta-analysis could facilitate identifying at-risk subgroups, developing relevant health policy for LGBTQ+ individuals and allocating health resources from an intersectionality perspective.

Health, Economic, and Social Disparities among Lesbian, Gay, Bisexual, and Sexually Diverse Adults: Results from a Population-Based Study

We investigated health, economic, and social disparities among lesbian, gay, bisexual, and sexually diverse adults, 18 years and older. Analyzing 2011-2019 Washington State Behavioral Risk Factor Surveillance System (N = 109,527), we estimated and compared the prevalence rates of background characteristics, economic and social indicators, health outcomes, chronic conditions, health care access, health behaviors, and preventive care by gender and sexual identity. Sexual minority adults reported heightened risks of poor general health, physical and mental health, disability, subjective cognitive decline, and financial barriers to health care, compared with their straight counterparts. Economic disparities and disability were evident for lesbians and both bisexual adult women and men. We found higher rates of smoking and excessive drinking among lesbians and bisexual women, and higher rates of smoking and living alone among gay men. Sexually diverse adults experience disparities in health care access. This study is one of the first to identify disparities among sexually diverse populations, in addition to lesbian, gay, and bisexual adults. More research is required to understand the mechanisms of disparities within these groups to address their distinct intervention needs.

Does intergenerational educational mobility vary by sexual identity? A comparative analysis of five OECD countries

Lesbian, gay and bisexual people are disadvantaged in terms of health and socio-economic status compared with heterosexual people, yet findings pertaining to educational outcomes vary depending on the specific identity and gender considered. This study delves into these unexplained findings by applying a social-stratification lens, thereby providing an account of how intergenerational educational mobility varies by sexual identity. To accomplish this, we use representative data from five OECD countries and a regression-based empirical specification relying on coarsened exact matching. We find that gay and lesbian people have higher educational attainment than heterosexual people in all five countries and that these higher levels of education stem from greater rates of upward educational mobility among gay/lesbian people. There were, however, few differences between heterosexual and bisexual people. Variation across countries emerged when analyses were stratified by gender, with higher rates of upward mobility observed for gay men in Australia, Chile, the United Kingdom, and the United States and lesbian women in Australia and Germany. Overall, our results align with previous claims that education can be a strategy for gay/lesbian people to avoid actual or anticipated discrimination. However, variation in these patterns across groups suggests that other mechanisms may also be at play.

Differences in the Prevalence of Adolescent Sexual Identity: Results of Expanding Survey Response Options

PURPOSE

To describe the prevalence of sexual identity by grade, racial and ethnic identities, and sex assigned at birth.

METHODS

Data came from the statewide 2022 Minnesota Student Survey of eighth, ninth, and 11th grade students (N = 99,688). Chi-square tests compared the prevalence of sexual identity across grades, racial/ethnic groups, and sex assigned at birth.

RESULTS

Over a fifth (22.2%) of students self-reported a minoritized sexual identity. Bisexual and pansexual were most common among Native+ (12.3%, 5.7%, respectively), multiracial (11.6%, 4.4%, respectively), and Latina/x/o (10.4%, 4.1%, respectively) youth. Asexuality was consistently reported across grades, and eighth graders reported gay/lesbian, bisexual, and queer identities less than 11th graders. Youth assigned female at birth were more likely to report gay/lesbian, bisexual, asexual, pansexual, queer, and questioning than youth assigned male at birth.

DISCUSSION

Results support the continued use of further expanded sexual identities in epidemiologic surveys.

Responses to Sexual and Gender Identity Measures in Population-Level Data by Birth Cohort: A Research Note

The measurement of sexual and gender identity in the United States has been evolving to generate more precise demographic estimates of the population and a better understanding of health and well-being. Younger cohorts of sexual- and gender-diverse adults are endorsing identities outside of the lesbian, gay, bisexual, and transgender (LGBT) labels. Current population-level surveys often include a category such as "something else" without providing further details, and doing so inadequately captures these diverse identities. In this research note, our analysis of the most recent federal data source to incorporate sexual and gender identity measures-the Household Pulse Survey-reveals that younger birth cohorts are more likely to select "something else" for their sexual identity and "none of these" for their gender identity. The observed sexual and gender identity response patterns across birth cohorts underscore the importance of developing and applying new strategies to directly measure sexual- and gender-diverse adults who identify with identities outside of those explicitly captured on surveys. The integration of sexual and gender identity measures in population-level surveys carries broader implications for civil rights and for addressing health inequities and therefore must be responsive to cohort differences in identification.

Demographic factors associated with healthcare avoidance and delay in the transgender population: Findings from a systematic review

Purpose

Healthcare avoidance and delay (HAD) in the transgender population has been well documented, and research has explored a range of associated factors that help to identify those most at risk of HAD. This review addresses a gap in the research by synthesizing research exploring associations between HAD and demographic factors.

Methods

A systematic search of literature published at any time up to December 2021 was conducted, using five databases (EBSCO, EMBASE, PubMed, Scopus, and Web of Science) and manually searching reference lists of included studies. After exclusion of duplicates, 608 unique records were subjected to double screening. Papers reporting statistical analyses of HAD in association with any sociodemographic variables were included in this review. Papers consisted of nineteen cross-sectional studies. Narrative synthesis was used to address findings.

Results

Nineteen studies met inclusion criteria, exploring HAD in association with a wide range of demographic factors, including sex and gender, social transition factors, age, race and ethnicity, socioeconomic factors, veteran status, education, sexuality, relationship status, citizenship, place of residence, and state demographics. Findings identified intra-community demographic risk factors, with consistent evidence for increased HAD among transmasculine, and younger, participants. Lower income and higher educational attainment were also associated with increased HAD, while remaining areas had weak or little evidence for association with HAD.

Conclusion

This review expands knowledge in this area by highlighting demographic factors associated with increased HAD in research literature, and exploring how these may be further investigated to address substantial gaps in the body of research.

Deeds, Not Words: Sexual Identities and Antiracist Activism Among White Americans

Sexual minorities of color often speak about racism in White lesbian and gay communities while White sexual minorities often consider themselves liberals, especially for issues of racial justice. This study explored this contradiction by analyzing the role of sexual identities in predicting antiracist thoughts and actions of self-identified White people. Data from the 2010-2012 American National Election Survey provided information on the racial consciousness and social movement participation of White people (N = 2,552). In the end, sexuality differences in racial attitudes was somewhat or partially confirmed as White lesbian, gay, and bisexual individuals endorsed fewer racial stereotypes and saw more racism than did White heterosexuals. However, these liberal sentiments of White lesbians, gays, and bisexuals were connected more to thoughts more than to political actions. Implications for methodological choices for studying race and sexuality were included, along with ideas for better understanding activism across racial lines.

"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.

Expanding Notions of LGBTQ

Sexual identity labels and meanings have been expanding. We explore how sexual identities are taking shape, intertwining, and emerging in new forms among a growing number of LGBTQ+ people (i.e., lesbian, gay, bisexual, transgender, queer, and questioning, or people whose identities are outside the historically privileged or dominant groups of heterosexual sexual identities). We situate contemporary sexual identities in theories of the social construction of identity, intersectionality, and the life course. We review recent research that illuminates identity complexity and intersectionality, the increasingly intertwined understandings and experiences of sexuality and gender, and intersections of sexuality and gender with identities embedded in race and social class. Finally, we consider new work that situates sexual identities in the context of life course development, including life stage, developmental processes, and relationships.

Critical action to redress systemic oppression: a person-centered approach

Introduction

In 2020, public outcry against police brutality prompted many social media users to post black squares and use the hashtag #BlackLivesMatter (BLM). Many of the people who posted these squares were engaging in performative action in the sense that they failed to engage with BLM's history and core principles. Drawing from a critical action framework, the current research seeks to more deeply understand what drives people to engage in more versus less impactful forms of action to resist systemic oppression.

Methods

We employed a mixed-methods and person-centered methodological approach with the goal of providing nuanced information about factors that distinguish among individuals who engage in different forms of action. Participants were 359 undergraduates who reported that they engaged in some form of action to support BLM.

Findings

Latent profile analysis identified three subgroups (i.e., latent classes) in the larger sample, which we labeled (1) intentional action, (2) intermediate action, and (3) passive action. Participants in each latent class differed from one another in their sociopolitical attitudes, sociodemographic background, and level of action to support BLM. Through the qualitative coding process, the research team unearthed three overarching themes and a range of subthemes that help to explain why the members of each class engaged in different forms of action.

Discussion

We conclude by proposing a flexible intervention that may motivate individuals to engage in critical action to support BLM.

Disclosure, minority stress, and mental health among bisexual, pansexual, and queer (bi+) adults: The roles of primary sexual identity and multiple sexual identity label use

Bisexual people are at increased risk for anxiety and depression compared to heterosexual and gay/lesbian people, but little is known about people who use other labels to describe attractions to more than one gender (e.g., pansexual, queer; collectively "bi+"). In addition, some people use more than one label to describe their sexual orientation, but research has yet to examine whether using one versus multiple labels is associated with identity-related experiences or mental health. To address these gaps, we explored potential differences in disclosure, minority stress, and mental health among bi+ adults based on primary sexual identity and multiple label use. As part of a larger project, 669 bi+ adults completed an online survey. Primary sexual identities included bisexual (53.2%), pansexual (26.3%), and queer (20.5%), and 55.2% used multiple labels. Compared to bisexual participants, pansexual participants reported higher disclosure, discrimination from heterosexual people, and depression. Pansexual participants also reported higher anxiety and lower internalized binegativity, but these associations became non-significant after adjusting for demographics. Queer participants reported higher disclosure, discrimination from heterosexual people, and anxiety, but only the difference in disclosure remained significant in adjusting analyses. Finally, participants who used multiple labels reported higher disclosure and discrimination from heterosexual and gay/lesbian people, but only the difference in discrimination from gay/lesbian people remained significant in adjusted analyses. Findings highlight the heterogeneity of bi+ individuals and the importance of considering bisexual, pansexual, and queer individuals as unique groups as well as considering whether bi+ individuals use one or multiple sexual identity labels.

The impacts of adverse childhood experiences on socioeconomic disadvantage by sexual and gender identity in the U.S

BACKGROUND

Adverse childhood experiences (ACEs) predict low education and low income, but this has scarcely been examined by sexual orientation and gender identity.

OBJECTIVE

We investigated prevalence and associations between ACEs, low income, and low education in sexual and gender diverse (SGD) and cisgender heterosexual (CGH) sub-groups.

PARTICIPANTS AND SETTING

Data came from 14 states in the 2019 Behavioral Risk Factor Surveillance System survey (n = 79,303).

METHODS

Chi-square, logistic regression, and moderation analyses were implemented to examine the prevalence and associations between ACEs, low income, and low education. Sample stratification was used to examine differences between SGD and CGH sub-groups.

RESULTS

SGD participants reported higher prevalence of ACEs, low income, and low education compared to CGH participants (p < 0.0001) with the highest proportions in transgender and queer/something else groups. ACEs were associated with low income (AOR 1.084, CI 1.067-1.102) and low education (AOR 1.056, CI 1.041-1.071) in the entire sample. Transgender and queer/something else groups had higher odds of low income (AOR 3.345, CI 1.975-5.665; AOR 1.702, CI 1.096-2.643) and low education (AOR 1.702, CI 1.096-2.643; AOR 3.552, CI 2.842-4.440) and gay/lesbian identity had reduced odds of low education (AOR 0.586, CI 0.457-0.751) compared to CGH males. The strength of associations between ACEs and low income and low education were weaker among SGD compared to CGH sub-groups.

CONCLUSION

These findings highlight the importance of including categories of sexual identity cross-classified by gender identity in population-based analyses in order to facilitate a comprehensive characterization of the life course outcomes of SGD populations.

Aspects of positive identity buffer the longitudinal associations between discrimination and suicidal ideation among bi+ young adults

OBJECTIVE

Prior research has demonstrated that discrimination is associated with suicidal ideation among bi + individuals, but little is known about resilience factors (both general and bi + specific) that may buffer these associations. This prospective study examined the main and interactive effects of antibisexual discrimination and resilience factors, including general resilience and positive bi + identity factors (community, authenticity, and intimacy), in predicting suicidal ideation at 1- and 2-month follow-up.

METHOD

Participants were bi + young adults (N = 396; ages 18-29; 42.7% cisgender men, 42.2% cisgender women, 15.2% transgender/gender diverse individuals; 37.9% racial and ethnic minority individuals) who completed measures of antibisexual discrimination (Brief Antibisexual Experiences Scale), positive bi + identity (Lesbian, Gay, and Bisexual Positive Identity Measure), general resilience (Brief Resilience Scale), and suicidal ideation (Beck Scale for Suicide Ideation) at baseline, and suicidal ideation again at 1- and 2-month follow-up.

RESULTS

Greater antibisexual discrimination was significantly associated with increases in suicidal ideation at 1-month follow-up at low levels of community, authenticity, and intimacy, and increases in suicidal ideation at 2-month follow-up at low levels of authenticity. In addition, at high levels of authenticity, greater antibisexual discrimination was significantly associated with decreases in suicidal ideation at 1-month follow-up. In contrast, general resilience did not moderate the associations between antibisexual discrimination and suicidal ideation at 1- or 2-month follow-up.

CONCLUSIONS

Results suggest that promoting positive aspects of bi + identity (community, authenticity, and intimacy), but not general resilience, may help attenuate the effects of antibisexual discrimination on suicidal ideation over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Parent-Adult Child Estrangement in the United States by Gender, Race/ethnicity, and Sexuality

Objective

To provide nationally-representative estimates of parent-adult child estrangement.

Background

Population-level research is needed on parent-adult child estrangement to understand the full range of family dynamics in the U.S.

Method

We estimate logistic regression models using data from the National Longitudinal Survey of Youth 1979 Child and Young Adult supplement to determine estimates of estrangement (and subsequent unestrangement) from mothers (N=8,495) and fathers (N=8,119) by children's gender, race/ethnicity, and sexuality. We then estimate hazards of first estrangement from mothers (N = 7,919) and fathers (N = 6,410), adjusting for adult child's and parents' social and economic characteristics.

Results

Six percent of respondents report a period of estrangement from mothers, with an average age of first maternal estrangement of 26 years old; 26 percent of respondents report estrangement from fathers, with an average age of first paternal estrangement of 23 years old. Results further show heterogeneity by gender, race/ethnicity, and sexuality; for example, daughters are less likely to be estranged from their mothers than are sons, Black adult children are less likely than White adult children to be estranged from their mothers but more likely to be estranged from fathers, and gay, lesbian, and bisexual adult children are more likely than heterosexuals to be estranged from fathers. The majority of estranged adult children become unestranged from mothers (81%) and fathers (69%) in subsequent waves.

Conclusion

This study provides compelling new evidence on an overlooked aspect of intergenerational relationships, concluding with insight into the structural forces that unequally contribute to estrangement patterns.

Contested Queerness: Identity Politics at the Party by Ostbahnhof

Here, I provide a descriptive account of The Party by Ostbahnhof grounded in interview and ethnographic work. Ostbahnhof is an underground warehouse party that "puts queer people … first." By closely examining a polemic manifesto, calling for the exclusion of "basic white-cis-homo-normal" gays, I document the popular theories of queerness that determine which individuals can participate in Ostbahnhof's project, how, and to what ends. I use the aperture of an the ever-contentious question-who qualifies as a queer person?-to uncover the contradictory and multivalent nature of queerness as theorized in and outside of the academy. Following the party's organizers, I conclude by questioning the political utility of purely "anti-normative" queer ideologies and look to their example if a "positive" definition of queerness as a potential roadmap for navigating a rapidly expanding queer public sphere.

Changes in Lesbian identity in the 21st century

A review of influential research on lesbian identity since the turn of the 21st century suggests changes in the experience and meaning of lesbian identity and community. The journey of adolescent women to lesbian identity is marked by an exploration of attractions and sexual behavior with people of different genders. Whereas some lesbians come to see their identity as immutable, others see it as fluid. With shifts in political goals and the dismantling of the gender binary, the meaning of lesbian identity is contested. The multiplicity in meaning and differences among lesbian women challenges a sense of belonging in lesbian communities, nevertheless, the centrality of lesbian friendship and networks of care sustain lesbians across their life span.

Queer identities in the 21st century: Reclamation and stigma

"Queer" has undeniably gained popularity as a reclaimed identity in the 21st century. Recent studies find that between 5% and 20% of non-heterosexuals identify as queer. Additionally, about 1 in 3 like to see the "Q" in "LGBTQ" and view "queer" as an empowering identity. Yet alongside this "queer" reclamation, queer people experience stigma including high rates of victimization with 3 in 4 queer women and men reporting sexuality-based discrimination, harassment, and/or violence. In addition, the negative stereotypes that queer women and men are "too hypersexual" and that they are not appropriately feminine/masculine remain fixtures in today's cultural climate. The "queer" slur is also reportedly used by 1 in 4. I conclude that currently, "queer" should be understood as both reclaimed and stigmatized.

Subcultural Identification, Penetration Practices, Masculinity, and Gender Labels within a Nationally Representative Sample of Three Cohorts of American Black, White, and Latina/o LGBQ People

Most quantitative research about lesbian, gay, bisexual, and queer (LGBQ) people's sexual subcultures and sexual practices has used non-probability samples due to data limitations. This paper used the Generations study, a national probability sample of LGBQ Americans in three age cohorts, 18-25 (n = 510), 34-41 (n = 294), and 52-59 (n = 425), who also identified as Black, white, or Latina/o. This paper analyzed men (n = 590) and women (n = 639) to answer the following sets of research questions: (1) What is the prevalence of subcultural identification as bear, leather/kink, twink, and jock among men, and how does it differ by cohort, race/ethnicity, and sexual identity? (2) What is the prevalence of men who describe themselves as a top, versatile top, versatile, versatile bottom, and bottom? What is the relationship between penetration practices and masculinity? (3) What is the prevalence of gender labels among women as femme, androgynous, and butch? How does the prevalence differ by cohort, race/ethnicity, and sexual identity? (4) What is the relationship between women's gender labels and masculinity? Penetration practices were fairly evenly distributed among men, and there were few differences in masculinity based on penetration practices after controlling for demographics and subcultural identification. Most women did not use gender labels, but butch identities were more common among lesbians and femme labels were more common among Black women and Latinas.

Childhood Experiences and Mental Health of Sexual Minority Adults: Examining Three Models

Three models of recalled childhood gender nonconformity (GNC) and maltreatment are proposed to explain disparities in current psychological distress and lifetime suicidality among sexual minority individuals, using a United States probability sample of cisgender lesbian/gay (n = 701), bisexual (n = 606), and other (e.g., queer, n = 182) adults. Indirect effects indicated that lesbian/gay individuals were more likely than bisexual individuals to experience maltreatment and suicidal ideation as childhood GNC increased. Other indirect effects found that bisexual individuals reported more psychological distress and greater likelihood of lifetime suicidal ideation and attempts than lesbian/gay individuals as maltreatment increased. The direct effects of sexual orientation were stronger than the indirect effects via maltreatment or GNC, with bisexual individuals reporting more maltreatment, distress, and suicidality than lesbian/gay individuals. Significant findings for individuals with other identities were similar to those of bisexual individuals. Adjusted findings were comparable for women and men. The findings indicated that sexual minority individuals reported experiences consistent with sexual minority stress during early developmental periods, before being aware of their sexual orientation. It is necessary to understand the early lived experiences of sexual minority individuals, differences between lesbian/gay and bisexual individuals in those experiences, and their implications for adaptation.

Sexual Identities and Reactions to Black Lives Matter

INTRODUCTION

This study traced sexuality differences in Black Lives Matter (BLM) approval before using theories of "political distinctiveness" to explain why sexuality differences occurred.

METHODS

A random sample of 3489 US adults completed the 2016 wave of the American National Election Survey (ANES) Time Series project. Ordinary least squares (OLS) regressions assessed differences in BLM support by reported sexual identity when adjusting for possibly relevant covariates.

RESULTS

Lesbians, gays, and bisexuals (LGB) backed BLM more than heterosexuals. Increased LGB support of BLM was driven by sexuality differences in racial backgrounds, marital statuses, perceptions of police biases, approval of Black empowerment, authoritarianism, and emotional bonds to people of color.

CONCLUSIONS

Sexual identities shape reactions to antiracist social movements. LGB alignment with BLM is partly due to sexual discrepancies in demographic qualities, group memberships, and the way sexual identities alter an awareness of social biases.

POLICY IMPLICATIONS

Greater LGB liberalism, plus the queer friendly nature of BLM, offers greater prospects in the creation and maintenance of intersectional social justice movements that seek to improve the lives of racial and sexual minorities.

Partnership Status and Mental Health in a Nationally Representative Sample of Sexual Minorities

Research has consistently shown mental health differences between sexual minority subgroups with bisexual people often reporting higher levels of psychological distress than lesbians and gay men. Relationship status has been suggested, but not well studied, as a potential factor contributing to subgroup differences in mental health. Using a national probability sample of non-transgender sexual minority adults across 3 age cohorts (18-25, 34-41, 52-59 years), we assessed group differences in psychological distress (Kessler 6) between lesbian/gay (N = 505), bisexual (N = 272), and queer/pansexual (N=75) respondents. We examined whether relationship status (single/partnered) moderated the relationship between sexual identity and psychological distress. Among those that were partnered, we tested whether key partner characteristics related to sexual identity - gender of partner (cisgender same-sex/transgender or cisgender different-sex) and partner sexual identity (same or mixed sexual orientation relationship) - were significantly associated with psychological distress. In bivariate analyses, bisexual and queer/pansexual respondents reported more psychological distress than gay/lesbian respondents, among both men and women. In multivariable analyses, there was not a significant main effect of sexual identity, but there was a significant interaction between sexual identity and partnership status on psychological distress among women. Specifically, while there were no significant differences in psychological distress between subgroups of single women, among partnered women, queer/pansexual women had more distress than lesbian/gay women. Further, partnership was associated with reduced distress among lesbian/gay women, but not among bisexual or queer/pansexual women. Among men, there were no significant interaction effects between sexual identity and partnership status on psychological distress. Being in a mixed orientation relationship, but not gender of partner, was a significant predictor of psychological distress among both women and men across sexual identities. Additional research should assess the partnership dynamics contributing to the association between partnership characteristics and mental health among sexual minority populations.

Diverse Sexual and Gender Identity, Bullying, and Depression Among Adolescents

Surveillance data indicate youth have many sexual and gender identities that should be included in clinical forms and surveys to document and improve health equity.

The perks of being bi+: Positive sexual orientation-related experiences among bisexual, pansexual, and queer male youth

Previous research on sexual minority health has largely focused on negative experiences related to one's sexual orientation with limited attention to the ways in which being a sexual minority can contribute to positive experiences. This is especially true of bisexual, pansexual, and queer (bi+) male youth, whose experiences have not been represented in the literature. To address these gaps, the goal of the current study was to characterize positive experiences related to one's sexual orientation in a sample of 46 bi+ male youth (ages 14-17) who were interviewed as part of a larger study. Interviews were transcribed and thematically analyzed. Almost all of the participants described at least one positive experience related to their bi+ identity. The positive experiences fell into six categories: (1) experiences with LGBTQ+ people in general; (2) experiences with other bi+ people; (3) experiences in LGBTQ+ environments; (4) experiences disclosing bi+ identities; (5) romantic and sexual experiences; and (6) experiences with allies. Participants described eight reasons for these experiences being positive: (1) feeling a sense of belonging in a community; (2) the normalization, acceptance, and visibility of one's identity or community; (3) providing or receiving support; (4) discussing shared experiences; (5) the promotion of authenticity; (6) celebrating one's identity or community; (7) experiencing personal growth; and (8) not feeling limited by gender when it came to romantic and sexual experiences. In sum, bi+ male youth report a range of positive experiences related to their sexual orientation, which may have important implications for promoting resilience and wellbeing.

Mental Health of Lesbian, Bisexual, and Other-Identified Parents and Non-Parents from a Population-Based Study

Studies have compared sexual minority mothers (mostly lesbian) to heterosexual mothers on mental health, but little research has compared sexual minority women with and without children. This was the first study to compare sexual minority women who did or did not have children, using a population-based sample with three age cohorts. Unlike prior convenience studies, this study finds parents more likely to be bisexual, in a relationship with a man, and non-urban. Bisexual parents scored higher than lesbian parents on psychological distress and lower on life satisfaction and happiness; they also reported less connection to the lesbian, gay, bisexual, and transgender (LGBT) community. Among lesbians, the oldest non-parents reported more happiness and less psychological distress than the youngest non-parents. Parents with other identities perceived more social support from friends and reported lower levels of internalized homophobia than bisexual parents. The results will help professionals and policymakers understand how parenthood status affects women across sexual identities.

Self-Identity, Beliefs, and Behavior Among Men Who Have Sex with Transgender Women: Implications for HIV Research and Interventions

While transgender women have been identified as a global priority population for HIV prevention and treatment, little is known about the cisgender male partners of transgender women, including their sexual behavior and HIV prevalence. Previous research has suggested that these male partners have varied identities and sexual behavior, which make identifying and engaging them in research difficult. This paper describes interviews conducted with fifteen cisgender men who reported recent sexual activity with transgender women in Lima, Peru. The purpose of this research was to explore how these men reported their identities and sexual behavior, to better understand how they would interact with HIV outreach, research, and care. The major themes were sexual orientation and identity; view of transgender partners; social ties to transgender women and other men with transgender women partners; disclosure of relationships; HIV knowledge and risk perception; and attitudes toward interventions. We found that language used to assess sexual orientation was problematic in this population, due to lack of consistency between orientation and reported behavior, and unfamiliarity with terms used to describe sexual orientation. In addition, stigma, lack of knowledge of HIV prevention methods, and fear of disclosure of sexual behavior were identified as barriers that could impact engagement in HIV research, prevention, and care. However, participants reported social relationships with both transgender women and other men who have transgender partners, presenting possible avenues for recruitment into HIV research and healthcare services.

Differences in Multimorbidity among Cisgender Sexual Minority and Heterosexual Adults: Investigating Differences across Age-Groups

Objectives: Despite increased risk for chronic disease, there is limited research that has examined disparities in multimorbidity among sexual minority adults and whether these disparities differ by age. Methods: Data were from the 2014-2018 Behavioral Risk Factor Surveillance System. We used sex-stratified multinomial logistic regression to examine differences in multimorbidity between sexual minority and heterosexual cisgender adults and whether hypothesized differences varied across age-groups. Results: The sample included 687,151 adults. Gay, lesbian, and bisexual adults had higher odds of meeting criteria for multimorbidity than same-sex heterosexual adults. These disparities were greater among sexual minority adults under the age of 50 years. Only other non-heterosexual men over the age of 50 years and lesbian women over the age of 80 years were less likely to have multimorbidity than their same-sex heterosexual counterparts. Discussion: Health promotion interventions to reduce adverse health outcomes among sexual minorities across the life span are needed.

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.

Minority stress, distress, and suicide attempts in three cohorts of sexual minority adults: A U.S. probability sample

During the past 50 years, there have been marked improvement in the social and legal environment of sexual minorities in the United States. Minority stress theory predicts that health of sexual minorities is predicated on the social environment. As the social environment improves, exposure to stress would decline and health outcomes would improve. We assessed how stress, identity, connectedness with the LGBT community, and psychological distress and suicide behavior varied across three distinct cohorts of sexual minority people in the United States. Using a national probability sample recruited in 2016 and 2017, we assessed three a priori defined cohorts of sexual minorities we labeled the pride (born 1956-1963), visibility (born 1974-1981), and equality (born 1990-1997) cohorts. We found significant and impressive cohort differences in coming out milestones, with members of the younger cohort coming out much earlier than members of the two older cohorts. But we found no signs that the improved social environment attenuated their exposure to minority stressors-both distal stressors, such as violence and discrimination, and proximal stressors, such as internalized homophobia and expectations of rejection. Psychological distress and suicide behavior also were not improved, and indeed were worse for the younger than the older cohorts. These findings suggest that changes in the social environment had limited impact on stress processes and mental health for sexual minority people. They speak to the endurance of cultural ideologies such as homophobia and heterosexism and accompanying rejection of and violence toward sexual minorities.

A Qualitative Analysis of Adolescent Responses to YouTube Videos Portraying Sexual and Gender Minority Experiences: Belonging, Community, and Information Seeking

Sexual and gender minority youth are at risk for negative mental health outcomes, such as depression and suicide, due to stigma. Fortunately, sense of community, connection, and social support can ameliorate these deleterious effects. Youth express that most of their social support comes from peers and in-school organizations, but these sources require in-person interaction. Past research has identified social media sites as virtual and anonymous sources of support for these youth, but the role of YouTube specifically in this process has not been thoroughly explored. This study explores YouTube as a possible virtual source of support for sexual and gender minority youth by examining the ecological comments left on YouTube videos. A qualitative thematic analysis of YouTube comments resulted in six common themes in self-identified adolescents' YouTube comments: sharing, relating, information-seeking, gratitude, realization, and validation. Most commonly, adolescents shared feelings and experiences related to their identity, especially when they could relate to the experiences discussed in the videos. These young people also used their comments to ask for identity-related advice or information, treating the platform as a source of education. Results suggest that sexual minority youth's use of YouTube can be advantageous for social support and community, identity-related information, identity development, and overall well-being.

Sexual identity development milestones in three generations of sexual minority people: A national probability sample

Using data from the first national probability sample of Black, White, and Latinx sexual minority people in the United States, we examined whether and how sexual identity development timing and pacing differs across demographic subgroups at the intersections of cohort, sex, sexual identity, and race/ethnicity. Among a sample of 1,491 participants aged 18-60 from 3 distinct birth cohorts, we measured participants' ages of sexual identity development milestones, including first same-sex attraction, first self-realization of a sexual minority identity, first same-sex sexual behavior, first disclosure to a straight friend, and first disclosure to a family member. Participants from more recent cohorts reported earlier and accelerated pacing of milestones relative to those from older cohorts. Subgroups defined by sex and sexual identity varied in milestone timing and pacing, with gay males reporting an earlier onset of some milestones than other subgroups. Those who used newer identity labels (e.g., pansexual, queer) reported younger ages of milestones relative to bisexual participants but similar ages to lesbian and gay participants. Black and Latinx participants reported some milestones at younger ages than White participants. Race-stratified models testing groups at the intersection of cohort, sex, and sexual identity revealed subgroup differences in ages of first disclosure to family, as well as differences in the time between self-realization, same-sex sexual behavior, and disclosure to a straight friend. The results suggest substantial variation in the developmental timing and pacing of milestones across social identities and the need to further examine how milestone timing is related to identity, stress, and health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Personality and Sexual Orientation: New Data and Meta-analysis

This research explored associations between personality and sexual orientation. In Study 1, we explored whether the Big Five trait dimensions relate to sexual orientation in a nationally representative sample of Australian adults (n = 13,351). Personality differences were observed between those who identified as heterosexual (straight), bisexual, and homosexual (gay/lesbian) on all five measured traits. In Study 2, we conducted an updated systematic review and meta-analysis of personality and sexual orientation. A total of 21 studies (35 independent samples, 262 effect sizes) comprising 377,951 men and women were identified that satisfied inclusion criteria. Results showed that bisexual individuals reported higher levels of openness than homosexual individuals, who in turn, reported higher levels of openness than heterosexual individuals. Bisexual individuals also report lower levels of conscientiousness than both heterosexual and homosexual individuals. Sex moderation effects showed that homosexual men scored higher than heterosexual men on neuroticism, agreeableness and conscientiousness, whereas homosexual women scored lower than heterosexual women on extraversion, agreeableness, and conscientiousness. There was also evidence that personality differences between sexual orientation categories tend to decline with age. These findings align with the gender-shift hypothesis and should be of interest to theorists working in personality science and sexual identity development.

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

Scientific evidence regarding sexual minority populations has generally come from studies based on two types of samples: community-derived samples and probability samples. Probability samples are lauded as the gold standard of population research for their ability to represent the population of interest. However, while studies using community samples lack generalizability, they are often better able to assess population-specific concerns (e.g., minority stress) and are collected more rapidly, allowing them to be more responsive to changing population dynamics. Given these advantages, many sexual minority population studies rely on community samples. To identify how probability and community samples of sexual minorities are similar and different, we compared participant characteristics from two companion samples from the Generations Study, each designed with the same demographic profile of U.S. sexual minority adults in mind. The first sample was recruited for a national probability survey, whereas the second was recruited for a multicommunity sample from four U.S. cities. We examined sociodemographic differences between the samples. Although there were several statistical differences between samples, the effect sizes were small for sociodemographic characteristics that defined the sample inclusion criteria: sex assigned at birth, race/ethnicity, and age cohort. The samples differed across other characteristics: bisexual respondents, respondents with less education, and those living in non-urban areas were underrepresented in the community sample. Our findings offer insights for recruiting community samples of sexual minority populations and for measuring sexual identity on probability surveys. They also bolster confidence in well-designed community samples as sources for data on sexual minority populations.