Pride and prejudice: employment discrimination against openly gay men in the United States

"…full of opportunities, but not for everyone": A narrative inquiry into mechanisms of labor market inequity among precariously employed gay, bisexual, and queer men

BACKGROUND

This study brings lesbian, gay, bisexual, transgender (trans), and queer (LGBTQ+) populations into scholarly discourse related to precarious employment through a political economy of queer struggle.

METHODS

Drawing on narrative inquiry, 20 gay, bisexual, and queer men shared stories of precarious employment that were analyzed using Polkinghorne's narrative analysis.

RESULTS

Results tell an overarching narrative in three parts that follow the trajectory of participants' early life experiences, entering the labor market and being precariously employed. Part 1: Devaluation of LGBTQ+ identities and adverse life experiences impacted participants' abilities to plan their careers and complete postsecondary education. Part 2: Participants experienced restricted opportunities due to safety concerns and learned to navigate white, cis, straight, Canadian ideals that are valued in the labor market. Part 3: Participants were without protections to respond to hostile treatment for fear of losing their employment.

CONCLUSIONS

These stories of precarious employment illustrate unique ways that LGBTQ+ people might be particularly susceptible to exploitative labor markets.

A research agenda for understanding how social inequality is linked to brain structure and function

Consistent evidence documents powerful effects of social inequality on health, well-being and academic achievement. Yet research on whether social inequality may also be linked to brain structure and function has, until recently, been rare. Here we describe three methodological approaches that can be used to study this question-single site, single study; multi-site, single study; and spatial meta-analysis. We review empirical work that, using these approaches, has observed associations between neural outcomes and structural measures of social inequality-including structural stigma, community-level prejudice, gender inequality, neighbourhood disadvantage and the generosity of the social safety net for low-income families. We evaluate the relative strengths and limitations of these approaches, discuss ethical considerations and outline directions for future research. In doing so, we advocate for a paradigm shift in cognitive neuroscience that explicitly incorporates upstream structural and contextual factors, which we argue holds promise for uncovering the neural correlates of social inequality.

Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study

Background

Employment outcomes among sexual minority (i.e., lesbian, gay, bisexual) workers are poorly understood, and previous research on this topic has focused almost exclusively on inequities in earnings, neglecting other important dimensions of job quality. We address this gap by describing and comparing the job quality of straight and sexual minority workers in Canada.

Methods

Data are from the 2016 General Social Survey: Canadians at Work and Home, the only national survey providing both a measure of sexual orientation and a multidimensional view of job quality in Canada. We identified 25 unique job quality indicators (e.g., temporary employment; job insecurity; health benefits; low income; job satisfaction; job control; discrimination). Latent class cluster analysis was used to establish a typology of job quality describing standard, flexible, and precarious employment types. We used multivariable regression methods to examine the association between sexual orientation and job quality.

Results

Sexual minorities reported lower job quality than their straight counterparts along many dimensions, with bisexual people reporting the lowest job quality. While inequities were generally observed among both sexual minority men and women, they sometimes differed in magnitude by gender. The prevalence of precarious employment was nearly three times higher among lesbian, gay, and bisexual workers (PR: 2.94, CI: 1.89-4.58 among all sexual minorities; PR: 3.04, CI: 1.71-5.43 among gay/lesbian workers; and PR: 2.81, CI: 1.45-5.47 among bisexual workers) compared to their straight counterparts.

Conclusion

Inequities in job quality among sexual minorities persist despite comprehensive human rights protections in Canada. These inequities are pervasive, extending well beyond conventional indicators such as dollars earned and hours worked. Multi-pronged interventions are needed that move beyond simply ensuring that sexual minority workers are employed. Sexual minority workers deserve access to secure, well-paid work with benefits where they can foster connection and be free from discrimination.

Sexual orientation and self-employment: New evidence

Early studies and theory suggest sexual minorities are drawn towards the relative independence of self-employment to avoid discrimination in paid employment. However, recent evidence is mixed, suggesting that a higher propensity for self-employment (relative to heterosexual people) is found only among lesbian women relative to heterosexual women. This study overcomes the data limitations of prior research by using data pooled from 2007-2017 cycles of the Canadian Community Health Survey (CCHS) and multivariate logistic regression to provide new evidence on LGB self-employment. The results show that self-employment is particularly high for bisexual people, especially bisexual women-but not for gay men or lesbian women. Overall, this study examines the enduring but nuanced relationship between self-employment and sexual orientation and discusses countervailing factors related to socio-economic resources, gender, and family structure.

The descriptive analysis of depressive symptoms and White Blood Cell (WBC) count between the sexual minorities and heterosexual identifying individuals in a nationally representative sample: 2005-2014

BACKGROUND

Sexual minorities are at a higher risk of suffering from depressive symptoms compared with heterosexual individuals. Only a few studies have examined the conditions of having depressive symptoms within different sexual minority groups, especially people with sexual orientation uncertainty in a nationally representative sample. Furthermore, few studies have explored whether the mean white blood count (WBC) is different between people with and without depressive symptoms among different sexual minority groups in a nationally representative sample.

METHODS

We analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 with a sample of 14,090 subjects. We compared the prevalence of depressive symptoms in subpopulations stratified by sex, sexual minority status, and race. We also examined the difference in mean WBC count between depressed and non-depressed people among heterosexual individuals and different sexual minority groups. Additionally, two multivariable logistic regression models were used to explore the association between sexual minority status and depressive symptoms, treating sexual minority status as both a binary and categorical variable.

RESULTS

Female sex (OR: 1.96, 95% CI: 1.72-2.22) and sexual minority status (OR: 1.79, 95% CI: 1.47-2.17) were both independently associated with depressive symptoms. Within the sexual minority population, subjects who were unsure about their sexual identities had the highest odds of having depressive symptoms (OR: 2.56, 95% CI: 1.40-4.68). In the subgroup analysis considering intersectionality, black sexual minority females had the highest rate of depressive symptoms (19.4%, 95% CI: 7.72-40.98). Finally, the mean WBC count differed significantly between people with and without depressive symptoms among male heterosexual individuals, female heterosexual individuals, and female sexual minorities, but not among male sexual minorities.

CONCLUSIONS

Based on sex, race, and sexual minority status, black females of sexual minority status had the highest rate of depressive symptoms. Within sexual minority groups, participants who were unsure about their sexual identities had the highest odds of having depressive symptoms. Finally, the mean WBC count was significantly higher among people with depressive symptoms than those without depressive symptoms only among male heterosexuals, female heterosexuals, and female sexual minorities, but not among male sexual minorities. Future research should investigate the social and biological mechanisms of the differences.

Gender benders and job contenders: cosmetics in selection contexts for women and men

Purpose

The aim of the present study was to contribute to the workplace diversity literature by experimentally manipulating gender expression through the use of makeup among women and men to determine makeup's impact on interpersonal discrimination in a real-world job selection context.

Design/methodology/approach

In an experimental field study, we applied either real (i.e. tinted) or placebo (i.e. transparent) cosmetic products to women and men confederate applicants. The women and men engaged in job inquiry and pre-interview conversations with store personnel in 136 retail stores across 3 shopping malls that were randomly assigned to one of 4 conditions in a 2 (confederate gender: women versus men) by 2 (cosmetic usage: real versus placebo) experimental design. The confederate applicants were accompanied by confederate observers and recorded interactions were later analyzed by naïve coders. The applicants, observers, and naïve coders rated interpersonal discrimination from store personnel in each interaction.

Findings

As hypothesized, women who enhanced their femininity through the use of makeup experienced significantly less interpersonal discrimination than women who did not. In contrast, there was no significant difference in interpersonal discrimination for men as a function of visual gender expression.

Originality/value

These findings highlight the pervasive gender norm expectations for women at work by examining gender non-conformity of women and men.

Development and Evaluation of the Ally Sexual and Gender Minority Diversity and Inclusion Training at the Centers for Disease Control and Prevention

CONTEXT

The Centers for Disease Control and Prevention (CDC) developed a workforce training on sexual and gender minorities (SGMs).

OBJECTIVE

This article describes the evaluation of the training.

DESIGN

Participants completed pre- and posttest surveys. After the pilot evaluation, some improvements were made to the curriculum and to the pre- and posttest questionnaires. Participants in subsequent (implementation) training were similarly asked to complete pre- and posttest questionnaires.

SETTING

CDC.

PARTICIPANTS

CDC staff.

MAIN OUTCOME MEASURES

Participants' knowledge, ally identity, and perceptions of SGMs.

RESULTS

Pilot and implementation training data showed increases in participant knowledge of 44% and 49%, respectively, increases in ally identity of 11% and 14%, respectively, and increases in positive perceptions of SGM of 25% and 31%, respectively.

CONCLUSION

These results suggest that the CDC Ally Training may be a useful tool for improving staff knowledge and perceptions of SGM people.

Gay and Straight Men Prefer Masculine-Presenting Gay Men for a High-Status Role: Evidence From an Ecologically Valid Experiment

There is increased acceptance of gay men in most Western societies. Nevertheless, evidence suggests that feminine-presenting gay men are still disadvantaged compared to gay men who present in a more traditionally masculine way. Though gay men themselves may be complicit in perpetuating this bias, studies that demonstrate this possibility are scant. Whereas most studies on perceptions of feminine-presenting gay men have manipulated gender nonconformity via written descriptions, research suggests that behavioural cues such as voice and body-language can mitigate or exacerbate prejudice toward a stereotyped individual. In the current study, audio-visual stimuli were created to investigate how masculine versus feminine behaviour would impact status endowment from other gay and heterosexual men. In total, 256 men (Mage = 42.73, SD = 14.48: half gay; half heterosexual) cast, from a selection of six video-taped candidates, one gay man to play a lead role in a purported ad for a tourism campaign. In the videos, the actors delivered a script related to the tourism campaign in a manner where their voice and body-language was manipulated to come across as either masculine or feminine-presenting. Findings indicated that gay and heterosexual participants showed a significant preference for the masculine videoclips. For heterosexual men, the preference for masculine-presenting actors was predicted by greater anti-gay sentiment, whereas internalised anti-gay prejudice did not predict a preference for masculine-presentation among gay men. Implications of the findings for discourse and education on intraminority prejudice and suggestions for future research are offered.

Masculinity and Leadership Effectiveness (Self-)Perceptions: The Case of Lesbian Leaders

In line with the gay glass ceiling effect, sexual minorities are often target of discrimination within work-related contexts, thus potentially undermining their wellbeing at work. For gay men, discrimination may partially be attributed to gay men's stereotypical feminine perception, which does not fit with the stereotypically masculine traits required for leadership positions. Yet, when considering lesbian women, the masculine stereotypical view associated with them may come to represent an advantage in work-related contexts, especially when compared to heterosexual women. In Study 1, N = 303 heterosexual participants rated a lesbian vs. a heterosexual woman as a job candidate on stereotypical gender (masculine vs. feminine) traits as well as leadership effectiveness. Results showed that being lesbian was associated with higher levels of masculinity (but not femininity), which in turn was related to high leadership effectiveness. In Study 2, N = 268 lesbian and heterosexual women rated themselves on the same measures. Results showed that both groups associated masculine traits with enhanced leadership effectiveness. These studies provide a better comprehension regarding how lesbian women may be perceived in work-related contexts and shed light on the role played by gender stereotypical perceptions in shaping both heterosexual and lesbian perceptions of leadership effectiveness.

Toward a Holistic Demographic Profile of Sexual and Gender Minority Well-being

Sexual and gender minority (SGM) populations experience disadvantages in physical health, mental health, and socioeconomic status relative to cisgender heterosexual populations. However, extant population research has tended to use objective measures and ignore subjective measures, examined well-being outcomes in isolation, and lacked information on less well studied but possibly more disadvantaged SGM subgroups. In this study, we use Gallup's National Health and Well-Being Index, which permits identification of gay/lesbian, bisexual, queer, same-gender-loving, those who identify as more than one sexual identity, transgender men, transgender women, and nonbinary/genderqueer populations. We estimate bivariate associations and ordinary least-squares regression models to examine differences along five dimensions of well-being: life purpose, residential community belonging, physical and mental health, financial well-being, and social connectedness. The results reveal that most SGM groups experience stark disadvantages relative to heterosexuals and cisgender men, which are most pronounced among bisexual, queer, and nonbinary/genderqueer populations. Intergroup and intragroup variations illuminate even greater disparities in well-being than prior research has uncovered, bringing us closer to a holistic profile of SGM well-being at the population level.

Sexualities and Geographic Mobility Between Childhood and Adulthood in the United States

Though research suggests that sexual minorities (e.g., nonheterosexual individuals) are more geographically mobile in the transition to adulthood than their heterosexual counterparts, quantitative estimates are rare and previously used data sources have significant limitations. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 11,705) that directly measure sexualities across dimensions (i.e., identity, behavior, and attraction), I examine variation in geographic mobility between childhood (ages 11-17) and adulthood (ages 26-34) across various sexualities (e.g., gay/lesbian and bisexual). Three findings emerge. First, mobility varies across sexualities. Individuals with gay/lesbian identity, same-sex behavior, and same-sex attraction are more geographically mobile than individuals with heterosexual identity, different-sex behavior, and different-sex attraction, respectively. By contrast, individuals with bisexual identity, both-sex behavior, and both-sex attraction tend to be statistically indistinct from individuals with heterosexual identity, different-sex behavior, and different-sex attraction, respectively. Second, mobility differences are largest and most prevalent when sexualities are operationalized according to identity. Third, evidence suggests that the effects of gay/lesbian identity, same-sex behavior, and same-sex attraction on mobility are larger for men than for women. In providing the first quantitative estimates of geographic mobility differences across broader sexual minority and heterosexual populations, this study expands inquiry related to sexualities and mobility.

Does Ageist Language in Job Ads Predict Age Discrimination in Hiring?

We study the relationships between ageist stereotypes - as reflected in the language used in job ads - and age discrimination in hiring, exploiting the text of job ads and differences in callbacks to older and younger job applicants from a resume (correspondence study) field experiment (Neumark, Burn, and Button, 2019). Our analysis uses computational linguistics and machine learning methods to examine, in a field-experiment setting, ageist stereotypes that might underlie age discrimination in hiring. In so doing, we develop methods and a framework for analyzing textual data, highlighting the usefulness of various computer science techniques for empirical economics research. We find evidence that language related to stereotypes of older workers sometimes predicts discrimination against older workers. For men, we find evidence that age stereotypes about all three categories we consider - health, personality, and skill - predict age discrimination, and for women, age stereotypes about personality predict age discrimination. In general, the evidence that age stereotypes predict age discrimination is much stronger for men, and our results for men are quite consistent with the industrial psychology literature on age stereotypes.

Food insecurity as a social determinant of sexual health and substance use independent of poverty status among men who have sex with men in the United States

PURPOSE

To characterize the prevalence of food insecurity among men who have sex with men (MSM) and assess its associations with sexual health measures and substance use, as compared to poverty status.

METHODS

In 2017, 10,049 US MSM were recruited online and completed the American Men's Internet Survey. The survey assessed food insecurity, annual household income and past-year behaviors: condomless anal intercourse (CAI), exchange sex, any illicit substance use other than marijuana, use of methamphetamine, alkyl nitrites or gamma-hydroxybutyrate (GHB), HIV testing and sexually transmitted infection testing and diagnosis. We tested associations between behavioral outcomes and food insecurity or poverty, controlling for demographic characteristics.

RESULTS

The prevalence of food insecurity among AMIS participants was 15.8%. Food insecurity non-response was 2.5% while income non-response was 19.0%. Food insecurity was significantly and positively associated with all behavioral outcomes, while poverty was significantly and positively associated only with exchange sex, any illicit substance use, methamphetamine and GHB use. In models that included both food insecurity and poverty as exposures, food insecurity remained independently positively associated with all behavioral outcomes and the associations for poverty level were null for all outcomes except methamphetamine and GHB use.

CONCLUSIONS

Assessing food insecurity in sexual health and substance use survey research may provide a more robust indicator of economic deprivation and provide insight for HIV and STI prevention interventions.

Too Manly and Too Straight? Perceived Sexual Orientation of Black and White Men and Women

Using data from an online survey assessing perceptions of 12 target¹ photos of Black and White males² and females, the current study examined a moderated mediation model of sexual orientation perceptions (N = 310). Results indicated that perceived masculinity/femininity was not a mediator in the association between target gender and perceived sexual orientation. Black male targets were perceived to be more heterosexual than White male targets, Black female targets were perceived as less heterosexual than White female targets, and Black targets were perceived as more masculine than White targets. These findings may indicate rigid gender- and sexuality-related expectations for Black men. Black women who are perceived as gay may be more at risk of related interpersonal harm than White women. Black sexual minority individuals may face challenges in navigating identity concealment or disclosure. Future research should explore the potential antecedents and consequences of perceptions of Black individuals' sexual orientation.

Reactions and Feelings to a Close Relative's Coming Out in a Heterosexual Relationship

Which different feelings and reactions do different family members show if an adult family member who has long been perceived as heterosexual discloses their sexual identity as lesbian, gay, or bisexual (LGB)? Previous studies have investigated reactions of spouses and sometimes children in the United States. This article describes the findings of qualitative interviews and a German-language quantitative survey (N = 188) in which family members were asked about their emotions, experiences during the coming out process, and their use of support options. The samples were recruited via different LGB+ online forums and organizations in Germany, Austria, and Switzerland (age M = 44.08). The results demonstrate that a coming out after years of a heterosexual biography and family life affects adults' parents and siblings in addition to spouses and children. Siblings were perceived as a supportive group of family members showing calm and mostly positive reactions. Parents mainly reported surprise but also showed on the one hand interest in supporting their children in the coming out process; on the other hand, we find also evidence for negative reactions including rejecting behavior. Children's coping and well-being depended on the time that had passed since the coming out and their age at the time of the coming out. Spouses felt shocked, angry, and the ground was pulled from under their feet. Comparing the perspectives of these groups of family members, differences between them, and their specific needs are discussed. Practical implications are derived from the support options mentioned, and range from information from books, the internet to professional advice. Spouses report the need of diverse support options, whereas other family members ask friends and other family members for support. Forums, counseling and the possibility to exchange were perceived as a support but were more accessible for women than for men. They provide the chance for a communicative exchange before the stress becomes too strong.

Everyday discrimination in later life: A social network approach

What factors shape everyday discrimination among older adults? Existing perspectives focus on individual identities and social group membership (e.g., race/ethnicity, age) as key determinants of perceived discrimination. This paper examines the idea that individuals' broader social contexts - including their personal social networks - also shape perceived discrimination, and in ways that may differ across racial groups. Using data from Round 3 of the National Social Life, Health, and Aging Project (N = 3312), I consider how properties of personal networks are associated with how frequently older adults report everyday discrimination. Results indicate that more kin-centric personal networks protect against more frequent everyday discrimination, but that this protective effect may be stronger among White older adults. I propose why more kin-centric networks may play a different role in the perceived discrimination of White and Black older adults, and close by suggesting that social network composition may be a source of heterogeneity in the link between everyday discrimination and inequality in later life outcomes such as health.

Fear and cultural background drive sexual prejudice in France – a sentiment analysis approach

Sexual prejudice and its negative consequences remain major issues in Western societies, and numerous studies have tried to pinpoint its sociocultural underpinnings. However, most research has operationalized sexual prejudice via self-report measures or via implicit association tests (IATs), although it surfaces in language use and can be traced in spontaneous speech.

Here, we report results from an experimental study investigating sexual prejudice in a corpus of spontaneous speech samples. Specifically, we tested in a context-sensitive sentiment analysis approach which attitudes (negative vs. positive) and emotions (joy, sadness, anger, fear, disgust) were voiced by the participants in response to picture prompts displaying homosexual couples. We also considered the sociocultural basis of prejudicial attitudes, in particular the effects of the participants’ cultural background (France vs. Maghreb), age and gender. We find strong effects of cultural background and gender both on the frequency of negative vs. positive attitudes expressed, and on discrete emotion categories, namely that male Maghrebian participants were more negative and conveyed more fear. The results are discussed in the context of current diversity approaches in France and their implications for potential prejudice regulation strategies. We further discuss in how far our context-sensitive sentiment analysis approach advances research on sexual prejudice.

A Founding Penalty: Evidence from an Audit Study on Gender, Entrepreneurship, and Future Employment

There is both widespread interest in encouraging entrepreneurship and universal recognition that the vast majority of these founders will fail, which raises an important unanswered question: What happens to ex-founders when they apply for jobs? Whereas existing research has identified many factors that facilitate movement out of an established organization and into entrepreneurship, far less attention has been devoted to understanding what transpires during the return journey—most notably, how employers evaluate entrepreneurial experience at the point of hire. We propose that employers penalize job candidates with a history of founding a new venture because they believe them to be worse fits and less committed employees than comparable candidates without founding experience. We further predict that the discount for having been an entrepreneur will diminish when other stereotypes about the candidate, particularly those based on gender, will contradict the negative beliefs about ex-founders. We test our proposition using a résumé-based audit and an experimental survey. The audit reveals that founding significantly reduces the likelihood that an employer interviews a male candidate, but there is no comparable penalty for female ex-founders. The experimental survey confirms the gendered nature of the founding penalty and provides evidence that it results from employers’ concerns that founders are less committed and worse organizational fits than nonfounders. Critically, the survey also indicates that these concerns are mitigated for women, helping to explain why they suffer no equivalent founding penalty.

“Here in the Bible Belt, It’s Predominantly Negative”: Sexual Identity Stigma in the American South, 50 Years After Stonewall

Lesbian, gay, bisexual, and pansexual (LGB+) individuals have disproportionate rates of mental illness. Minority stress and sexual identity stigma are posited as the primary social determinants of LGB+ mental health disparities. Discussions in the literature have questioned the impact of sexual identity stigma in a world increasingly accepting of sexual minorities. Additionally, the LGB+ population in the United States South is often overlooked in American research. This article details a qualitative study exploring experiences related to sexual identity stigma among adults who identify as LGB+ in the United States South. Semi-structured interviews with 16 individuals were analyzed using content analysis. Six thematic categories of stigma emerged from participants’ experiences: (a) navigating an LGB+ identity, (b) social acceptability of an LGB+ identity, (c) expectation of LGB+ stigma, (d) interpersonal discrimination and harassment, (e) structural stigma, and (f) relationship with the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Findings suggest that sexual identity stigma remains a common experience among these Southern United States participants. Further, thematic categories and subcategories primarily aligned with extant theory with one exception: Intracommunity stigma, a form of stigma emanating from the LGBTQ community, emerged as a stigma type not currently accounted for in theoretical foundations underpinning mental health disparities in this population.

Collateral Damage: The Relationship Between High-Salience Events and Variation in Racial Discrimination

To what extent are individual or organizational biases affected by racially salient events? We propose that acts of discrimination and the individual biases that undergird them are sensitive to high-salience events and will oscillate with the salience of the focal attribute. In short, that the propensity to discriminate reflects both individual and environmental differences, and therefore a given person may become more prone to discriminate in the aftermath of a high-salience event. We test our hypothesis in three online experiments that examine how varying the salience of race affects the evaluation of in-group or out-group founders. We find that respondents evaluate their in-group members more favorably, and out-group members less favorably, when exposed to a high-salience event, which translates into a significant disadvantage for the minority (African American) group. We complement these studies with an assessment of how police shootings affect fundraising outcomes on Kickstarter to confirm the external validity of our findings. Together, these studies indicate that racially salient events depress the quality evaluations and success odds of African American entrepreneurs relative to others. Hence, discrimination levels can be affected by salient yet unrelated events, and such events are consequential for the economic fortunes of individuals belonging to minority and disadvantaged groups.

Listening to Transgender Patients and Their Providers in Non-Metropolitan Spaces: Needs, Gaps, and Patient-Provider Discrepancies

Trans and gender non-conforming (TGNC) patients need better care; providers need TGNC focused medical trainings. TGNC health conferences can help, yet these events occur mostly in urban centers. Meanwhile, patients in non-metropolitan areas often face significant discrimination and notably poor access to TGNC care. This study explores the ongoing needs of TGNC patients and their providers following a one-day TGNC health conference in a small town in the American Midwest. Exploratory semi-structured interviews were used to gather in-depth information from TGNC conference attendees (N = 25). Theme analysis methods were used to identify areas of need for future trainings. Providers reported that they needed more exposure to TGNC patients, judgement-free opportunities to learn the basics about TGNC care, and ongoing trainings integrated into their medical school and ongoing education credits. Patients needed better access to care, more informed providers, and safer clinics. They cited lack of specialty care (e.g., mental health, surgery) as particularly problematic in a non-metropolitan setting. TGNC patients, and their providers in non-metropolitan areas, urgently need support. Patients lack specialized care and often possess greater knowledge than their health care teams; providers, in these areas, lack opportunities to work with patients and stay up to date on treatments.

Effects of the Affordable Care Act Dependent Coverage Mandate on Health Insurance Coverage for Individuals in Same-Sex Couples

A large body of research documents that the 2010 dependent coverage mandate of the U.S. Affordable Care Act was responsible for significantly increasing health insurance coverage among young adults. No prior research has examined whether sexual minority young adults also benefitted from the dependent coverage mandate despite previous studies showing lower health insurance coverage among sexual minorities. Our estimates from the American Community Survey, using difference-in-differences and event study models, show that men in same-sex couples aged 21-25 experienced a significantly greater increase in the likelihood of having any health insurance after 2010 than older, 27- to 31-year-old men in same-sex couples. This increase is concentrated among employer-sponsored insurance, and it is robust to permutations of periods and age groups. Effects for women in same-sex couples and men in different-sex couples are smaller than the associated effects for men in same-sex couples. These findings confirm the broad effects of expanded dependent coverage and suggest that eliminating the federal dependent mandate could reduce health insurance coverage among young adult sexual minorities in same-sex couples.

Physical and Mental Disabilities among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, BRFSS (2017-2019): A Propensity-Matched Analysis

This propensity-matched analysis utilized the publicly available Behavioral Risk Factor Surveillance System (2017–2019) data to compare the burden of disabilities among transgender/non-binary (TGNB) and cisgender groups. The groups were matched (1:1 ratio) on demographic variables using Nearest Neighborhood Matching. Categorical variables were compared among groups using a Chi-square analysis to test differences in the proportions. Multivariate logistic regression analysis was fit to predict the likelihood of the physical and mental disabilities among the TGNB group compared with the cisgender group while controlling for healthcare access factors, income, and employment. Survey weights were included in the model to account for the complex survey design. In a weighted sample of 664,103 respondents, only 2827 (0.4%) self-identified as TGNB. In the matched sample, a higher proportion of the TGNB group belonged to the low-income group (39.5% vs. 29.8%, p < 0.001), were unable to work (12.5% vs. 8.6%, p < 0.001), and delayed care due to cost barriers (19.0% vs. 12.4%, p < 0.001). Compared with the cisgender group, the odds of having difficulty making decisions were 1.94 times higher (95% CI: 1.67–2.27) and odds of difficulty walking were 1.38 times higher (95% CI: 1.19, 1.59) among the TGNB group. Additionally, the TGNB group had 59.8% higher adjusted odds ratio (aOR) (aOR 1.598, 95% Confidence interval (CI): 1.256, 2.034) of experiencing difficulty dressing and 83.3% higher odds (aOR 1.833, 95% CI: 1.533, 2.191) in having difficulty doing things alone. The findings of this study advocate for developing policies and interventions to deliver culturally competent care to the TGNB population with disabilities.

Cigarette taxes and smoking among sexual minority adults

We provide the first quasi-experimental evidence on the relationship between cigarette taxes and smoking among sexual minority adults, a group that has been understudied in past research. We use large samples of individuals in same-sex households (a large share of whom are sexual minorities in same-sex romantic relationships) from the 1996-2018 Behavioral Risk Factor Surveillance System. We find that cigarette taxes significantly reduced smoking among men and women in same-sex households, and the effects we find for men in same-sex households are very robust and significantly larger than the associated effects for men in different-sex households (the vast majority of whom are heterosexual married or partnered men). For men in same-sex households, we find no unintended consequences of higher cigarette taxes on other risky behaviors, and in fact we find that cigarette taxes are associated with significant improvements in self-rated health for men in same-sex households. These results suggest that the sizable disparities in adult smoking rates between heterosexual and sexual minority men would have been even larger in the absence of stricter tobacco control policy. However, in line with previous research indicating that cigarette taxes have 'lost their bite', we find no significant relationship between cigarette taxes and sexual minority smoking in more recent years.

Birth Cohort Trends in Health Disparities by Sexual Orientation

Lesbian, gay, and bisexual-identified (LGB) people experience worse mental and physical health than their straight-identified counterparts. Given remarkable social and legal changes regarding LGB status in recent decades, we theorize that this profound health disadvantage may be changing across cohorts. Using data from the 2013–2018 National Health and Interview Surveys, we analyze five mental and physical health outcomes—psychological distress, depression, anxiety, self-rated physical health, and activity limitation—across three birth cohorts colloquially known as (1) Millennials, (2) Generation Xers, and (3) Baby Boomers and pre-Boomers. We find no evidence of reduced health disparities by sexual orientation across cohorts. Instead, relative to straight-identified respondents, the health disadvantages of gay, lesbian, and—most strikingly—bisexual-identified people have increased across cohorts. Findings highlight the importance of identifying the causes of increased health disparities as well as designing and implementing more direct public policies and programs to eliminate health disparities among more recent LGB cohorts.

The Motherhood Penalty in Context: Assessing Discrimination in a Polarized Labor Market

Prior research provides important insights into employer discrimination against mothers but has focused exclusively on college-educated mothers in professional and managerial occupations. As a result, we lack evidence about whether less-educated mothers navigating the low-wage labor market experience similar disadvantages and whether the mechanisms underlying discrimination vary across contexts. These gaps are important because more- and less-educated mothers increasingly possess distinct resources and face unique demands both at home and at work, which may impact employer perceptions of conflicts between motherhood and job performance. This study reports results from an original field experiment in which 2,210 fictitious applications were submitted to low-wage service and professional/managerial job openings across six U.S. cities, experimentally manipulating signals of motherhood status. Findings provide causal evidence that employers in both contexts discriminate against mothers relative to equally qualified childless women. However, within labor market segments, distinct job demands listed in job advertisements are associated with stronger discrimination: time pressure, collaboration, and travel in professional/managerial jobs and schedule instability in low-wage service jobs. These findings have important implications for our understanding of the mechanisms underlying mothers' disadvantages in an increasingly polarized labor market.

Exercise as a Mitigator of Poor Mental Health Among Lesbian, Gay, and Bisexual Adults

INTRODUCTION

There is a positive association between exercise and improved mental health in the general population. Although there is a greater burden of psychological distress among lesbian, gay, and bisexual (LGB) people, little is known about the association between exercise and mental health in this population. The authors explored the association between exercise and poor mental health reported by LGB adults in the United States.

METHODS

Our analyses used data from the 2017 Behavioral Risk Factor Surveillance System survey. Multiple regression analyses were used to determine the association between exercising and mental health days adjusting for sociodemographic characteristics.

RESULTS

Data were available for 6371 LGB participants. LGB adults who participated in any exercise reported almost 1.0 day less of poor mental health in the past 30 days compared with LGB adults who did not exercise (P ≤ .01). LGB adults who met one or both of the physical activity guidelines had between 1.2 and 1.7 days less of poor mental health compared with those who did not meet the guidelines (P ≤ .01).

CONCLUSION

Fewer days of poor mental health were reported by LGB adults who exercised. Determining whether physical activity interventions, including aerobic and strengthening exercises, could improve mental health outcomes in LGB adults should be studied.

Correlates of Transactional Sex and Violent Victimization among Men Who Inject Drugs in Los Angeles and San Francisco, California

Men who inject drugs (MWID) and engage in transactional sex (i.e., receive money or drugs in exchange for sex) are vulnerable to HIV and violence. However, MWID who engage in transactional sex have been less studied than women. We examine factors associated with transactional sex among MWID in Los Angeles and San Francisco and whether transactional sex is associated with violent victimization. MWID were recruited using targeted sampling methods in 2011-2013 and completed surveys that covered demographics, drug use, HIV risk, violence, transactional sex, and other items. Multivariable logistic regression was used to (1) determine factors independently associated with transactional sex and (2) determine if transactional sex was independently associated with violence victimization in the last 6 months among MWID. An interaction term between income source and sexual identity was included in the transactional sex model. Of the 572 male PWID in the sample, 47 (8%) reported transactional sex in the past 6 months. Self-reported HIV infection was 7% for MWID who did not report transactional sex, 17% for MWID who reported transactional sex, and 24% for MWID who reported transactional sex and reported gay or bisexual identity. In multivariable analysis, transactional sex was positively associated with gay or bisexual identity (GB without illegal income adjusted odds ratio [AOR] = 5.16; 95% confidence interval [CI] = 1.86-14.27; GB with illegal income AOR = 13.55, CI = 4.57-40.13), coerced sex in the last 12 months (AOR = 11.66, CI = 1.94-70.12), and violent victimization in the last 12 months (AOR = 2.31, CI = 1.13-4.75). Transactional sex was negatively associated with heroin injection (last 30 days) (AOR = 0.37; 95% CI = 0.18-0.78). Transactional sex was independently associated with violent victimization in the last 12 months (AOR = 2.04; 95% CI = 1.00-4.14) while controlling for confounders. MWID who engaged in transactional sex are at elevated risk for HIV and multiple forms of violent victimization. Interventions focused on this at-risk subpopulation are urgently needed and should include access to substance use disorder treatment, victimization services, and harm reduction services across the HIV care continuum.

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

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

Systemic inequalities for LGBTQ professionals in STEM

Researchers have documented race and gender inequality in science, technology, engineering, and math (STEM) for decades. Do lesbian, gay, bisexual, transgender, and queer (LGBTQ) professionals face parallel experiences of disadvantage in STEM? Using representative survey data from 21 STEM professional societies (N sample = 25,324; N LGBTQ = 1006), this paper presents multidimensional and methodologically robust documentation of 5 dimensions of LGBTQ inequality in STEM. Controlling for variation by demographic, discipline, and job factors, LGBTQ STEM professionals were more likely to experience career limitations, harassment, and professional devaluation than their non-LGBTQ peers. They also reported more frequent health difficulties and were more likely to intend to leave STEM. These trends were similar across STEM disciplines and employment sectors. We found no differences by LGBTQ status in education level, work effort, or job commitment. These findings reveal LGBTQ status as a clear axis of inequality in STEM and motivate further research into the mechanisms producing such outcomes.

Addressing Bias and Reducing Discrimination: The Professional Responsibility of Health Care Providers

The prevalence of harmful bias and discrimination within the health professions is staggering. Moreover, literature consistently demonstrates their persistence and their negative impact on patient care. Several professional codes of conduct for health professionals highlight the importance of addressing these forces in practice. However, despite this, these forces are often discussed as tangential within health professions curricula. This paper examines the prevalence of bias and discrimination, its effects on patient care and health professions trainees, and reviews the historical context of societal bias and discrimination within the health professions institution. The authors argue that addressing harmful bias and discrimination is the professional responsibility of every provider and essential to effective and equitable care.

Embrace the leadership challenge: The role of Gay men's internalized sexual stigma on the evaluation of others' leadership and one's own

Grounded in the framework of the gay glass ceiling, the current research investigated the effect of gay men's internalized sexual stigma (ISS) on both the perceived effectiveness of other gay men's leadership and on their self-perceived leadership effectiveness and their intention to apply to a leadership position. In three studies (N = 402), we manipulated either the leader's sexual orientation (SO) (study 1), or his adherence to traditional gender roles (TGR) (study 2), or participants' fictitious masculinity score (study 3). Our hypotheses were as follows: the leader's SO and TGR would moderate the association of gay participants' ISS with their positive attitudes towards the leader and with his leadership effectiveness; and gay participants' masculinity threat would moderate the association of their ISS with their intention to apply to a leadership position, and with their self-perceived effectiveness as potential leaders. Moderated regression analyses showed that: participants reported a more positive attitude towards a gay man (vs. heterosexual) as leader only when they had low - and not high - ISS; participants with high (vs. low) ISS perceived the masculine gay leader as more effective than the feminine gay leader; under masculinity threat, participants with high (vs. low) ISS showed less intention to apply to a leadership position. These studies provide both confirmation and novel insights into the key role of internalized sexual stigma and traditional gender roles. Indeed, these factors can strengthen and perpetuate the gay glass ceiling effect.

Pathways Into Homelessness Among LGBTQ2S Adults

This article examines entries into homelessness among adults who identify as LGBTQ2S (lesbian, gay, bisexual, transgender, queer, two-spirit). Twenty LGBTQ2S adults who were currently or formerly homeless participated in one qualitative interview. The interview protocol included questions on the participants' history of homelessness, causes of homelessness, and relationship of their gender and/or sexual identity to their homelessness. Data were analyzed using an iterative coding process. Results demonstrated that the participants listed both structural (i.e., discrimination) and intrapersonal (i.e., substance use) variables related to their homelessness. In particular, substance abuse was a common antecedent of their homelessness, and some participants linked their homeless experiences to discrimination and victimization based on their sexual and/or gender identity. The results are discussed in terms of interventions to prevent homelessness among LGBTQ2S adults and support their exits out of homelessness.

Are There Differences in Anti-Gay Beliefs Among U.S. Veterans and Non-Veterans? Results from the General Social Survey

Only since 2011 have sexual minorities been able to serve openly in the U.S. military. The previous anti-gay policies and culture of the military may have increased anti-gay beliefs among veterans. Using data from the 2010-2016 General Social Survey, we tested whether veterans more frequently endorsed anti-gay beliefs than their non-veteran peers. Adjusting for sociodemographic characteristics with multiple logistic regression, we tested the associations of veteran status with five anti-gay beliefs (i.e., disallowing a gay person (1) from publicly speaking or (2) teaching at a university, (3) removing a gay-supportive book from a library, (4) whether same-sex sexual relations are wrong, and (5) support of same-sex marriage. Veteran status was associated with greater disagreement with same-sex marriage (B = 0.16, p = 0.033) but not with other anti-gay beliefs. Most anti-gay beliefs among veterans were explained by other sociodemographic factors and may not be inherent to veteran status.

Employment Discrimination against Indigenous Peoples in the United States: Evidence from a Field Experiment

We conducted an audit study - a resume correspondence experiment - to measure discrimination in hiring faced by Indigenous Peoples in the United States (Native Americans, Alaska Natives, and Native Hawaiians). We sent employers 13,516 realistic resumes of Indigenous or white applications for common jobs in 11 cities. We signalled Indigenous status in one of four different ways. Interview offer rates do not differ by race, which holds after an extensive battery of robustness checks. We discuss multiple concerns such as the saliency of signals, selection of cities and occupations, and labour market tightness that could affect the results of our audit study and those of others. We also conduct decompositions of wages, unemployment rates, unemployment durations, and employment durations to explore if discrimination might exist in contexts outside our experiment. We conclude by highlighting the essential tests and considerations that are important for future audit studies, regardless of if they find discrimination or not.

New Research on Sexual Orientation and Gender Identity Discrimination: Effect of State Policy on Charges Filed at the EEOC

In 2013, the Equal Employment Opportunity Commission (EEOC) began allowing anyone who believed that they experienced sexual orientation or gender identity (SOGI) discrimination to file charges of sex discrimination under Title VII of the Civil Rights Act. Very little is known about the impact of the EEOC's decision and whether it has enhanced protections for LGBT people. In this brief report, we present preliminary findings on trends and patterns in charge filing, paying particular attention to differences that emerge in charges filed in states with and without SOGI employment nondiscrimination laws. Differences in the characteristics of charging parties, allegations, and charge outcomes suggest that legal protections operating at the state level shape the experiences and disputing behaviors of LGBT individuals in pursuing Title VII remedies.

Multiple Discrimination against Female Immigrants Wearing Headscarves

Western countries have experienced a large influx of Muslim immigrants, and concomitantly the Muslim headscarf has become the subject of major controversy. Drawing on theories of stigma, social identity, and multiple discrimination/intersectionality, this study examines the effect of wearing this headscarf in the German labor market. The author applies the method of correspondence testing that allows measuring discrimination in a controlled field setting. Findings show that when applying for a job in Germany, women with a Turkish migration background are less likely to be invited for an interview, and the level of discrimination increases substantially if the applicant wears a headscarf. The results suggest that immigrant women who wear a headscarf suffer discrimination based on multiple stigmas related to ethnicity and religion.

Physical activity and body image: Intertwined health priorities identified by transmasculine young people in a non-metropolitan area

Background: A dearth of research exists about the health behaviors of transgender young people (TYP). As we seek to learn more about transgender (trans) health, community-based participatory research (CBPR) approaches are crucial for incorporating TYP's needs into the formulation of research questions and development of health behavior programing. Aim: Explore body image and exercise as priorities among TYP. Methods: Trans masculine young adults (N = 16) in a small city in the Midwest took part in semi-structured interviews about their health behaviors and priorities. Theme analysis was used to capture key patterns in participants' responses. Specific analysis steps included initial and more specific coding, analytical memos, organizational matrices and reports, and discussion about results with participants. Results: Participants identified exercise and body image as connected primary health concerns. They discussed these issues in terms of three themes: Body shape as motivation for exercise; Poor body image, stigma and fear as exercise barriers, and; Exercise or lack of, as destructive. Participants wanted to exercise to achieve a certain body shape, not for health or as stress relief. They cited gyms as unwelcoming, however. They also worried about discrimination and did not feel sufficiently comfortable with their bodies to exercise. When they could not exercise, they used harmful behaviors, like restricted eating, to achieve a specific male shape. Conclusions: Using participatory methods allowed us to understand the priorities of a group of Transmasculine young people. Our findings suggest that it is important to continue to explore TYP's body-related motivations for exercise and understand the balance between exercise as a positive health behavior, and a potentially harmful one, in light of TYP's complex body image concerns. Trans friendly gyms and gym policies could promote safe exercise and continued anti trans discrimination work and policy advocacy can promote the safety of TYP in all spaces.

Modern Discrimination in Organizations

This review describes the history, current state, and future of modern discrimination in organizations. First, we review development of discrimination from the early 1900s to the present day, specifically discussing various stigmatized identities, including gender, race, sexual orientation, religion, disability, weight, and age. Next, we describe both individual-level (e.g., identity management, allyship) and organization-level (e.g., training, norm setting) strategies for reducing and reacting to discrimination. Finally, we describe future research directions in the relationship between subtle and overt discrimination, intersectionality, the impact of social media, and cross-cultural considerations—areas that we suggest would help us gain a more comprehensive understanding of modern discrimination.

Structural stigma and all-cause mortality among sexual minorities: Differences by sexual behavior?

Using updated data from the General Social Survey/National Death Index (GSS/NDI) study, we examined whether the relationship between structural stigma-measured by aggregating 4 items assessing prejudice towards homosexuality to the community level-and all-cause mortality is present among gay men/lesbian women. Our hypothesis is based on emerging evidence that indicators of structural stigma specific to homosexuality, such as those used in the GSS/NDI, uniquely predict health outcomes among this group. Because the GSS/NDI lacked an identity-based measure of sexual orientation, we tested our hypothesis by employing a strategy that has a relatively high degree of sensitivity and specificity for ascertaining individuals most likely to identify as gay or lesbian: restricting analyses to individuals who reported same-sex sexual partners in the past year. We compared this approach against an alternative strategy, which has weaker specificity for identifying gay men/lesbian women: restricting analyses to individuals who reported any lifetime same-sex sexual behaviors. After controlling for 6 individual-level factors and fixed effects of survey year, structural stigma was associated with mortality among individuals who reported past-year same-sex sexual partners (HR = 1.95, 95% CI: 1.14, 3.31). Further, there was a dose-response relationship with mortality in this group, such that those residing in communities in the highest quartile of structural stigma had the greatest mortality risk, controlling for these same factors (HR = 2.12, 95% CI: 1.03, 4.38). In sensitivity analyses, the effect size for structural stigma ranged from 1.54 to 2.30, indicating a consistent, but small-to-moderate, effect. In contrast, no association between structural stigma and mortality was observed among respondents who reported lifetime same-sex sexual partners, nor among those reporting only opposite-sex sexual partners. This analysis therefore delimits potential boundary conditions of the association between structural stigma related to same-sex sexuality and all-cause mortality, highlighting the conditions under which this association is (and is not) observed.