Search

OBJECTIVE: Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective. METHODS: We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module. RESULTS: Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point. CONCLUSION: A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community.

Current models of discrimination fail to account for the fact that many people belong to intermediate identity groups, that is, groups that share characteristics with both a low-status minority and a high-status majority group (e.g., biracial, bisexual), and thus do not occupy one clear position on a status hierarchy. We investigated bisexual targets to test whether perceivers rely on perceived status differentials to determine whether someone faced discrimination. As predicted, whether bisexual people were perceived as victims of discrimination depended on contextual cues about their relative status. Participants expected both gay/lesbian and bisexual individuals to face more discrimination than heterosexual individuals. But they were more likely to say that a bisexual woman who had lost out to a heterosexual woman competitor had faced discrimination compared to a bisexual woman who had lost out to a lesbian woman. These results may help make sense of how real-world discrimination claims are adjudicated.

Objectives: Screening tools in which participants self-report sexual behaviors can identify people at risk of HIV acquisition for enrollment in preexposure prophylaxis (PrEP). We compared enrollment outcomes (ie, receiving PrEP vs being excluded by a counselor or declining PrEP) in Mexico's PrEP demonstration project and evaluated the validity of a 4-criteria PrEP eligibility tool in which participants self-reported risk behavior—having condomless anal sex, transactional sex, a partner living with HIV, or a sexually transmitted infection—as compared with PrEP eligibility assessed by a counselor. Methods: We recruited men who have sex with men and transwomen who were offered PrEP services in Mexico. We characterized participants according to enrollment outcome and identified underlying factors through logistic regression analyses. We calculated the sensitivity and specificity of the self-reported risk criteria, using the counselor's risk assessment as the point of reference. Results: Of 2460 participants, 2323 (94%) had risk criteria of HIV acquisition according to the 4-criteria tool; 1701 (73%) received PrEP, 247 (11%) were excluded by a counselor, and 351 (15%) declined PrEP despite being considered eligible by the counselor. Participants who were excluded or who declined PrEP were less likely to report HIV risk behaviors than those who received PrEP, and participants who declined PrEP were more likely to be transwomen (vs men who have sex with men) and aged ≤25 years (vs >25 y). The 4-criteria risk tool had high sensitivity (98.6%) and low specificity (29.8%). Conclusion: The screening tool identified most participants at risk of HIV acquisition, but counselors' assessment helped refine the decision for enrollment in PrEP by excluding those with low risk. Public health strategies are needed to enhance enrollment in PrEP among some groups. [ABSTRACT FROM AUTHOR]

Bisexuality in fatherhood is largely invisible, with very little known about the experiences of bisexual fathers. Conducted by researchers in the United Kingdom, this study is one of the first to explore the experiences of bisexual fathers, and, using an identify-focused approach, it aims to understand bisexual fathers' experiences of managing their bisexuality and role as a father. Twenty-four bisexual fathers in Europe and North America took part in qualitative, semistructured interviews that focused on their bisexual identity, becoming a parent, experiences of family life, and community involvement. Reflexive thematic analysis was conducted, and four themes were identified: valuing different types of authenticity, seeking safety in the community, reconciling bisexuality with the traditional family, and sharing and learning across age groups. Despite describing their identity as often invisible, fathers indicated that their personal identity had a significant impact on their social interactions as well as their individual parenting and family practices. Findings contrast stage models of LGBTQ+ identity development, as fathers' identity work practices were often more important for their identity development and integration than aspiring for full "outness." Findings expand our scholarly understanding of the role of identity in parenting and highlight the need to improve representation and support for bisexual fathers. [ABSTRACT FROM AUTHOR]

Sexual minorities have higher rates of anxiety, depression, and binge eating compared to heterosexual peers. Internalized weight bias (IWB) is also higher for sexual minorities when compared to heterosexual peers. However, research has not examined whether the relationships between IWB and anxiety, depression, and binge eating differ among heterosexual and sexual minority adults pursuing bariatric surgery. To examine whether sexual orientation (heterosexual or sexual minority) moderated the relationships between IWB and anxiety, depression, and binge eating among adults pursuing bariatric surgery. University hospital, United States Participants included 811 adults who presented for bariatric surgery, 45 (5.5%) of which identified as a sexual minority. Self-reported data were collected as part of a standard preoperative psychological evaluation for surgical clearance. Three separate moderation models were run to test hypotheses. Sexual orientation did not moderate the association of IWB with anxiety or depression. The IWB by sexual orientation interaction was significant for binge eating (F 1856) = 4.84, P =.03, R2 =.27 such that the association between IWB and binge eating was significantly stronger for sexual minority patients (b =.54, 95% confidence interval {CI} [.36,.70]), compared to heterosexual patients (b =.33, 95% CI [.30,.38]). Minority stress from identifying as a sexual minority may increase vulnerability to binge eating from IWB among bariatric candidates. Future research examining the directionality of the relationship between IWB and binge eating among sexual minorities is warranted. • Internalized weight bias by sexual orientation was significant for binge eating. • This association was significantly stronger for sexual minority patients. • Minority stress may increase vulnerability to distress prior to bariatric surgery. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the self-perceived reasons of suicide attempts among sexual and gender minorities (SGM). We surveyed SGM living in Canada (n = 2778) and respondents who had attempted suicide answered open-ended questions about their perceived reason(s) of their first/only attempt (FOA) and last attempt (LA) (for those who attempted multiple times). Responses were double-coded and categorized as discrete findings. A quarter (25%, n = 695) of the total sample reported a history of suicide attempt, of whom 72% reported multiple attempts. Respondents described a wide variety of reasons for their suicide attempts, with an important number of individuals reporting multiple reasons (corresponding to 47.5% of FOA and 43% of LA). Emotional issues (FOA:42.1%, LA:44.0%) were the most prevalent category of reasons for suicide attempts followed by experience of mental illness (FOA:30.1%, LA:36.1%). Other common reasons included violence (FOA:23.2%, LA:10.2%), interpersonal conflict (FOA:13.4%, LA:6.0%), stress related to life circumstances (FOA:9.5%, LA:16.7%), relationship issues (FOA:7.9%, LA:13.3%), and minority stress related to sexuality (FOA:11.1%, LA:6.2%) and gender identity (FOA:5.0%, LA:6.8%). SGM assessments of the reasons underlying their suicide attempts yielded a variety of factors, many of which were absent from the literature on SGM suicide but amenable to tailored interventions. [ABSTRACT FROM AUTHOR]

This qualitative study was conducted to understand how gay and bisexual men (GBM) in Taiwan cope with childhood bullying because of their sexual orientation or gender nonconformity. We explored their journey from feeling disturbed to receiving social support, developing coping strategies, and achieving self-growth. Colaizzi’s phenomenological approach was used to investigate subject experiences. Semi-structured interviews were conducted with 21 GBM who had experienced high-level sexual bullying in childhood. Relevant data were collected to assess their experiences of sexual bullying, their coping strategies, and subjective effects of corresponding adjustments in interpersonal interactions. Subject experiences concentrated on six themes related to sexual bullying and coping strategies: bullying at developmental stages, bullying everywhere, facing bullying alone, various impacts of bullying, overcoming challenges of interpersonal relationships, and building a strong and carefree self. Our findings can provide mental health professionals with key insights into the contexts of sexual bullying and the associated psychological distress in GBM. This study further clarifies the coping responses of these individuals and their psychological growth following such adverse experiences. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusions Implications We estimate the prevalence of suicidal ideation among partnered U.S. adults overall and by sexual identity using a population‐representative sample of cohabiting and married adults.Intimate partner problems and other aspects of intimate relationships are substantial precipitating factors to suicide. Even so, there are currently no family‐based interventions targeting suicide risk among adults; this may be because little is known as to how prevalent suicidal ideation and behaviors are in the context of intimate relationships. Sexually diverse adults show higher proportions of suicidal ideation than heterosexual adults.Weighted logistic regression was used to analyze data from a subsample of the National Couples' Health and Time Study (n = 3,618), a population‐representative sample of cohabiting and married adults. Unadjusted and model‐adjusted prevalence estimates for suicidal ideation (thoughts and plans) were calculated.The model adjusted prevalence estimates for suicide thoughts and plans were similar to estimates among general population samples. Bisexual and queer+ respondents had double the odds of reporting suicide thoughts and plans compared with gay, lesbian, and heterosexual respondents.Cohabiting and married adults showed a similar prevalence of suicidal ideation as the general population. Bisexual and queer+ adults are a growing U.S. population and require unique attention because they confront higher suicide risk compared with not only heterosexual but also gay and lesbian adults.Family‐based interventions are needed to target suicidal ideations and behaviors among adults, including those who are married or cohabiting. Sexually diverse adults should not be treated as a monolithic group when tailoring interventions for sexually diverse populations. [ABSTRACT FROM AUTHOR]

Background: Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel. Methods: Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender. Results: The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach's alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual. Conclusions: In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence. Trial registration NR: Not applicable. [ABSTRACT FROM AUTHOR]

There is a long history of institutional and interpersonal stigma, violence, and oppression of sexual and gender minority (SGM) individuals in the United States and around the world. Structural and sociocultural factors have served to promote and justify criminalization, discrimination, and violence targeting SGM groups. This commentary provides a brief chronological summary of laws and policies that served to pathologize, oppress, and justify violence and discrimination; the evolution of academic study and understanding; activism aimed at changing laws, questioning pathologizing assumptions and practices, and protecting human rights; current challenges; and recommendations for policy, research, and practice. This commentary pays particular attention to the roles the Global Alliance for Behavioral Health and Social Justice and its journal, American Journal of Orthopsychiatry, have played to advocate for full recognition of the human rights of SGM individuals. Public Policy Relevance Statement: There is a long history of institutional and interpersonal stigma, violence, and oppression of sexual and gender minority (SGM) people. This commentary provides recommendations for promoting the rights and well-being of SGM individuals, with a particular focus on the Global Alliance and the American Journal of Orthopsychiatry. In particular, the commentary recommends strategies for countering anti-SGM propaganda, creating safe and supportive environments for SGM people, and accessing high-quality, culturally, and context appropriate services. [ABSTRACT FROM AUTHOR]

In this primer, following best practice recommendations and drawing upon their own expertise in psychometrics, the authors provide a step-by-step guide for developing measures relevant to sexual- and gender-marginalized persons (SGMPs). To ensure that readers operate from a uniform understanding, definitions for central elements of psychometric testing (e.g., reliability and validity) are provided. Then, detailed information is given about developing and refining scale items. Strategies designed to reduce a pool of items to a manageable number are also highlighted. The authors conclude this primer by discussing various forms of validation (e.g., convergent, discriminant, and known groups). To further readers' understanding, illustrative examples from measures designed for SGMPs are brought into focus throughout. [ABSTRACT FROM AUTHOR]

LGBTQ + people experience protective benefits from faith community participation, although some also experience minority stress from rejection and discrimination. Social workers, counselors, psychologists, nurse practitioners, and others can assist LGBTQ + people in looking for a faith community that fits their needs and desires. This study reveals how LGBTQ + people in this sample, most of whom identify as Christians, decided to attend their current faith community through an analysis methodology called Sort and Sift Think and Shift. Four contrasting themes were identified: welcoming versus inclusive, racial/ethnic versus LGBTQ+, inward versus outward, and role modeling versus blending. The authors explore the implications of these themes for helping professionals. [ABSTRACT FROM AUTHOR]

(1) Background: This paper presents an analysis of the associations between minority stressors and activism in the population of lesbian, gay, and bisexual individuals in Poland. (2) Methods: The cross-sectional online-based research was conducted among 192 lesbian, gay, and bisexual (LGB) people in two groups: activists (n = 51) and people not engaged in activism (n = 141). Four scales of the Sexual Minority Stress Scale were used: Internalized Homophobia, Expectation of Rejection, Concealment, and Sexual Minority Negative Events Scale. Activism was measured using the Activism Scale and a single item asking about belonging to an activist group. (3) Results: Activists, lesbians, and gays scored significantly higher in the Sexual Minority Negative Events than people not involved in activism and bisexual individuals. Attitude toward LGBT+ activism correlated weakly and positively with Sexual Minority Negative Events and Expectation of Rejection while negatively with Internalized Homophobia. The Network Analysis showed that positive attitudes toward LGBT+ activism, the expectation of rejection, and negative events in minority stress are the most influential variables in the network model, playing a crucial role in the interaction between particular dimensions of minority stress. (4) Conclusions: Prevention and intervention programs should focus on reducing minority stress, especially negative events and rejection, especially among lesbians, gays, and people engaged in LGBT+ activism. The cooperation of politicians, lawyers, social workers, and psychologists is required to decrease homophobia and the stigmatization of people representing sexual and gender minorities. [ABSTRACT FROM AUTHOR]

Whether in the form of same-sex attraction or love, the history of same-sex relationships has been well documented in every culture across the globe. In India, evidence of the same can be found on the monolithic sculptures of the Vishvanath Temple in Khajuraho and texts like Mahabharata and Sushrata Samahita. The acceptance and openness enjoyed by the non-hetero-normative and non-cis-gender individuals in ancient India, changed after the nation's colonization. In current times, mainstream society holds heterosexual intercourse as the norm while considering same-sex relationships as deviations. Same sex relationships are a highly stigmatized and garner objections from several religious and political sects. This social stigma and erasure becomes harsher when directed toward individuals with polysexual or asexual orientations. The lack of awareness and representations garners bisexuals, pansexuals and asexuals the status of sexual minorities within the LGBTQ + community. This study makes use of three focus group discussions to explore the perception of each sexual minority regarding social equality within the Indian LGBTQ + community and outside it, alongside trying to understand the community support received by the sexual minorities in the Indian LGBTQ + community. The study uses inductive thematic analysis to draw out themes. The results indicate a predominant feeling of being misunderstood, exploited, fetishized and alienated even within the LGBTQ + community while finding solace in their own sub-communities and the online community. The results also reveal feelings expectations held by individuals from each sexual minority in terms of their desired place in society. [ABSTRACT FROM AUTHOR]

This study examined intimate partner violence (IPV) and identity abuse (i.e., partner violence targeting someone's sexual orientation) among bisexual-spectrum and heterosexual cisgender undergraduate women in relation to their mental health and academic adjustment. Participants were first- and second-year bisexual-spectrum (n = 81) and heterosexual (n = 243) undergraduate cisgender women at a large, public university in the Midwest. IPV was prevalent in the sample, but bisexual-spectrum cisgender women who had been in relationships were significantly more likely to report IPV than their heterosexual counterparts (77.44% vs. 44.44% respectively). Over half of bisexual-spectrum cisgender women in dating relationships reported identity abuse. Most participants that experienced identity abuse indicated the perpetrator was heterosexual and/or a cisgender man. Sexual orientation did not moderate the relationship between IPV and depression, anxiety, or negative academic adjustment outcomes. Universities should integrate education on LGBTQ oppressions into their primary prevention programs, while also continuing to bolster IPV prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

This article is premised on critiquing the idea that bi+ people – that is, those with multiple gendered attractions - have 'straight-passing privilege.' This assumed straight-passing privilege suggests that bi+ people are not equally affected by homophobia and heteronormativity when compared with lesbian and gay people. This article aims to demonstrate that this notion of straight-passing privilege is harmful in understanding bi+ people. To explore these arguments, this article uses literature relating to passing and identity management to understand how bi+ specific identities relate to these theoretical concepts. Through a sociological lens, this article argues that the idea of straight-passing privilege neglects the real circumstances of bi+ people, who experience safety and wellbeing concerns and presumed privileges because of these assumptions. It is correct that bi+ people may be able to pass as straight in certain circumstances, as may many lesbian and gay people, but the understanding of this as a privilege fails to account for the difficulties that anyone living outside of a heterosexual norm experiences. Rather, bi+ people are subject to biphobia and bisexual invisibility/erasure that impacts their ability to be 'out' at all—leaving them ontologically incom-prehensible. [ABSTRACT FROM AUTHOR]

AbstractBi+ individuals are at increased risk for mood and anxiety disorders compared to heterosexual and lesbian/gay individuals in part due to unique experiences of discrimination. Minority stress theory posits that associations between discrimination and adverse mental health outcomes may be stronger for those with higher identity centrality and lower identity affirmation, but few studies have tested these hypotheses. Therefore, the current study examined whether identity centrality and affirmation moderated the associations between discrimination and depression and anxiety symptoms among 715 bi+ adults. In bivariate analyses, discrimination was positively associated with depression and anxiety symptoms, whereas identity centrality and affirmation were not significantly associated with either. However, in multivariate analyses, identity centrality and affirmation were negatively associated with depression and anxiety symptoms, respectively. Neither identity centrality nor affirmation moderated any associations. These findings raise the question whether identity characteristics moderate associations between discrimination and mental health, but replication is needed. [ABSTRACT FROM AUTHOR]

Purpose of Review: To consolidate recent literature addressing eating disorders and disordered eating behaviors among sexual and gender minority (SGM) adolescents, including but not limited to lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents. Recent Findings: Sexual and gender minority adolescents are at heightened vulnerability to eating disorders and disordered eating behaviors compared to their cisgender and heterosexual peers, potentially due to minority stress, gender norms, objectification, and the influence of the media, peers, and parents. We report findings from recent literature on the epidemiology and prevalence, assessment, mental health comorbidity, quality of life and psychosocial functioning, risk and protective factors, and treatment and interventions for eating disorders in sexual and gender minority adolescents. Summary: Addressing eating disorders in sexual and gender minority adolescents requires an integrated approach consisting of screening, tailored treatment, and comprehensive support to address intersectional challenges. Gender-affirming and trauma-informed care approaches may be considered. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Psicoterapia is the property of Revista de Psiquiatria y Psicologia Humanista, S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We sought to understand technology-based communication regarding mpox (monkeypox) among gay, bisexual, and other men who have sex with men (GBMSM) during the global outbreak in 2022. Methods: Forty-four GBMSM (Mage = 25.3 years, 68.2% cisgender, 43.2% non-White) living in the United States participated. From May 2022 to August 2022, all text data related to mpox (174 instances) were downloaded from the smartphones of GBMSM. Text data and smartphone app usage were analyzed. Results: Content analysis revealed 10 text-based themes and 7 app categories. GBMSM primarily used search and browser, texting, and gay dating apps to share vaccine updates, seek mpox vaccination, find general mpox information, share mpox information with other GBMSM, and discuss links between mpox and gay culture. Data visualizations revealed that changes in communication themes and app usage were responsive to major milestones in the mpox outbreak. Conclusion: GBMSM used apps to facilitate a community-driven mpox response.

Background: Syphilis and HIV are diseases that can be transmitted through sexual contact. Bisexual groups have a higher potential for HIV and syphilis transmission. In syphilis patients who have been infected with HIV, secondary syphilis often occurs along with primary syphilis, which can be found 2-3 times more often than in those who are not infected by HIV. Case: A 24-year-old male with HIV who is a bisexual man, complained chancre on his scrotum and on the tip of the penis that was painless and also has condyloma lata around the anus. Dermatological examination revealed multiple papules, patches, and plaques. The serological results for VDRL and TPHA were reactive. Histopathology examination of skin plaque suggests secondary syphilis. The Patient was diagnosed with overlapping primary-secondary syphilis and given therapy with single-dose intramuscular injection of benzathine penicillin G. Discussion: Bisexual groups have a higher potential for HIV and syphilis transmission. In HIV patients, primary and secondary syphilis often overlap. This was due to changes in the immune system causing the spread of Treponema pallidum more quickly and slowing the healing of primary lesions. Conclusion: Overlapping of primary and secondary syphilis in bisexual patients with HIV is common; in addition, the appearance of skin lesions in secondary syphilis can resemble other diseases, so confirmation by histopathology examination needs to be done.

Abstract Background Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel. Methods Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender. Results The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach’s alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual. Conclusions In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence. Trial registration NR Not applicable.

BackgroundMethamphetamine use disorder (MethUD) disproportionately affects men who have sex exclusively with men or with men and women (collectively MSM/W), compared to men who have sex with women (MSW). This study is the first MethUD medication trial to compare treatment effect for these groups, hypothesizing that extended-release injectable naltrexone 380mg every 3 weeks plus oral extended-release bupropion 450mg daily would be less effective for MSM/W than MSW.MethodsData come from men (N = 246) in a multi-site, double-blind, randomized, placebo-controlled trial with sequential parallel comparison design. In Stage 1 (6-weeks), participants were randomized to active treatment or placebo. In Stage 2 (6-weeks), Stage 1 placebo non-responders were rerandomized. Treatment response was ≥3 methamphetamine-negative urine samples, out of four obtained at the end of Stages 1 and 2. Treatment effect was the active-versus-placebo between-group difference in the weighted average Stages 1 and 2 responses.ResultsMSM/W (n = 151) were more likely than MSW (n = 95) to be Hispanic, college-educated, and living with HIV. Adjusting for demographics, among MSM/W, response rates were 13.95 % (active treatment) and 2.78 % (placebo) in Stage 1; 23.26 % (active treatment) and 4.26 % (placebo) in Stage 2. Among MSW, response rates were 7.69 % (active treatment) and 5.80 % (placebo) in Stage 1; 3.57 % (active treatment) and 0 % (placebo) in Stage 2. Treatment effect was significantly larger for MSM/W (h = 0.1479) than MSW (h = 0.0227) (p = 0.04).ConclusionsFindings suggest efficacy of extended-release naltrexone plus bupropion for MSM/W, a population heavily burdened by MethUD. While a secondary outcome, this intriguing finding merits testing in prospective trials.

This study aims to investigate the stresses of the initiator during the termination of their romantic relationship among Bisexual individuals. This study uses phenomenological research design that utilizes phenomenological analysis, the purpose of this research is to understand further the experiences of being an initiator of the breakup inside the bisexual community. This study's participants are 15 bisexual individuals who have initiated the break up with their previous relationship and reside within District Five (5) of Bulacan (Balagtas, Bocaue, Guiguinto, and Pandi). The researchers also acquired a semi-structured interview guide that included questions pertaining to their participants' experiences, challenges, and coping strategies of bisexual initiators of the breakup. The findings of this study revealed that bisexual initiators of the breakup experience anger, grief, depressive symptoms, and experience trying to fix the relationship. Aside from that, this study also reveals that bisexual initiators can feel regret, experience confusion about their gender, experience challenges within their previous relationship, and have bad good coping mechanisms, as well as finding a reason to reconnect with intrapersonal relationships. [ABSTRACT FROM AUTHOR]

Background: Research has indicated that sexual minorities have higher prevalence rates for ATOD use and suicide ideation and behavior compared to heterosexual youth. Yet, most studies to date have combined gay, lesbian, and bisexuals into one category. This study sought to assess the uniqueness of bisexuality to assess the risk of ATOD use and suicide ideation and behavior among bisexual high school students. Methods: Data for this study were derived from the 2019 Centers for Disease Control's Youth Risk Behavior Survey (YRBS). Chi-square analysis was conducted to determine the prevalence of ATOD use and suicide ideation and behavior. Logistic regression was then used to estimate the association between ATOD use and suicide ideation and behavior among bisexual adolescents. Results: This study found that ever use an electronic vape product, non-medical use of prescription drugs, and current alcohol and marijuana use were significant predictors for suicide ideation and behavior. Conclusions: Based on our results, we believe that it is important to address the relationship of substance use as a risk factor for suicide and ideation and behavior of bisexual adolescents, as bisexual adolescents may need more emotional support as they come to understand their sexual identity. [ABSTRACT FROM AUTHOR]

(1) Background: This paper presents an analysis of the associations between minority stressors and activism in the population of lesbian, gay, and bisexual individuals in Poland. (2) Methods: The cross-sectional online-based research was conducted among 192 lesbian, gay, and bisexual (LGB) people in two groups: activists (n = 51) and people not engaged in activism (n = 141). Four scales of the Sexual Minority Stress Scale were used: Internalized Homophobia, Expectation of Rejection, Concealment, and Sexual Minority Negative Events Scale. Activism was measured using the Activism Scale and a single item asking about belonging to an activist group. (3) Results: Activists, lesbians, and gays scored significantly higher in the Sexual Minority Negative Events than people not involved in activism and bisexual individuals. Attitude toward LGBT+ activism correlated weakly and positively with Sexual Minority Negative Events and Expectation of Rejection while negatively with Internalized Homophobia. The Network Analysis showed that positive attitudes toward LGBT+ activism, the expectation of rejection, and negative events in minority stress are the most influential variables in the network model, playing a crucial role in the interaction between particular dimensions of minority stress. (4) Conclusions: Prevention and intervention programs should focus on reducing minority stress, especially negative events and rejection, especially among lesbians, gays, and people engaged in LGBT+ activism. The cooperation of politicians, lawyers, social workers, and psychologists is required to decrease homophobia and the stigmatization of people representing sexual and gender minorities.

Abstract Background The U.S. mpox outbreak in 2022 introduced new and exacerbated existing challenges that disproportionately stigmatize gay, bisexual, and other sexual minoritized men (GBSMM). This study contextualizes the perceptions, susceptibility, and lived experiences of the mpox outbreak among GBSMM in the U.S. using an intersectional framework. Methods Between September 2022 to February 2023, we conducted 33 semi-structured qualitative interviews with purposively sampled GBSMM in the Northeast and the South region of the United States on various aspects related to their experience during the mpox outbreak. Results We identified four themes: (1) understanding and conceptualizations of mpox, (2) mpox vaccine availability and accessibility, (3) mpox vaccine hesitancy and mistrust, and (4) call to action and recommendations. GBSMM collectively discussed the elevated mpox stigmatization and homophobic discourse from mainstream social media and news outlets. GBSMM also discussed the lack of availability of mpox vaccines, unclear procedures to receive the vaccine, and continued mistrust in government, non-government, and other institutions of health that were complicit in anti-LGBTQ + narratives related to mpox. However, they expressed that these challenges may be addressed through more LGTBQ + representation and leveraging ways to empower these communities. Conclusion GBSMM have mpox experiences that are distinct and multifaceted. Effectively addressing mpox and mitigating public health emergencies for GBSMM requires prioritizing destigmatizing communication channels and vaccine distribution strategies by centering their stories and lived experiences to advance health equity.

Abstract Background Gay, bisexual, and cis-gender men who have sex with men (GBMSM) face severe consequences, especially within stigmatized environments. However, very little is known about the experiences of GBMSM living in slums in SSA and Ghana. This study investigates the experiences of stigma, victimization, and coping strategies and proposes some interventional approaches for combating stigma facing GBMSM in slum communities. Methods We engaged GBMSM living in slums in two major Ghanaian cities. We used a time-location sampling and collected data through in-depth individual interviews. Two major themes emerged from the study: (1) insecurities and criminalization of GBMSM activity, and (2) GBMSM coping strategies. Results Findings show GBMSM experienced negative attitudes from the community due to their sexual behavior/orientation. GBMSM also developed coping strategies to avert negative experiences, such as hiding their identities/behavior, avoiding gender non-conforming men, and having relationships with persons outside their communities. Conclusion We propose interventions such as HIV Education, Empathy, Empowerment, Acceptance, and Commitment Therapy as possible measures to improve the experiences of GBMSM living in Ghanaian slum communities.

Parent mental health challenges in the postpartum and early parenthood have profound implications for parent, child, and family well‐being. Little research has focused on postpartum mental health challenges and barriers to help‐seeking among queer birthing people, including members of this community who may be particularly vulnerable to mental health difficulties, such as queer cis women partnered with men, trans/nonbinary parents, and queer parents who are young, low‐income, and/or of color. This mixed‐methods study of queer parents (n = 99), all of whom were assigned female at birth (AFAB) and gave birth to a child within the past several years, explores parents' postpartum mental health difficulties and perceived barriers to seeking help. Using a structural stigma framework, this study found that participants reported high rates of postpartum mental health difficulties (89%) and reported various barriers to seeking support including fears of discrimination and being deemed “unfit” by providers, which might lead to child welfare system involvement. Young parents and low‐income parents were particularly fearful of child welfare system contact and potential child removal. Factors that encouraged help‐seeking (e.g., desire to be a good parent; partner pressure to seek help) and implications for family practitioners are discussed. [ABSTRACT FROM AUTHOR]

AbstractBi+ men are more likely to use alcohol and drugs than heterosexual and often gay men. The minority stress model is the predominant framework for understanding these disparities, but it is unknown whether this framework is consistent with bi+ men’s perspectives. As part of an online survey, 69 bi+ young men (ages 18-29; 29% transgender) were asked why they think bisexual men are more likely to use alcohol and drugs than other men (including gay men). Responses were thematically analyzed and seven themes were identified. The first set reflect unique experiences related to their sexual orientation (bi+ discrimination, internalized bi+ stigma, and aspects of community); the second set reflect general risk factors that disproportionately affect bi+ men (trauma exposure and mental health problems); and the third set reflect motivational risk factors (to lower inhibitions and in connection with sex). These results are largely consistent with the minority stress model while shedding light on contributing factors that have received less empirical attention (e.g., to feel comfortable enough to have sex with a man). [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion Intimate partner violence (IPV) involves an individual committing acts intended to harm or intimidate a current or former romantic partner. The COVID‐19 pandemic and subsequent stay‐at‐home orders often trapped victims with perpetrators and intensified IPV. Although sexual and gender diverse people disproportionately experience IPV compared to cisgender, heterosexual people, their experiences are not well documented in the Canadian context. This study aimed to explore the experiences of Two‐Spirit, lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender diverse (2S/LGBTQIA+) people with IPV in Ontario and how the COVID‐19 pandemic affected their IPV experiences.We conducted in‐depth, semi‐structured interviews with self‐identified 2S/LGBTQIA+ people who experienced IPV on/after March 15, 2020. We audio‐recorded and transcribed all interviews and coded the transcripts for content and themes using inductive and deductive techniques.Our 20 participants experienced physical, psychological, sexual, and financial abuse. Technology‐facilitated violence extended abuse geographically and temporally. IPV experiences were associated with negative mental health outcomes that were intensified by the COVID‐19 pandemic. Participants struggled to see themselves as legitimate victims of IPV. Although participants regretted being victims of violence, many saw their abusive relationship(s) as a learning experience to inform future relationships.Our findings suggest that 2S/LGBTQIA+ people may experience unique forms of identity abuse and may have difficulty recognizing their IPV experiences as abuse. Ensuring that comprehensive sexual health education is trauma‐informed, anti‐oppressive, and includes information about healthy relationship dynamics, 2S/LGBTQIA+ relationships, and IPV is critical. [ABSTRACT FROM AUTHOR]

AbstractBi + sexual individuals are sexually and/or romantically attracted to more than one gender. They encounter various forms of discrimination, such as identity invisibility. Little is known about how bi + invisibility is experienced and what strategies are used to deal with it. Drawing on the minority stress model, this quantitative study explored these processes in a sample of 532 self-identified bi + adults living in Germany. A significant percentage reported generally feeling visible “never” (7.5%), “rarely” (53.2%) or only “sometimes” (33.6%). Invisibility was felt in queer and heterosexual communities. Participants older than age 30 felt less visible than younger participants. A substantial majority (71.3%) desired increased visibility “always” or “often.” To this end, bi + individuals made use of a range of visibility-strategies, primarily (in-)direct communication, but also community engagement, public behavioral or gender-based visual displays. The findings emphasize the importance of supporting bi + visibility, shedding light on the challenges faced by non-monosexual individuals. [ABSTRACT FROM AUTHOR]

In the United States, cultural forces have led to the stigmatization of lesbian, gay, bisexual, transgender, and queer (and additional identities) (LGBTQ+) parenthood. However, pushing back against this stigmatization, developing a positive LGBTQ+ identity, and investing in one's LGBTQ+ community may inform empowering narratives of future parenthood and related constructs, such as LGBTQ+ parent socialization. Perceived self-efficacy related to preparation for bias (i.e., discussions of discrimination, prejudice, or bias-based bullying) socialization is likely associated with an individual's own perceptions or experiences of stigmatization given the conceptual overlap of bias and stigma. However, other constructs related to stigmatization and socialization self-efficacy, such as positive LGBTQ+ identity or community connectedness, have yet to be simultaneously considered (to our knowledge). Further, previous research has rarely included different assessments of stigma (i.e., perceived and enacted) and/or dimensions of positive LGBTQ+ identity (i.e., authenticity and self-awareness). Thus, this study aimed to rectify these gaps and provide a greater understanding of sexual stigma and LGBTQ+ parent socialization self-efficacy. Using data from a survey-based, online, cross-sectional study of LGBTQ+ childfree adults (N = 433; Mage = 29.85 years old) in the United States, we found that experiences of enacted or perceived sexual stigma were differentially associated with LGBTQ+ parent socialization preparation for bias self-efficacy. Further, positive LGBTQ+ identity authenticity and self-awareness, as well as LGBTQ+ community connectedness played distinct roles as mediators of the relationships between sexual stigma and LGBTQ+ parent socialization self-efficacy. These findings have implications for how we might understand the role of stigma, identity, community, and socialization among future LGBTQ+ parents. [ABSTRACT FROM AUTHOR]

This research focused on Black gay, bisexual, and queer men (BGBQM) and addressed the nuanced ways BGBQM experienced a sense of belonging within mentorship program settings, given their intersecting identities. Utilizing a novel research design that blended aspects of phenomenology and arts-based research, this study explored the following research questions: (1) How do BGBQM experience a sense of belonging in Black Male Initiatives (BMI) and Men of Color (MoC) mentorship programs? (2) What formative experiences do BGBQM develop in belonging to these mentorship program environments? Findings revealed approaches to how BGBQM experienced Blackness and queerness within mentorship programs in higher education settings. Being immersed in traditionally heteronormative enclaves, these men found solace in racial belonging yet experienced isolation due to their sexuality. This work provides key insight into addressing the pervasive ways mentorship programs need to dismantle heteronormativity and hypermasculine norms and ideals. [ABSTRACT FROM AUTHOR]

Several studies using representative data have found that individuals identifying as LGBTQ tend to be less religious when compared to individuals identifying as heterosexual or straight. This is likely in part due to the hostility such individuals have faced by some religious traditions and communities. Relatively little quantitative research, though, has examined how sexual identity might influence beliefs and practices associated with alternative spiritualities. Using data from a national probability survey of US adults, we examine patterns of belief and engagement in witchcraft, spiritualism, psychism, and other phenomena we broadly label as paranormal in nature. Analyses find that, independent of a broad set of controls, individuals identifying as bisexual score higher on paranormal beliefs and engagement compared to individuals identifying as heterosexual. We do not find a difference between gay- or lesbian- and heterosexual-identifying individuals. The findings expand our understanding of how sexual identity influences spirituality beyond traditional definitions and measures of religion. [ABSTRACT FROM AUTHOR]

This article explores sexual negotiation beyond dominant consent frameworks that have centered on heterosexuality, responding to and preventing sexual violence, and the pursuit of autonomous, free choice. Building on the work of feminist theorists, I challenge the prevailing emphasis on individual responsibility and autonomy in understanding sexual violence and consent and urge a deeper consideration of how bodies and choices are shaped by social, cultural, and historical contexts. Drawing on 32 in-depth interviews, I examine how bi+ individuals in Australia negotiate sexual encounters with partners of diverse genders. Using a queer phenomenological framework of comfort and discomfort, I focus on experiences where participants felt they have been able to negotiate sex well. This framework acknowledges the complex interplay between sexual negotiation, gendered norms and sexual scripts, and subjectivity. I argue that hetero and queer norms and scripts both constrain and give possibility to sexual negotiation, and I propose that queer bodies and queer sex can disrupt normative constraints in ways that positively impact sexual negotiation. I conclude by advocating for a deeper understanding of the nuanced ways our choices are shaped during sexual encounters and suggest that we must look beyond heterosexuality and violence prevention going forward. [ABSTRACT FROM AUTHOR]

A growing body of literature has found that sexual orientation and gender impact labor market outcomes, including earnings. This literature generally finds that gay and bisexual men earn less than heterosexual men. Despite being the highest earners among women, lesbians earn less than heterosexual men, and bisexual women earn the least. Far less research has explored intersectional disadvantages/advantages of being a lesbian, gay, or bisexual (LGB) individual and belonging to other minority groups. Using data from the 2013 to 2018 US National Health Interview Survey, this paper explores whether being an LGB racial minority or LGB immigrant results in cumulative earning disadvantages/advantages. This study finds that regardless of race or immigrant status, gay men’s earnings did not statistically differ from white/US-born heterosexual men’s earnings. For white and US-born women, their earnings followed the same pattern, with lesbians earning the most, followed by heterosexual women, then bisexuals; however, for nonwhite women, bisexuals earned the most and lesbians earned the least. The results for immigrant sexual minorities were not statistically significant. These findings suggest that disadvantage/advantage is multilayered—sexual minorities who occupy multiple minority positions may experience different levels of disadvantage/advantage. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective. METHODS: We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module. RESULTS: Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point. CONCLUSION: A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community. [ABSTRACT FROM AUTHOR]

AbstractDespite the web’s revolutionary impact on LGBTQ communities, the preservation and study of LGBTQ web histories have been largely overlooked by archives and scholars. This neglect has contributed to a “queer digital dark age,” perpetuating the symbolic annihilation of LGBTQ people in the historical record. Drawing on an extensive review of queer archive and library studies literature, as well as a survey of curators of queer web archives, this article argues for urgent intervention. Specific actions are needed: heritage institutions should prioritise creating queer web collections, and scholars must begin consulting existing collections. Failure to address this undermines the representation of LGBTQ experiences and hinders our understanding of online LGBTQ life. By examining extant initiatives, specifically the LGBT + web archive of the National Library of the Netherlands, this article demonstrates the potential of studying queer internet histories through web archives. Such endeavours enable diachronic research and the application of computational methods like hyperlink analyses, revealing the interconnected nature of queer online cultures. Ultimately, this article advocates a collaborative dialogue between queer archival and librarian studies, web archive studies, and LGBTQ internet studies—which must lead to pressing steps to preserve and comprehensively examine LGBTQ online heritage. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusion This study examines how marriage‐cohabitation gaps in household specialization (labor supply and earnings) vary across institutional contexts for same‐sex couples (SSCs) and different‐sex couples (DSCs) in Canada.Prior research suggests that marriage‐cohabitation gaps are smaller in contexts where cohabitation is more prevalent, but it has overlooked how legal protections (at the contextual level) and gender composition (at the couple level) moderate this association. As a result, little is known about whether differences in household specialization stem from heightened gendered expectations attached to marriage or stronger legal protections for married couples. This study posits that marriage‐cohabitation gaps will be larger in contexts where legal protections for cohabitors are less marriage‐like.Using the 2006 and 2016 Canadian Census and the 2011 National Household Survey, I estimate ordinal and fractional logit models to examine marriage‐cohabitation gaps in specialization among all couples (N = 2,788,055) and couples with young children (N = 826,305).Among DSCs, marriage‐cohabitation gaps were larger in Québec than in English Canada vis‐à‐vis earnings but not labor supply. Patterns among SSCs were more heterogeneous: gaps in labor supply were larger in English Canada for female couples but larger in Québec for male couples. Gaps in earnings were generally larger in Québec, with few exceptions. However, DSCs consistently specialized more than SSCs.While existing research suggests marriage‐cohabitation gaps in household specialization are largely explained by the prevalence of cohabitation, my results indicate that legal protections (at the contextual level) and gender composition (at the couple level) play a more decisive role. [ABSTRACT FROM AUTHOR]

The aim of this study is to gauge the current social climate in neurosurgical residency training and attitudes regarding sexual orientation and gender identity. We conducted a cross-sectional study through a 35-question questionnaire distributed to roughly 1700 residents at all U.S. neurosurgical residency programs. A total of 107 responses were obtained. Seventeen residents (16%) identified as being an LGBTQ+ individual. The majority (76%) of LGBTQ+ residents were concerned about how their sexual orientation would be perceived while applying to programs, and 47% endorsed purposefully concealing sexual orientation at work for fear of rejection or reprisal. More than half (56%) of those surveyed have witnessed homophobic/transphobic remarks by patients. While at work, 29% of LGBTQ+ individuals stated they are uncomfortable being open with their sexual orientation, and 3 LGBTQ+ individuals admitted being the target of direct homophobic/transphobic comments. This is the first study to our knowledge that has been conducted assessing the presence, perception, and treatment of LGBTQ+ trainees in neurosurgical residency. Our study outlines the challenges LGBTQ+ individuals face when applying to neurosurgical programs, which involves the perception of their sexual orientation, their witnessed instances of homophobic and transphobic comments by coworkers and patients, and their hesitation with discussing their social lives compared with their non-LGBTQ+ peers at work for fear of judgment or reprisal. Ongoing research is needed to address these issues to obtain workplace respect and fairness in this population and thus create an accepting atmosphere and achieve social justice in neurosurgery training. [ABSTRACT FROM AUTHOR]

This article introduces the multidimensional properties of social connectedness among sexual and gender minority (SGM) midlife and older adults and examines the relationship between these properties and general health. Data were analyzed from Aging With Pride: National, Aging, and Sexuality/Gender Study, including 2,450 SGM adults aged 50 and older in the United States. The structure, function, and quality of interpersonal relations as well as community-level activities and engagement were measured through a self-administered survey and an in-person interview. Findings indicated that SGM midlife and older adults, on average, had a large social network with high bridging potential and low density, consisting of more nonrelative family members than immediate family members. They also showed frequent availability of social support, moderate or higher satisfaction with interpersonal relations, and moderate SGM community engagement. Properties of social connectedness differed by gender, sexual identity, and gender identity, with SGM men, sexually diverse women, and transgender people showing distinct challenges in interpersonal relations. All aspects of social connectedness were positively associated with good general health, particularly network diversity, outdoor leisure activity engagement, and access to health-related decision support, controlling for age and chronic conditions. Care receiving and loneliness were negatively associated with good general health. Intervention development can target these factors to promote social and community connectivity and reduce the negative health effects of persistent social stressors. This study underscores the necessity of addressing all facets (i.e., structure, function, and quality) of interpersonal relations encompassing both immediate and chosen family as well as community-level social connectedness. Public Policy Relevance Statement: Limited knowledge exists regarding the multidimensional aspects of social connectedness of sexual and gender minority older adults. This study delineates the distinct nature of their interpersonal relationships and community engagement and identifies social connectedness factors that can contribute to health equity. By addressing these factors, culturally tailored programs and policies could foster resilience and mitigate the negative health consequences of ongoing social stressors. [ABSTRACT FROM AUTHOR]

Disparities in youth homelessness by racial/ethnic, sexual, and gender identities are well documented, though this literature lacks specificity regarding intersectional social identities of youth who are most likely to experience homelessness. Population-based cross-sectional data on youth from the 2019 Minnesota Student Survey (N = 80,456) were used to examine the relationship between parent caring and intersections of minoritized identities that experience the highest prevalence of two distinct types of unaccompanied unstable housing with expanded categories of sexual and gender identities. Exhaustive chi-square automatic interaction detection models revealed that low parent caring was the most common predictor of unaccompanied homelessness and running away, but there was important variation among youth of color at the intersection of sexual and gender identities. The findings reveal a more complex story of disparities in unaccompanied unstable housing among youth with multiple marginalized social identities and highlight the need to create culturally informed prevention and intervention strategies for parents of LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and questioning) youth of color. The implications for prevention and intervention among subgroups with the highest prevalence are discussed in the context of interlocking systems of power and oppression. Public Policy Relevance Statement: Having caring and supportive parents may buffer against unaccompanied unstable housing for youth across racial, ethnic, sexual, and gender identities. Our findings suggest the need for increased use of intersectional frameworks and methods in health disparities research and specifically point to certain intersectional populations that need support to improve parent caring and reduce unaccompanied unstable housing, building on efforts focused on a single minoritized identity. Such strategies would center and work alongside affected communities in the interpretation and application of research findings and partner with existing parent education programs in those communities to build culturally informed awareness and understanding of diverse sexual and gender identities. [ABSTRACT FROM AUTHOR]

Lesbian, Gay, Bisexual (LGB) people can experience discrimination because of their minoritized status, which can be exacerbated when they come from a less privileged group or background compared to the rest of society. Travel can play a unique role in their lives by providing an opportunity to escape the constrictors of how one is defined and positioned in their home environment. The experiences enabled through travel can help build capacities that enhance well-being and the ability to cope with prejudice at home. This paper explores how LGB people with intersectional identities perceive the role of travel in contributing to their well-being and the activities they participate in while travelling. We frame intersectionality as one's sexual orientation and the differences arising from one's relative socioeconomic status. Through an online survey of 473 Australian LGB people, we identify five well-being segments, which differed on their socioeconomic status, travel activity choices, and sexual orientation. The results have implications for how travel is a well-being tool that supports different segments of LGB people through the provision of pleasure activities while also facilitating self-development, social contribution, and minimizing the impact of negative experiences on day-to-day life. [ABSTRACT FROM AUTHOR]