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Sexual minority men (SMM) in the US are twice as likely to experience mental health challenges, including depressive symptoms, compared with their heterosexual counterparts. Having a like-mentor, or a sexual minority mentor, is associated with improved mental well-being among SMM mentees. However, few studies have explored the potential benefits to mentors. Using confirmatory factor analysis, we calculated a perceptions of mentoring score that encompasses experiences and beliefs regarding mentoring of SMM from the Healthy Aging Substudy of the Multicenter AIDS Cohort Study. We used a generalized estimating equations model to assess associations between perceptions of mentoring and clinically significant depressive symptoms adjusted for key covariates; models were also stratified by HIV serostatus. Among 1,246 men aged 40+ years, the strongest agreement was with the statement I have encouraged people to be proud of their sexual orientation, for which 770 individuals (72%) indicated Agree or Strongly Agree. Each unit increase in the mean perceptions of mentoring score was associated with 8% decreased odds of having clinically significant depressive symptoms (adjusted odds ratio: 0.92; 95% CI: 0.85-0.99). We show that SMM reported like-mentoring experiences and had positive mentoring beliefs, and that these were associated with a decreased odds of having depressive symptoms. Encouraging SMM to serve as like-mentors could be a way to counter depressive symptoms among this key population. There is a need for increased research regarding how mentoring programs can best be designed to benefit sexual minority mentees and mentors.

Athletic spaces are often perceived as unwelcoming by sexual minority (SM) athletes, contributing to disparities in sports persistence in early adulthood. Further examination of how SM navigate decisions about sports participation during the transition to college is needed to develop and maintain inclusive campus athletic offerings, including recreational sports. By analyzing interview data from 23 SM college students, we found that SM find supportive athletic community through important vetting of these spaces prior to initiation. SM look at two aspects of a program's makeup—its' values and visible diversity of its members—through one's own personal "vibe check" either in-person or online. SM men in particular look for gender "outsiders," as all-male spaces threaten their perceived safety. Among those who had previously dropped out of sports, finding mixed-gender teams through this vetting process provided promise for an eventual return to sport, highlighting the importance of recreational sports in engaging underrepresented groups of athletes. [ABSTRACT FROM AUTHOR]

College years are a formative life stage; however, students who identify as a sexual minority participate in insufficient physical activity. This study examined differences in level of comfort 1) with/in campus recreation facilities overall, and 2) using specific amenities, by sexual orientation. Students at four public universities completed online surveys assessing perceived comfort using their campus recreation facility. Among participants (n = 160), Kruskal-Wallis analyses showed comfort using campus recreation facilities, free weights, non-intramural sports,and intramural sports was significantly higher among heterosexual students compared to sexual minority students (all p < 0.005). These findings highlight inequities in comfort using campus recreation facilities and provide evidence of the need for inclusive recreation spaces for all students regardless of sexual orientation. Future research is needed to assess LBGTQ+ student's health disparities related to campus recreation facility use and how to increase perceived comfort for all students. [ABSTRACT FROM AUTHOR]

Latino men, especially Latino men who have sex with men (LMSM), experience disparities in HIV prevention. Lack of attention to key barriers to care, such as stigma, result in inequitable access to HIV prevention and care for LMSM. This paper describes how intersectional stigma and related factors act as barriers to HIV prevention among Latino men and proposes strategies to overcome these barriers. Qualitative data were collected via in-depth interviews (n = 15) with Latino men about HIV prevention services, mobile outreach, peer navigation and care coordination, and analyzed using rapid qualitative methods. Three key themes emerged: (1) HIV stigma as a barrier to HIV testing, (2) sexual minority stigma as a barrier to accessing HIV prevention services and (3) strategies for stigma reduction, such as confidentiality, comprehensive education about HIV and prevention, and empathy and warmth from staff/care providers. Identified stigmas were intersectional. Addressing and reducing stigma is critical to engaging Latino men in HIV prevention and care, and requires strategies sensitive to the Latino cultural context and community. [ABSTRACT FROM AUTHOR]

Orthopaedic researchers need new strategies for engaging underrepresented minority (URM) students. Our field has demonstrated noticeable gaps in racial, ethnic, and gender diversity, which inhibit our ability to innovate and combat the severe socioeconomic burden of musculoskeletal disorders. Towards this goal, we designed, implemented, and evaluated Learning on a Limb (LoaL), an orthopaedic research outreach module to teach URM high school students about orthopaedic research. During the 4‐h module, students completed hands‐on activities to learn how biomechanical testing, microcomputed tomography, cell culture, and histology are used in orthopaedic research. Over 3 years, we recruited 32 high school students from the Greater Philadelphia Area to participate in LoaL. Most participants identified as racial/ethnic or gender minorities in orthopaedic research. Using pre/post‐tests, we found that students experienced significant learning gains of 51 percentage points from completing LoaL. In addition to teaching students about orthopaedic research, post‐survey data demonstrated that participating in LoaL strongly influenced students' interest in orthopaedic research and scientific confidence. Several students acted on this interest by completing summer research experiences in the McKay Orthopaedic Research Laboratory at the University of Pennsylvania. LoaL instructors also benefited by having the opportunity to “pay it forward” to the next generation of students and build community within their department. Empowering institutions to host modules like LoaL would synergistically inspire URM high school students and strengthen community within orthopaedic departments to ultimately enhance orthopaedic research innovations. [ABSTRACT FROM AUTHOR]

This article examines and critically analyses the contributions of a diverse group of cultural actors who participated in focus group sessions organised as part of the public consultation held between 2022 and 2023 by the Catalan government for the development of a future Cultural Rights Law in Catalonia. This study problematises the four key dimensions that were discussed in the focus group sessions. First, it analyses access to culture, highlighting the barriers and facilitators. Second, it explores cultural participation, addressing the complexities of promoting active audiences, individual and collective creation and participation in cultural governance. Third, it investigates the intersectionality of gender in cultural practices, underscoring the challenges faced by women and gender minorities. Finally, it discusses the professionalisation of culture, pointing out the precarious working conditions in the sector. The article provides evidence of the integration of cultural rights into policies, reflecting on the socio-political contexts that shape them. [ABSTRACT FROM AUTHOR]

BackgroundAimMethodsResultsConclusionBirth complications increase the risk of birth injuries and neonatal complications, as well as the risk of experiencing childbirth as a trauma. This, in turn, increases the risk of postpartum mental ill-health and may affect early bonding with the baby. Birth complications add additional stress on lesbian, bisexual, transgender and queer (LBTQ) parents, as they also must navigate hetero- and cisnormative assumptions, being subject to othering, and negative attitudes from healthcare staff.To explore LBTQ parents’ experiences of bonding with their child following a complicated birth.Semi-structured interviews with 22 birthing and non-birthing parents. Interviews were recorded, transcribed, and analysed using thematic analysis.The results describe obstructive and facilitating factors. Being traumatised was the main obstacle for mentally engaging with the baby. A focus on physical injuries and healing hindered caretaking and bonding for birthing parents. Stress related to their parental role was obstructive for some non-birthing parents, who struggled to find space to process their own experiences when the partner and/or child was not well. Other non-birthing parents experienced a head start in the bonding process when their partner was injured. Some birthing parents had positive bonding experiences despite the birth complications, as they felt an alliance with their child in the harsh situation.Complicated births and minority stressors can increase the risk of bonding difficulties and mental ill-health. Tailored, LBTQ-competent care is essential to support both birthing and non-birthing parents in overcoming these challenges. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions Queer asylum‐seekers should be given an opportunity to have their claim evaluated in a fair and unbiased manner. Despite this, research shows they risk having their claims rejected based on stereotypes about sexual minorities. In the present study, we investigated how the Finnish Immigration Service evaluated credibility in asylum claims lodged by sexual minorities.We analysed 68 negative asylum decisions to assess the arguments made to reject the asylum claim. To do this, we developed a detailed coding scheme to investigate the specific themes and credibility indicators cited in the asylum decisions.We found that the asylum claims were most often rejected because the applicant's account of their sexual orientation was not found to be sufficiently detailed, consistent, or plausible. Officials appeared to hold assumptions around sexual identity development and interpersonal relationships that are partially unsupported by established psychological science.Assessments of SOGI claims would benefit from a greater consideration of the factors affecting queer asylum applicants' ability to describe their claims, including cross‐cultural differences in understandings of sexuality, variability in human behaviour, and practical barriers within the asylum procedure. [ABSTRACT FROM AUTHOR]

The article puts an emphasis on the need to protect the rights of LGBT communities. Although the issue of protecting LGBTI rights was considered in the writings of domestic scientists, the RussianUkrainian war has become a new challenge for LGBT representatives and caused new problems for them. In the conditions of the war in Ukraine, this is an urgent issue today, because nowadays, persons in same-sex relationships experience restrictions on their rights. The author emphasizes that in connection with the desire of our country to become a full member of the EU, a significant task for it is to prevent discrimination based on such grounds as sexual orientation and gender equality. Despite the public’s negative attitude towards representatives of the so-called “sexual minorities”, the latter stood up to protect their Motherland. Therefore, the state’s performance of its obligations towards such persons is an important issue today. The problem is that there is no normative consolidation of the legal status of LGBT communities in Ukraine and this leads to a limited amount of constitutional, civil, and family rights compared to other citizens. However, in the conditions of the war, representatives of the LGBT community feel even more restricted in their rights than before the war. In particular, they cannot legalize their relations and because of this certain difficulties arise. The author draws attention to the fact that the presence of gaps in the current legislation leads to the fact that LGBT military personnel do not have the same rights as other citizens of Ukraine, although they fight for the independence and territorial integrity of our state. The article highlights that changes to the Constitution of Ukraine cannot be made during the war. Therefore, injustice towards LGBT military personnel should be eliminated by adopting the Law of Ukraine “On the Institute of Registered Partnerships”. The article draws attention to the fact that national courts, if to analyze their practice, are «not ready» to protect LGBTI rights due to the negative perception of these persons in the state. The author emphasizes that the courts must effectively protect the rights of LGBTI people and restore their violated rights. They should also take into account the fact that the practice of the ECtHR is aimed at protecting the rights of the LGBT community. However, a completely different situation is observed in Ukraine, which leads to the adoption of decisions against our state and this generates negative consequences for it. [ABSTRACT FROM AUTHOR]

Students of sexual and gender minority (SGM) identities have long been underserved in higher education, and the limited research thus far has focused on undergraduates. There is a large gap in understanding the outcomes and experiences of LGBTQ+ graduate students, particularly in STEM. We undertook the first scoping review to examine the available literature on LGBTQ+ student experiences in research-focused doctoral programs. A scoping review methodology was utilized to compile a broad set of publications for a narrative review of emergent themes. A comprehensive search of 5 bibliographic databases yielded 1,971 unique studies, which were screened by two independent reviewers for data on LGBTQ+ doctoral students in non-clinical fields. Eighty-two publications were included in the analysis, over half of which were published in the past 5 years. Thirteen themes emerged from analyzing the included publications. LGBTQ+ ientities can continue evolving during graduate school, and some students incorporated SGM identities in their research ("mesearch"). Though students expected academia to be welcoming, many encountered repeated anti-LGBTQ+ bias that impacted their perceived safety for coming out. Nearly half of the studies mentioned intersectionality with other marginalized identities, including race/ethnicity, religion, disability, and others. Based on the information presented, we outline recommendations for practitioners to improve doctoral education, such as preparing teaching assistants to manage discriminatory classroom conduct. [ABSTRACT FROM AUTHOR]

Researchers can unintentionally reinforce societal prejudice against minoritized populations through the false assumption that psychological measurements are generalizable across identities. Recently, researchers have posited that gender and sexually diverse (GSD) people could feel excluded or confused by the Ambivalent Sexism Inventory (ASI) due to its overtly heteronormative statements like "A man is incomplete without the love of a woman." Yet, the ASI is used for indexing the endorsement of sexism in GSD samples and across diverse populations. An ideal test of these experiences is to directly consult GSD participants for their reactions. In the current study, we report a reflexive thematic analysis of lesbian women and gay men's (N = 744) feedback immediately after completing the ASI. Four themes characterized participants' reactions to the ASI: Exclusion: Heteronormative items erase diverse genders and sexualities, Confusion: Inability to meaningfully respond due to heteronormativity, Hope: Exclusion understood as a necessary sacrifice toward progress, and Distress: Exclusion inflicts distress by reflecting societal prejudice. The themes captured the experience that many participants found heteronormative assumptions salient in the ASI and had varied reactions to the heteronormativity. Our results extend prior research that questions the generalizability of results drawn from the ASI, especially studies including GSD participants. We discuss the implications of the continued use of the ASI and encourage researchers to critically evaluate underlying theories and assumptions to ensure participants can engage with measures as intended. [ABSTRACT FROM AUTHOR]

Despite experiencing disproportionately high rates of trauma exposure and traumatic stress, sexual and gender minority populations are underrepresented in research on posttraumatic growth (PTG). Data from two waves of semistructured life review phenomenological interviews with 14 sexual minority women and nonbinary individuals were analyzed to explore sexual minority women and nonbinary individuals' lived experiences of growth and healing from exposure to traumatic events. Three main themes were identified: (1) healing through interpersonal connection; (2) new learning about the self and relationships; and (3) healing as political. The first theme describes the central role of interpersonal connection; whereas some participants described seeking and receiving social support from others, most discussed the value of healing with others. The second theme characterizes new learning following trauma, such as learning that, in healthy and safe relationships, one can be loved for who they are. The third theme encompasses how participants politicized their PTG and that even the process of politicizing the traumatic experience itself facilitated growth, as participants understood their struggle as connected to larger systems of oppression, contributing to further identity development. Our findings suggest that sexual minority women and nonbinary individuals experience PTG as a political, iteratively individual and relational process of queer worldmaking (Berlant & Warner, 1998). Public Significance Statement: This study found that posttraumatic growth among a sample of sexual minority women and nonbinary individuals was facilitated by interpersonal connection and a process of relating traumatic experiences to larger systems of oppression. This suggests that some trauma-exposed sexual and gender minorities may benefit from connecting with their communities to engage in communal meaning-making and counter posttraumatic experiences. [ABSTRACT FROM AUTHOR]

Reciprocal in vitro fertilization (IVF) and intravaginal culture (IVC) are two technologies that allow same-sex female couples to jointly contribute biologically to a pregnancy. This systematic review aimed to synthesize the clinical outcomes of each method including live birth rate, clinical pregnancy rate, embryo quality, and perinatal complications. A dual-reviewer protocol identified eight studies on reciprocal IVF and ten studies on IVC. In retrospective studies reporting on a total of 1,405 reciprocal IVF cycles, reciprocal IVF has demonstrated similar cycle and pregnancy outcomes to autologous IVF. One study that reported on pregnancy complications found a comparable rate of hypertensive disease in pregnancy between patients undergoing reciprocal IVF and intrauterine insemination. However, a lack of prospective studies on reciprocal IVF limits the generalizability of these results. Overall, small prospective and retrospective studies reporting on a total of 776 IVC cycles show that IVC offers good cycle and pregnancy outcomes, comparable to IVF. However, randomized prospective studies reported that the rate of quality embryo creation in IVC may be lower than in IVF. Although both reciprocal IVF and IVC show promise for same-sex female couples and the larger lesbian, gay, bisexual, transgender, intersex, asexual, and other sexual or gender minorities community, this review has highlighted the need for larger, prospective, more diverse studies on methods of shared biological contribution for family building. [ABSTRACT FROM AUTHOR]

This study examined the influence of adverse childhood experiences (ACEs) on Black sexual minority women's mental health and substance use disorders in adulthood. Secondary data analysis was conducted using N = 149 Black sexual minority women's reports from the Generations Study. Study variables included psychological distress, chronic strains, stressful life events, ACEs, and substance use disorders, including alcohol use disorder and drug use disorder. Quantitative data analysis consisted of descriptives and bivariate correlations. Participants' total ACE scores were positively significantly correlated with increased alcohol misuse, chronic life strains, and stressful life events. Exposure to household interpersonal violence and household mental illness during childhood were significantly correlated with alcohol misuse. Black sexual minority women with ACEs are at higher risk for mental health concerns throughout their lifespan and maladaptive coping strategies (e.g., substance use). Implications for counselors and therapists are provided. [ABSTRACT FROM AUTHOR]

In North America, LGBTQ+ youth have high rates of cannabis use and face mental health issues. We conducted a photovoice study to describe the perspectives, needs, and motivations of forty-six LGBTQ+ youth who use cannabis as they access mental healthcare services. Participants' photographs were discussed in individual semi-structured interviews conducted by peer researchers. Following a thematic analysis of the interview transcripts, we first found that, beyond medication, LGBTQ+ youth sought mental health services facilitating introspection to better understand their sexual and gender identities and mental health. Second, participants sought affirming health professionals but often felt judged by providers. Third, access to desired services was often described as uncertain and taxing, which impacted their mental health. Fourth, participants' agency was determined by their experience with mental health services, which translated into resilience to tackle access challenges and cannabis use to mitigate their mental health struggles. Our findings point to the need for mental healthcare delivery that goes beyond medication provision but which in addition foster therapeutic processes based on a holistic understanding of mental health. A trusting dynamic between health professionals and LGBTQ+ youth is imperative to counteract the feelings of stigma experienced by LGBTQ+ youth using cannabis in Canada. [ABSTRACT FROM AUTHOR]

Background: The Brief COPE is a widely used coping instrument, but there is a paucity of research regarding its ability to measure coping among sexual minority (SM) persons. Objective: This study determined the psychometric properties of the Brief COPE and identified coping domains among a sample of SM individuals. Methods: An online survey was conducted with 530 SM persons in the United States. Participants completed the dispositional version of the Brief COPE. Confirmatory factor analysis (CFA) determined construct validity. Cronbach's alpha examined the reliability of resulting domains. Exploratory structural equation modeling (ESEM) was employed to identify coping domains and criterion-related validity was assessed by examining the relationship of the domains with substance use measures (alcohol, cannabis, and drug use). Results: CFA replicated the original 14-factor structure. ESEM identified 3 second-order domains with acceptable fit (chi-square [χ2] = 905.81; degrees of freedom [d f ] = 334, P <.001; comparative fit index [CFI] = 0.90; root mean square error of approximation = 0.06; 90% confidence interval = 0.05-0.06; and standardized root mean residual = 0.08). The 3 second-order domains demonstrated good reliability: adaptive (ω = 0.84), support (ω = 0.85), and disengaged coping (ω = 0.84). Disengaged coping exhibited the strongest correlations with substance use outcomes. Conclusions: Findings provide evidence to support the reliability and validity of the Brief COPE and validates its use with SM persons. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Sexual- and gender-diverse youth face unique stressors that negatively impact their health. The objective of this study was to use National Fatality Review-Case Reporting System data to epidemiologically describe fatalities among identified sexual- and gender-diverse youth to inform future prevention efforts. METHODS: We used 2015 to 2020 data from the National Fatality Review-Case Reporting System to identify deaths among sexual- and gender-diverse youth and compare their characteristics to a matched sample of youth from these same data who were not known to be sexual- and gender-diverse. Demographic, injury, death, history, and life stressor characteristics were analyzed using descriptive statistics. RESULTS: During the study period, 176 fatalities were identified among sexual- and gender-diverse youth. Decedents' mean age was 15.3 years. A greater proportion of deaths was attributed to suicide among sexual- and gender-diverse youth (81%) compared with nonsexual- and genderdiverse youth (54%). Receiving prior (69%) and/or current (49%) mental health services was more common among sexual- and gender-diverse youth, compared with nonsexual- and genderdiverse youth (50% and 31%, respectively). Sexual- and gender-diverse youth were significantly more likely to experience problems in school or be victims of bullying, compared with nonsexualand gender-diverse youth (63% versus 47% and 28% versus 15%, respectively). CONCLUSIONS: Suicide was the most commonmanner of death for sexual- and gender-diverse youth, despite many decedents receiving current or prior mental health services. These findings indicate the need to improve and diversify interventions to prevent these deaths. [ABSTRACT FROM AUTHOR]

Introduction: To explore the existing research on sexual health experiences of sexual and gender minority women (SGMW) post-curative cancer treatment. Methodology: This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Four articles that focused on sexual health experiences of SGMW post-curative cancer treatment were included. Results: Four themes were identified: (a) sexual function; (b) sexual orientation and gender identity, including disclosure and health care provider reactions; (c) relationship dynamics, such as relationship status and the quality of romantic relationships; and (d) body image. Discussions: The findings underscore substantial challenges faced by SGMW cancer survivors in achieving optimal sexual well-being, impacting their access to post-treatment care. This study advocates for more expansive research efforts involving diverse participant cohorts, extending beyond breast cancer, to gain deeper insights into these critical issues. [ABSTRACT FROM AUTHOR]

AbstractSuicidal behaviors are a significant concern in Latin American countries. However, validated scales in Brazil do not address all behaviors on the suicide spectrum. We aimed to adapt the Suicidal Behaviors Questionnaire-Revised (SBQ-R) for Brazil. The SBQ-R was independently translated, back-translated, and evaluated by experts—two thousand eight hundred ninety-eight participants (68.30% women; M = 27.42; A = 18–69) from Brazil. The SBQ-R items presented adequate reliability (ω = .86). Confirmatory factor analysis (CFA) confirmed the construct validity (χ2(df) = 52.707(2), p<.001; CFI = .997; TLI = .992; RMSEA = .052; SRMR = .024). Multigroup CFA indicated that the SBQ-R is invariant for gender, sexual orientation, race, and education level. The SBQ-R has convergent validity for depression (r = 0.61), anxiety (r = 0.49), stress (r = 0.49), impulsivity (r = 0.40), hopelessness (r = 0.60) and divergent validity, with gender and sexual minorities showing higher levels of suicidal behaviors. The Brazilian SBQ-R is designated for use by Brazilian adults. Future studies must investigate the predictive validity of the SBQ-R in clinical samples. [ABSTRACT FROM AUTHOR]

Researchers have increasingly paid attention to prejudice against trans people and its predictors. However, few studies have explored if potential predictors may interact to affect people’s attitudes towards trans people. In this experimental study, we examined the impacts of participant-related factors (i.e. gender and prior contact experience with gender or sexual minorities), target-related variables (i.e. gender identity and facial appearance), and their interactions on Chinese young adults’ attitudes towards trans men. We recruited 172 Chinese young adults to rate images of men with different gender identity labels (i.e. cisgender or trans men) and facial appearances (i.e. feminine or masculine). Results showed that a three-way interaction existed among targets’ gender identity labels, targets’ facial appearances, and participants’ genders. Overall, female participants were less likely than men to show more negative attitudes towards trans men than cisgender men. Participants showed more positive attitudes towards masculine-appearing trans men than feminine trans men. The current findings implied that people favoured trans men’s masculine faces, which match the roles of their gender identities. [ABSTRACT FROM AUTHOR]

Prior research has been conflicted on whether gay community involvement serves as a risk or protective factor for body image and eating disorders (EDs) in sexual minority men (SMM), perhaps given that prior research has examined community involvement unidimensionally. The present study examined whether non-appearance-based ("social activism") and appearance-based ("going out/nightlife") community involvement differentially predicted ED prevention outcomes in SMM. SMM (N = 73) enrolled in a randomized controlled trial of an ED prevention program completed measures of community involvement, drive for muscularity, body dissatisfaction, and bulimic symptoms at pre-intervention, post-intervention, and 1-month follow-up. "Social activism" community involvement moderated intervention effects for drive for muscularity and body dissatisfaction scores, but not bulimic symptoms, such that those who placed higher importance on social activism demonstrated expected improvements, while those who placed lower importance on social activism did not exhibit expected improvements. "Going out/nightlife" community involvement did not moderate intervention outcomes; however, greater importance of going out/nightlife was associated with increased body dissatisfaction. Findings support that the impact of community involvement on body image and ED risk for SMM may be nuanced. Encouraging community involvement through activism could help enhance ED prevention efforts for SMM. [ABSTRACT FROM AUTHOR]

Individuals involved with community supervision experience multi-level obstacles impacting health outcomes. This is a high-risk period for HIV acquisition due to potential reengagement in unprotected sex and/or unsafe injection drug practices. This study aimed to assess the congruence between actual and perceived HIV risk and the degree to which individual, social, and behavioral factors impact risk perception among individuals on community supervision. While all participants were clinically indicated for PrEP, most participants (81.5%) did not consider themselves at risk for HIV (69.5%) or were not sure of their risk (12.0%). Among those with no or unsure perceived risk, 94% engaged in sexual behaviors that put them at-risk of HIV. Perceived HIV risk was associated with sharing injection equipment (aPR = 1.8, 95% CI [1.02, 3.3]), identifying as a sexual minority (aPR = 2.3, 95% CI [1.3, 3.9]), and having sex with a partner living with HIV (aPR = 2.4, 95% CI [1.3, 4.3]). Having sex with a partner living with HIV was the only sexual risk behavior associated with a perceived risk of HIV. These findings indicate a substantial discrepancy between actual and perceived HIV risk, highlighting the need for targeted interventions to improve risk perception accuracy and enhance risk prevention among individuals on community supervision. [ABSTRACT FROM AUTHOR]

This study draws on social normative and social learning theories to examine the masspersonal safer sex communication (i.e., Facebook posts about safer sex) and safer sex behavior (i.e., condom use) in a cohort of Black sexual minority men (BSMM) (N = 340), with an eye toward understanding their relationship with the safer sex communication and behaviors of their BSMM Facebook friends. Using linear network autocorrelation regression models, results showed that BSMM's safer sex communication and condom use behavior were each associated with the communication and behavior of their online peers. Specifically, BSMM's condom use was positively associated with their friends' condom use and friends' safer sex communication, and BSMMs' safer sex communication was positively associated with friends' safer sex communication. Moreover, contrary to prior research, BSSM's safer sex communication and condom use were not related to one another, suggesting that talking about safer sex on social media should not be interpreted to be an indication of engageDment in safer sex behavior. These findings underscore an opportunity to leverage peer influence in social media networks, particularly in the form of masspersonal communication, to encourage cascades of safer sex messaging among peers and adoption of safer sex behavior. [ABSTRACT FROM AUTHOR]

• This review summarizes the history and science of LGBTQ-affirmative psychotherapy. • This review outlines a future research agenda for LGBTQ-affirmative psychotherapy. • Research is needed on LGBTQ-affirmative psychotherapy mechanisms and moderators. • Research is needed on therapy orientations beyond CBT and with diverse populations. • Future implementation efforts should embed therapy within structural interventions. Sexual and gender minority (SGM) individuals experience significantly higher levels of depression, anxiety, and behavioral comorbidities (i.e., substance use, suicide) compared to heterosexual and cisgender individuals. LGBTQ-affirmative psychotherapy aims to ameliorate the adverse psychosocial processes, ultimately caused by stigma, that underlie this disparity. Over the past two decades, the mental health field has introduced professional guidelines and treatment protocols for LGBTQ-affirmative psychotherapy, and established their efficacy across distinct SGM populations, delivery modalities, and settings. This state of the science review outlines the history, current evidence, and future directions of LGBTQ-affirmative psychotherapy. It provides an historical account of clinically relevant research for SGM populations and outlines the factors that moved the field from pathologizing perspectives to affirmative approaches. It then discusses the current evidence for LGBTQ-affirmative psychotherapy, as well as studies identifying treatment moderators, including race/ethnicity and stigma exposure, as well as potential treatment mechanisms, including hypervigilance, shame, negative self-schemas, unassertiveness, and emotion dysregulation. SGM individuals can only benefit from LGBTQ-affirmative psychotherapy if protocols are widely available and used by therapists. To this end, the article presents current findings on implementation and dissemination, such as therapist training, and different treatment delivery modalities. Finally, the article outlines an agenda for future research to advance the field of LGBTQ-affirmative psychotherapy, including identifying treatment mechanisms, successfully implementing and disseminating treatment protocols, determining which contexts and client characteristics warrant adaptations to current protocols, and understanding how LGBTQ-affirmative psychotherapy can interact with structural and systemic conditions to exert the strongest possible impact on SGM mental health. [ABSTRACT FROM AUTHOR]

Following the recent proliferation of anti-discrimination protections supporting LGBTIQ+ youth internationally, backlash periods have ensued. Whilst liberal-progressive rights models theorise 'backlash' as an expected consequence of rights recognitions progress, some post-colonial and Queer scholars frame backlash within enduring authoritarian anti-rights tendencies, and question assumptions of progress. To understand backlash more adequately, this paper explores state-level anti-LGBTIQ+ Bills potentially impacting youth proposed in the USA between 2018 and 2022. Critical discourse analysis is used to map the different types, locations, conceptual arrangements and outcomes of 543 anti-LGBTIQ+ rights US state-level proposed Bills. Bill attempts were mainly concentrated in Republican-governed states including Tennessee (48), Missouri (40), Iowa (39), Oklahoma (32) and Texas (32). Overly extended claims concerning girls/women's religious and parental rights were advanced in opposition to LGBTIQ+ youth rights, and as part of wider rights attacks. Bills used anti-rights and pro-rights discourses to mask as 'backlash' the rights claims advanced by elite-led anti-rights mobilisations. [ABSTRACT FROM AUTHOR]

Aim: To explore the feasibility of development and implementation of an educational intervention addressing sexual and gender minority healthcare issues; examine recruitment processes and instrument appropriateness. Design: Non‐randomized feasibility study. Methods: The educational intervention was developed and implemented in family nurse practitioner courses with data collection from August through December 2022. Clinical preparedness, attitudinal awareness and basic knowledge were measured using the lesbian, gay, bisexual and transgender Development of Clinical Skills Scale. Results: Development and implementation of the intervention was feasible but will require amendment before progressing to the pilot study. Clinical preparedness and basic knowledge increased post‐intervention, but attitudinal awareness did not improve. Recruitment did not achieve the desired sample size. Instrument internal consistency reliability was confirmed. Conclusion: Feasibility was established but will require amendment prior to the pilot study. Implications for the Profession and/or Patient Care: To prepare nurses and nurse practitioners to care for sexual and gender minority patients. Impact: This study addressed the feasibility of developing and implementing a sexual and gender minority healthcare education using an e‐Learning platform. Findings confirm that the intervention was feasible but will require amendment. The intervention increased knowledge and clinical preparedness in caring for this population, but recruitment was challenging. This research will impact nurses, nurse practitioners and nurse educators. Reporting Method: The authors adhered to the relevant EQUATOR guidelines. The Consolidated Standards of Reporting Trials guideline extension for reporting randomized and feasibility guidelines were used. Public Contribution: Sexual and gender minority community members contributed to the intervention development. What Does this Paper Contribute to the Wider Global Clinical Community?: The feasibility of using interactive e‐learning educational resources to provide sexual and gender minority healthcare curriculum.Evidence to support the use of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale to measure learning outcomes. Trial Registration: This study was not prospectively registered because it was an educational intervention involving graduate student nurses and did not assess clinical outcomes of patients. [ABSTRACT FROM AUTHOR]

This longitudinal study examined the relationships between multiple dimensions of singlehood and mental health, along with their moderators, in a diverse cohort of sexual and gender minority youth assigned female at birth (N = 205, Mage = 19.5; 39% < 18 years old; 27% gender minority; 74% racial/ethnic minority) who were single (no romantic partnership) at least once across 7 visits (retention >90% at all visits). Singlehood dimensions included single status, length of singlehood, and transitions into and out of singlehood at each visit, as well as proportion of singlehood periods across all visits. At the between-person level, individuals with a higher proportion of singlehood periods across the study reported higher stress, anxiety, and depression. At the within-person level, while youth experienced increased depression when single, their depression and stress decreased as the length of singlehood increased. Additionally, fear of being single (FOBS) and perceived social support, each showing unique associations with mental health outcomes in this study, were included as moderators. Notably, only those with low to average (not high) FOBS experienced a reduction in mental health problems as singlehood length increased. Taken together, the findings shed light on the factors associated with mental health and well-being in single individuals from a vulnerable and marginalized population. [ABSTRACT FROM AUTHOR]

Background: Prior research suggests that sexual minority status is related to victimization, mental health issues, and substance use. However, few studies have sought to connect these relationships in a way supported by theory, and fewer have utilized probability and/or nationally representative samples. Objective: The current study seeks to test the relationships among these variables, guided by general strain theory (GST). Methods: One wave of the National Longitudinal Study of Adolescent to Adult Health dataset (Add Health) (N = 14,121) and path modeling in Mplus are utilized. Results: Models run separately by race/ethnicity suggest that the relationship among these variables largely support expectations from GST, but with some notable differences by race/ethnicity. Conclusion: Results suggest a relationship among these variables that concurs with criminological theorizing. Implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

Background: Previous non-fatal overdose may increase risk of overdose fatality for women reentering the community following incarceration, but pre-incarceration overdose experiences are understudied. This study describes the prevalence and correlates of non-fatal overdose prior to jail among women with opioid use disorder (OUD). Methods: Women (N = 700) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed as part of the NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) trial. Descriptive statistics were used to examine women's prior overdose experiences, while bivariate analyses and logistic regression were used to identify correlates of overdose in the 90 days prior to jail. Results: Analyses found that 55.4% of women had overdosed in their lifetime, and 21.4% overdosed in the 90 days prior to jail. Of those who overdosed in the 90 days prior to jail, heroin (80.7%) was the most-commonly used drug prior to overdose, 35.2% received emergency, medically-attended services post-overdose, and 92.4% were administered naloxone – primarily by acquaintances. Overdosing in the 90 days prior to jail was positively correlated with identifying as a sexual minority, being from an urban community, childhood victimization, as well as recent heroin, fentanyl, and injection drug use. Conclusions: Findings indicate that prior overdose is common among jailed women with OUD, and although naloxone was often administered, few women received medically-attended services post-overdose. Results highlight the importance of distributing naloxone to community members and women reentering the community from jail, and suggest additional research is needed to understand factors inhibiting medical care following an overdose. [ABSTRACT FROM AUTHOR]

Social determinants of health (SDOH) contribute to differences in health outcomes and exacerbate health disparities. This study characterizes the National Institute on Minority Health and Health Disparities' (NIMHD) portfolio of funded grants in SDOH research, identifies gaps, and provides suggestions for future research. Using the National Institutes of Health's SDOH Research, Condition, and Disease Categorization, research projects funded from 2019 to 2023 were identified and linked with NIMHD's internal coding system to extract in-depth study characteristics, including sociodemographics of study participants, disease and condition focus, and alignment with strategic priorities. Natural Language Processing methods were used to categorize projects into five Healthy People 2030 SDOH domains. The resulting sample included 675 unique research projects. Most projects included racial and ethnic minority groups (89%), followed by people with lower socioeconomic status (33%), underserved rural communities (16%), and sexual and gender minority groups (13%). Most projects focused on the Etiology of health disparities (61%), followed by Interventions (54%), and Methods and Measurement (39%). Of the Healthy People 2030 domains, Social and Community Context had the greatest representation (61%) whereas Education Access and Quality had the least (6%). Variation in research project characteristics across SDOH domains is also presented. This study documents characteristics of SDOH research funded by NIMHD and explores how they differ across Healthy People 2030 SDOH domains. Findings highlight how study characteristics and foci align with strategic priorities and suggest opportunities for future research. [ABSTRACT FROM AUTHOR]

• Ask prostate cancer patients about sexual orientation, gender identity, and sexual behaviors. • Consider receptive anal intercourse at every stage in the cancer continuum. • Gender affirming hormone therapy can influence prostate specific antigen levels. • Consider patient interest in genital affirming surgery when recommending prostate cancer treatment. At every stage of the cancer continuum, the management of sexual and gender minorities with prostate cancer requires a thoughtful and multidisciplinary approach. For example, it is important to recognize that receptive anal intercourse, common among sexual minority men—i.e. gay and bisexual men—can potentially elevate prostate-specific antigen (PSA) leading to overdiagnosis and overtreatment. Additionally, it is important to understand that sexual minority men with prostate cancer might engage in insertive and/or receptive anal intercourse, as opposed to insertive vaginal intercourse, requiring a treatment conversation that expands beyond the usual discussion of sexual health in prostate cancer patients. For gender minorities—i.e. transgender women or trans feminine individuals (those recorded male at birth with feminine gender identities)—it is important to consider gender affirming hormones and pelvic surgeries as they can cause diagnostic and treatment challenges, including PSA suppression, more aggressive disease, and anatomical changes. Furthermore, it is essential to recognize that gender minorities are a diverse cohort and may or may not be on gender affirming hormone therapy and may or may not have received or intend to receive pelvic affirming surgery. In this seminar article, we highlight considerations for personalized management of prostate cancer in sexual and gender minorities to improve care for this understudied cohort and enhance health equity. [ABSTRACT FROM AUTHOR]

Recognizing sexual orientation and gender identity (SOGI) is paramount in the management of genitourinary cancers, as sexual and gender minority (SGM) individuals encounter unique healthcare challenges leading to disparities. SGM patients often confront systemic barriers, provider biases, and scarcity of tailored resources, resulting in diminished satisfaction and adverse health outcomes. The evaluation and treatment of genitourinary cancers in SGM patients demand a nuanced, multidisciplinary approach that focuses on the unique health determinants often overlooked by the healthcare system. This review highlights recommendations for the inclusivity of SGM patients within the clinic, from inclusive signage to gender inclusive language. For the evaluation and treatment of SGM patients with genitourinary cancers, it is recommended to employ organ-based language, to utilize validated questionnaires encompassing mental health, sexual behavior, and patient-reported outcomes, and to provide timely referrals to social work and onco-fertility when appropriate. Ultimately, approaching inclusivity through education targeted at both SGM patients and healthcare providers is pivotal for centering care around the patient, improving the quality of life and outcomes for SGM patients facing genitourinary cancers. [ABSTRACT FROM AUTHOR]

Bladder cancer, a common urologic malignancy, has poor morbidity and mortality in sexual and gender minority (SGM) individuals, stemming from higher risk, poor access to care and lack of quality cancer care. To begin addressing this disparity, this review offers key considerations for evaluation, diagnosis and treatment of SGM individuals with bladder cancer. In addition to thorough medical and surgical history, initial evaluation should include discussion of patient goals for sexual function and organ preservation, as well as an evaluation of sexual function. Prior gender affirming surgery and patient specific sexual function goals will impact diagnosis and treatment approaches, including surgical and radiation therapy. Throughout care for SGM individuals with bladder cancer, it is critical to acknowledge the systemic discrimination that may be experienced by these individuals and approach conversations with sensitivity and humility and incorporate mental and social support as appropriate. [ABSTRACT FROM AUTHOR]

Gender-responsive monitoring and evaluation (M&E) for health and health systems interventions and programs is vital to improve health, health systems, and gender equality outcomes. It can be used to identify and address gender disparities in program participation, outcomes and benefits, as well as ensure that programs are designed and implemented in a way that is inclusive and accessible for all. While gender-responsive M&E is most effective when interventions and programs intentionally integrate a gender lens, it is relevant for all health systems programs and interventions. Within the literature, gender-responsive M&E is defined in different and diverse ways, making it difficult to operationalize. This is compounded by the complexity and multi-faceted nature of gender. Within this methodological musing, we present our evolving approach to gender-responsive M&E which we are operationalizing within the Monitoring for Gender and Equity project. We define gender-responsive M&E as intentionally integrating the needs, rights, preferences of, and power relations among, women and girls, men and boys, and gender minority individuals, as well as across social, political, economic, and health systems in M&E processes. This is done through the integration of different types of gender data and indicators, including: sex- or gender-specific, sex- or gender-disaggregated, sex- or gender-specific/disaggregated which incorporate needs, rights and preferences, and gender power relations and systems indicators. Examples of each of these are included within the paper. Active approaches can also enhance the gender-responsiveness of any M&E activities, including incorporating an intersectional lens and tailoring the types of data and indicators included and processes used to the specific context. Incorporating gender into the programmatic cycle, including M&E, can lead to more fit-for-purpose, effective and equitable programs and interventions. The framework presented in this paper provides an outline of how to do this, enabling the uptake of gender-responsive M&E. [ABSTRACT FROM AUTHOR]

Sexual and gender minorities (SGM; i.e. lesbian, gay, bisexual, transgender, queer, intersex, asexual and other identities aka LGBTQIA+) experience homelessness at disproportionately higher rates than their cisgender and heterosexual peers. Adverse childhood experiences (ACE)—experiences of abuse, neglect, or challenges in the family setting—have been identified as a key risk factor for experiencing homelessness. The present study assessed the relationship between ACE and first-time homelessness in a community sample of SGM adults in South Texas. Participants (n = 910) completed a cross-sectional survey and logistic regression models were used to estimate associations with first-time homelessness childhood and adulthood. Adjusting for covariates, the odds of first-time homelessness increased by 1.58 times in childhood (95% CI = 1.36–1.84) and 1.33 times in adulthood (95% CI = 1.21–1.46) for every additional ACE reported. Specific ACE categories were also associated with homelessness experiences. Research is needed to understand the breadth of causes and consequences of homelessness among SGM individuals. [ABSTRACT FROM AUTHOR]

Homelessness disproportionately impacts sexual and gender minority (SGM) people, however, few studies have examined factors that predict homelessness among SGM adults. The present secondary analysis of a survey of SGM adults living in the Southeastern U.S. in 2016 (N = 427) assessed factors associated with report of past or current homelessness, which was endorsed by 17% of participants. Congruent with our hypotheses, past socioeconomic status (SES), current SES, mental health, and race were all significant predictors and accounted for 50.5% of variance in homelessness in this population. Discrimination and housing access difficulties did not account for a significant portion of variance over and above these factors. Factors contributing to poverty and psychological distress are needed to address housing disparities for SGM adults. Discrimination factors may have become more salient since 2016. Future research is warranted to better support SGM individuals, particularly those living in the South. [ABSTRACT FROM AUTHOR]

Introduction: Homelessness is associated with an increased risk of syphilis, HIV, and other STIs and disproportionately impacts sexual and gender minorities. Method: Data for this analysis came from a longitudinal cohort study of 285 urban gay, bisexual, and other men who have sex with men (MSM). The study aimed to (1) describe the prevalence of homelessness over time (2) identify characteristics associated with homelessness, and (3) measure associations between recent homelessness and substance use and STI/HIV risk behaviors three months later. Participants were recruited from clinical and non-clinical settings and attended a baseline visit and study visits every three months for up to 18-months. Data was collected between July 2018 and September 2020. Descriptive analyses and mixed-effects logistic regression models were utilized. Results: One-third of participants (94) reported experiencing homelessness throughout the study. Homelessness was significantly and independently associated with increased risk for future drug/alcohol use before/during sex (aOR: 3.8, 95% CI: 1.7, 8.6), methamphetamine use (aOR: 6.3 95% CI: 2.6, 15.2), injection drug use (adjusted odds ratio (aOR): 3.7, 95% CI: 1.0, 13.1), and sex exchange (aOR: 12.7; 95% CI: 5.5, 29.4). Conclusion: Interventions to reduce homelessness are necessary to lower risk of substance use and STI/HIV risk behaviors. [ABSTRACT FROM AUTHOR]

Objectives: In view of the accumulated stress associated with the combination of intergenerational trauma and minority stress, we aimed to examine whether offspring of Holocaust survivors (OHS) reported stronger evil-related threats compared to non-OHS individuals and whether OHS gay men experienced stronger threats. We also examined whether sexual orientation moderated the hypothesized indirect effect of Holocaust background on mental health through evil-related threats. Method: Participants were 346 middle-aged and older Israeli men (mean age = 60.56, SD = 8.42, range 50–86). Among them, 173 identified as gay men, and 81 identified as OHS. Participants completed measures of evil-related threats, depression, and life satisfaction. Results: Analysis of covariance revealed that OHS men reported stronger evil-related threats compared to non-OHS men. Yet, an interaction between Holocaust background and sexual orientation indicated that OHS gay men reported stronger evil-related threats compared to non-OHS gay men, while no such difference existed among heterosexual counterparts. Conditional indirect effect analysis showed a significant indirect effect, in which Holocaust background related to higher depressive symptoms and lower life satisfaction through evil-related threats among gay men, but not among heterosexual men. Conclusion: This study sheds light on the particular experience of evil-related threats, focusing on older OHS gay men and the mental health vulnerability associated with it. In applied contexts, this might help identify a sexual minority group that is particularly sensitive to adverse mental health and offer it supporting interventions. [ABSTRACT FROM AUTHOR]

Sexually minoritized men (SMM) with HIV who use stimulants experience difficulties achieving and maintaining an undetectable viral load (VL). Home-based VL monitoring could augment HIV care by supporting interim, early identification of detectable VL. We describe implementation challenges associated with a home-collection device for laboratory-based VL testing among SMM with HIV who use stimulants. From March-May 2022, cisgender SMM with HIV reporting moderate-to-severe stimulant use disorder and suboptimal (< 90%) past-month antiretroviral therapy (ART) adherence were recruited via a consent-to-contact participant registry. Eligible men completed teleconference-based informed consent and were mailed a HemaSpot-HD blood collection device (volume capacity 160 µL; lower limit of detection 839 copies/mL) with detailed instructions for home blood self-collection and return shipment. Implementation process measures included estimated blood volume and VL quantification. Among 24 participants, 21 (88%) returned specimens with a median duration of 23 days (range: 10–71 days) between sending devices to participants and receiving specimens. Of these, 13/21 (62%) included enough blood (≥ 40 µL) for confidence in detectable/undetectable results; 10/13 (77%) had detectable VL, with 4/10 (40%) were quantifiable at ≥ 839 copies/mL. The remaining 8/21 had low blood volume (< 40 µL), but 3/8 (38%) still had detectable VL, with 1/3 (33%) quantifiable at ≥ 839 copies/mL. Home blood collection of ≥ 40 µL using HemaSpot-HD was feasible among this high-priority population, with > 50% having a VL detected. However, interim VL monitoring using HemaSpot-HD among those experiencing difficulties with ART adherence may be strengthened by building rapport via teleconferencing and providing detailed instructions to achieve adequate sample volume. [ABSTRACT FROM AUTHOR]

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