Showing papers in "Journal of Homosexuality in 2017"
TL;DR: Addressing gender identity and sexuality issues within medical curricula may remove barriers to accessing health care and improve encounters for LGBTQ patients.
Abstract: Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people frequently report negative health care encounters. Medical professionals may inadequately manage LGBTQ persons' health if they have not received training in this area. An anonymous survey measuring efficacy in health situations among LGBTQ persons was answered by 166 medical students across all years of a UK university. Results show that 84.9% of participants reported a lack of LGBTQ health care education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ patients. Most participants reported that they would not clarify gender pronouns or ask about gender or sexual identity in mental health or reproductive health settings. Participants reported infrequently observing doctors making similar inquiries. Participants held positive attitudes toward LGBTQ patients, with attitude scores positively correlating with LGBTQ terminology knowledge scores (rs = 0.5052, p < .01). Addressing gender identity and sexuality issues within medical curricula may remove barriers to accessing health care and improve encounters for LGBTQ patients.
129 citations
TL;DR: Examination of a diverse sample of LGBTQ young adults and their experiences of disclosure and nondisclosure to medical providers confirmed and extend previous research on young adults’ identity disclosure and provide avenues for health professionals’ continuing education when working with LGBTQ patients.
Abstract: Shifting cultural attitudes and legislation have increased focus on the health care needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient nondisclosure of LGBTQ...
113 citations
TL;DR: Micro and macro interventions aimed at increasing social connectedness and decreasing internalized transphobic stigma may be paramount for enhancing resiliency and wellbeing in the TGNC community.
Abstract: The transgender and gender non-conforming (TGNC) community continues to represent a notably marginalized population exposed to pervasive discrimination, microaggressions, and victimization. Congruent with the minority stress model, TGNC individuals persistently experience barriers to wellbeing in contemporary society; however, research uncovering resilience-based pathways to health among this population is sparse. This study aimed to explore the impact and interaction between internalized transphobic stigma and a potential buffer against minority stress-social connectedness-on the self-esteem of TGNC identified adults. Data were collected from 65 TGNC identified adults during a national transgender conference. Multiple regression analysis reveals that self-esteem is negatively impacted by internalized transphobia and positively impacted by social connectedness. Social connectedness did not significantly moderate the relationship between internalized transphobia and self-esteem. Micro and macro interventions aimed at increasing social connectedness and decreasing internalized transphobic stigma may be paramount for enhancing resiliency and wellbeing in the TGNC community.
103 citations
TL;DR: Quantitative data were gathered regarding demographics, persecution histories, and mental health of 61 clients from a torture survivors program in New York City who reported persecution due to LGBT identity to explore how persecution and symptoms may differ for LGBT clients.
Abstract: Asylum seekers are a unique population, particularly those who have endured persecution for their sexual orientation or gender identity. Little data exist about the specific experiences and needs of asylum seekers persecuted due to lesbian, gay, bisexual, or transgender (LGBT) identity. Quantitative data were gathered regarding demographics, persecution histories, and mental health of 61 clients from a torture survivors program in New York City who reported persecution due to LGBT identity. Thirty-five clients persecuted due to their LGBT identity were matched by country of origin and sex with clients persecuted for other reasons to explore how persecution and symptoms may differ for LGBT clients. LGBT asylum seekers have a higher incidence of sexual violence, persecution occurring during childhood, persecution by family members, and suicidal ideation. Understanding the type of persecution experiences and how these influence mental health outcomes is an essential step toward designing and delivering effective treatments.
99 citations
TL;DR: Five overarching themes emerged regarding patients’ suggestions for providers: be comfortable with LGBTQI patients; share medical decision-making; avoid assumptions; apply LGBTQI-related knowledge; and address the social context of health disparities.
Abstract: This qualitative study explored the experiences of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) people in health care and their recommendations for physicians. Six focus groups...
76 citations
TL;DR: This study analyzes cross-sectional survey data collected among a diverse sample of LGBTQ college students to test main effects of interpersonal heterosexism and engagement with campus organizations on depression, as well as moderating effects of campus engagement.
Abstract: LGBTQ people experience health disparities related to multilevel processes of sexual and gender marginalization, and intersections with racism can compound these challenges for LGBTQ people of color. Although community engagement may be protective for mental health broadly and for LGBTQ communities in buffering against heterosexism, little research has been conducted on the racialized dynamics of these processes among LGBTQ communities. This study analyzes cross-sectional survey data collected among a diverse sample of LGBTQ college students (n = 460), which was split by racial status. Linear regression models were used to test main effects of interpersonal heterosexism and engagement with campus organizations on depression, as well as moderating effects of campus engagement. For White LGBTQ students, engaging in student leadership appears to weaken the heterosexism–depression link—specifically, the experience of interpersonal microaggressions. For LGBTQ students of color, engaging in LGBTQ-specif...
74 citations
TL;DR: These three studies provide initial evidence for the development, factor structure, reliability, and validity of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), a new interdisciplinary LGBT clinical self-assessment for health and mental health providers.
Abstract: These three studies provide initial evidence for the development, factor structure, reliability, and validity of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LG...
69 citations
TL;DR: A systematic review to assess evidence for disparities for lesbian and bisexual women in comparison with heterosexual women across a range of nine physical health conditions found evidence of disparities as indicated by statistically significant adjusted odds ratios for asthma, obesity, and cardiovascular disease.
Abstract: We conducted a systematic review to assess evidence for disparities for lesbian and bisexual women (i.e., sexual minority women [SMW]) in comparison with heterosexual women across a range of nine physical health conditions. Among the k = 11 studies meeting eligibility criteria, almost every comparison (i.e., heterosexual vs. (a) lesbian, (b) bisexual, or (c) both lesbian and bisexual women) was in a direction indicating SMW disparities. Despite limited power due to small samples of SMW, we found evidence of disparities as indicated by a statistically significant adjusted odds ratios for asthma (5 of 7 comparisons), obesity (8 of 12), arthritis (2 of 3), global ratings of physical health (4 of 7), and cardiovascular disease (1 of 1). Evidence was lacking for cancer (1 of 4), diabetes and hypertension (both 1 of 5), and high cholesterol (0 of 3). Future work should confirm findings in more diverse, larger samples and should examine potential explanatory factors.
64 citations
TL;DR: Five ways in which asexually identified individuals disrupted compulsory sexuality are identified: adopting a language of difference and a capacity to describe asexuality; deemphasizing the importance of sexuality in human life; developing new types of nonsexual relationships; constituting a sexual orientation or identity; and engaging in community building and outreach.
Abstract: This article explores the relationship between contemporary asexual lives and compulsory sexuality, or the privileging of sexuality and the marginalizing of nonsexuality. Drawing on 30 in-depth interviews, I identify four ways the asexually identified individuals in this study saw themselves as affected by compulsory sexuality: pathologization, isolation, unwanted sex and relationship conflict, and the denial of epistemic authority. I also identify five ways these asexually identified individuals disrupted compulsory sexuality: adopting a language of difference and a capacity to describe asexuality; deemphasizing the importance of sexuality in human life; developing new types of nonsexual relationships; constituting asexuality as a sexual orientation or identity; and engaging in community building and outreach. I argue that some of these practices offer only a limited disruption of compulsory sexuality, but some of these practices pose a radical challenge to sexual norms by calling into question the widespread assumption that sexuality is a necessary part of human flourishing.
63 citations
TL;DR: In a country where LGBT rights are not yet recognized and antidiscrimination legislation covering sexual orientation and gender identity is still nonexistent, findings demonstrate perceived discrimination of LGBTs rarely turns into a legal complaint.
Abstract: This article explores the discrimination practices encountered by lesbian, gay, bisexual, and transgender (LGBT) individuals in education, income, employment, and health care in Turkey. Limited quantitative data on LGBT individuals are available in Turkey. This study collected data from 2,875 LGBT individuals through a Web-based survey. The findings suggest that LGBT individuals report perceived direct and indirect discrimination in accessing education, employment, and health care. In a country where LGBT rights are not yet recognized and antidiscrimination legislation covering sexual orientation and gender identity is still nonexistent, findings demonstrate perceived discrimination of LGBTs rarely turns into a legal complaint. Even when they do, most LGBTs in our sample report that they did not feel that the justice system addressed their grievances.
62 citations
TL;DR: The importance of creating affirming spaces for LGBY, particularly in areas of the country that experience greater political oppression of sexual minorities, such as the Mid-South, is highlighted.
Abstract: Lesbian, gay, and bisexual youth (LGBY) report higher rates of mental health concerns compared to heterosexual youth due to minority stressors. This study examined the interpersonal and intrapersonal variables that predict psychological distress and self-reported suicide attempts in a sample of 61 LGBY in the Mid-South, which is a highly overlooked regional area for LGBY research. Youth who lost friends when coming out were 29 times more likely to report suicide attempts, and those who experienced psychological maltreatment from caregivers were 9.5 times more likely to report a suicide attempt. Internalized heterosexism, feelings of guilt or shame, and psychological maltreatment from caregivers were significant predictors of depression and anxiety symptoms. This study highlights the importance of creating affirming spaces for LGBY, particularly in areas of the country that experience greater political oppression of sexual minorities, such as the Mid-South.
TL;DR: The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.
Abstract: Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.
TL;DR: Findings indicate that the Sexual-Romantic and Gender-Inclusive scales appear to address some of the concerns raised in previous research regarding the measurement of sexual orientation among sexual minority individuals.
Abstract: Previous qualitative research on traditional measures of sexual orientation raise concerns regarding how well these scales capture sexual minority individuals’ experience of sexuality. The present research focused on the critique of two novel scales developed to better capture the way sexual and gender minority individuals conceptualize sexuality. Participants were 179 sexual minority (i.e., gay, lesbian, bisexual, pansexual, queer, asexual) individuals who identified as cisgender (n = 122) and transgender (n = 57). Participants first completed the new scales, then provided qualitative responses regarding how well each scale captured their sexuality. The Sexual-Romantic Scale enabled the measurement of sexual and romantic attraction to each sex independently (same-sex and other-sex). Participants resonated with the way the Sexual-Romantic scale disaggregated sexual and romantic attraction. Although cisgender monosexual (lesbian/gay) individuals positively responded to the separation of same- and o...
TL;DR: Resilience from weathering a lifetime of discrimination was identified as a strength to handle aging challenges and recommendations for establishing an aging in place model included establishing welcoming communities and resource centers and increasing cultural competence of service providers.
Abstract: This qualitative study conducted by a community-research partnership used multiple types of data collection to examine variables relevant for LGBTQ older adults who wished to age in place in their urban Denver neighborhood. Focus groups, interviews, and a town hall meeting were used to identify barriers and supports to aging in place. Participants (N = 73) identified primarily as lesbian or gay, aged 50–69, and lived with a partner. Ageism, heterosexism, and cisgenderism emerged as cross-cutting themes that negatively impact access to health care, housing, social support, home assistance, and legal services. Resilience from weathering a lifetime of discrimination was identified as a strength to handle aging challenges. Recommendations for establishing an aging in place model included establishing welcoming communities and resource centers and increasing cultural competence of service providers. This study provides a unique contribution to understanding the psychosocial, medical, and legal barriers...
TL;DR: Language as a means of exhibiting cultural competence as well as the barriers to facilitating this degree of competence are discussed as a framework for contextualizing LGBT-specific cultural competence in health care.
Abstract: Changes in the language and terminology used to refer to individuals identifying as lesbian, gay, bisexual, and transgender (LGBT), as well as how best to discuss issues of sexual and gender identi...
TL;DR: Come out was shown to have both positive and negative effects on communication and social support and was associated with both increases and decreases in experiences of stigma, and concealment was related to hypervigilance and unique strategies of accessing social support.
Abstract: Disclosure of a sexual or gender minority status has been associated with both positive and negative effects on wellbeing. Few studies have explored the disclosure and concealment process in young ...
TL;DR: A close reading of how “stress” is conceptualized in the minority stress model is provided and it is suggested that aspects of the model do not attend to the institutionalized nature of stressors experienced by people with marginalized identities.
Abstract: To date, research that has drawn on Meyer's (2003) minority stress model has largely taken for granted the premises underpinning it. In this article we provide a close reading of how "stress" is conceptualized in the model and suggest that aspects of the model do not attend to the institutionalized nature of stressors experienced by people with marginalized identities, particularly lesbian, gay, bisexual, and transgender individuals. As a counter to this, we highlight the importance of a focus on the effects of ideology and social norms in terms of stress, and we argue why an intersectional approach is necessary to ensure recognition of multiple axes of marginalization and privilege. The article then outlines the concept of decompensation and suggests that it may offer one way to reconsider the effects of ideology and social norms. The decompensation approach centers on the need for social change rather than solely relying on individuals to be resilient.
TL;DR: Findings showed that transgender content in education was positively correlated with transphobia, and 1-way ANOVA showed that transphobic levels differed significantly across the majors.
Abstract: The study was designed to further the understanding of transphobia among students majoring in the helping professions including social work, occupational therapy, and nursing. The study's hypotheses examined the effects of transgender content in education (e.g., textbooks and lectures), religiosity, contact with transgender people, and several sociodemographic variables with transphobia. Differences in transphobia levels between social work students and those in aligned professions were also explored. The sample consisted of 600 students of a public, urban university in New York City who participated in an online survey. Measures included transphobia and transgender content scales. Students reported (75%) a deficient amount of transgender content in education, and almost one half of the sample reported moderate to high levels of transphobia. Other findings showed that transgender content in education was positively correlated with transphobia, and 1-way ANOVA showed that transphobia differed significantly across the majors. The author suggestions included increasing transgender content in textbooks, lectures, and class discussions as well as developing field sites that provide students with opportunities to serve this population.
TL;DR: Examining the lived experiences of Australian gay men and lesbians who were previously or were currently experiencing family rejection because of their sexuality revealed several themes that provided greater understanding of the portrayals and perceptions of family rejection.
Abstract: A myriad of negative psychosocial outcomes face gay men and lesbians who experience rejection by their family for not being heterosexual. However, what constitutes rejection is not clear, and, more importantly, it is not known how resilience is fostered within such a context. This qualitative study sought to examine these issues by exploring the lived experiences of Australian gay men and lesbians who were previously or were currently experiencing family rejection because of their sexuality. A total of 21 in-depth, semistructured interviews were individually conducted and analyzed. Thematic analysis of the interviews revealed several themes that provided greater understanding of the portrayals and perceptions of family rejection; the impact of family rejection on mental health; and, importantly, how these individuals came to establish resilience in the face of experiencing family rejection. Limitations, directions for future research, and clinical implications of the findings are also discussed.
TL;DR: The systemic enactment of homophobia, transphobia, and hegemonic masculinity are often normalized in shelters and create significant barriers to safe, accessible, and supportive services for LGBTQ2S youth.
Abstract: This study examined the experiences that lesbian, gay, bisexual, transgender, queer, questioning, and two-spirit (LGBTQ2S) homeless youth have in shelters and the disjunctures that occur for this population in Toronto’s shelter system. The attitudes and behaviors of shelter workers and management toward LGBTQ2S youth were also explored. A critical action research approach, informed by critical ethnography and institutional ethnography was employed. Thirty-three people participated in this study in the Greater Toronto Area. The study triangulated data from interviews, focus groups, observations, and document analysis. The systemic enactment of homophobia, transphobia, and hegemonic masculinity are often normalized in shelters and create significant barriers to safe, accessible, and supportive services for LGBTQ2S youth. Excessive bureaucratic regulation and the lack of necessary bureaucratic regulation in highly significant areas play a key role in creating the disjunctures that occur for LGBTQ2S y...
TL;DR: A tentative conceptual model is presented to describe the potential relationships between family rejection and HIV risk for young, gay, and bisexual men aged 18 to 24.
Abstract: Young, gay, and bisexual men (YGBM) are at increased risk of family rejection, which is related to HIV infection. What remains unknown is how family rejection leads to HIV risk. In this exploratory study, qualitative interviews were conducted with 21 HIV-positive YGBM aged 18 to 24. Most participants reported family rejection, which decreased instrumental and emotional support and resulted in participants using riskier ways to support themselves, such as engaging in survival sex. Conceptualizing the findings using a family systems framework, we present a tentative conceptual model to describe the potential relationships between family rejection and HIV risk for YGBM.
TL;DR: Experiences that young bisexual and other nonmonosexual people perceive as affirming of their sexual identity are reported and implications for positive health outcome research and the integration of positive psychology with LGBTQ psychology are discussed.
Abstract: The majority of LGBTQ psychological research focuses on dysfunction. The exclusion of strengths-based perspectives in LGBTQ psychology limits the understanding of LGBTQ mental health. In this article we report experiences that young bisexual and other nonmonosexual people perceive as affirming of their sexual identity. A 28-day, daily diary study was used to investigate whether bisexual-identified participants encountered positive experiences related to their sexual identity, and which type of experiences they perceived to be positive. Using a constructivist grounded theory approach, participants' experiences were organized according to a social ecological model. Experiences were reported at the intrapersonal, interpersonal, and institutional levels, but most positive sexual identity experiences occurred at the interpersonal level. Implications for positive health outcome research and the integration of positive psychology with LGBTQ psychology are discussed, as well as study limitations.
TL;DR: The author explains why he decided to write the book, and some of the reasons why he chose to write it in the first place, are unclear.
Abstract: Before I offer my review of the book and its contribution to our field—a caveat. Recently, I have found myself becoming increasingly ambivalent about the opportunity to review books. On the one han...
TL;DR: A sample of U.S. sexual minority and heterosexual adults completed a battery of mental health inventories prior to the nationwide legalization of same-sex marriage revealed sexual minority participants living in states where same- sex marriage was banned experienced significantly higher levels of internalized homonegativity.
Abstract: Previous psychological and public health research has highlighted the impact of legal recognition of same-sex relationships on individual identity and mental health. Using a sample of U.S. sexual minority (N = 313) and heterosexual (N = 214) adults, participants completed a battery of mental health inventories prior to the nationwide legalization of same-sex marriage. Analyses of covariance (ANCOVAs) examining identity revealed sexual minority participants living in states where same-sex marriage was banned experienced significantly higher levels of internalized homonegativity than sexual minority participants living in states where same-sex marriage was legal, even after controlling for state-level political climate. Mental health ANCOVAs revealed sexual minority participants residing in states without same-sex marriage experienced greater anxiety and lower subjective wellbeing compared to sexual minority participants residing in states with same-sex marriage and heterosexual participants residing in states with or without same-sex marriage. Implications for public policy and future research directions are discussed.
TL;DR: Facebook is both transformative and risky for college-aged gay men, as it represents a new platform for them to come out as gay to friends and family, as well as other areas of their lives where they must actively manage the presentation of their sexual identity.
Abstract: The rapid proliferation of social media, mobile applications, and Internet technologies has shifted a wide variety of social interaction from physical spaces to an online environment. Drawing from 42 semistructured, in-depth interviews with gay college-aged men between the ages of 18 and 27, this article explores these changing patterns of social interaction among gay men. I discuss three strategies of identity management college-aged gay men use to disclose or conceal their sexual identity to others. The first group of men, “Out and Proud,” uses Facebook as a way to celebrate and reaffirm their sexual identity, in addition to actively coming out to others on the social media Web site. The second group, “Out and Discreet,” uses Facebook to indirectly come out to some of their friends while hiding this information from others. The men in the last group I identify, “Facebook Closeted,” actively manage their online profiles to ensure their sexual identity is not exposed. Facebook is both transformati...
TL;DR: A systematic review and citation analysis of the literature regarding sexual minority parent families, particularly attending to what theories have been used and how, and recommendations for how theory might be more fully integrated into the social science literature on sexual minority parents and their children are provided.
Abstract: This article includes a systematic review and citation analysis of the literature regarding sexual minority parent families, particularly attending to what theories have been used, and how. We cons...
TL;DR: Using data from the National Longitudinal Study of Adolescent to Adult Health, it is found that sexual minority women are less likely than women with no same-sex sexuality to complete college, in part due to their high school performance and transition into college.
Abstract: Research finds lower levels of academic performance among sexual minority high school students, but some studies suggest sexual minorities have higher levels of educational attainment in adulthood. To further our understanding of how and why sexual orientation is associated with educational success, this study turns attention to the pathways to college completion, examining points along educational trajectories in which sexual minorities fall behind or surpass their heterosexual peers. Using data from the National Longitudinal Study of Adolescent to Adult Health, we find that sexual minority women are less likely than women with no same-sex sexuality to complete college, in part due to their high school performance and transition into college. Men who experience same-sex sexuality only in adolescence struggle in high school, but men who experience same-sex sexuality for the first time in adulthood are more likely to earn a college degree than men who do not experience same-sex sexuality.
TL;DR: The concept of stereotyped identification is introduced—the idea that cognitively and emotionally identifying with fictional characters can increase acceptance of minorities, while reinforcing implicit stereotypes about how they look, act, and talk.
Abstract: Scholars examining homosexual television characters have typically come to one of two conclusions: either exposure to homosexual characters can lead to increased acceptance, or homosexual characters serve to reaffirm negative stereotypes. We seek to bridge these two bodies of research by introducing the concept of stereotyped identification—the idea that cognitively and emotionally identifying with fictional characters can increase acceptance of minorities, while reinforcing implicit stereotypes about how they look, act, and talk. Results from our national survey (N = 972) offer support for this hypothesis.
TL;DR: The objective of this article was to explore manifestations of violence among this population in Puerto Rico and to focus on the quantitative data analysis.
Abstract: Violence is a public health concern faced on a daily basis by transgender women. Literature has documented how it adversely affects quality of life and health and in some instances leads to homicide. Considering the lack of research documenting the experiences of violence among transgender women, the objective of this article was to explore manifestations of violence among this population in Puerto Rico. The data presented in this article are part of a larger study on transgender/transsexual health in Puerto Rico. For the purpose of this article we focus on the quantitative data analysis. Participants (N = 59 transgender women) were recruited via respondent driven sampling. Implications and specific recommendations are discussed in light of these findings.
TL;DR: This article explored the experiences of lesbian women choosing motherhood and explored the various methods of conception and other decisions that participants made when planning their family, the challenge of heteronormativity in health care, and legitimizing the role of the non-birth mother in de novo families.
Abstract: The aim of this recent Australian study was to explore the experiences of lesbian women choosing motherhood. Participants included 30 self-identifying lesbian mothers. Data were collected via interviews, data collection sheets, and online journaling. The interview and journaling data were analyzed using constant comparative analysis and subsequently illuminated three main themes: becoming mothers, constructing motherhood, and legitimizing our family. These papers described the journey to motherhood and specifically explored the various methods of conception and other decisions that participants made when planning their family, the challenge of heteronormativity in health care, and legitimizing the role of the non-birth mother in de novo families. This article aims to present the participants’ experiences of motherhood that was a constant topic found woven throughout all three of the identified themes. Participants identified that they had a unique opportunity to create their own mothering roles in...