LGBT health最新文献

Purpose: The purpose of this study was to describe disparities in the severity of substance use disorders (SUDs) between sexual minority (SM) and heterosexual youth.

Methods: The current study analyzed data from the 2023 National Survey on Drug Use and Health to examine differences in SUDs between SM and heterosexual youth. Analyses were limited to participants aged 12-25 years (n = 23,333). Participants reported on their sexual identity and completed items on past-year substance use. SUDs were classified using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. A separate multinomial regression model was conducted for each outcome (alcohol use disorder [AUD] severity, cannabis use disorder [CUD] severity, and drug use disorder severity), stratified by age and sex. Each model included sexual identity as the primary predictor.

Results: Odds for meeting criteria for an SUD at any severity level were generally highest for bisexual youth compared with all other youth, with few exceptions. AUD severity varied slightly among adolescents, and CUD varied slightly among males.

Conclusion: This study is the first to identify differences in DSM-5 SUD severity between SM and heterosexual youth. The findings underscore the importance of developing clinical interventions tailored to the distinct challenges faced by SM youth, especially bisexual youth, to help reduce disparities in substance use outcomes.

Purpose: Adolescents with internalizing mental health (IMH) symptoms are more likely to use nicotine/tobacco products; however, the association with gender identity remains unclear. We examined differences in the relationship between IMH symptoms and nicotine/tobacco use by gender identity.

Methods: Data came from the U.S. arm of the International Tobacco Control Youth Tobacco and Vaping Survey, an online cross-sectional survey of adolescents aged 16-19, conducted from 2020 to 2023 (n = 28,959). Current nicotine/tobacco use was categorized as: (1) no use, (2) exclusive combustible product use, (3) exclusive noncombustible product use, and (4) use of both product types. Current depression and anxiety symptoms were aggregated into an IMH symptoms variable (yes/no). Gender identity was determined based on responses to questions regarding current gender identity and sex assigned at birth. Analyses examined differences in IMH symptoms and nicotine/tobacco use by gender identity and the potential moderating role of gender identity in the relation between IMH symptoms and nicotine/tobacco use.

Results: Risk for nicotine/tobacco use and IMH symptoms varied across gender identities. Transgender women reported the highest prevalence of any product use (29%) followed by transgender men (24%), cisgender men (22%), cisgender women (19%), and gender nonconforming (GNC) adolescents (14%). GNC adolescents reported the highest prevalence of IMH symptoms (85%), followed by transgender men (80%), cisgender women (67%), transgender women (65%), and cisgender men (45%). We found significant interactions between IMH symptoms and gender identity (p < 0.0001).

Conclusion: This study revealed the importance of disaggregating GNC and transgender identities in research related to nicotine/tobacco use and mental health among adolescents.

Purpose: This study examined associations between sexual identity and both substance use and mental health outcomes via nationally representative data from adolescents and young adults, using a six-response sexual identity assessment.

Methods: Data were from 11,328 adolescents (12-17 years) and 13,131 young adults (18-25 years) completing the 2023 National Survey on Drug Use and Health. Sexual identity had six-response options: heterosexual, lesbian/gay, bisexual, using a different term, unsure/don't know, and do not understand the question. Substance use variables included alcohol, cannabis, nicotine, prescription drug misuse, polysubstance use, and substance use disorder (SUD). Mental health variables included major depressive episodes, suicidal ideation, and serious psychological distress (measured only among young adults). Multivariable logistic regression models were fitted to examine whether substance use and mental health differed by sexual identity. Analyses adjusted for sociodemographics, occurred separately by age group and sex, and heterosexual individuals were the reference category.

Results: Youth identifying as lesbian, gay, bisexual, unsure/don't know, or using a different term had significantly higher rates of all mental health concerns than their heterosexual peers, with 80% of adjusted odds ratios above 3.0. Substance use-sexual identity links were less consistent, although lesbian and bisexual females were more likely than heterosexual females to have past-year SUD. Individuals not understanding the sexual identity question had lower rates than their heterosexual peers on 15 of 36 outcomes (41.7%).

Conclusion: Screening and indicated prevention for mental health concerns and SUD are needed for sexual minority youth, along with the development of culturally sensitive interventions.

Purpose: We examined the associations of sexual orientation and gender identity change efforts (SOGICE), both experienced over the lifetime and before adulthood, with demographic characteristics and a wide range of mental health outcomes in a sample of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adults.

Methods: The analytic sample was 3023 LGBTQ+ adults (M_age = 31.59) from a cross-sectional survey conducted in 2024 in North Carolina. Participants reported SOGICE experiences during their lifetime and before age 18, past-year mental health conditions (i.e., depression, bipolar disorder, post-traumatic stress disorder, anxiety disorder, gender dysphoria, eating disorder, nonsuicidal self-injury, suicidal thought, and suicide attempt), and past-2-week anxiety and depressive symptoms. Bivariate regression models and multivariate regression models were tested on the associations between SOGICE experiences and mental health conditions.

Results: Reports of SOGICE experiences were higher among those assigned male at birth compared with those assigned female at birth, Black participants compared with White participants, and transgender and gender-diverse participants compared with cisgender participants. In multivariate models, lifetime SOGICE was associated with three out of nine mental health conditions. In multivariate models, experiencing SOGICE before age 18 was associated with higher odds of five out of nine mental health conditions.

Conclusion: Our study demonstrates that SOGICE experiences, particularly before adulthood, were associated with multiple severe mental health conditions. These findings reinforce calls from professional organizations to end SOGICE due to its threat to LGBTQ+ well-being and to support legislative efforts to ban such practices.

Purpose: This study explored how minority stress and social safety jointly shape mental health among Taiwanese sexual minority men (SMM) through the identification of psychosocial profiles and their associations with depression.

Methods: Between April and May 2023, 415 Taiwanese SMM completed an online cross-sectional survey. Latent profile analysis (LPA) identified groups based on minority stress (sexuality-related discrimination, acceptance concerns, internalized homonegativity) and social safety (identity affirmation, family support, community connectedness) indicators. Multinomial logistic regression examined sociodemographic correlates of profile membership, and linear and binary logistic regressions assessed associations with depressive symptom severity (DSS) and major depressive disorder (MDD).

Results: LPA identified three distinct profiles: "Moderate Minority Stress-Low Social Safety" (MMS-LSS; n = 201, 48.4%); "Low Minority Stress-High Social Safety" (LMS-HSS; n = 182, 43.9%); and "High Minority Stress-Moderate Social Safety" (HMS-MSS; n = 32, 7.7%). Individuals identifying as heterosexual men who have sex with men, pansexual, asexual, queer, or questioning had greater odds of belonging to the MMS-LSS (odds ratio [OR] = 5.00, 95% confidence interval [CI] = 1.42-17.63) and HMS-MSS (OR = 10.35, 95% CI = 2.32-46.13) profiles, relative to the LMS-HSS profile. Compared with individuals in the LMS-HSS profile, residence in the Central, Eastern, or Outer Island regions was associated with higher odds of HMS-MSS profile membership (OR = 3.58, 95% CI = 1.46-8.83). After adjusting for covariates, membership in the MMS-LSS (β = 0.16, 95% CI = 0.06-0.25; adjusted OR [aOR] = 1.87, 95% CI = 1.06-3.35) and HMS-MSS (β = 0.11, 95% CI = 0.01-0.20; aOR = 2.98, 95% CI = 1.13-7.69) profiles, relative to the LMS-HSS profile, was associated with greater DSS and higher odds of MDD.

Conclusion: These findings revealed diverse experiences of minority stress and social safety among Taiwanese SMM and their implications for depression, supporting culturally responsive interventions.

Purpose: The purpose of the study was to investigate mental and physical health diagnoses for sexually diverse and/or gender-diverse (SGD) autistic adults.

Methods: We conducted a cross-sectional study using electronic health record (EHR) data from Kaiser Permanente Northern California. Participants were individuals with an autism diagnosis enrolled in the health plan between 2015 and 2019. SGD individuals were identified via sexual orientation and gender identity data or a stepwise methodology involving computerized searches of the EHR. Diagnostic codes for mental and physical health conditions were examined during the study period.

Results: Of 4159 autistic participants, n = 122 were identified as sexually diverse and n = 90 as gender diverse. Using multivariable logistic regression models adjusted for age, race/ethnicity, and gender identity, we found that both the sexually diverse and gender diverse groups had greater odds of mental health diagnoses compared with individuals not identified as SGD. Sexually diverse adults had greater odds of alcohol or drug dependence, and gender-diverse adults had greater odds of other psychoses compared with individuals not identified as SGD. Both sexually diverse and gender diverse groups had greater odds of some physical health diagnoses, including pain not elsewhere classified, migraines, and gastrointestinal disorders, compared with individuals not identified as SGD.

Conclusion: SGD autistic adults had greater odds of diagnosis of some mental and physical health conditions than autistic adults not identified as SGD, warranting further research on structural and interpersonal factors that affect their well-being and how best to support them.

Recent changes to the National Crime Victimization Survey (NCVS) remove questions to identify transgender people. The NCVS, a national probability sample developed to capture crimes not reported to law enforcement, is a primary source for chronicling violent victimization in the United States. NCVS data have shown that transgender people experience four times more violent victimization than cisgender people. Following a recent Executive Order, the Justice Department removed questions about gender from future surveys, preventing identification of transgender respondents. Erasing transgender people from the survey will undermine efforts to monitor and prevent violence against them.

Purpose: Bisexual women are an understudied population in perinatal health research, despite evidence of elevated behavioral health risks. This study examined differences in substance use and psychological distress during pregnancy between bisexual and heterosexual females.

Methods: Using pooled 2021-2023 National Survey on Drug Use and Health data, we analyzed pregnant females aged 18-44 (n = 1888). Outcomes included past-month marijuana use, alcohol use, binge drinking, cigarette smoking, and psychological distress. Poisson regression was used to estimate risk ratios, both unadjusted and adjusted for sociodemographic factors.

Results: Compared with heterosexual females, bisexual females reported higher prevalence of marijuana use (21.4% vs. 4.9%) and psychological distress (19.6% vs. 6.5%) during pregnancy; disparities persisted after adjustment for sociodemographic factors. Bisexual females also reported higher prevalence of smoking during pregnancy, although differences were not significant in adjusted models. Substance use and distress declined from preconception to pregnancy in both groups, but percentage declines in alcohol and marijuana use were smaller among bisexual females. Marriage, parenthood, and higher income were associated with reduced substance use and psychological distress among heterosexual females but less so for bisexual females.

Conclusion: Pregnant bisexual females experienced elevated risks of marijuana use and psychological distress compared with pregnant heterosexual females, and protective social resources appeared less impactful. These findings underscore the importance of inclusive, affirming perinatal care and highlight the need for research and interventions that address the unique stressors and contexts shaping bisexual women's perinatal experiences.

Purpose: The purpose of this review was to examine socioecological risk factors for substance use among sexually and gender diverse (SGD) Latine youth and young adults (YYA).

Methods: We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided search in PubMed, PsycInfo, Web of Science, and MEDLINE on July 16, 2025. Inclusion criteria were the following: (1) peer-reviewed journal article published on or after January 2014; (2) sample aged between 10 and 29 years old; (3) intersectional analysis of Latine and SGD subsample; (4) analysis for associative or predictive properties of individual-level, interpersonal-level, and/or structural-level risk factors with substance use. Studies that failed to meet all criteria were excluded. The quality of articles was assessed using the Appraisal tool for Cross-Sectional Studies and the Quality of Reporting of Observational Longitudinal Research tool.

Results: Twelve studies were included in the final synthesis, the majority being cross-sectional studies (9, 75%) with youth/adolescent samples (8, 67%). Outcomes from reviewed studies indicated that depression and psychological distress were associated with substance use among SGD Latine YYA. In addition, victimization, discrimination, and absence of social support contributed to substance use among SGD Latine YYA.

Conclusions: Outcomes from reviewed studies prompt targeted consideration of individual-level mental health and interpersonal-level discrimination and support as it relates to substance use prevention and intervention among SGD Latine YYA. Future research should explore the intersecting cultural influences of being Latine and SGD on substance use and access to mental health and social support resources among SGD Latine YYA.

Purpose: Identifying the situational and psychological factors that support well-being in disadvantaged sexual and/or gender minority (SGM) youth is important for guiding interventions and policies. The current work investigated differences in the perceptions of caring relationships reported by SGM and cisgender heterosexual youth in foster care and how these differences related to youth's mental health.

Methods: We analyzed data from 727 ninth- and eleventh-grade youth in foster care who completed the 2016 and 2019 Minnesota Student Survey. We used t-tests and multiple linear and logistic regression to study the relationship between sexual orientation and gender identity, perceptions of caring relationships, and mental health among youth in foster care.

Results: SGM youth in foster care perceived people around them as caring about them less than did their cisgender heterosexual peers. Greater perceptions of caring were related to reduced mental health concerns among youth in foster care. Mental health concerns were greater among SGM youth than their cisgender heterosexual counterparts, and these differences existed even when controlling for perceptions of caring.

Conclusion: SGM foster youth's perception that the people around them cared about them less than their cisgender heterosexual peers may contribute to differences in mental health often observed among these populations, but cannot wholly explain these differences.