LGBT health最新文献

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: 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: 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: 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.

Purpose: The purpose was to investigate differences in polycystic ovary syndrome (PCOS) prevalence by sexual orientation among young adults in the United States.

Methods: We used data from the Growing Up Today Study, a longitudinal cohort of young adults (age 23-35 in 2019). Participants assigned female at birth (N = 11,148) reported PCOS diagnoses on questionnaires between 2010 and 2019. We used modified-Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for PCOS diagnoses, comparing completely heterosexual participants (referent) to sexual minority participants (i.e., heterosexual with same-sex partnership, mostly heterosexual, bisexual, and lesbian). We also assessed whether health care utilization modified the association between sexual orientation and PCOS diagnosis. Models were adjusted for age and race/ethnicity.

Results: The overall prevalence of PCOS in the sample was 8.1%. Compared to completely heterosexual participants, sexual minority participants had a higher adjusted prevalence of PCOS diagnosis (PR: 1.28, 95% CI: 1.12-1.46). Within sexual minority subgroups, mostly heterosexual (PR: 1.24, 95% CI: 1.06-1.45), bisexual (PR: 1.69, 95% CI: 1.29-2.22), and lesbian (PR: 1.50, 95% CI: 1.04-2.16) participants had an elevated prevalence of PCOS compared to completely heterosexual participants. Differences in PCOS diagnosis persisted within strata of time since the last routine physical exam.

Conclusion: These findings provide some of the first estimates of PCOS among sexual minority people, emphasizing the need to address differences in reproductive health among sexual minority young adults. They also reveal that health care utilization increases the likelihood of receiving a diagnosis and highlight the importance of health care access.

Purpose: We aimed to classify youth using a longitudinal, multidimensional construct of gender, and examine associations of gender subgroups with substance cognitions and substance use.

Methods: We used data from the Adolescent Brain Cognitive Development study (N = 11,868 youth ages 9-10 years at baseline [2016-2018] through the year 4 follow-up [ages 13-14 years, 2020-2022]) to conduct latent class models using measures of gender identity, felt gender, gender expression, and gender non-contentedness. We used multivariable logistic regression to assess associations of gender classes with curiosity to use, intention to use, and use of alcohol, nicotine/tobacco, and cannabis, respectively, adjusting for sociodemographic factors.

Results: A four-class model was selected based on model fit: transgender (2.5%), questioning (9.0%), naïve (36.3%), and cisgender (52.1%). Youth in the questioning and transgender classes were more likely to report curiosity to use alcohol, nicotine/tobacco, and cannabis (adjusted odds ratio [aOR] range 1.68-2.45, p < 0.001) and intention to use alcohol and nicotine/tobacco (questioning youth; aOR range 1.69-1.88, p < 0.01) or nicotine/tobacco and cannabis (transgender youth; aOR range 2.66-3.14, p < 0.001) but not actual use of alcohol, nicotine/tobacco, and cannabis, whereas members of the naïve class were less likely to report curiosity to use alcohol, nicotine/tobacco, and cannabis, intention to use cannabis, and use of alcohol, nicotine/tobacco, and cannabis (aOR range 0.48-0.81, p < 0.001), relative to cisgender youth.

Conclusion: These findings suggest that a more nuanced understanding of gender among preadolescent youth and their heterogeneous risk for substance use is critical for the development of early prevention services. The timing of prevention efforts may be ideal during this developmental period.

Purpose: This study investigated how age at the time of surgery influences patient-reported outcomes using the Transgender Quality of Life Questionnaire (TRANS-Q).

Methods: We conducted a retrospective survey from 2021 to 2023 among trans masculine individuals who underwent bilateral mastectomy at a single academic institution. The TRANS-Q was distributed postoperatively (n = 131; response rate: 49.2%). In addition, three items assessing the perceived ideal age for surgery were added. Participants were stratified into three age groups based on age at the time of surgery (16-20, 21-30, ≥31 years). Primary outcomes were group comparisons across TRANS-Q items. Secondary outcomes included predictors of (1) overall satisfaction, (2) ideal age for surgery, (3) self-confidence during sex, and (4) scar appearance. Predictors, selected based on clinical rationale, were incision technique, body mass index (BMI), mental disorder, resection weight, satisfaction scores, and age group. Analyses included nonparametric group comparisons and proportional odds logistic regression.

Results: Across all age cohorts satisfaction scores were high. The only significant intergroup variation concerned the ideal age for surgery: younger patients expressed a preference for earlier intervention compared to older cohorts (p < 0.001). Regression models identified BMI and incision technique as relevant predictors of satisfaction and scar appearance, respectively. Mental health diagnoses were weakly associated with earlier preferred timing.

Conclusions: Our findings affirm the benefit of chest masculinization across age groups, while highlighting that younger patients favor earlier surgical timing. This underscores the need for age-sensitive counseling. Personalized timing strategies-rooted in autonomy-may optimize long-term outcomes in gender-affirming care.

Purpose: Sexual and gender minority (SGM) populations face substance use disparities attributed to minority stress. We examined the relationship between discrimination and alcohol and cannabis use among SGM and cisgender heterosexual people.

Method: We conducted a cross-sectional analysis of the All of Us Research Program data (2017-2022) to examine the relationship between discrimination (Everyday Discrimination Scale [EDS]) and alcohol use (Alcohol Use Disorders Identification Test-consumption items [AUDIT-C]) and past 3-month cannabis use. Adjusted linear and logistic regression models were used for AUDIT-C scores and past 3-month cannabis use, respectively. We used interaction terms to assess how associations differed across sexual orientation and gender modality groups.

Results: Among 98,820 participants, mean EDS scores were highest among gender minority (GM) people assigned female at birth (M = 14.78) and lowest among cisgender heterosexual men (M = 6.14). There was a nonlinear association between EDS and AUDIT-C scores. EDS scores were positively associated with AUDIT-C scores at low levels of discrimination; there was an inverse association at higher levels of EDS. EDS was associated with greater odds of past 3-month cannabis use, but associations were not significant at 2 standard deviations above mean EDS and higher. Interaction by sexual orientation and gender modality group was significant (p < 0.05), indicating that associations between discrimination and alcohol and cannabis use varied by group. Although estimates were largely imprecise, associations particularly varied among GM groups and cisgender sexual minority men.

Conclusion: Discrimination had a nonlinear relationship with alcohol and cannabis use, and these relationships were pronounced among SGM subgroups.

Purpose: Experiences with the criminal legal system can increase the risk of HIV transmission and disrupt linkage to HIV care and prevention. This study quantified the association between criminal legal system involvement and HIV outcomes among transgender women of color (TWOC).

Methods: We conducted a cross-sectional analysis using first-wave data from the Trying to Understand Relationships, Networks, and Neighborhoods Among Transgender Women of Color Cohort Study (n = 314). We investigated the association between measures of criminal legal system involvement (history of arrest and history of incarceration) and HIV care and prevention outcomes (serostatus, testing, condom use, pre-exposure prophylaxis use, and viral load suppression) among TWOC living in New York City from August 2020 to November 2022. We used modified Poisson regression models to calculate the adjusted prevalence ratios.

Results: Among our cohort of TWOC, 50% had previously been arrested and 28% had previously been incarcerated. Half of the participants were living with HIV. History of incarceration was positively associated with living with HIV. Among those living with HIV, a history of incarceration was associated with an increased risk of having a detectable HIV viral load.

Conclusions: Among TWOC in our study, criminal legal system involvement was significantly associated with HIV seropositivity and having a detectable viral load among those living with HIV. These findings highlight the negative health implications of the criminal legal system for a socially oppressed population and can potentially inform future directions to challenge policing practices that disproportionately target TWOC.

Purpose: This study compared the prevalence of hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD) between transgender and gender-diverse (TGD) individuals and cisgender individuals.

Methods: We conducted a retrospective analysis using a large electronic health record database spanning 2004-2024. TGD individuals were identified using International Classification of Diseases, Tenth Revision codes related to gender identity and stratified by hormone therapy status. Cisgender comparison groups were defined by the absence of gender identity diagnoses and hormone therapy exposure. Prevalence odds ratios (ORs) with 95% confidence intervals were calculated to compare hEDS and HSD diagnoses between groups.

Results: TGD individuals demonstrated a significantly higher prevalence of hEDS and HSD than cisgender individuals (OR: 18.45). The prevalence among TGD individuals assigned female at birth was 2.62%, and among those assigned male at birth, 1.00%, compared with 0.16% and 0.04% in cisgender females and males, respectively. Hormone therapy status was not associated with significant differences in prevalence.

Conclusions: These findings indicate a substantially increased burden of hypermobility-related disorders among TGD individuals. Enhanced clinical recognition and multidisciplinary management strategies are needed to address the unique health care challenges faced by this population.