LGBT health最新文献

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.

Purpose: The purpose of this study was to reexamine the association between marriage and health among partnered gay and lesbian adults, comparing married individuals with those in unmarried couples.

Methods: Using a decade of large-scale, representative data from the Behavioral Risk Factor Surveillance System 2014-2023, we analyzed partnered, cisgender gay and lesbian adults aged 18-65 (N = 10,973). Negative binomial regression models estimated the number of poor mental and physical health days, whereas logistic regression models predicted the probability of frequent mental and physical distress. Analyses adjusted for sociodemographic factors and explored the role of socioeconomic factors. To enhance comparability between married and partnered, unmarried individuals, a propensity score-based inverse probability weighting approach was adopted.

Results: Married gay and lesbian individuals exhibited mental and physical health comparable to their partnered, unmarried counterparts. However, an exception was that married gay men experienced a mental health advantage, even after adjusting for socioeconomic resources.

Conclusion: The mental health advantage among married gay men highlights the importance of symbolic resources such as social recognition. Overall, however, the findings did not support the marital advantage theory among partnered lesbian and gay individuals, potentially due to the weaker institutionalization of same-sex marriage and elevated couple-level minority stress. Future research should further investigate sexual minority health within family contexts, incorporating diverse gender and sexual identities.

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: 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.

Purpose: We aimed to investigate the association between sexual orientation and multiple types of adverse childhood experiences (ACEs) and to what extent ACEs mediate the association between sexual orientation and symptoms of depression and anxiety among sexual minority women (SMW). Methods: This was a cross-sectional analysis nested within the nationally representative Icelandic Stress-And-Gene-Analysis cohort. Data were collected from March 2018 to June 2019. Participants included 11,007 women, aged 18-69, with data on sexual orientation and ACEs. Self-reported data were obtained on 13 different ACEs, and current symptoms of depression and anxiety. Results: Overall, 724 (6.6%) identified as sexual minority. The mean age of SMW was 34.0 years (standard deviation [SD] 14.0) and 44.7 years (SD 14.0) for heterosexual women. SMW were more likely to report six or more ACEs than heterosexual women (21.7% vs. 11.3%, respectively), yielding an adjusted odds ratio (aOR) of 2.26 (95% confidence interval [CI] 1.76-2.91). SMW were more likely than heterosexual women to report four types of ACEs: specifically bullying, emotional abuse, sexual abuse, and mental illness in the household (aOR ranging from 1.36 to 1.71). SMW reported higher odds of current symptoms of depression (aOR = 2.10, 95% CI 1.77-2.49) and anxiety (aOR = 1.69, 95% CI 1.41-2.02). The total number of ACEs mediated 32.6% of the association between sexual orientation and depression, and 43.2% of the association between sexual orientation and anxiety. Conclusion: These findings suggest that ACEs are a major contributor to the mental health disparities observed among SMW.

Purpose: Our aim was to expand existing evidence on structural determinants of cardiovascular health disparities among lesbian, gay, and bisexual (LGB) adults by examining sexual orientation differences in the impact of sexual orientation-related nondiscrimination laws on 30-year cardiovascular disease (CVD) risk. Methods: We analyzed data from Waves III (2001-2002), IV (2008-2009), and V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health. Sexual orientation was categorized as exclusively heterosexual, mostly heterosexual, bisexual, or gay/lesbian. We categorized changes in sexual orientation-related nondiscrimination laws between Waves III-IV as no change (reference group), increased, or decreased. We assessed 30-year CVD risk at Wave V using the Framingham Risk Score. We ran sex-stratified regression models to examine whether the association between changes in sexual orientation-related nondiscrimination laws and 30-year CVD risk was moderated by sexual orientation. Results: The sample included 3768 participants (mean age [standard deviation] = 28.7 [±1.72] years) of whom approximately 77% were White, 11% Hispanic, and 51% female. Compared with exclusively heterosexual participants, an increase in nondiscrimination laws was associated with lower CVD risk among mostly heterosexual women (B = -5.05, 95% confidence interval [CI] = -8.50 to -1.59) and gay men (B = -10.22, 95% CI = -19.05 to -1.39). There were no significant differences for other LGB subgroups when compared with exclusively heterosexual adults. Conclusions: Increasing laws that prohibit sexual orientation-related discrimination may play an important role in reducing CVD risk among some LGB subgroups. These findings can inform structural-level interventions to reduce CVD risk among LGB adults.

Amid increasing political threats to sexual and gender minority (SGM) research, this perspective reflects on the evolution of SGM research from the margins of public health to a robust field and assesses the unique vulnerabilities facing SGM researchers across career stages. We discuss how the field can protect its infrastructure, sustain its workforce, and preserve its impact, drawing inspiration from the harm reduction movement and our individual and collective experiences. This is both a reflection and a call to action grounded in care, intergenerational knowledge and solidarity, and the refusal to be erased.

Purpose: This study examined receipt of a well-woman visit (WWV) and cervical cancer screening (CCS) at the intersection of sexual orientation and race/ethnicity among Illinois women aged 21-65. Methods: This study used 2016, 2018, and 2020 Illinois Behavioral Risk Factor Surveillance System (BRFSS) data for women aged 21-65 to examine rates of CCS (n = 2848) and 2016-2018, 2020, and 2021 Illinois BRFSS data to examine WWV receipt (n = 5863) by sexual orientation (heterosexual vs. lesbian, gay, and bisexual [LGB]). Self-reported race/ethnicity was tested as an effect modifier to assess intersectionality. Using binomial regression, adjusted prevalence differences (aPD) and 95% confidence intervals (CIs) were estimated. Covariates included age, education, marital status, employment, and health insurance coverage. Results: Overall, 4.6% of Illinois women aged 21-65 self-identified as LGB. Heterosexual and LGB women had a similar prevalence of receipt of both a WWV (77.1% and 71.7%, respectively; aPD = 3.22, 95% CI: -3.62 to 10.06) and CCS (85.3% and 83.4%, respectively; aPD = 2.13, 95% CI: -4.77 to 9.04). Among non-Hispanic (NH) Black women, heterosexual compared with LGB women had a higher prevalence of receiving both types of care; however, adjusted associations included the null. Hispanic women had similar prevalence estimates by sexual orientation for both outcomes, and NH White heterosexual compared with LGB women had a higher prevalence of CCS, but not WWV. Conclusion: In Illinois overall, heterosexual and LGB women received preventive care at similar rates. However, when stratified by race/ethnicity, WWV and CCS receipt rates may be higher for heterosexual compared with LGB women, indicating potential missed opportunities for preventive care.

Purpose: This study aimed to characterize benefits of asynchronous online focus groups (AOFGs) for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexuality- and gender-expansive (LGBTQIA+) young adults with a cervix and to identify strategies for maximizing those benefits and optimizing data collection in order to increase equitable representation of this population in health research. Methods: From March to September 2022, we conducted six gender-stratified AOFGs with cisgender women, nonbinary people, and transgender men with a cervix ages 21-29 living in Massachusetts and Rhode Island. Participants completed a questionnaire to evaluate AOFG procedures and experiences. Based on these data and our observations of AOFG engagement, we developed and evaluated strategies to optimize both data collection and participant benefit. Results: AOFGs provided participants with informational and instrumental support, connection through shared experiences, and opportunity for introspection. Participants expressed a strong desire for social interaction within AOFG discussions, and we identified several strategies that were effective in promoting engagement and interaction in AOFGs. Conclusion: AOFGs can facilitate inclusion in research of LGBTQIA+ individuals for whom other data collection methods are inaccessible, and may offer direct social and emotional benefits to participants. Promoting social interaction among participants is essential for optimizing these benefits. These findings offer important insight for AOFG methodology as a means of increasing equitable representation of LGBTQIA+ people in health research while offering direct and immediate benefits to participants.