Sexuality Research and Social Policy最新文献

Introduction: Research on the role of LGBTQ+ policies in the US has primarily examined how policies are associated with perceptions of LGBTQ+ communities, LGBTQ+ people's experiences of discrimination, or LGBTQ+ mental health. However, no research that we are aware of has examined the indirect effects of distinct LGBTQ+ policies on mental health outcomes among sexual minority women and gender diverse individuals assigned female at birth (SMWGD) through sexual orientation discrimination prospectively.

Methods: We used state level data from the Movement Advancement Project in combination with baseline and follow up data from a sample of 429 SMWGD to understand associations between distinct LGBTQ+ policies, anxiety, and depression through sexual orientation discrimination. Participants were recruited online August 2020 through May 2021.

Results: Only LGBTQ+ nondiscrimination policies, and no other policies, were significantly associated with sexual orientation discrimination. Participants living in states with more LGBTQ+ nondiscrimination policies experienced less sexual orientation discrimination at baseline, which in turn predicted less anxiety at follow-up (when controlling for anxiety at baseline). Additionally, living in states with better overall LGBTQ+ policies and youth policies were associated with significantly less anxiety, but not depression or sexual orientation discrimination.

Conclusion: Results suggest that LGBTQ+ policies in the US have direct and indirect effects on the mental health of SMWGD. However, we must continue to monitor the role of LGBTQ+ policies on the lives of LGBTQ+ community members.

Policy implications: Policymakers should promote nondiscrimination policies and address the real-life impact of LGBTQ+ polices in the lives of their LGBTQ+ citizens.

Youth Advisory Boards (YABs) can meaningfully incorporate youth voices into sexual health research with the combined benefits of leading to higher-quality, more effective research as well as providing YAB members with personal benefits such as exposure to scientific methods, research principles, and professional development opportunities. Previously published commentaries have outlined the experience of developing and maintaining a YAB in other areas of research and from a researcher perspective. This commentary, written by YAB members themselves, shares how they participated as equal co-creators in the development of a YAB for a sexual health study, what made it successful, and how other sexual health researchers can incorporate YABs into their own work.

Introduction: Youth involved with the child welfare system face notably poorer sexual and reproductive health (SRH) outcomes compared to their peers. Several SRH programs have been developed to address these health disparities, yet there is limited consolidated research examining these programs. The purpose of this systematic review was to synthesize quantitative and qualitative research on programs and conceptual models that could improve the SRH of child welfare system-involved youth.

Methods: We conducted a systematic search of published articles using PsychINFO, Medline, CINAHL, and Communication Source through March 1, 2023, as well as a gray literature search. Study inclusion criteria included: 1) a program or conceptual model designed to promote the SRH of child welfare system -nvolved youth; 2) a U.S.-based sample; and 3) available in English.

Results: We located 29 articles; 24 assessed programs (20 targeting youth and 4 targeting adults) and 5 presented conceptual models. Most youth programs focused on reducing pregnancies or HIV/STIs. Four programs for youth evaluated through RCTs were efficacious in improving SRH outcomes over time. Four programs for foster caregivers and social workers emphasized developing skills for communicating with youth about SRH topics.

Conclusions: This review sheds light on the current effectiveness of existing SRH programs for youth and adults, as well as gaps in available programs and research.

Policy implications: Increased investment is needed in youth programs that emphasize the positive dimensions of sexuality and relationships, alongside adult programs designed to enhance skills for supporting youth SRH. Additionally, funders should prioritize rigorous evaluations of these SRH initiatives to ensure their effectiveness and sustainability.

Introduction: Prevailing abortion stigma may contribute to how people feel prior to receiving an abortion, and these feelings may influence healthcare decision making. We analyzed data from a patient intake questionnaire regarding feelings at the time of first abortion appointment. We described responses, co-occurrence of sentiments, and associations between responses and abortion characteristics.

Methods: We abstracted data from a random 20% sample of medical charts at an abortion facility in Ohio for patients who sought abortions from 2014-2018 (N=762). We analyzed data from an intake questionnaire used to assess patients' sentiments prior to their abortion. The questionnaire had 10 intake items to which patients could respond "yes," "maybe," or "no." The questionnaire also asked, "How are you feeling today?" and listed several emotions for patients to select.

Results: About 37% of patients responded with exclusively positive emotions, 27% with mixed emotions, and 27% with exclusively negative emotions. Reporting mixed (adjusted odds ratio [95%CI]: 0.33[0.16-0.71]) and negative only (0.38[0.18-0.32]) sentiments was associated with a decreased odds of receiving an abortion. Responding "yes" (vs. "no") to being afraid an abortion will hurt was associated with a decreased odds of having a procedural abortion vs. a medication abortion (0.62[0.40-0.96]). Responding "yes" to "I am not sure if I am making the right decision" was associated with a longer time between consultation and the abortion (adjusted incident rate ratio [95%CI]: 2.16[1.48-3.16]).

Conclusions: Sentiment toward abortion is complicated and deserves nuanced attention, rather than being grouped into a strictly positive or negative experience.

Policy implications: Assessing patient sentiment prior to an abortion procedure may be valuable for providing patient-centered abortion care.

Introduction: Despite global commitments to advance economic inclusion for all, lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI +) workers around the world continue to face workplace discrimination based on their sexual orientation, gender identity, gender expression, and sex characteristics (SOGIESC). Developing a detailed global understanding of national laws addressing SOGIESC-based employment discrimination is a critical step towards making progress in these commitments.

Methods: In this study, we systematically analyzed how detailed measures of legal prohibitions of SOGIESC-based employment discrimination across hiring, pay, promotions, access to training, and terminations changed from 2016 to 2023. Additionally, we examined measures that support implementation and enforcement, as well as exceptions to protections. We also assessed differences in protections between regions as classified by the World Bank using Pearson's Chi-squared tests.

Results: We found that 71 countries prohibited at least some form of workplace discrimination based on sexual orientation, 41 countries did so based on gender identity, 18 did so based on gender expression, and 14 did so based on sex characteristics.

Conclusions: Notable legal gaps remained in prohibition specificity, nationwide coverage, and enforcement mechanisms. Protections are also undermined by exemptions for faith-based institutions found in 4 countries. While progress in protections is sizable and steady, inequities persist across regions.

Policy implications: These findings offer actionable insights regarding the strengths and shortcomings of current national laws and can act as the foundation for further legal progress in protecting LGBTQI + people at work.

Introduction: Discussion on the rights and inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals in Hong Kong is often based on taken-for-granted socio-cultural norms but not grounded in empirical studies.

Methods: A scoping review was conducted to map out the current status of LGBTQ+ inclusion in Hong Kong, with results reported according to PRISMA-ScR guidelines. The review captured 1205 unduplicated studies which were scoped to 152 peer-reviewed articles published from 2010 to 2022. Findings were categorised using an adapted Global LGBTI Inclusion Index into six domains: education, economic well-being, family, health, political and civic participation, and personal security and violence.

Results: LGBTQ+ individuals in Hong Kong face prevalent exclusion and discrimination across major domains of life, which does material harm to their well-being. This underscores the importance of legal protection and recognition to address the exclusion of LGBTQ+ individuals.

Conclusions: Gaps were identified for future research: (a) the need to address understudied domains other than health; (b) the need to focus on understudied populations (lesbian, bisexual, and transgender people); (c) the wide range of terminologies adopted in existing LGBTQ+ research; and (d) lack of representative data.

Policy implications: This review highlights the importance of collecting empirical data and obtaining representative data on the LGBTQ+ population to assess the current situation and progress made in LGBTQ+ inclusion in Hong Kong, and to inform policy changes related to LGBTQ+ rights.

Introduction: LGBTQ+ individuals are more vulnerable to experiencing sexual victimization. To truly prevent sexual victimization, preventing perpetration is necessary. The goal of this study was to increase the inclusivity of sexual violence research by examining the rates of sexual violence perpetration among cisgender, monosexual (e.g., attracted to a single gender, heterosexual or gay/lesbian) adults.

Methods: Participants were 828 adult Amazon Mechanical Turk workers who completed the study between March and September 2018. Participants completed the short version of the Post-Refusal Sexual Persistence Scale - Perpetration as part of a larger experiment. Analyses compared four gender by sexual identity groups: heterosexual women (31.5%), heterosexual men (27.8%), lesbian women (21.1%), and gay men (19.6%).

Results: There were group differences in reported perpetration rates. Perpetration rates were higher in both groups of men (heterosexual = 33.0%, gay = 35.0%) compared to both groups of women (heterosexual = 12.6%, lesbian = 20.5%), but rates did not differ within gender. Among the subsample with perpetration histories, heterosexual men were more likely to report using verbal coercion tactics (52.0%) than the other groups (45.5% [heterosexual women], 31.6% [gay men], 30.6% [lesbian women]), and heterosexual women were more likely to report using both verbal coercion and physical force in combination (24.2%) than gay men (5.3%).

Conclusions and implications: There are gender-driven differences in the rate of sexual violence perpetration among monosexual adults, suggesting the need for population-specific prevention efforts.

Introduction: The multidimensionality of stigma that LGBT people experience globally necessitates research to explore the processes at work. The study aimed to quantify the level of othering and explore the process of LGBT othering in Rwanda.

Methods: We conducted a sequential cross-sectional mixed-methods study of LGBT lived experiences in Rwanda. We recruited 499 participants to complete the LGBT-specific survey and 1254 for the non-LGBT survey. We conducted 16 in-depth interviews (IDIs) with non-LGBT participants. For LGBT participants, we completed six focus groups with 59 participants, six in-depth interviews, and three digital storytelling interviews. For the quantitative surveys, we conducted multivariable linear regressions and reported beta coefficients and 95% confidence interval estimates examining LGBT discrimination (LGBT survey) and attitudes toward LGBT (non-LGBT survey). We used deductive and inductive thematic and narrative analysis to analyze the qualitative data.

Results: In adjusted analyses of the non-LGBT survey, as compared to those who knew zero LGBT persons, persons who knew more than five had lower negative attitude scores (β =  - 1.3, 95% CI - 2.2, - 0.5), while the score was lower for those that knew one to five (- 0.2), it was not significant (95% CI - 0.8, 0.5). In the LGBT survey, adjusted analyses indicated that there was no significant difference found in discrimination between bisexual, gay, or lesbian participants. However, as compared to cisgender participants, transgender participants had discrimination scores that were 2.1 points higher (95% CI 1.1, 3.0), and gender non-confirming individuals had scores that were one point higher (95% CI 0.2, 1.9). The qualitative findings showcased how societal "othering" occurs in the everyday life of LGBT Rwandans, with large ramifications in creating feelings of isolation and hampering one's capacity to live authentically and with dignity.

Conclusion: The findings from our study indicate a high level of othering of the LGBT community across multiple domains, including housing, employment, healthcare, education, religion, and family within Rwanda.

Policy implications: The findings highlight the importance of social education campaigns about LGBT people, particularly among vital societal role-holders, including healthcare providers and educators. Integrating the rich historical and indigenous culture related to LGBT could be successful in combating anti-West rhetoric.

Introduction: Research from sub-Saharan Africa has shown that women's relationships and partners influence their contraceptive use. Most relevant studies focus on relationship status with few considering how the quality of a relationship might influence women's use of contraceptives. This study is the first to examine how both positive and negative relationship dynamics are associated with young women's modern contraceptive use among those who want to postpone pregnancy for at least two years or stop childbearing altogether.

Methods: We analyze survey data collected in 2010 and 2011 from 745 young women aged 16-26 in partnerships in southern Malawi. The data include positive relationship dynamics such as expressions of love, communication, and partner support (relationship unity) and negative dynamics including unequal power and intimate partner violence.

Results: Logistic regression models show that relationship unity is significantly and positively associated with modern contraceptive use whereas negative relationship dynamics are not associated with contraceptive use among the sample. When stratified by relationship status, model results show the effects are driven by unmarried women.

Conclusions: Results suggest that positive relationship dynamics among unmarried couples can facilitate modern contraceptive use among those who want to avoid pregnancy.

Policy implications: Efforts to encourage partner communication and support surrounding the use of contraception, and expanding access to a variety of modern methods, may be beneficial for reducing unintended pregnancies and enhancing unmarried young women's reproductive autonomy to meet their contraceptive and fertility desires.

Introduction: Literature has found that LGBTQIA + faculty members experience discrimination both within the classroom and the larger academic environment, including decreased faculty collaboration, student support, and opportunities for promotion and tenure. However, few researchers have examined the experiences of LGBQ faculty within social work programs. Given this paucity in the literature, we examined the perceptions of faculty members in US social work schools regarding inclusive LGBTIA + policies, and how these policies influence the environments for and experiences of LGBQ faculty members.

Methods: This primary data collection consisted of a survey provided to social work faculty from the Baccalaureate Social Work Program Directors and the Master of Social Work Program Directors in 2017, consisting of 193 respondents. A multi-level path analysis with latent factors was conducted using structural equation modeling (SEM) in R.

Results: We found that higher support was significantly associated with less phobia and fewer incidences; likewise, more intervention was significantly correlated with less phobia and fewer incidences. Additionally, more inclusive LGBTQIA + policies were associated with more interventions. Interestingly, the presence of more policies was linked with higher levels of reported phobia and more incidences.

Conclusion: The results encourage a need for active interventions to combat homophobia and racism within schools of social work.

Policy implications: Additionally, the results support a need for inclusive LGBTQIA + policies with social work programs to support and create safe environments for LGBTQIA + faculty.