Psychology of Sexual Orientation and Gender Diversity最新文献

Intimate partner violence (IPV), including physical violence, psychological aggression, and coercive control, is highly prevalent among sexual and gender minority young adults assigned female at birth (SGM-AFAB). However, we know little about the contexts in which IPV occurs (e.g., overall tenor of the relationship in which IPV occurred, immediate precursors to IPV incidents) or the motives behind acts of IPV. Aiming to address these gaps in the literature, in 2019 we conducted semi-structured interviews with 39 SGM-AFAB young adults with histories of severe IPV victimization and/or perpetration. Thematic analysis of interviews revealed that IPV commonly occurred in relationships characterized by power differentials, anti-SGM stigma, infidelity, and unhealthy couple dynamics. Conflict was the most common situational context, followed by perceived or real infidelity; IPV was also triggered during technology-based communication, substance use, and breakups. IPV motives varied, including expression of negative emotions, desire to control the partner, jealousy, and self-defense. Relational and situational contexts and motives behind IPV varied by IPV type but not direction. Results highlight the importance of considering context and motivations when seeking to understand SGM-AFAB people's IPV experiences. Findings also suggest that IPV prevention and treatment efforts should include individual and dyadic interventions to improve regulation of negative emotion, awareness of power dynamics, and conflict management among SGM-AFAB and their partners, as well as policy efforts to reduce anti-SGM stigma.

Research has clearly documented high rates of human immunodeficiency virus (HIV) infection among transfeminine (TF) people (including trans women). This research has largely overlooked nonbinary people assigned male at birth (NBAMAB) despite their gender fluidity. This study examined similarities and distinctions in the occurrence and frequency of condomless anal sex (CAS) with casual male partners and associated drug use among TF and NBAMAB people. Between November 2017 and March 2020, a total of 2,758 TF and 2,347 NBAMAB adult (aged ≥18 years) participants living in the US completed an online survey assessing sociodemographics, drug use, sexual behavior, relationship status and relationship characteristics among those who were partnered. Multigroup hurdle models indicated that the occurrence and frequency of CAS with casual male partners did not differ significantly between TF and NBAMAB people who were not in a relationship. Partner gender and sexual agreement predicted CAS with a casual partner among TF but not NBAMAB respondents. Those TF participants with male partners and nonmonogamous sexual agreements had the highest odds of engaging in CAS and the highest frequency of CAS when they did. In both groups, illicit drug use was associated with higher occurrence and frequency of CAS with casual male partners. Cannabis use was not associated with either. The findings align with prior studies highlighting TF individuals' risk for HIV infection, particularly those who are single and partnered TF with male partners and nonmonogamous agreements. Despite being largely overlooked in HIV research, some people who identify as NBAMAB may engage in similar behaviors as TF individuals.

Previous research indicates that both minority stressors and interpersonal factors may facilitate increased risk for suicidal ideation (SI) among lesbian, gay, bisexual, queer, and other nonheterosexual (LGB+) individuals. These studies examined the potential indirect effects of two interpersonal factors, thwarted belongingness and perceived burdensomeness, on the associations that overt heterosexist discrimination and homonegative microaggressions share with SI. Percentile bootstrapped parallel indirect effects models were tested on a sample of 320 LGB+ community members between the ages of 18 and 74 (M = 30.98, SD = 7.15; Study 1) and a sample of 139 LGB+ college students between the ages of 18 and 39 (M = 20.12, SD = 3.03; Study 2). Results showed that perceived burdensomeness fully accounted for the association between heterosexist discrimination and SI in Study 1; however, this model lacked causal specificity. In Study 2, perceived burdensomeness fully accounted for the association between homonegative microaggressions and SI. Thwarted belongingness did not significantly account for any relationships. These findings suggest that perceived burdensomeness, over thwarted belongingness, is an important consequence of experiencing discrimination, particularly regarding its relationship with SI. Results also highlight microaggressions as an especially pernicious form of discrimination that potentially relates to internalized homophobia. Treatment, public health, and policy implications are discussed.

Posttraumatic stress symptoms are very high among sexual and/or gender minority (SGM) people. Development and testing of trauma interventions with SGM people is needed, but first we need to understand who among SGM people are at greatest risk of posttraumatic stress symptoms, how minority stress may contribute, and the frequency of substance use comorbidity with significant posttraumatic stress symptoms among SGM people. General linear models and logistic regressions were used to examine demographic differences, minority stress, and substance use related to posttraumatic stress symptoms among a national sample of SGM people (N = 4,589, M _age = 32.1, 55% cisgender). All gender groups had greater posttraumatic stress symptoms than the reference group of cisgender men. All sexual orientation groups, except for straight/heterosexual SGM people, had greater posttraumatic stress symptoms than participants in the reference gay/lesbian group. Younger age or identifying as American Indian or Alaska Native, or Hispanic, Latino, or Spanish was associated with more posttraumatic stress symptoms. Non-specific and SGM-specific minority stress were each related to greater odds of significant posttraumatic stress symptoms, even after accounting for Criterion A events. Among participants with significant posttraumatic stress symptoms, 13.6% were at risk for alcohol use disorder, and 56.4% were at risk for other substance use disorder. Marginalized SGM subgroups have more posttraumatic stress symptoms. Interventions for SGM people should consider minority stress coping strategies and substance use comorbidities.

Understanding the frequency and patterns of experiencing changes in sexual orientation identity (SOI) is critical to the health of adolescents and young adults (AYA). Failure to measure and acknowledge change experiences may miss opportunities to tailor care, such as sexual and reproductive health care, accordingly. Much of the prior research among AYA assesses change either retrospectively, or prospectively over relatively long time intervals. The study objective was to prospectively examine the prevalence and sociodemographic patterns of sexual orientation identity change over a short interval among adolescents and young adults (AYA). AYA ages 14-25 years in the United States who participated in two consecutive waves of a longitudinal, online cohort survey in 2021 (N=1,628) were included in the analyses. Self-reported SOI at baseline and follow-up (2 months later) were compared. Overall, 11.4% of AYA reported a different SOI at follow-up. SOI change was more common among transgender boys/men (30.4%) and nonbinary people (25.7%) compared to cisgender girls/women (11.9%) and cisgender boys/men (7.4%; p<0.01). Participants selecting "not sure" or who preferred to self-identify/write-in their SOI were most likely to report SOI change (55.8% and 81.8%, respectively) compared to those identifying as heterosexual (4.3%), queer (13.6%), and bisexual (18.9%) AYA (p<0.01). Participants reporting sexual minority identities at baseline who experienced a change in SOI (n=110) often reported another sexual minority identity at follow-up (54.5%). Surveys with a single time measure of SOI likely underestimate the extent of SOI change among AYA and may introduce bias in addressing needs of AYA experiencing SOI change.

Although research has shown that social support generally is beneficial to mental health among trans and nonbinary (TNB) adults, less is known regarding what forms of support and the degree to which they mitigate the harms of minority stress on mental health over time. This study investigated differences in types of social support and their association with mental health over time in a sample of 2,411 TNB adults, predominantly younger in age (53% 18-30 years old), diverse in sexual orientation (97.5%, LGBQA+, 2.5% straight/heterosexual), gender identity (53.3% non-binary, 26% trans man, 12.4% trans woman), and similar in race and ethnicity to the US national population. We conducted a latent profile analysis (LPA) to identify social support typologies. A three-profile solution classified participants into a Low (39.6%), Moderate (40.7%), or High Support profile (19.7%). Significant variability in gender-related support experiences was noted for those in the Moderate and High Support profiles, while those in the Low Support profile had almost uniformly little to no support from family. Mental health outcomes differed between the profiles; Low Support participants reported significantly worse depression and PTSD symptoms; demographically, the greatest proportion of participants with marginalized identities clustered in the Low Support profile. Finally, we tested profile membership as a moderating variable in the association of minority stressors with mental health over time. Few significant differences emerged between groups, suggesting that being in a higher support profile may not necessarily buffer the harms of minority stress on mental health over time. Intervention implications are discussed.

Nonsuicidal self-injury (NSSI), intentional harm to the body without intent to die, is a major public health concern. Transgender people may be at higher risk for NSSI compared to cisgender peers, but evidence is limited regarding prevalence, demographic correlates, and risk factors. This study is the first to examine NSSI in a probability sample of the U.S. transgender population. We analyzed data from the first U.S. nationally representative sample of transgender people which was recruited through random-digit-dial methods and address-based sampling. Using logistic regression, we examined associations between demographic factors, minority stress processes, early life adversity, and lifetime history of NSSI. The sample consisted of 270 transgender individuals; 144 (53.3%) were transfeminine or nonbinary assigned male at birth and 126 (46.7%) were transmasculine or nonbinary assigned female at birth. The mean age was 34.2 (SD = 17.1, range: 18-81); 68.5% identified as non-Hispanic White and 31.5% as Black, Latino, or multi-race. NSSI was reported by 50% of the sample. Victimization and discrimination, adverse childhood experiences, lower nonconformity in childhood gender expression, and transgender community connectedness were associated with higher odds of NSSI. NSSI is common among transgender people in the U.S. Victimization and discrimination, adverse childhood experiences, and factors related to gender identity development may increase vulnerability to NSSI. Additional research is needed to better understand the relationships between these variables and NSSI. Findings can inform tailored interventions to address specific risk factors that affect this population.

The present study examined rates and factors associated with past-year Veterans Health Administration (VHA) overall healthcare utilization and VA mental health treatment among LGBTQ+ and cisgender heterosexual veterans. Baseline data from a national longitudinal study of LGBTQ+ and cisgender heterosexual veteran VHA users and non-users (N = 1,062) were used in generalized linear models to estimate the predicted prevalence of VHA healthcare utilization for each LGBTQ+ and cisgender subgroup, stratified by gender. Additional multivariable regressions were guided by the Andersen health services utilization model. There were no significant differences in healthcare utilization among women subgroups. Among men subgroups, cisgender gay men had lower predicted prevalence of VHA utilization than cisgender heterosexual and transgender men. In both the women's and men's models, VHA eligibility indicators and perceived lack of service availability were associated with increased odds for any past-year utilization; higher income, difficulty understanding eligibility/benefits, and logistical barriers were associated with decreased odds. Lifetime harassment at VHA was positively associated with past-year overall VHA utilization in women's models. LGBTQ+ specific factors explained significant variance in some models while transgender/gender diverse specific needs did not. These findings suggest that veterans generally need assistance navigating VHA eligibility issues and that LGBTQ+ veterans would benefit from systemic attention to provider sensitivity and availability of services focused on their needs. The high rates of harassment reported across women subgroups (19% to 25%) and by transgender men (38%) warrant institution-wide action.

The purpose of this study was to provide an in-depth, daily, and qualitative examination of oppression-based stress experiences among sexual and gender minority adolescents (SGMA) across varying social contexts-that is, varying interpersonal relationships and social environments. A sample of 94 SGMA were recruited and completed up to 21 days of daily diaries, in which respondents answered an open-ended question surrounding their daily negative experiences-or "lows"-associated with their marginalized identities. A total of 1,629 entries were analyzed using qualitative content analysis methods. Five themes of daily oppression-based stress experiences emerged from the responses, encompassing: (1) social rejection and discomfort, (2) relationship stressors, (3) stress related to identity development and disclosure, (4) negative or inadequate representation, and (5) structural cissexism-related stressors. Our findings further elucidate the content and type of oppression-based stressors SGMA experience across multiple intrapersonal, interpersonal, and structural domains; additionally, we identify salient, intervenable areas for future research to reduce the everyday oppression-based stress experiences of SGMA.

A handful of existing studies have examined positive sexual identity experiences at the daily level. However, these studies have focused predominately on concurrent associations, produced mixed results for most outcomes (e.g., anxious affect, internalized stigma), and have not examined positive gender identity experiences. The current study aims to address these limitations by examining prospective associations between positive sexual and gender identity experiences, affect, proximal stressors (i.e., internalized and anticipated stigma), and perceived coping efficacy. The study also aims to explore contextual factors that may increase the likelihood of these events. We used data from a 30-day ecological momentary assessment study with 429 sexual minority women and gender diverse sexual minorities assigned female at birth (SMWGD). Positive sexual and gender identity experiences prospectively predicted increases in perceived coping efficacy. Positive sexual identity experiences also prospectively predicted increases in positive affect and decreases in internalized stigma. Positive sexual and gender identity experiences were also associated with increases in anxious and depressed affect, but these effects did not persist into the next day. Finally, positive sexual identity experiences were more likely to occur when participants interacted with friends, partners, and sexual and gender minority individuals. Given that reduced perceived coping efficacy and increased internalized stigma link enacted stigma with subsequent increases in anxiety and depression, our findings suggest that positive identity experiences may help to interrupt these processes and build resilience to enacted stigma, although this should be tested by future research.