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Concept: Gay

190

Objectives. We investigated health disparities among lesbian, gay, and bisexual (LGB) adults aged 50 years and older. Methods. We analyzed data from the 2003-2010 Washington State Behavioral Risk Factor Surveillance System (n = 96 992) on health outcomes, chronic conditions, access to care, behaviors, and screening by gender and sexual orientation with adjusted logistic regressions. Results. LGB older adults had higher risk of disability, poor mental health, smoking, and excessive drinking than did heterosexuals. Lesbians and bisexual women had higher risk of cardiovascular disease and obesity, and gay and bisexual men had higher risk of poor physical health and living alone than did heterosexuals. Lesbians reported a higher rate of excessive drinking than did bisexual women; bisexual men reported a higher rate of diabetes and a lower rate of being tested for HIV than did gay men. Conclusions. Tailored interventions are needed to address the health disparities and unique health needs of LGB older adults. Research across the life course is needed to better understand health disparities by sexual orientation and age, and to assess subgroup differences within these communities. (Am J Public Health. Published online ahead of print June 13, 2013: e1-e8. doi:10.2105/AJPH.2012.301110).

Concepts: Health care, LGBT, Epidemiology, Population health, Sexual orientation, Homosexuality, Bisexuality, Gay

59

Although bisexual men are known to be less likely to disclose their sexual orientation to others than gay men, the reasons why bisexual men choose or feel unable to disclose have received minimal research attention. To examine the reasons behaviorally bisexual men offer for not disclosing to their friends, family, and female partners, in-depth interviews were conducted with an ethnically diverse sample of 203 men who had not disclosed their same-sex behavior to their female sexual partners in New York City. Men were recruited from multiple venues and online sources using a targeted sampling approach. Transcripts were thematically analyzed using Atlas.ti software. Contrary to the theory that non-disclosure is due to uncertainty about one’s sexual identity, the reasons offered for non-disclosure revealed that it was largely a method to avoid stigmatizing reactions from others. Men reported a number of specific reasons for non-disclosure, including (1) anticipation of negative emotional reactions; (2) anticipation of negative changes in relationships; (3) belief that others held stigmatizing attitudes toward homosexuality; (4) prior experience with negative reactions to disclosure; (5) wanting to maintain others' perceptions of him; (6) fear that those told would disclose to additional people; and (7) fear of rejection due to culture or religion. These findings provide insights into the reasons why many behaviorally bisexual men choose not to disclose, potential reasons why bisexual and gay men differ in the extent to which they disclose, and potential reasons why some bisexual men report greater emotional distress than gay men. Further, they suggest that greater attention needs to be placed on addressing the stigmatizing contexts that confront bisexual men and providing them with strategies to manage stigma.

Concepts: LGBT, Gender, Gender identity, Sexual orientation, Homosexuality, Bisexuality, Men who have sex with men, Gay

33

Previous studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults. Our aims were to determine an estimate of the association between sexual orientation identity and poor mental health and wellbeing among adults from 12 population surveys in the UK, and to consider whether effects differed for specific subgroups of the population.

Concepts: LGBT, Mental disorder, Sexual orientation, Homosexuality, Bisexuality, Gay, Lesbian, Sexual orientation identity

32

The growing body of literature on the recognition of sexual orientation from voice (“auditory gaydar”) is silent on the cognitive and social consequences of having a gay-/lesbian- versus heterosexual-sounding voice. We investigated this issue in four studies (overall N = 276), conducted in Italian language, in which heterosexual listeners were exposed to single-sentence voice samples of gay/lesbian and heterosexual speakers. In all four studies, listeners were found to make gender-typical inferences about traits and preferences of heterosexual speakers, but gender-atypical inferences about those of gay or lesbian speakers. Behavioral intention measures showed that listeners considered lesbian and gay speakers as less suitable for a leadership position, and male (but not female) listeners took distance from gay speakers. Together, this research demonstrates that having a gay/lesbian rather than heterosexual-sounding voice has tangible consequences for stereotyping and discrimination.

Concepts: LGBT, Gender, Sexual orientation, Homosexuality, Bisexuality, Gay, Heterosexism, Lesbian

28

Objectives. We examined purging for weight control, diet pill use, and obesity across sexual orientation identity and ethnicity groups. Methods. Anonymous survey data were analyzed from 24 591 high school students of diverse ethnicities in the federal Youth Risk Behavioral Surveillance System Survey in 2005 and 2007. Self-reported data were gathered on gender, ethnicity, sexual orientation identity, height, weight, and purging and diet pill use in the past 30 days. We used multivariable logistic regression to estimate odds of purging, diet pill use, and obesity associated with sexual orientation identity in gender-stratified models and examined for the presence of interactions between ethnicity and sexual orientation. Results. Lesbian, gay, and bisexual (LGB) identity was associated with substantially elevated odds of purging and diet pill use in both girls and boys (odds ratios [OR] range =  1.9-6.8). Bisexual girls and boys were also at elevated odds of obesity compared to same-gender heterosexuals (OR = 2.3 and 2.1, respectively). Conclusions. Interventions to reduce eating disorders and obesity that are appropriate for LGB youths of diverse ethnicities are urgently needed. (Am J Public Health. Published online ahead of print December 13, 2012: e1-e7. doi:10. 2105/AJPH.2012.301150).

Concepts: LGBT, Nutrition, Sexual orientation, Homosexuality, Bisexuality, Gay, Heterosexuality, Lesbian

27

The U.S. military’s ban on open homosexuality has become an increasingly salient issue since its implementation in 1993 and its repeal in 2011. The military is an organization with a unique professional and social organization. Evaluating military attitudes from a network perspective may offer insight into the role of formal and informal leadership in engendering attitudinal change and cultural tolerance around homosexuality. This study evaluates the role of network centrality and network exposure across formal (command networks) and informal (friendship and perceived leadership networks) structures on attitudes toward homosexuality in the military. This work analyzes survey data from a single cadet company within the U.S. Military Academy (n = 139) prior to the repeal of Don’t Ask, Don’t Tell. Results indicate that popular students tend to show tolerance toward homosexuality, whereas those who hold command leadership positions are more likely to have personal and professional opposition to homosexuality. In addition, formal superior-subordinate relationships are somewhat more likely to suggest social contagion compared to informal leadership and friendship relationships. Recommendations offer guidance for training strategies particularly with respect to a military leaders and socialization. Future research should monitor these issues relative to the post-DADT environment.

Concepts: Sociology, Leadership, Social psychology, Military of the United States, Homosexuality, Gay, Cadet, Societal attitudes toward homosexuality

27

Emerging evidence from general population studies suggests that lesbian, gay, and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. No studies have examined whether sexual orientation disparities exist in biomarkers of early cardiovascular disease risk.

Concepts: LGBT, Cardiovascular disease, Sexual orientation, Homosexuality, Bisexuality, Gay, Heterosexuality, Lesbian

26

The cultures and service needs of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing speech language pathologists.

Concepts: LGBT, Sociology, Culture, Sexual orientation, Homosexuality, Cross-cultural communication, Gay, Queer

25

Research focused on sexual orientation and gender identity among youth is scarce in school psychology journals. Graybill and Proctor (2016; this issue) found that across a sample of eight school support personnel journals only .3 to 3.0% of the articles since 2000 included lesbian, gay, bisexual, transgender (LGBT)-related research. It appears that special issues are a mechanism for publishing LGBT-related scholarship. This commentary includes a call for more research in school psychology and other related disciplines that intentionally addresses experiences of LGBT youth and their families. Two articles in this special section are summarized and critiqued with clear directions for future scholarship. Researchers and practitioners are ethically responsible for engaging in social justice oriented research and that includes assessing gender identity and sexual orientation in their studies and prevention program evaluations.

Concepts: LGBT, Gender, Gender identity, Sexual orientation, Transgender, Third gender, Homosexuality, Gay

25

Lesbian, gay, and bisexual (LGB) young people experience a variety of developmental trajectories that consist of milestones, the sequence and timing of which differ across individuals. They include early feelings of being different from peers, the onset of same-sex attraction, questioning one’s sexuality, first same-sex sexual experience, recognition and self-labelling, disclosure to others, first romantic relationship, and self-acceptance. The invention of ‘gay youth’ during the 1970s and 1980s is briefly reviewed with an emphasis on the ways in which the portrait created by early research fails to capture the developmental trajectories of millennial young people. Although some young people struggle with mental health problems as they navigate these milestones, research documents the complexity, variety, and normative nature of the vast majority of LGB young people. A growing chorus of developmental, behavioural, and social scientists now emphasize that many contemporary young people forego sexual confusion, recognize the sex or gender to which they are attracted to and love, and believe they are as mentally healthy as heterosexual young people.

Concepts: LGBT, Sexual orientation, Transgender, Homosexuality, Bisexuality, Gay, Heterosexuality, Lesbian