Article

Parents' Supportive Reactions to Sexual Orientation Disclosure Associated With Better Health: Results From a Population-Based Survey of LGB Adults in Massachusetts

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Abstract

This study investigated associations between coming out to parents, experiences of parental support, and self-reported health behaviors and conditions among a population-based sample of LGB individuals using data collected via the 2002 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS; N = 177). We explored the following two hypotheses: 1) Lesbian, gay, and bisexual (LGB) individuals who had never disclosed their sexual orientation to a parent would report higher levels of risk behaviors and poorer health conditions than those who had come out; and 2) among LGB respondents who had come out to their parents, the individuals whose parents had reacted unsupportively would report higher levels of risk behaviors and poorer health conditions than those who had come out to parents who were supportive. Approximately two thirds of gay and bisexual (GB) males and lesbian and bisexual (LB) females reported receiving adequate social and emotional support from the parent to whom they first disclosed their sexual orientation. Among LB females, no disclosure of sexual orientation to a parent was associated with significantly elevated levels of past-month illicit drug use (AOR 12.16, 95% CI 2.87-51.54), fair or poor self-reported health status (AOR 5.71, 95% CI 1.45-22.51), and >15 days of depression in the past month (AOR 5.95, 95% CI 1.78-19.90), controlling for potential confounders. However, nondisclosure to a parent by GB males was not associated with greater odds of any of the health indicators assessed. Among GB males, those with unsupportive parents were significantly more likely to report current binge drinking (AOR 6.94, 95% CI 1.70-28.35) and >15 days depression in the past month (AOR 6.08, 95% CI 1.15-32.15), and among LB females, those with unsupportive parents were significantly more likely to report lifetime illicit drug use (AOR 11.43, 95% CI 2.50-52.30), and >15 days depression in the past month (AOR 5.51, 95% CI 1.36-22.36). We conclude that coming out may be associated with better health for LB women, and that parents who react nonsupportively when their children disclose LGB sexual orientation may contribute to children's increased odds of depression and hazardous substance use.

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... For some older lesbian and gay adults, their parents may have never known about their sexual orientation and may consequently feel that their parents never fully knew them. Research has shown that being out to one's parents is associated with better mental health across a range of age groups (D'Amico & Julien, 2012;LaSala, 2000;Rothman, Sullivan, Keyes, & Boehmer, 2012), and could form an important part of the development and management of sexual identity for 5 many older lesbian and gay people . Of particular relevance is the Health Equity Promotion Model Fredriksen-Goldsen et al., 2014), which describes how health and well-being outcomes in lesbian, gay, bisexual and transgender (LGBT) populations are shaped by the stigma experienced by this group as well as resilience and protective factors. ...
... However, none of these studies investigated links between parental knowledge and mental health. Given that being out to parents is associated with better mental health in younger samples (D'Amico & 6 Julien, 2012;LaSala, 2000;Rothman et al., 2012), research is needed on older samples to examine whether similar associations are present. ...
... There may be a range of possible explanations for the gender differences we found, which would require further study. One possibility is that being out to parents is somehow 14 more important overall to women than to men (LaSala, 2000), or that women experience greater stress from not disclosing their sexual orientation to their parents (Rothman et al., 2012). Some participants, for example, may have been in heterosexual relationships and raised children, with support from their parents, but also had to face ongoing concealment of their sexual orientation in interactions with their parents. ...
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Objective: Research suggests that lesbian and gay people’s disclosure of their sexual orientation to parents is associated with better mental health and identity adjustment. However, adolescents and younger adults have been the main focus with little known about the experiences of older people. The following study focused on older lesbian and gay adults, and examined whether believing that their parents knew about their sexual orientation is linked to better current mental health and identity adjustment. Method: A survey of 548 lesbian and gay adults aged 60 years and older in Australia measured psychological distress, positive mental health, internalised homonegativity, sexual identity affirmation, and whether participants believed their parents knew about their sexual orientation Results: After controlling for age of first disclosure, whether their parents were alive, and socio-demographic variables, women who reported at least one parent definitely knowing of their sexual orientation were significantly lower on psychological distress and higher on positive mental health and identity affirmation than those who reported neither parent knowing or were uncertain of their parents’ knowledge. No significant effects were found for the men. Conclusion: Believing that at least one parent definitely knew about their sexual orientation was linked to better mental health outcomes among lesbian women, but not among older gay men. These findings reveal a potential risk factor for poorer mental health among older lesbian women, as well as important gender differences, and may be useful in understanding and supporting the well-being of older lesbian and gay adults.
... Sexual orientation disclosure affects LGBQ people's well-being. Prior research showed that when disclosure receivers react positively to the disclosure, LGBQ disclosers tend to have better mental health outcomes (Rosario et al., 2009;Rothman et al., 2012;Ryan et al., 2015). Similarly, when LGBQ people come out in an interpersonal context that supports their autonomy, they experience better mental health (Legate et al., 2012;Ryan et al., 2017). ...
... Perceived receiver reactions. Disclosure receivers' responses to sexual orientation disclosure have significant impacts on LGBQ disclosers' mental health (Rothman et al., 2012;Ryan et al., 2015). Thus, receivers' reactions were measured and controlled in data analyses. ...
... This study also contributed to research on disclosure outcomes of coming out. First, prior studies showed that LGBQ disclosers' mental health is contingent upon receivers' responses to the disclosure (Rothman et al., 2012), the discloser-receiver relationships (Ryan et al., 2017), and characteristics of the disclosure messages (Li & Samp, 2019). We found that independent of receivers' reactions, adverse impacts of the pandemic moderated how characteristics of coming out messages predicted post-disclosure depression. ...
Article
Guided by the Theory of Coming Out Message Production and the Constitutive Model of Coming Out, this study explores how negative COVID-19 experiences (adverse impacts of the pandemic) moderate the effects of cognitive factors (disclosure goals, relational power, and internalized homophobia) on sexual orientation disclosure, and the effects of disclosure on mental health. Results (N = 403 U.S. LGBQ adults) showed that as adverse impacts of the pandemic increased, the positive relationship between disclosure goals and sexual orientation disclosure decreased, but the negative association between internalized homophobia and disclosure increased. Higher disclosure levels predicted lower depression one month later, only when participants reported lower negative impacts of the pandemic. Theoretical accounts for coming out message processes should consider both environmental and cognitive factors and differentiate their distinct roles in predicting disclosure messages. Moreover, the positive impacts of effective coming out seem to disappear when the pandemic heavily impacts LGBQ people’s daily lives.
... While understanding heterosexual partners' post-disclosure strategies is vital, researchers also underline that coming out is not always beneficial for LGB disclosers (Legate, Ryan, & Weinstein, 2012). Specifically, based on disclosure receivers' immediate reactions (Rothman, Sullivan, Keyes, & Boehmer, 2012) and the disclosure messages produced by disclosers (Li & Samp, 2019b), LGB individuals could experience either more positive or more negative mental health outcomes. Thus, depending on how they come out and how their heterosexual partners react to the disclosure, sexual orientation disclosure may be harmful to LGB partners. ...
... Thus, we aim to examine how COMP constructs are related to receivers' reactions. Given that confidants' responses to sexual orientation disclosure affect LGB individuals' post-disclosure mental health outcomes (Rothman et al., 2012), the results not only have theoretical implications for COMP and selfdisclosure theories, but also have practical applications to help people who plan to come out. ...
... Another aspect of disclosure events that has significant disclosure outcomes is the receivers' reactions (Chaudoir & Fisher, 2010). In the context of coming out, researchers found that receivers' negative responses have predicted LGB people's lower self-esteem (Ryan, Legate, & Weinstein, 2015) and increased odds of substance use and depression (Rosario, Schrimshaw, & Hunter, 2009;Rothman et al., 2012). While the importance of receivers' reactions in shaping COMING OUT TO HETEROSEXUAL PARTNERS 9 coming out outcomes is well documented, less is known about the antecedent factors that affect receivers' reactions, which have crucial implications for disclosers for preparing for coming out. ...
Article
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LGB individuals coming out to heterosexual partners can be difficult in mixed- orientation relationships. This study examined the predictors and outcomes of LGB people’s sexual orientation disclosure and perceived partner reactions. Participants (N = 417) were LGB adults residing in the US who came out to their heterosexual romantic partners. Path analysis results showed that LGB individuals’ disclosure goals, internalized homophobia, and perceived power over partners were associated with degrees of disclosure and partners’ reactions, which in turn were related to LGB disclosers’ depressive symptoms and relationship satisfaction. The results have implications for coming out studies and suggest how, what, and when LGB people to come out to their heterosexual partners.
... Nevertheless, families may also play a protective role in the positive and healthy development of LGBT youth (Doty et al., 2010;Rothman et al., 2012;António and Moleiro, 2015;Watson et al., 2019). In this regard, sexual minority youth who felt supported by their parents also showed lower levels of depression and a more positive self-esteem (Watson et al., 2019). ...
... Even though parents tend to be more accepting of their child's sexual identity over time (Vincke and Van Heeringen, 2002;Savin-Williams and Ream, 2003;Beals and Peplau, 2006) and Family can be protective factor of LGBT youths well-being (Doty et al., 2010;Rothman et al., 2012;Watson et al., 2019), this network was only mentioned twice as a source of social support. This low frequency may be related to the fact that our participants are still in the process of revealing their sexual orientation and/or gender identity to their family, experiencing mostly difficulties in this stage (Savin-Williams and Ream, 2003;D'Augelli et al., 2005;Rosario et al., 2008Rosario et al., , 2009Ryan et al., 2009;Needham and Austin, 2010;Freitas et al., 2015;McConnell et al., 2016;Rodrigues et al., 2016;Watson et al., 2016). ...
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Portugal is one of the most egalitarian countries in Europe in terms of lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals’ legal rights. However, regarding education Portugal still lacks specific policies, plans and interventions to protect LGBTI students. To assess the perceptions of self-identified LGBTI youth regarding their school context, a total of 663 participants (aged from 15 to 20 years old) filled in an on-line questionnaire about their school climate. One hundred and forty-six of them answered an open-ended question about their personal experiences. A thematic analysis of these answers was conducted, and four main categories were identified: (i) victimization, (ii) coming out experiences, (iii) support networks, and (iv) demands. Most participants reported experiences of discrimination, and several sources of prejudice were identified. Furthermore, participants also recognized a lack of LGBTI information in school curriculum and made several demands. Besides inclusive laws, we suggest that the safety and the well-being of LGBTI youths in Portuguese schools depend upon others measures, such as teacher and school staff training, curricula inclusive of LGBTI diversity, and local strategies, such as Gay-Straight Alliances.
... Rothman, Sullivan, Keyes, & Boehmer, 2012). The decision to come out, or to disclose one's sexual identity or orientation, to parents and family members has emerged as an important milestone in the identity formation process (Baiocco et al., 2015;Ryan, 2001;Savin-Williams & Ream, 2003). ...
... This might suggest that the LGB child is more adversely affected than the parents in terms of the parent-child relationship. Furthermore, negative family reactions to coming out and rejection of a child's sexuality have been linked to negative mental health and behavioral outcomes (Rothman et al., 2012;Ryan, Russell, Huebner, Diaz, & Sanchez, 2010;Willoughby, Doty, & Malik, 2010). ...
Article
Disclosures of same‐sex attraction are some of the most difficult experiences for lesbian, gay, and bisexual (LGB) individuals. For LGB individuals of faith, disclosure to parents is often complicated by the intersection of religion/spirituality and sexuality. This study presents a grounded theory about a particular subgroup to address gaps in the literature concerning how LGB students on Christian college campuses describe and experience their parental disclosures. Consensual qualitative research analysis (Hill, Knox, Thompson, Williams, & Hess, 2005; Hill, Thompson, & Williams, 1997) revealed themes related to predisclosure influencing factors, the disclosure event experience, and longer term impacts of the disclosure. Implications for parents, counselors, and college faculty/staff are provided.
... For example, outness among SMI has been found to be associated with increased self-esteem, positive affect, and wellness behavior, and with reduced levels of anxiety, psychological distress, and sexual risk-taking behaviors (Jordan & Deluty, 1998;Morris, Waldo, & Rothblum, 2001;Rosario, Hunter, Maguen, Gwadz, & Smith, 2001;Tabaac, Perrin, & Trujillo, 2015). Inversely, nondisclosure among SMI is associated with poorer health outcomes, such as increased depression and substance use (Rothman, Sullivan, Keyes, & Boehmer, 2012). ...
... In our model's second primary pathway, greater dual-identity centrality had a positive indirect effect on self-reported health through greater outness and greater positive affect (Dual ID→outness→positive affect→health). This indirect effect likewise supports extant research that highlights the positive relationship between outness and myriad health outcomes (Jordan & Deluty, 1998;Rosario et al., 2001;Rothman et al., 2012;Tabaac et al., 2015). However, what the current study offers the scholarship on dual-identity development among AASMI is a pathway through which the process can be a positive influence on their health and wellbeing: via increased outness. ...
Article
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Asian American sexual minority individuals (AASMI) face the challenge of navigating two identities as both a sexual minority and a racial minority. However, the research base examining AASMI dual-identities remains underdeveloped. In the current study, we investigated the link between AASMI dual-identity centrality and their health and wellbeing using a subsample of 303 AASMI drawn from the Social Justice Sexuality Project dataset (n = 4,953). We conducted structural equation modeling (SEM) to test our hypothesized model and used bootstrap analysis to test the indirect effects therein. Findings indicated strong support for our model, which theorized that dual-identity centrality among AASMI can act as a “double-edged sword” on their health, whereby the process worsens their health through increased discomfort in their racial/ethnic community while simultaneously improving it through increased outness. Implications for future research and new avenues of intervention efforts at improving AASMI health are discussed.
... Often starting at young ages with the coming out process, lesbian and gay youth who disclose their non-heteronormative sexual identities to their families face a range of familial responses that often either affirm or reject their identities (Beals, Peplau, and Gable 2009;D'Augelli et al. 2005;D'Augelli et al. 1998D'Augelli et al. , 1998. High levels of parental rejection and low levels of family support can put lesbian and gay children and adults at increased risk for numerous adverse experiences (Bird et al. 2017;Carastathis et al. 2017;Mustanski 2015, 2016a;Needham and Austin 2010;Rothman et al. 2012;Ryan et al. 2009;Soler et al. 2018;Willoughby, Doty, and Malik 2010). For example, one study using a population-based sample of LGB individuals (N = 177) found that lesbian women and gay men who disclosed their sexual orientation to unsupportive parents were significantly more likely than those with supportive parents to report negative life experiences (Rothman et al. 2012). ...
... High levels of parental rejection and low levels of family support can put lesbian and gay children and adults at increased risk for numerous adverse experiences (Bird et al. 2017;Carastathis et al. 2017;Mustanski 2015, 2016a;Needham and Austin 2010;Rothman et al. 2012;Ryan et al. 2009;Soler et al. 2018;Willoughby, Doty, and Malik 2010). For example, one study using a population-based sample of LGB individuals (N = 177) found that lesbian women and gay men who disclosed their sexual orientation to unsupportive parents were significantly more likely than those with supportive parents to report negative life experiences (Rothman et al. 2012). ...
... Often due to small sample sizes or measurement limitations, previous research on outness has dichotomized youth as out or not out, or has combined outness contexts into one variable. Some studies treat outness as a binary condition (e.g., out versus not out) across different contexts, such as parents, siblings, and people at school (e.g., Martos et al., 2015, Rothman et al., 2012, Shilo & Savaya, 2012. Other studies treat outness as a continuous measure, ranging from being out to nobody to being out to everybody in a given context (e.g., Kosciw et al., 2015, Russell et al., 2014, Watson et al., 2015. ...
... Furthermore, support from friends following disclosure is associated with greater well-being and lower distress (Shilo & Savaya, 2012). In the family context, non-disclosure to any parent is associated with experiencing more depression compared to those with disclosure to at least one parent (Rothman et al., 2012). In addition, sexual orientation-specific family acceptance among adolescence who have come out to their parents is associated with lower depression among sexual minority young adults (Ryan et al., 2010). ...
Article
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Prior scholarship has documented health-relevant consequences of sexual minority youth (SMY) sexual identity disclosure (i.e., “outness”), yet most of the extant work focuses on one social context at a time and/or measures outness as dichotomous: out or not out. However, SMY are out in some contexts (e.g., family, friends) and not in others, and to varying degrees (e.g., to some friends, but not to all). Using a national sample of 8884 SMY ages 13–17 (45% cisgender female, 67% White, 38% gay/lesbian and 34% bisexual, and 36% from the U.S. South), this study used latent class analysis to identify complex patterns of outness among SMY, as well differences in class membership by demographics, depression, family rejection, and bullying. The results indicated six distinct classes: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ peers (n = 1707), out to LGBTQ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). The findings reveal significant differences in class membership by age, sexual identity, gender identity, race and ethnicity, geography, and well-being outcomes. Moreover, these findings underscore the complex role of outness across social contexts in shaping health and well-being.
... 1,51,52 Where present, parental connectedness and support act as critical buffers against negative health behaviors and outcomes. 51,[53][54][55] Researchers have also begun to investigate family interactions specific to adolescents' LGBTQ identity, such as attitudes of acceptance or rejection of this aspect of the adolescent's identity [56][57][58] and positive or negative reactions to disclosure of a sexual minority identity. 54,59,60 For example, LGB young adults reporting high levels of family rejection had odds of attempting suicide that were over 8 times higher than those with families reporting no or low levels of family rejection. ...
... 51,[53][54][55] Researchers have also begun to investigate family interactions specific to adolescents' LGBTQ identity, such as attitudes of acceptance or rejection of this aspect of the adolescent's identity [56][57][58] and positive or negative reactions to disclosure of a sexual minority identity. 54,59,60 For example, LGB young adults reporting high levels of family rejection had odds of attempting suicide that were over 8 times higher than those with families reporting no or low levels of family rejection. 57 In contrast, family acceptance of LGBT status and identity predicts greater self-esteem and better general health, and protects against depression, substance use, and suicide involvement. ...
Article
This study explored weight-based victimization by family members, accepting lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) attitudes, and family connectedness, and how these experiences are associated with health, self-esteem, and depressive symptoms among LGBTQ adolescents. Data came from the LGBTQ National Teen Survey (N = 9261, mean age = 15.6 years). The 3 key variables were significantly associated with poorer self-rated health, self-esteem, and depressive symptoms. For example, weight-based victimization was associated with approximately 2 more points on the depressive symptoms scale (β = 1.81, P < .001), adjusting for covariates. Findings highlight the negative impact of weight-based victimization among LGBTQ youth, even in the context of other types of family support.
... A supportive family environment is known to be highly desired, particularly for sexual minority people, while it is dependent on parental response to the issue of sexual orientation (Darby-Mullins & Murdock, 2007;Heatherington & Lavner, 2008;Jhang, 2018). Robust evidence has documented the salubrious effects of parental acceptance on sexual minority offspring's mental health and self-acceptance (Elizur & Ziv, 2001;Hershberger & D'Augelli, 1995;Rothman et al., 2012;Ryan et al., 2010;Shao et al., 2018;Shilo & Savaya, 2011), highlighting the need for research into its factors and context (Ghosh, 2020). ...
Article
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Introduction Previous research has utilized a typological approach to characterizing intergenerational relationships and exploring their associations with children’s socioemotional outcomes. This study applied this method to Taiwanese gay and bisexual men via a tentative typology constituted by two conditions: co-residence with, and outness to, parent(s). Aside from describing the prevalence of different types of living arrangement, we further examined their links with the internal drivers, filial piety and internalized homophobia, and life satisfaction. Age group difference and the moderation effect of typology on the association between internal drivers and life satisfaction were also investigated. Methods A cross-sectional survey was completed by a sample of Taiwanese gay and bisexual men recruited via Facebook. Besides reporting their co-residence and outness status, respondents also completed the Contemporary Filial Piety Scale, Chinese Internalized Homophobia Scale, and Satisfaction with Life Scale. Descriptive statistics, ANCOVA, and moderation analysis were performed for young adults and early middle-aged adults separately. Results While half of the total sample lived with parents, more than half (65.5%) were not out to them. Comparison of categories shows that closeted young adults reported significantly stronger internalized homophobia. Among early middle-aged men, those who were not out to and living with parent(s) reported the highest filial obligations and lowest life satisfaction compared with other groups. Conclusions This study contributes to existing knowledge about various forms of family environments and the ways they are involved in Taiwanese gay and bisexual men’s lives. Implications for the use of this typology in social policy and practice are discussed
... Social support from family of origin for sexual minority youth and emerging adults is associated with less suicidal ideation (Button, 2015 for review;Eisenberg & Resnick, 2006;Ryan, Russell, Huebner, Diaz, & Sanchez, 2010). Although disclosure of sexual orientation (i.e., coming out) to parents and family may be a significant hurdle for sexual minority people, for those who are more fortunate to have loving and accepting families, positive parental and family responses may foster feelings of safety and confidence (Pollitt, Muraco, Grossman, & Russell, 2017;Rothman, Sullivan, Keyes, & Boehmer, 2012). Studies suggest that support from parents may stimulate feelings of social belongingness in sexual minority youth, which may promote healthy psychosocial adjustment (Detrie & Lease, 2007). ...
Article
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Sexual minority emerging adults are more likely to engage in suicidal ideation than their heterosexual counterparts. Experiences of homophobic violence are associated with suicidal ideation. Yet, the specific mechanisms linking homophobic violence to suicidal ideation remain unclear. Entrapment and social belongingness were tested to determine their relevance for understanding the link between homophobic violence and suicidal ideation. A sample of sexual minority Dutch emerging adults (N = 675; ages 18–29, M = 21.93 years, SD = 3.20) were recruited through online platforms and flyers. Homophobic violence was expected to be positively associated with suicidal ideation and entrapment. The association between homophobic violence and suicidal ideation was expected to be indirectly linked through entrapment. We explored whether various sources of social belongingness moderated the path between entrapment and suicidal ideation and whether those sources of social belongingness moderated the indirect effect of homophobic violence on suicidal ideation through entrapment. Results showed that homophobic violence and entrapment were positively associated with suicidal ideation and that family belongingness was negatively associated with suicidal ideation. Homophobic violence and suicidal ideation were not indirectly linked through entrapment. The interaction effect between entrapment and family belongingness was significant, suggesting that, on average, the effect of entrapment on suicidal ideation decreased when family belongingness was high. These results suggest that family belongingness may reduce the association between entrapment and suicidal ideation while adjusting for homophonic violence. Reducing entrapment and improving family belongingness may be useful targets for programs aimed at preventing suicidal ideation among sexual minority emerging adults.
... Likewise, parental acceptance of a child's minority sexual orientation predicts lower levels of anxiety (D'Augelli, 2002) and depression (Hall, 2018;Ryan et al., 2010). Even in the absence of overt hostility, a lack of acceptance can still be detrimental to those who identify as LGBþ, resulting in higher levels of symptomatology (Rothman et al., 2012). This research emphasizes the importance of experiences of acceptance in promoting resilience to anxiety and depression in the LGBþ population (Kwon, 2013). ...
Article
Background: Social media has become increasingly widespread among young adults, yet its relationship to depression and anxiety may depend on the users’ experiences. For LGB+ individuals, who exhibit disproportionate rates of anxiety and depression, social media may present a unique source of acceptance or of hostility and stress. Methods: This study examined whether sexual orientation (SO) moderated the relationship between social media experiences of acceptance of acceptance and hostility and symptoms of depression and anxiety. Questionnaires assessing depression, anxiety, and social media experiences were completed by 382 young adults from a large Midwestern university at three time points. Results: Significant interactions were observed between SO and social media experiences of acceptance on depression from T1 to T2 and T1 to T3. Similar results were found for anxiety from T1 to T2. Higher levels of acceptance on social media predicted lower symptoms of depression and anxiety in LGB+, but not heterosexual, participants. No significant interactions were observed between SO and social media experiences of hostility on depression or anxiety. Conclusion: Social media may serve as an important should of support and acceptance, rather than a source of hostility, that can protect against depression and anxiety in LGB+ individuals.
... Family and peers comprise the social microsystems in which LGB individuals are embedded, and they can profoundly influence LGB individuals' health [7][8][9][10][11]. Sexual stigma from family and peers indicates the ignorance, prejudice and discrimination enacted by family members and peers toward sexual minorities [12,13]. ...
Article
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This study aimed to examine the moderating factors of the association between perceived sexual stigma from family and peers and internalized homonegativity, as well as to compare the effects of perceived sexual stigma from family and peers and internalized homonegativity on loneliness, depression, and anxiety in gay and bisexual men. In total, 400 gay and bisexual men participated in this study. The experiences of perceived sexual stigma from family and peers on the Homosexuality subscale of the HIV and Homosexuality Related Stigma Scale, internalized homonegativity on the Measure of Internalized Sexual Stigma for Lesbians and Gay Men, loneliness on the UCLA Loneliness Scale (Version 3), depression on the Center for Epidemiological Studies-Depression Scale, and anxiety on the State subscale of the State-Trait Anxiety Inventory were collected. The results indicated that perceived sexual stigma from family and peers was significantly associated with internalized homonegativity in both gay and bisexual men, and that sexual orientation moderated the association. Moreover, the association between internalized homonegativity and loneliness was significantly greater than that between perceived sexual stigma from family and peers and loneliness, although no significant differences were observed in their associations with depression and anxiety. Intervention programs that promote changes in the attitudes toward gay and bisexual men among the general population are needed to help prevent the development of internalized homonegativity and further loneliness, depression and anxiety.
... In a sample of lesbian women in New Zealand, Saphira, and Glover [105] found no association between level of disclosure and alcohol use; however, women who reported marijuana use reported higher levels of disclosure. Rothman and colleagues [106] examined disclosure and others' reactions to disclosure in a sample of LGB participants in the 2002 Massachusetts Behavioral Risk Factor Surveillance Survey. Most (73%) LGB participants had disclosed their sexual identity to their parents (or stepparents). ...
Article
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Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peer-reviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW’s use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.
... Research as begun to examine the impact of different sources of social support, such as family, peers, and significant others among LGBQ people. Much of this work has focused on support from family, which has been negatively associated with distress over time (McConnell, Birkett, & Mustanski, 2016) and suiciality (Ryan, Huebner, Díaz, & Sanchez, 2009), while presence of support can protect against mental health problems (Rothman, Sullivan, Keyes, & Boehmer, 2012). Nevertheless, families are not always willing or able to provide support and point to support from peers and significant others as important support networks that impact mental health (McConnell et al., 2016). ...
Article
Background: Heterosexism has been identified as being a contributing factor of suicidality in sexual minority adults (SMA), and social support is believed to be important for mitigating these effects. Research evaluating racial/ethnic differences in suicidality among SMA is limited despite racial/ethnic minorities being at greater risk. Aims: We aimed to examine the associations between heterosexism, suicidal ideation, and social support in a sample of racially/ethnically diverse SMA. Method: SMA ( N = 239) were recruited as part of an online survey on sexuality and health based in the United States. Results: There were significant positive main effects of heterosexism and significant negative main effects for non-White racial/ethnic identity on suicidal ideation. There were significant negative main effects for social support from family and a significant other but not from friends. A significant interaction of social support from a significant other and racial ethnic identity was qualified by a significant three-way interaction with heterosexism. Social support from a significant other buffered the effect of heterosexism on suicidal ideation among non-White but not among White SMA. All other interactions were not significant. Limitations: Within-group differences of racial/ethnic groups and other domains of social support were not examined, and the cross-sectional nature of the data precludes causal inference. Conclusion: Support from a significant other may be important for suicidality, particularly for racial/ethnic minority SMA.
... We believe that parental support significantly reduces the psychological pressure and symptoms resulting from homophobic victimisation, parental involvement in school should be central in providing resilience to school-related violence due to non-normative sexual orientations. We are further motivated by other research conducted which has indicated that if and when the parents of children with diverse sexual orientations and the school work together, occurrences of homophobic bullying, violence, and any other forms of discrimination decreases significantly (Keyes & Boehmer, 2012). ...
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The parental involvement strategies in the education of their child are crucial to improve learning at home and in school. However, concerning issues of samesex sexuality in South African schools, it is uncertain how schools engage with parents whose child identifies with a non-heterosexuality. We were interested in investigating and exploring the parents experience with school involvement, where the parents under investigation affirm their children s sam-seex sexualities. Using a qualitative research design, through a case study methodology, we conducted, semi-structured interviews with six (6) parents who affirm their children s sam-seex sexuality in the Free State Province (3rd largest Province in South Africa) and t h e Gauteng Province (Largest Province in South Africa). Our findings suggest from our study that the parents who affirm and embrace their child's same-sex sexuality were antagonized with gender binaries, heteronormative, and heterosexist school culture. Their children faced insurmountable acts of discrimination daily. For this specific reason, these parents wanted to be active agents in creating a safe, enabling, and inclusive schooling space for their non-normative sexuality children. The Parents in our study recognized that the idea of such a secure and enabling learning environment did not realise due to traditional cultures, along with the constructions of gender and sexuality. These parents were exposed to negative experiences due to the unwillingness of school authorities, insufficient strategies and values, and norms. We thus endorse a structured approach to parental involvement for all learners regardless of gender expression and sexual orientation. We further advise school governance bodies should affirm learners with diverse sexual orientations through the various policies and legislations.
... As in adolescence, acceptance from parents in adulthood is associated with a lower psychological impact of internalized homophobia (Feinstein, Wadsworth, Davila, & Goldfried, 2014). For example, a study of 98 LGB young adults (ages 18-21) shows more support from network members was associated with lower levels of emotional distress (Doty, Willoughby, Lindahl, & Malik, 2010), and LGB adults who thought their parents did not provide emotional and social support had higher odds of depression and substance use in adulthood (Rothman, Sullivan, Keyes, & Boehmer, 2012). Later in the life course, bisexual older adults report worse health than gay and lesbian older adults in part because they have less social support from the family of origin (Fredriksen- Goldsen et al., 2016), and the disclosure of gay grandfathers to their grandchildren is associated with grandfathers' better mental health (Tornello & Patterson, 2016). ...
Article
Objective: To review research on sexual and gender minority (SGM) families-including lesbian, gay, bisexual, transgender, queer, asexual, and intersex (LGBTQAI+) families- from 2010-2020. Background: Research on the SGM population has increased and diversified in the past decade. Results: This paper reviews three subareas that make up the majority of research on SGM families today: (1) SGM family of origin relationships, (2) SGM intimate relationships, and (3) SGM-parent families. This review also highlights three main gaps in the existing literature: (1) a focus on same-sex and gay and lesbian families (and to a lesser extent bisexual and transgender families) and a lack of attention to the families of single SGM people as well as intersex, asexual, queer, polyamorous, and other SGM families; (2) an emphasis on white, socioeconomically advantaged SGM people and a failure to account for the significant racial-ethnic and socioeconomic diversity in the SGM population; and (3) a lack of integration of SGM experiences across the life course, from childhood to old age. Conclusion: The next decade should aim to examine the full range of SGM family ties, include more vigorous examinations of race-ethnicity and socioeconomic status, and develop more robust accounts of family across the life course with novel theory and data sources across the methodological spectrum.
... A growing body of research examining parent and family rejection, acceptance, and support among lesbian, gay, and bisexual (LGB) youth has emerged (McConnell, Birkett, & Mustanski, 2016;Rothman, Sullivan, Keyes, & Boehmer, 2012;Samarova, Shilo, & Diamond, 2013;Savin-Williams, 2001a); and it shows that while negative familial responses to the youths' sexual orientation have often been linked to negative health outcomes such as depression, substance abuse, homelessness, and sexual risk-taking (Ryan et al., 2009), family acceptance has been associated with psychosocial support and protective against LGB youths' psychological distress (Ryan et al., 2010). Empirical studies on the responses of parents to TGNC youth are starting to emerge, but more studies are needed (Institute of Medicine [IOM], 2011; Katz-Wise, Rosario, & Tsappis, 2016). ...
Article
The purpose of this study was to examine parental responses to transgender and gender nonconforming [TGNC] youths’ gender identities and explore associations of parent support with parental abuse, depressive symptoms, and LGBT-identity disclosure stress. TGNC youth (N = 129), ages 15–21 (M = 18.00, SD = 1.74), completed surveys (2011–2012); experiences of transfeminine (TF; n = 58) and transmasculine (TM; n = 71) youth were analyzed separately. Among mothers of TF youth, 42.0% of initial and 45.3% of current responses were positive; among fathers, 30.0% of initial and 36.0% of current responses were positive. Among mothers of TM youth, 26.0% of initial and 53.3% of current responses were positive; among fathers, 24.0% of initial and 44.6% of current responses were positive. Among TM youth, higher levels of parental support were associated with more positive responses from mothers and fathers. Among both TF and TM youth, greater parent support was associated with less parental abuse, depressive symptoms, and LGBTQ-identity disclosure stress. Parental responses to youths’ gender identities became more positive with time for TF youth; however, approximately 50% of all TGNC youth continued to experience minority stress related to parent rejection. Limitations and implications for practice and research are discussed.
... The benefits of social support on the mental health of LGBTQ individuals have been well-documented. Social support is a protective factor against psychological distress (Pflum et al., 2015), suicidality (Ryan, Russell, Huebner, Diaz, & Sanchez, 2010), and substance use (Rothman, Sullivan, Keyes, & Boehmer, 2012). These findings contribute to this body of literature in that social support works directly and indirectly on promoting mental health and positive health behaviors among LGBTQ adults. ...
Article
Objective: The minority stress model and much research based upon it tend to adopt and reinforce a deficit-based approach. This study created and initially validated the minority strengths model, which by contrast outlines how personal and collective strengths in minority populations create resilience and positive mental and physical health. Method: A sample of 317 lesbian, gay, bisexual, transgender, and queer individuals from diverse racial/ethnic backgrounds completed a national online survey. Results: A minority strengths path model was generated with statistically significant paths and good fit indices, including all possible significant indirect effects. The model explained 16.8% of the variance in identity pride, 19.7% in self-esteem, 32.9% in resilience, 41.6% in mental health, and 13.0% in positive health behaviors. Conclusions: The minority strengths model holds promise to stimulate research on personal and collective strengths of minority populations and the ways in which strengths generate resilience and positive mental and physical health.
... Much research exists in support of the buffering hypothesis. Individuals who report more social support have better overall well-being and physical health outcomes as compared to individuals who report less social support, a finding that has been found among both sexual minorities(Burton et al., 2014; Detrie and Lease, 2007;Rothman et al., 2012) and heterosexuals(Kawachi, 2000;Uchino, 2009). It may be that social support from one's father or father-figure may act as either a buffer or an additional source of stress among sexual minorities.On one hand, positive social support from one's father or father-figure may serve as a protective base through which sexual minority individuals can mitigate the harmful experiences related to discrimination(Bouris et al., 2010; D'Augelli et al., 2010). ...
Article
Background: Exposure to sexual orientation-related discrimination among sexual minorities may lead to elevated levels of C-reactive protein (CRP) as compared to their heterosexual counterparts. However, little is known about factors that may buffer the association between discrimination and CRP among sexual minorities versus heterosexuals. The current study examined if the association between discrimination, sexual orientation, and CRP differed across levels of social support from one's father/father-figure or mother/mother-figure between sexual minorities and heterosexuals. Methods: Data came from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The sample sizes for father support and mother support was 3167 and 3575, respectively. Participants ranged in age from 24 to 33 years. Stratified linear regression models examined if father and mother support moderated the association between discrimination and CRP among sexual minorities and heterosexuals. Results: Father support significantly moderated the association between discrimination and CRP among sexual minorities but not heterosexuals. Sexual minorities with higher father support and who experienced discrimination had lower CRP as compared to those with lower father support and who experienced discrimination. Mother support did not moderate the association between discrimination and CRP among either sexual minorities or heterosexuals. Conclusion: Father support may mitigate the negative effects of stress from discrimination on CRP among sexual minorities. Future research should further examine the potential differential role that father support may play in reducing cardiovascular risk among sexual minorities versus heterosexuals who experience discrimination.
... If disclosure is met with a negative response, this can result in further concealment, isolation, feelings of rejection, and negative views of oneself (Chaudoir & Fisher, 2010). Conversely, positive responses following a disclosure are associated with positive psychological outcomes, such decreased loneliness and lower lifetime suicidal ideation (D'Augelli et al., 2001;Pachankis, 2007;Pachankis et al., 2015;Rothman et al., 2012). ...
Article
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Minor attracted persons (MAPs) represent a highly stigmatized population. While robust literatures exist linking stigma-related stressors to negative psychological sequalae in other stigmatized populations, the research examining stigma processes in MAPs has only recently begun to develop. The present study expands this area of research by examining associations between stigma-related stressors (e.g., internalized pedonegativity, perceived support from close others, disclosing minor attraction), relational quality, loneliness, and psychological distress in an online sample of MAPs (n = 202). Results demonstrated expected associations between perceived lack of support from others, increased internalized pedonegativity, psychological distress, and suicidality. Mediation modelling suggest loneliness mediates the relationship between perceived support from family and mental health outcomes and partially mediates the relationship between internalized pedonegativity and psychological distress. Our findings also show that most MAPs had disclosed their minor attraction to someone in their life but disclosure itself was not associated with improved mental health; whether a disclosure was followed by support was associated with increased wellbeing. The results of this study improve our understanding of MAPs’ mental health and can help inform how clinicians provide support to this population.
... For example, internalized homonegativity has been associated with identity concealment (Gonçalves et al., 2020), dissatisfaction with sex life (Berg et al., 2015), less quality in romantic relationships (Doyle & Molix, 2015;, and less emotional intimacy with the romantic partner (Šević et al., 2016;Thies et al., 2016). To the extent that romantic partners, friends, and parents are important sources of emotional support to sexual minority people (e.g., Bauermeister et al., 2010;Doty et al., 2010;Friedman & Morgan, 2009;Rodrigues, Huic, et al., 2019;Rothman et al., 2012;Whitton et al., 2018), future research should examine if such sources of support moderate some of our findings and their implications for interpersonal relationships and individual wellbeing. Future research should also seek to further understand the coming out process by using more detailed measures of coming out (e.g., breadth and depth of disclose in the social network) and the engagement in strategies to conceal one's sexual identity from others, and include other relevant measures to assess prejudice and discrimination (e.g., polymorphous prejudice; Lopes et al., 2017). ...
Article
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Introduction Studies examining why heteronormative beliefs shape the coming out process of sexual minority men are still scarce. This study aimed to examine whether heteronormative beliefs result in more internalized homonegativity and more sexual identity stigma. We also compared socio-cultural contexts—Portugal and Turkey—with distinct social policies toward sexual minority people. Lastly, we explored the correlates of coming out to friends and family members. Methods A cross-sectional study with 562 sexual minority men (93.4% cisgender; Mage = 26.69, SD = 9.59) from Portugal and Turkey was conducted between March and July 2019. Results Heteronormative beliefs were associated with increased internalized homonegativity and, in turn, with increased sexual identity stigma (identity stigma and social discomfort). This mediation was moderated by country, such that conditional direct effects were stronger among Turkish sexual minority men. Conditional indirect effects, however, were stronger among Portuguese sexual minority men. Furthermore, less internalized homonegativity and less social discomfort were associated with coming out to friends and family members in different ways. Conclusions This study contributed to the understanding of sexual identity development and acceptance among sexual minority men in two distinct socio-cultural contexts. Findings showed that the internalization of heteronormative beliefs was associated with identity stigma and highlighted the role of socialization in these processes. Policy Implications For people working with sexual minority men from diverse socio-cultural contexts, our findings can offer new insights on how to offer the best help in the coming out process of these sexual minority men.
... Moreover, factors relating to minority stress, such as perceived stigma relating to one's sexual and/or gender identity and discrimination, have also not been examined as risk factors. Finally, factors which have been found to significantly protect SMM from the development of other high-risk behaviours, such as resilience, social support and community connectedness, have also not been examined in relation to problem gambling [43][44][45]. It is evident that further research is needed to examine the risk and protective factors for the development of problem gambling and gambling-related harms in SMM populations. ...
Article
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Background Sexual minority men (SMM) often experience stressful social environments dominated by stigma and discrimination. SMM are typically more likely than heterosexual men to engage in certain risky behaviours such as problem gambling. This study aimed to compare gambling behaviour among SMM and examine potential risk factors (erroneous gambling cognitions, gambling outcome expectancies, hazardous alcohol use, impulsivity, and psychological distress; as well as perceived stigma and discrimination for the SMM participants) and potential protective factors (resilience, social support, and community connectedness) for problem gambling severity and gambling-related harms among SMM living in Australia. Methods An online survey, with an over-representation of SMM participants and problem, moderate-risk, and low-risk gamblers, was completed by 101 SMM (mean age = 28.5) and 207 heterosexual men (mean age = 26.4). Results SMM were found to have significantly lower levels of problem gambling severity compared with heterosexual men, and report significantly lower gambling participation, frequencies and expenditure on any gambling activity, casino table games, horse racing/greyhound betting, sports betting, and keno. However, in the SMM group, 38.3% were classified in the problem gambling category of the Problem Gambling Severity Index and 27.6% were classified in the moderate-risk gambling category. There were no significant differences between groups in gambling-related harms. Multiple regression analyses revealed that problem gambling severity and related harms were independently predicted by higher levels of impulsivity and erroneous gambling cognitions for both groups. Conclusions Lower frequency of gambling behaviours among SMM and similar risk factors predicting problem gambling severity/harms for both groups suggests that problem gambling is not pronounced among SMM. This study adds new evidence to the gambling literature which can be used as comparative benchmarks for future research.
... A large body of research demonstrates the importance of interpersonal factors (in social ecological models) and relational social supports (in the Minority Stress Model) for the mental health of LGBQ adolescents. Parents and other family members in particular play a crucial role, and research has shown the protective effects of general parental support, family connectedness, and family acceptance of sexual orientation (Bouris et al., 2010;Eisenberg & Resnick, 2006;Mustanski & Liu, 2013;Rothman et al., 2012;Russell & Fish, 2016;Ryan et al., 2010). The present study extends existing literature by focusing on modifiable factors at the school (i.e., organizational) and community levels, which may be particularly helpful where interpersonal support is lacking. ...
Article
Supportive school and community resources are associated with reduced risk of suicidality among lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ +) adolescents as well as their cisgender, heterosexual peers. This study examined whether adolescents attending schools and living in communities with more versus fewer LGBTQ +-supportive resources were at lower risk of a past-year suicide attempt. Data on sexual orientation and past-year suicide attempt were obtained from student surveys administered in 30 Massachusetts public high schools between 2014 and 2017 (N = 20,790). Data on school resources were obtained from a questionnaire administered to school officials, and community resources were assessed through internet searching. Modified Poisson generalized estimating equations tested associations between school and community LGBTQ +-supports and suicide attempt separately by sex/gender, adjusting for student, school, and community covariates. Several school resources and the availability of community-wide LGBTQ +-supportive resources were associated with lower risk of a suicide attempt among several subgroups of students, even after controlling for the presence of multiple school and community resources and covariates. For example, the risk of a suicide attempt among gay, bisexual and questioning boys in schools with a gender-neutral restroom was approximately half compared to gay, bisexual and questioning boys in schools without this resource. Past year suicide attempts were also significantly lower among questioning, RR = 0.56, CI [0.37-0.86], and heterosexual, RR = 0.59, CI [0.50-0.68], girls living in communities with more supportive resources compared to those in communities with fewer resources. LGBTQ +-supportive resources in schools and communities may be beneficial for all adolescents regardless of sexual orientation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Family support can protect LGB individuals from mental health problems caused by stigma related to heteronormativity [97], whereas low family support may exacerbate suicidality and internalized homonegativity among young LGB individuals [98]. The results of this study indicate the importance of the family environment for LGB individuals [99,100]. ...
Article
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This study investigated (1) the associations of homophobic bullying victimization in childhood with borderline personality disorder (BPD) symptoms in early adulthood among gay and bisexual men; (2) the mediating effect of depressive symptoms on the association between homophobic bullying victimization and BPD symptoms, and (3) the moderating effects of perceived family support on the association between homophobic bullying victimization and BPD symptoms. A total of 500 gay or bisexual men aged between 20 and 25 years were recruited into this study. The experiences of physical, verbal and social relationship bullying victimization during childhood were evaluated using the Mandarin Chinese version of the School Bullying Experience Questionnaire. The experiences of cyberbullying victimization during childhood were evaluated using the Cyberbullying Experiences Questionnaire. BPD symptoms were assessed using the Borderline Symptom List. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale. Perceived family support was evaluated using the Family Adaptation, Partnership, Growth, Affection, and Resolve index. The results of mediation analyses demonstrated that all the types of homophobic bullying victimization in childhood were directly associated with BDP symptoms in young adulthood as well as indirectly associated with BPD symptoms through the mediation of depressive symptoms. The results of moderation analyses demonstrated that the association between homophobic bullying victimization and BPD symptoms decreased when the individuals had more family support. Intervention programs to reduce homophobic bullying victimization and enhance family support for gay and bisexual men and their families are necessary. Interventions to improve depressive and BPD symptoms among gay and bisexual men are also necessary, especially for those who experienced homophobic bullying victimization during childhood.
... Overall, parents today show less rejection and more acceptance of their LG children than before (Beals and Peplau, 2006;Hank and Salzburger, 2015). That said, there is still considerable variability in parental reactions toward their child's coming out (Rothman et al., 2012;Samarova et al., 2013;Martos et al., 2015;Rosati et al., 2020). Most research that examined influential factors related to parental reactions to their children's coming out showed that the parent's gender matters. ...
Article
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The present study examined associations between fathers’ masculinity orientation and their anticipated reaction toward their child’s coming out as lesbian or gay (LG). Participants were 134 German fathers (28 to 60 years) of a minor child. They were asked how they would personally react if, one day, their child disclosed their LG identity to them. As hypothesized, fathers with a stronger masculinity orientation (i.e., adherence to traditional male gender norms, such as independence, assertiveness, and physical strength) reported that they would be more likely to reject their LG child. This association was serially mediated by two factors: fathers’ general anti-LG attitudes (i.e., level of homophobia) and their emotional distress due to their child’s coming out (e.g., feelings of anger, shame, or sadness). The result pattern was independent of the child’s gender or age. The discussion centers on the problematic role of traditional masculinity when it comes to fathers’ acceptance of their non-heterosexual child.
... On the other hand, research is clear on the benefits of disclosure in an accepting family climate. For example, when disclosure is received with family support and acceptance, it is concurrently associated with greater family closeness (Gonzalez et al., 2013), better self-esteem (Ryan et al., 2010), better physical health (Rothman et al., 2012), more positive affect (Shilo & Savaya, 2011), and lower levels of depression (Needham & Austin, 2010) and substance use (Ryan et al., 2010). Taken together, these findings denote the salient role of the family in sexual minority adolescents' adjustment and well-being. ...
Article
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Sexual minority adolescents’ disclosure of sexual identity to family plays a significant role in their identity development. Studies have identified various predictors of coming out to family, yet these findings have yet to be systematically integrated to identify gaps and directions of future research. The goal of this study was to conduct a systematic review of predictors of sexual minority adolescents’ and young adults’ disclosure to family about their sexual identity. Drawing upon an existing conceptual model of antecedents of disclosure of stigmatized identities to organize the findings, this review focused on individual characteristics and proximal (e.g., familial and social) and distal (e.g., historical) environmental factors that influence disclosure to family. A total of 35 empirical studies were included. Regarding individual factors, less internalized homonegativity and greater identification of sexual identity promoted disclosure. Among familial and social factors, positive family relationship quality and friend support predicted greater disclosure. Distal environmental factors included differences in the proportion of disclosure by historical periods. The findings highlight the important role of acceptance and visibility of sexual minorities within family and social environments in promoting youth’s disclosure of sexual identity to family.
... Coming out to others is not a one-time event, but rather a multitude of events occurring over the life course with various people (e.g., family members, friends, classmates, and co-workers) and settings (e.g., home, neighborhood, school, workplace, place of worship, and social media). Nonetheless, the first time someone discloses their LGB+ identity to a friend or family member may be particularly vulnerable for the person coming out, and the nature of reactions of others can significantly influence mental health and interpersonal relationships in positive and negative ways (Beals and Peplau, 2006;Rosario et al., 2009;Rothman et al., 2012;D' Amico et al., 2015;Ryan et al., 2015). The emotional and behavioral reactions of others to disclosure can vary considerably from affirmation to rejection. ...
Article
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This paper is a systematic review and meta-analysis on sexual orientation identity development milestones among people who are lesbian, gay, bisexual, or another sexual minority identity (LGB+). Common milestones measured in the 30 studies reviewed were becoming aware of queer attractions, questioning one’s sexual orientation, self-identifying as LGB+, coming out to others, engaging in sexual activity, and initiating a romantic relationship. Milestones occurred in different sequences, although attraction was almost always first, often followed by self-identification and/or sexual activity; coming out and initiating a romantic relationship often followed these milestones. Meta-analysis results showed that the mean effect sizes and 95% confidence intervals varied by milestone: attraction [M age=12.7 (10.1, 15.3)], questioning one’s orientation [M age=13.2 [12.8, 13.6]), self-identifying [M age=17.8 (11.6, 24.0)], sexual activity [M age=18.1 (17.6, 18.6)], coming out [M age=19.6 (17.2, 22.0)], and romantic relationship [M age=20.9 (13.2, 28.6)]. Nonetheless, results also showed substantial heterogeneity in the mean effect sizes. Additional meta-analyses showed that milestone timing varied by sex, sexual orientation, race/ethnicity, and birth cohort. Although patterns were found in LGB+ identity development, there was considerable diversity in milestone trajectories.
... Considering the detrimental consequence of parental abuse, the objective of this study was to better understand the psychological symptoms that resulted from the abuse received by parents. While there are many studies that have focused on families' attitudes towards the lesbian, gay, bisexual, and transgender (LGBT) youth community [13][14][15][16], the transgender subgroup is underrepresented in this area of research, providing little information to explain the family cold violence experienced. To begin to explore the influence of parental psychological abuse on psychopathology symptoms, the study aimed to investigate the networks of anxiety and depression, the two most frequently reported symptoms, as well as the symptoms of self-harm and suicidal ideations, among transgender youth. ...
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Background This is the first study to investigate the effect of parental psychological abuse on potential psychopathological symptoms in gender minority youth subgroups, including transgender women, transgender men, and gender queer individuals. Methods Data was analysed from the Chinese National Transgender Survey in 2017; the survey was distributed through community-based organizations to transgender adolescents and adults residing in China, with representation from all 32 provinces and autonomous regions. A total of 1293 youth that self-identified as transgender or gender queer completed the study. Measures covered psychopathological symptoms including depression, anxiety, risk of suicide and self-harm. Parental psychological abuse was assessed in terms of neglect and avoidance, force to change, and verbal insults. Both the edges and centralities were computed via network analysis, and the network properties were then compared among the three gender minority subgroups. In addition, linear regression was adopted to test the predictive ability of node centrality for low self-esteem. Results Descriptive analysis revealed that among the three subgroups, transgender women had more severe psychopathological symptoms and reported the most psychological abuse. Network analysis revealed that the risk of suicide and self-harm was directly connected with one type of parental psychological abuse (“neglect and avoidance”). Node centrality was significantly associated with the predicting value of the nodes on low self-esteem (r2 = 0.25, 0.17, 0.31) among all three gender minority subgroups. Conclusions The distinctive core psychopathological symptoms, within the networks of the gender minority subgroups, revealed specific symptoms across each group. The significant association between node centrality and low self-esteem indicated the extent of parental psychological abuse. Parental psychological abuse directed towards gender minority youth should be recognized as a form of family cold violence. It is recommended that schools and local communities should support early intervention to improve psychological well-being.
... Relatedly, after years of human developmental research documenting the ways that family rejection undermines the well-being of LGB youth (D'Augelli, Hershberger, & Pilkington, 2001;Ryan, Huebner, Diaz, & Sanchez, 2009), studies now identify accepting and supportive families and show that family acceptance is strongly linked to the well-being of LGB (Rothman, Sullivan, Keyes, & Boehmer, 2012;Ryan, Russell, Huebner, Diaz, & Sanchez, 2010;Watson, Barnett, & Russell, 2016;Watson, Grossman, & Russell, 2016) and transgender youth (Olson, Durwood, DeMeules, & McLaughlin, 2016). Importantly, amid changing social acceptance, parental attitudes towards LGB children have also shifted. ...
Article
Few societal attitudes and opinions have changed as quickly as those regarding sexual minority people and rights. In the context of dramatic social change, there have been multiple policy changes toward social inclusion and rights for lesbian, gay, and bisexual (LGB) people, and perceptions that the sociocultural context for LGB people—perhaps particularly for youth—has improved. Yet recent evidence from the developmental sciences points to paradoxical findings: in many cases there have been growing rather than shrinking health disparities. The authors suggest that there is a developmental collision between normative adolescent developmental processes and sexual minority youth identities and visibility.
... With the rupture of attachment and potential loss of a secure base following their coming out, therefore, YMSM may begin to develop a negative sense of self in the form of shame about one's identity (Willoughby et al., 2006) where the self is perceived as flawed, worthless, or unlovable by a loved one (Mikulincer & Shaver, 2005, 2007. Therefore, such parental rejection may painfully exacerbate shame among YMSM, which is likely to enhance emotional and behavioral challenges such as depression, isolation, and suicidal ideation (Baiocco et al., 2016;Legate, Ryan, & Weinstein, 2012;Rothman, Sullivan, Keyes, & Boehmer, 2012;Vaughan & Waehler, 2010). ...
Article
Identity development is a fragile process for any youth, but this fragility may be entangled with greater complexity for young men who have sex with men (YMSM), particularly if confronted by rejection from those “closest to home”: their parents. While parental rejection to coming out may contribute to a range of maladaptive effects, the present work aims to distill the underlying mechanisms of such effects, specifically by exploring the intersection of self-disclosure and emotional intimacy. Drawing from a sample of YMSM age 18 to 24 (N = 364), we found that the link between YMSM’s emotional detachment from their fathers in response to their coming out and the experience of shame surrounding their sexuality was indirectly and serially mediated by YMSM’s positive associations with emotional bonding needs and intimacy with their romantic partner. Findings provide initial support for the reparative potential of romantic bonding and intimacy to heal identity-based shame from parental rejection and detachment, which would otherwise be a source of self-devaluation of YMSM’s identity.
Article
Objective Sexual minority women (SMW; e.g., lesbian, bisexual) report substantially higher rates of hazardous drinking (HD) than heterosexual women. Yet, few studies have examined sub-group differences. In this study, we investigated the relationship between gender self-concept and HD among SMW. Research consistently shows a link between heavier drinking and masculinity. SMW are more likely than heterosexual women to be gender non-conforming, and masculinity among SMW is associated with increased minority stress, a key HD risk factor. Methods We used Wave 3 data from the Chicago Health and Life Experiences of Women study, a longitudinal study of SMW (N=598), which assessed participants’ self-perceived levels of masculinity and femininity and their perception of how masculine/feminine others viewed them. Using multivariable logistic regression, we examined the association between gender self-concept and past 12-month heavy episodic drinking (HED), drinking-related problems, and alcohol dependence. Results Controlling for demographics and minority stress, greater masculinity (both self-perceived and perceptions by others) was associated with higher odds of HED and alcohol dependence. Masculinity as perceived by others was associated with higher odds of drinking-related problems. Neither femininity measure was associated with HD. Additionally, minority stress (i.e., discrimination, stigma, internalized stigma) did not account for the relationship between gender self-concept and HD. Conclusions/Importance: In this sample, masculinity, particularly SMW’s beliefs that others viewed them as masculine, was associated with HD. This association was not attributable to differences in minority stress and may be related to differences in gendered drinking norms, which could be targeted in intervention studies.
Article
Sexual and gender minority (SGM) persons, including lesbian, gay, bisexual, transgender/gender diverse, questioning/queer, intersex, and asexual (LGBTQIA) individuals, represent a historically underserved population within the field of medicine, though their unique health needs are increasingly recognized. Unfortunately, our understanding of these needs as they relate to dermatology is still nascent, particularly with respect to children and adolescents. This two‐part review will discuss the dermatologic care of SGM youth, with Part 1 providing practical advice for dermatologists seeking to provide more culturally mindful and accessible care for SGM children and adolescents. A more comprehensive understanding of the psychosocial and physical needs of SGM youth will allow dermatologists to more actively and compassionately care for this health disparity population.
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Statistics concerning the high prevalence of discrimination, suicidal ideation, and feelings of hopelessness among LGBTQIA+ youth are a major concern in schools. This chapter provides counselor educators with foundational information and recommendations for training school counseling graduate students to provide affirmative LGBTQIA+ youth services. By highlighting two main components of intentional educational processes and inclusive educational content, this chapter provides strategies and ideas for each CACREP core area in relation to the American School Counselor Association (ASCA) Ethical Standards. Recommendations are provided and are intentionally designed to be inclusive and equity-oriented to decenter heteronormative and gender-normative views in counselor training while emphasizing the primacy of social justice and advocacy.
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Females were not given the liberty to express their sexuality in historically male dominated world until education was accessible to them and women were educated to socialize their thinking. Homosexuality refers to same sex attraction. Although much was written about male homosexuality, female homosexuality is less studied and still reasons for female homosexuality are not that evident. A huge gap could be identified between early recognition of symptoms of homosexuality to self-acceptance and disclosure to other's about own-sexual-orientation. Although family is usually the first place for disclosure of own sexual orientation, fear sustains regarding acceptance. Homosexual women face multiple problems in all walks of life and may be abused or denied basic rights for a dignified living. An empathetic and non-judgemental attitude from the clinicians might help in easily approaching the mental and physical health issues faced by female homosexuals.
Article
Background Self-disclosing a concealable stigmatized identity (CSI) such as mental illness is generally associated with enhanced psychological well-being. Research also supports the link between social support and psychological well-being. Yet, few theoretical explanations exist for the role that mental illness disclosure plays in the association between social support PWB. Aims To test two competing models linking self-disclosure to psychological well-being: a mediator model in which self-disclosure indirectly contributes to psychological well-being via social support quality (i.e., self-disclosure is a pre-requisite of social support), and a moderator model in which self-disclosure enhances social support benefits (i.e., self-disclosure is a “booster” of social support benefits). Method College students (N = 174) who identified as being diagnosed with a mental illness completed an online survey. Results Structural equation modeling results largely supported both the mediator and the moderator models; however, which model statistically outperformed the other depended on the confidant (e.g., mother, friends). Conclusions These findings suggest the validity of conceptualizing social support as both pre-requisite of social support and the “booster” of social support benefit on psychological well-being.
Article
Background and aims: Sexual minority (SM) populations experience higher rates of substance use disorder (SUD) associated with increased sexual orientation-related stress. Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM-5 SUD by sex and sexual minority identity. Design: Cross-sectional study using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Setting and participants: A nationally representative cross-sectional sample of adults (n=36,309) in the United States. Measurements: SUD were defined based on the DSM-5 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non-kin contact, and functional social support was measured by the Social Provision Scale. Findings: SM adults had higher odds of all SUD compared to heterosexual adults (AUD: 1.56, 95%CI 1.28-1.84; TUD: 1.51, 95%CI 1.23-1.85; DUD: 1.52, 95%CI 0.41-0.63); SM women experienced the highest proportion of all SUD (AUD: 27.1%, TUD: 29.1%, DUD: 10.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD (adjOR 0.77, 95%CI 0.71-0.84), TUD (adjOR 0.75, 95%CI 0.69-0.80) and DUD (adjOR 0.56, 95%CI 0.49-0.64). Marriage was associated with lower SUD among heterosexual men (AUD: adjOR 0.50, 95%CI 0.43-0.58); TUD: adjOR 0.60, 95%CI 0.52-0.70; DUD: adjOR 0.50, 95%CI 0.37-0.69) and women (AUD: adjOR 0.64, 95%CI 0.53-0.77; TUD: 0.0.58, 95%CI 0.51-0.67; DUD: adjOR 0.52, 95%CI 0.37-0.71). Compared to heterosexual adults, SM women with at least one child under the age of 18 had higher odds of TUD (adjOR 1.99, 95%CI 1.33-2.99). SM-related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually-identifying individuals reporting same-sex attraction or behavior was associated AUD (adjOR 4.61, 95%CI 1.62-13.14) CONCLUSIONS: In the U.S. there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status.
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This pilot open trial examined the efficacy of attachment-based family therapy (ABFT) for Israeli sexual and gender minority (SGM) young adults and their persistently nonaccepting parents. Thirty families received up to 26 weeks of treatment, with parental rejection, parental acceptance, and young adults' attachment avoidance and attachment anxiety assessed at baseline, 8, 16, 24, and 36 weeks (three months post-treatment). Analyses using multilevel growth models revealed that both young adults and their mothers independently reported increases in mothers' acceptance of their young adult's same-sex orientation or noncisgender identity. In addition, young adults reported decreases in both parents' levels of rejection. Also, mothers, but not fathers, reported decreases in their own level of rejection. Finally, young adults reported a decrease in attachment avoidance in their relationships with both mothers and fathers, but not a decrease in attachment anxiety. Importantly, these treatment gains were maintained three months after the end of treatment. Together, these results suggest that ABFT-SGM, a manualized, affirmative, experiential, family-based treatment, may be effective in reducing long-standing parental rejection, promoting parental acceptance, and improving the quality of LGBTQ+ young adults' relationships with their parents. These findings are encouraging in light of the urgent need for efficacious interventions to reduce family generated minority stress and promote safer, more supportive environments for sexual and gender minority people.
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Compared to heterosexual individuals, gay men and lesbian women experience multiple health inequities, including higher prevalence of substance use and cardiovascular disease (CVD). Gay men and lesbian women also face structural stigma, including laws that fail to protect or actively discriminate against them. These phenomena can be understood by considering two theories previously tested among gay men and lesbian women: minority stress and cognitive escape. Minority stress theory suggests being stigmatized for one's minority identity relates to negative health sequelae, while cognitive escape theory suggests escape-related behaviors may mediate links between chronic stress exposure and health. Using 2017 Behavioral Risk Factor Surveillance System data, we ran binary logistic regressions to test models in which binge drinking and cigarette smoking independently mediated links between structural stigma and health among gay men and lesbian women. Structural stigma was operationalized at the U.S. state level as number of sexual orientation anti-discrimination laws. Health was operationalized as presence of any CVD. Models were tested in an aggregated sample, and also in subsamples by sex. In bivariate and component-path analyses, structural stigma predicted smoking across samples. Structural stigma-binge drinking associations were more salient among lesbian women compared to gay men. Per Sobel test results, smoking mediated associations between structural stigma and CVD in the gay men sample, suggesting gay men may smoke to escape from structural stigma, with negative implications for cardiovascular health.
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This study was conducted using Interpretative Phenomenological Analysis to explore and understand psychosocial issues of the gay community living in the Pakistani cultural context. Six adult gay men, aged 20–40 years, were interviewed using semi-structured interviews at their preferred locations. Thorough and in-depth analysis of the transcripts revealed two superordinate themes: (1) The experience of verbal harassment and associated emotional disturbance was universal, (2) The experience of sexual violence was universal. These themes describe participants’ experience of verbal harassment with followed emotional reaction, and experiences of different forms of sexual violence. This study helps in understanding what it means to be a gay man in Pakistan.
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This chapter focuses on the many factors affecting the social integration of the elderly and the psychological complexities associated with loneliness. Partners and the family are first in line as potential social factors that can contribute to elders’ well-being, but the community at large, including friends and acquaintances, can also become important, especially if direct family members are not available. Social interactions can be also negative and therefore we analyse the important issue of stigma affecting the elderly, and the various ethical issues, including those associated with the abuse of old people, that are relevant to old age. The oldest-old represent a special case as they face unique social challenges, not only due to their physical frailty, but also because at very advanced ages their peer network of social relationships weakens considerably. In multi-ethnic societies older immigrants experience specific problems of adaptation that cannot be ignored, and thus a section is also devoted to this topic. Other minorities are also important, and they may have unique needs associated with their ageing. Here we address the social issues relevant to older gay, lesbian, bisexual, transsexual/transgender (trans), and intersex people, and in a separate section we focus on the experience of ageing prison inmates. We conclude the chapter with an analysis of the challenges associated with caring for older people and the consequences of such care in terms of caregiver burden.
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Household job loss during COVID-19 constitutes a public health crisis. Research suggests associations between household job loss, harsher parenting practices, and mental health challenges in the general population. Sexual minority adolescents (SMA) face high rates of family stress and rejection, but evidence linking household job loss to SMA mental health is lacking. This study evaluated associations between household job loss, family rejection, and mental health with a national sample of SMA who were sheltering in place with families during the pandemic. SMA from an ongoing prospective study completed an online questionnaire between May 13-31, 2020. It was hypothesized that household job loss during the pandemic would be associated with elevated depressive and anxiety symptoms through family rejection. Household job loss during the pandemic was indirectly associated with SMA mental health through family rejection. These findings highlight how socioeconomic change and policy carry implications for SMA health.
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The study engages with several lesbian, gay, bisexual, transgender, pansexual and queer (LGBTPQ) identifying youth in South Africa to explore their perceptions and realities regarding coming out to their parents and parental reactions. In-depth interviews were utilized to engage with the 17 participants, aged 19 to 32 years old, all of whom were students at the same university in South Africa. The study found that participants who have not come out tended to view coming out as a problematic act that reproduces the heteronormative discourse of sexuality in which heterosexuality is normalized, while same-sex sexuality is seen as odd and as deviant. The study also found that many participants perceived coming out as an individual choice. However, the choice of whether or not to come out, when to come out, and which parent to come out to, is dependent on 1. the nature of the relationship the participants have with their parents, and 2. perceived parental reactions. Analysis reveals how religion, gender norms based on heteronormativity, and parent-child relationship dynamics intersect to shape participants’ perceptions regarding parental reactions. This intersectionality also shaped the realities of coming out. Such realities involved a variety of reactions from parents, including acceptance, rejection, forms of violence, and silence. Parents reacting with silence was a common, yet complex experience among the participants. The participants’ experiences suggest ways through which they could be empowered to cope better with their parents’ silence and other non-supportive reactions.
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Clothing type can have a significant impact on the way people are perceived. In this study, we were interested in the effect of business versus casual clothing on the perception of Asian American women, given various stereotypes about them. We used a between-subjects design with a sample of college students from a university in the United States. Participants saw 3 Asian American women (and 1 European American woman to distract from the nature of the study) in either business attire or casual outfits, and rated each woman on a series of descriptors based off various stereotypes of Asian American women. We used the Scale of Anti-Asian American Stereotypes to measure internal prejudice toward Asian Americans and the Ambivalent Sexism Inventory to measure sexism. The Scale of Anti-Asian American stereotypes was a significant covariate, F(4, 233) = 6.09, p < .001, ηp2 = .10. Participants rated models in business attire as less stereotypically Asian, F(1, 239) = 46.56, p < .001, ηp2 = .17, less sexualized, F(1, 239) = 12.91, p < .001, ηp2 = .05, and less invisible, F(1, 239) = 42.01, p < .001, ηp2 = .15. Our results show that stereotypes can indeed be influenced by business attire. It is important to note that future research may be oriented toward changing the attitudes of those who hold harmful stereotypes, rather than the actions (i.e., clothing choices) of the subjects of prejudice.
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In this study, I examined three case studies of Assigned-Female-At-Birth (AFAB) teenagers who came out to their families in the course of therapy; all cases are derived from private practice work from 2015 to 2018. These all have in common some of the important and distinct differences between “coming out” as LGB and “coming out” as transgender or nonbinary. Overall, these cases emphasize: (1) Specific needs of transgender teenagers and young adults, particularly with regard to appealing for permission to use hormones; (2) Race and class implications for coming out as transgender and non-binary; (3) The necessity of better general education about transgender lives; and (4) The impact of parents on transitioning experiences and self-identity. The different outcomes of gender identity outness, including different parameters for what parental approval and validation means, are explored. I conclude with clinical implications for doing work with transgender teenagers and their parents, along with advice to practitioners for how to work with a sample of parental responses in order to minimize trauma and harm to transgender and non-binary teens.
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A qualitative analysis of 151 coming out narratives written by members of sexual minority groups or gender minority groups suggested that individuals who disclosed their identity experienced supportive responses from friends and family members more often than nonsupportive ones. The majority of the narrative writers described the coming out process as leading to enhanced levels of communion, as many of the narratives recounted strengthening or forming relationships, feeling understood more authentically by others, and experiencing greater unity and connectedness with others. Many others described an empowering experience that led to a greater sense of personal identity and self-determination. Results suggest that the coming out process can have positive effects on the lives of LGBTQ+ individuals, marking a positive turning point in their life histories. Direct link: https://cdn.ymaws.com/www.psichi.org/resource/resmgr/journal_2021/26_3_Rouse.pdf
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This study examined how minority stressors mediate the association between sexual orientation disclosure to classmates and well‐being in a sample of 238 Latinx sexual minority youth (SMY; age range: 14–24 years). Results indicated that sexual orientation disclosure to classmates was associated with higher levels of sexual orientation‐based victimization, which contributed to higher levels of internalized homonegativity, which ultimately contributed to higher levels of depressive symptoms and lower self‐esteem. Sexual orientation‐based victimization and internalized homonegativity were positively associated with depressive symptoms and negatively associated with self‐esteem but sexual orientation disclosure to classmates was only positively associated with depressive symptoms. Associations between sexual orientation‐based victimization and internalized homonegativity were stronger among college Latinx SMY compared to SMY in high school.
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Almost no research has examined factors that contribute to mortality risk among sexual minority women (SMW). This study capitalizes on a 21-year community-based longitudinal study of SMW to examine the association between sexual identity disclosure and mortality risk. Forty-nine SMW who were recruited in 2000-01 or 2010-12 (6.3% of the sample), were confirmed dead by 2019. The mean age at death was 56.5 years. We used Cox proportional hazard models to show that SMW who had disclosed their sexual identity to 100% of their immediate family members had a 70% reduction in the risk of mortality compared to SMW who disclosed to less than 33% of their immediate family, after adjusting for several sociodemographic and health variables. Our results suggest that facilitating acceptance of SMW and their ability to disclose their identity may be an important way to improve health and life expectancy among SMW.
Thesis
This research examined the perceptions of family support among LGBT (Lesbian, Gay, Bisexual and Transgender) young adults, and the relationship to perceived family support and different career development outcomes variables. The career development outcome variables that were examined are occupational self-efficacy, decent work and life satisfaction. The research was meant to expand the little academic knowledge about the interface between family support, career development processes and LGBT identity development. This research was conducted under the psychology of working theory framework and is a mixed method research. The quantitative part includes 94 LGBT participants of the ages of 20-35 (M=29.7, SD=3.13) and the qualitative part is based on half-constructed interviews with 8 male adults of the ages 27-34 (M=30.13, SD=2.1). The results support most of the hypotheses and significant correlations were found between the variables family support, positive LGBT identity and decent work. The interviews emphasized the unique perceptions LGBT young adults have about the relationships with their parents and vocational development during life-span. Implications and recommendations are discussed.
Thesis
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This work uses Crenshaw’s (1989) Intersectional theory to quantitatively study intersectional experiences of discrimination and depressive symptoms among historically marginalized and ignored populations. Using a series of multiple mediation models, discrimination (attributed to gender, sexual orientation and/or race/ethnicity) was modeled as a mediator between identity and depressive symptoms among seven diverse identity-based subgroups from Project STRIDE (75% sexual minority, 50% racial/ethnic minority; Meyer et al., 2006). I hypothesized marginalized subgroups would experience more discrimination, and in turn, more depressive symptoms. All models (7 multiple mediation models) were compared against the eighth, least marginalized subgroup: straight White men. Discrimination partially mediated the effect of identity on depressive symptoms for sexual minority Black women, but only when accounting for discrimination on the basis of all three marginalized identities (woman, Black, and lesbian/bisexual). Sexual minority Black men experienced significantly less/less frequent depressive symptoms relative straight White men; after holding constant discrimination (at 0 for both groups), this was also true for sexual minority White men. Despite the nuances to quantitatively modeling intersectionality and potential issues of generalizability, this work might serve as a framework for carrying out future quantitative intersectionality-based studies. Enacted, this work has the potential to create a healthier and more equitable society for all.
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In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress— explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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Gay-related stress occurs when gay men and lesbians must deal with stressors that are unique to their sexual orientation. This research examined the relationship of gay-related stress and life events to depressive symptoms. Other potential predictors of depressive symptoms were also considered (internalized homophobia, stigma consciousness, and openness about sexual orientation). A sample of 204 (110 men, and 91 women, three sex-unspecified) gay/lesbian/bisexual individuals completed a packet of self-report measures. The importance of the construct of gay-related stress was demonstrated by explaining independent variance in depressive symptoms compared to variance explained by life stress. Those who reported more severe life stress and more severe gay-related stress also reported more depressive symptoms. Also, gay-related stress and stigma consciousness were independent predictors of depressive symptoms. Those with more severe gay-related stress and more stigma consciousness reported more depressive symptoms. Our results suggest that the construct of gay-related stress is important to understanding the experiences of gay/lesbian/bisexual individuals.
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examine 3 assumptions that mental health professionals—including lesbian and gay therapists—commonly hold about same-sex couples / as a consequence of female gender-role socialization, lesbian couples have a tendency to be emotionally fused / as a consequence of male gender-role socialization, gay male couples have a tendency to be emotionally disengaged / it is essential for the well-being of lesbian and gay male couples that the partners come out to their families of origin explore these notions from both theoretical and research standpoints / review the family systems concepts of fusion and disengagement / present some research findings that call into question the validity of these common beliefs about lesbian and gay couples / the results of these studies are interpreted in light of the California Inventory model of family connectedness and recent findings about gender-role nonconformity among lesbians and gay men / conclude by offering some new "lenses" for therapists to use when working with same-sex couples (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Explored the relationship between outness in lesbian & bisexual women and psychological health. 2,401 lesbian and bisexual women (15–83 yrs old) responded to a nation-wide Lesbian Wellness Survey. A theoretical model tested in this study proposed predictors and outcomes of outness. It included 3 predictors believed to be positively related to outness: (1) lesbian versus bisexual orientation, (2) years self-identified as lesbian or bisexual, and (3) involvement in the lesbian, gay, or bisexual communities. The 3 variables of lesbian sexual identity were found to predict outness, which predicted lower psychological distress, which, in turn, predicted lower suicidality. The model held true for the subsamples of European-American and African-American women, and to a lesser extent for those of Latina, Asian-American, Native-American, and Jewish Women.
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We provide estimates of several leading US adult health indicators by sexual orientation identity and gender to fill gaps in the current literature. We aggregated data from the 2001-2008 Massachusetts Behavioral Risk Factor Surveillance surveys (N = 67,359) to examine patterns in self-reported health by sexual orientation identity and gender, using multivariable logistic regression. Compared with heterosexuals, sexual minorities (i.e., gays/lesbians, 2% of sample; bisexuals, 1%) were more likely to report activity limitation, tension or worry, smoking, drug use, asthma, lifetime sexual victimization, and HIV testing, but did not differ on 3-year Papanicolaou tests, lifetime mammography, diabetes, or heart disease. Compared with heterosexuals, bisexuals reported more barriers to health care, current sadness, past-year suicidal ideation, and cardiovascular disease risk. Gay men were less likely to be overweight or obese and to obtain prostate-specific antigen tests, and lesbians were more likely to be obese and to report multiple risks for cardiovascular disease. Binge drinking and lifetime physical intimate partner victimization were more common among bisexual women. Sexual orientation disparities in chronic disease risk, victimization, health care access, mental health, and smoking merit increased attention. More research on heterogeneity in health and health determinants among sexual minorities is needed.
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Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay-bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian-bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use.
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In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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We used data from the National Health Interview Survey to compare health care access among individuals involved in same-sex versus opposite-sex relationships. We conducted descriptive and logistic regression analyses from pooled data on 614 individuals in same-sex relationships and 93418 individuals in opposite-sex relationships. Women in same-sex relationships (adjusted odds ratio [OR]=0.60; 95% confidence interval [CI]=0.39, 0.92) were significantly less likely than women in opposite-sex relationships to have health insurance coverage, to have seen a medical provider in the previous 12 months (OR=0.66; 95% CI=0.46, 0.95), and to have a usual source of health care (OR=0.50; 95% CI=0.35, 0.71); they were more likely to have unmet medical needs as a result of cost issues (OR=1.85; 95% CI=1.16, 2.96). In contrast, health care access among men in same-sex relationships was equivalent to or greater than that among men in opposite-sex relationships. In this study involving a nationwide probability sample, we found some important differences in access to health care between individuals in same-sex and opposite-sex relationships, particularly women.
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Tobacco and alcohol use and related morbidity and mortality are critical public health problems. Results of several, but not all, studies suggest that lesbians and gay men are at elevated risk for smoking tobacco and alcohol misuse. Data from random sample general health surveys of adult members of a large Northern California Health Plan conducted in 1999 and 2002 were analyzed using gender-based multivariate logistic regression models to assess whether lesbians (n = 210) and gay men (n = 331) aged 20-65 were more likely than similarly aged heterosexual women (n = 12,188) and men (n = 9342) to be smokers and heavy drinkers. After adjusting for age, race/ethnicity, education, and survey year, lesbians were significantly more likely than heterosexual women to be heavy drinkers (OR 2.14, 95% CI 1.08, 4.23) and current smokers (OR 1.60, 95% CI 1.02, 2.51). Among men, gays were significantly more likely than heterosexuals to be current smokers (OR 2.40, 95% CI 1.75, 3.30), with borderline significant increased risk for heavy drinking (OR 1.54, 95% CI 0.96, 2.45). Lesbians and gay men may be at increased risk for morbidity and mortality due to higher levels of cigarette and alcohol use. More population-based research is needed to understand the nature of substance use in these communities so that appropriate interventions can be developed.
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Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women. Data came from comparable face-to-face interviews with 405 self-identified Chicago-area lesbians and with 548 urban women from a U.S. national sample. Rates of hazardous drinking (heavy episodic drinking, intoxication, drinking-related problems, alcohol-dependence symptoms) were compared for exclusively heterosexual, mostly heterosexual, bisexual, mostly lesbian, and exclusively lesbian subgroups. Exclusively heterosexual women had lower rates than did all other women on all measures of hazardous drinking. Exclusively heterosexual women also reported less childhood sexual abuse, early alcohol use, and depression. Bisexual women reported more hazardous drinking indicators and depression than did exclusively or mostly lesbian women. These results indicate that sexual minority women are likely to have elevated risks of hazardous drinking. The differences between lesbian and bisexual women suggest that more attention is needed to subgroup differences among sexual minority women. Health care providers need to know the sexual identity of their patients and how their sexual identity may affect their risks for hazardous drinking. Higher rates of childhood sexual abuse, early drinking, and depression among sexual minority women suggest that these experiences may be important in assessing and treating problems related to their drinking, and in developing prevention and early intervention strategies.
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A model is proposed and explored that links the coming‐out process to the psychological functioning (i.e., self‐esteem and distress) and sexual behaviors of gay, lesbian, and bisexual youths recruited from gay‐focused community‐based and college organizations in New York City. The coming‐out process is multidimensional, consisting, as defined here, of involvement in gay/lesbian activities, attitudes toward homosexuality, comfort with homosexuality, self‐disclosure of sexual identity to others, and sexual identity. The coming‐out dimensions were related to self‐esteem, distress, and unprotected sexual behaviors. In addition, the relations between the coming‐out dimensions and unprotected sexual behaviors were explained by psychological functioning. In particular, limited involvement in gay/lesbian activities was associated with more unprotected sex. Negative attitudes toward homosexuality were related directly to more unprotected sex, and they were related indirectly to more unprotected sex by means of increasing emotional distress. These and other findings have implications for designing preventive interventions to increase the youths' psychological functioning and reduce their unprotected sexual behaviors.
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Gay and lesbian political activists encourage lesbians to "come out" and get involved. Is this good advice for lesbian couples? In these secondary analyses of data collected from 784 lesbian couples in 1979 for the American Couples Study (Blumstein & Schwartz, 1983), we examined whether social involvement and disclosure of sexual orientation were systematically associated with the quality of women's relationships. We predicted and found that partners matched on level of social involvement were happier than mismatched couples. The extent of women's social involve- ment had a curvilinear association with relationship quality: moderately involved couples were the most satisfied. Contrary to predictions, lesbians who had disclosed to a greater number of important others did not have more satis- fying romantic relationships, nor did partner matching on self-disclosure enhance relationship quality.
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Existing theories of child and family development have rarely been applied to the families of same-sex-attracted young people. This review employs family stress theory as a framework to understand parental reactions to their child's sexual orientation disclosure and the impact of parental reactions on child and family development. Empirical evidence is reviewed to support the notion that parental reactions may depend on (1) the availability of family-based resources to manage the stress, (2) the meaning attributed to the stressful event, and (3) the pileup of co-occurring stressors taxing a family's coping resources. Empirical links between parental reactions and child outcomes are also discussed. There is need for research on individual, dyadic, and family factors that influence parental responses to their child's same-sex attractions.
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The threat of job discrimination causes many gay men and lesbians to keep their sexual orientation secret at work. This study investigates the relationships between extent of communication about sexual orientation and critical work attitudes. We hypothesize that “closeted” gay workers will experience more negative work attitudes than will either “openly” gay or heterosexual workers. The sample consisted of 900 lesbian, gay, and heterosexual workers identified from the mailing list of a civil rights group focused on homosexual rights. The hypothesis is supported for affective organizational commitment, job satisfaction, belief in support of top management, role ambiguity, role conflict, and conflict between work and home issues, but not for continuance commitment. Although causal relationships are not specified, we conclude that work attitude levels of gay and lesbian workers are predicted in part by the amount of communication about their sexual orientation in which these workers engage.
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This study examined what parents of children with disabilities and special needs found helpful about belonging to mutual support groups. Quantitative data (based on 56 parents from 6 groups) indicated that members found the groups very helpful and were very satisfied with the support they received from their groups; they also described the groups as high in cohesion, expressiveness, task orientation, and self-discovery. A grounded theory analysis of focus group data (based on 43 parents from 5 of the groups) indicated that such support was helpful in three broad domains: (1) the sociopolitical, which involved developing a sense of control and agency in the outside world; (2) the interpersonal, which involved asense of belonging to a community; and (3) the intraindividual, which involved self change. A central theme of identity change emerged as superordinate to these three categories.
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Sexual minority women, defined as having a lesbian or bisexual identity or reporting a preference for a female partner, are not considered by cancer surveillance. This study assesses the representativeness of sexual minority breast cancer survivors, defined as having a lesbian or bisexual identity or reporting a preference for a female partner, who were recruited into a convenience sample compared with a population-based registry sample of sexual minority breast cancer survivors. Long-term survivors of non-metastatic breast cancer who self-reported as sexual minority were recruited from a cancer registry and subsequently from the community using convenience recruitment methods. Sexual minority breast cancer survivors who screened eligible participated in a telephone survey about their quality of life and factors associated therewith. Participants in the convenience sample were similar to the registry-based sample with respect to adjustment to cancer, physical health, trust in physician, coping, social support, and sexual minority experiences. Compared with the convenience sample, breast cancer survivors in the registry sample were more likely married, more educated, diagnosed more recently, at an earlier stage of cancer, and more likely treated with breast-conserving surgery; they differed on adjuvant therapies. Because sexual minority breast cancer survivors who volunteered for the community-based sample shared most characteristics of the sample recruited from the cancer registry, we concluded that the community sample had comparable representational quality. In the absence of cancer surveillance of sexual minorities, thoughtful convenience recruitment methods provide good representational quality convenience samples.
Article
Sexual minority youths are youths who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or youths who have only had sexual contact with persons of the same sex or with both sexes. Population-based data on the health-risk behaviors practiced by sexual minority youths are needed at the state and local levels to most effectively monitor and ensure the effectiveness of public health interventions designed to address the needs of this population. January 2001-June 2009. The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, dietary behaviors, physical activity and sedentary behaviors, and weight management) and the prevalence of obesity and asthma among youths and young adults. YRBSS includes state and local school-based Youth Risk Behavior Surveys (YRBSs) conducted by state and local education and health agencies. This report summarizes results from YRBSs conducted during 2001-2009 in seven states and six large urban school districts that included questions on sexual identity (i.e., heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (i.e., same sex only, opposite sex only, or both sexes), or both of these variables. The surveys were conducted among large population-based samples of public school students in grades 9-12. Across the nine sites that assessed sexual identity, the prevalence among gay or lesbian students was higher than the prevalence among heterosexual students for a median of 63.8% of all the risk behaviors measured, and the prevalence among bisexual students was higher than the prevalence among heterosexual students for a median of 76.0% of all the risk behaviors measured. In addition, the prevalence among gay or lesbian students was more likely to be higher than (rather than equal to or lower than) the prevalence among heterosexual students for behaviors in seven of the 10 risk behavior categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management). Similarly, the prevalence among bisexual students was more likely to be higher than (rather than equal to or lower than) the prevalence among heterosexual students for behaviors in eight of the 10 risk behavior categories (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management). Across the 12 sites that assessed sex of sexual contacts, the prevalence among students who had sexual contact with both sexes was higher than the prevalence among students who only had sexual contact with the opposite sex for a median of 71.1% of all the risk behaviors measured, and the prevalence among students who only had sexual contact with the same sex was higher than the prevalence among students who only had sexual contact with the opposite sex for a median of 29.7% of all the risk behaviors measured. Furthermore, the prevalence among students who had sexual contact with both sexes was more likely to be higher than (rather than equal to or lower than) the prevalence among students who only had sexual contact with the opposite sex for behaviors in six of the 10 risk behavior categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, and weight management). The prevalence among students who only had sexual contact with the same sex was more likely to be higher than (rather than equal to or lower than) the prevalence among students who only had sexual contact with the opposite sex for behaviors in two risk behavior categories (behaviors related to attempted suicide and weight management). Sexual minority students, particularly gay, lesbian, and bisexual students and students who had sexual contact with both sexes, are more likely to engage in health-risk behaviors than other students. Effective state and local public health and school health policies and practices should be developed to help reduce the prevalence of health-risk behaviors and improve health outcomes among sexual minority youths. In addition, more state and local surveys designed to monitor health-risk behaviors and selected health outcomes among population-based samples of students in grades 9-12 should include questions on sexual identity and sex of sexual contacts.
Article
Significantly compromised health care delivery and adverse health outcomes are well documented for the lesbian, gay, bisexual, and transgender (LGBT) community in the United States compared with the population at large. LGBT individuals subject to societal prejudice in a heterosexist world also suffer from the phenomenon known as "minority stress," with its attendant negative mental and physical health effects. Reports in the medical and social science literature suggest that legal and social recognition of same-sex marriage has had positive effects on the health status of this at-risk community. Improved outcomes are to be expected because of the improved access to health care conferred by marriage benefits under federal or state law and as a result of attenuating the effects of institutionalized stigma on a sexual minority group.
Article
Relatively little is known about how parents influence the health and well-being of lesbian, gay, and bisexual (LGB) adolescents and young adults. This gap has led to a paucity of parent-based interventions for LGB young people. A systematic literature review on parental influences on the health of LGB youth was conducted to better understand how to develop a focused program of applied public health research. Five specific areas of health among LGB young people aged 10-24 years old were examined: (a) sexual behavior; (b) substance use; (c) violence and victimization; (d) mental health; and (e) suicide. A total of 31 quantitative articles were reviewed, the majority of which were cross-sectional and relied on convenience samples. Results indicated a trend to focus on negative, and not positive, parental influences. Other gaps included a dearth of research on sexual behavior, substance use, and violence/victimization; limited research on ethnic minority youth and on parental influences identified as important in the broader prevention science literature; and no studies reporting parent perspectives. The review highlights the need for future research on how parents can be supported to promote the health of LGB youth. Recommendations for strengthening the research base are provided.
Article
We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults. On the basis of previously collected in-depth interviews, we developed quantitative scales to assess retrospectively in young adults the frequency of parental and caregiver reactions to a lesbian, gay, or bisexual sexual orientation during adolescence. Our survey instrument also included measures of 9 negative health indicators, including mental health, substance abuse, and sexual risk. The survey was administered to a sample of 224 white and Latino self-identified lesbian, gay, and bisexual young adults, aged 21 to 25, recruited through diverse venues and organizations. Participants completed self-report questionnaires by using either computer-assisted or pencil-and-paper surveys. Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence. This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults. Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.
Article
The present study surveyed male gay couples to determine how their relationships began and were maintained, the types of conflict they experienced, and how the issues of monogamy, sexual behavior and AIDS affected the relationships. Ninety-two couples responded to the survey. The gay bar was the most common initial meeting place and relationships had lasted from less than one to 35 years. Few had had a commitment ceremony, although many reported wanting one if it were available. Most of the close friends of respondents were also gay couples and about two-thirds of family members were supportive of the relationship. The most persistent conflicts centered around finances and relations with family members. Virtually all respondents described their relationships as monogamous, but only about half practiced safe-sex. More attention needs to be given to understanding male couples and to targeting AIDS-prevention messages to them.
Article
This study was a survey of 402 parents of gay and lesbian children from the northeastern, southern, midwestern, and western regions of the United States. Of particular interest was parental response to the knowledge of their child's homosexuality and the AIDS outbreak. Although parents suffered emotional upset upon learning of their children's homosexuality, many progressed through a five-stage grief process that ended with acceptance. Fear of the spread of AIDS, that their offspring might contract AIDS, or that their child might suffer from the backlash related to AIDS were concerns for most parents. Attitudes toward AIDS were not very different between mothers and fathers. However, older parents were more likely to have more positive attitudes toward AIDS than younger parents, and liberal parents were more likely to have a more positive outlook than their conservative counterparts.
Article
The present study investigated relations between lesbians' disclosure of their sexual orientation and psychological adjustment. The 499 participants responded to a questionnaire assessing level of self-disclosure, sources of social support, forms of socializing, self-description of sexual orientation, and length of self-identification as a lesbian. The more widely a woman disclosed her sexual orientation the less anxiety, more positive affectivity, and greater self-esteem she reported. Degree of disclosure to family, gay and lesbian friends, straight friends, and co-workers was related to overall level of social support, with those who more widely disclosed reporting greater levels of support. Participants who more widely disclosed their sexual orientation were less likely to engage in anonymous socializing, had a larger percentage of lesbian friends, and were more involved in the gay and lesbian community. Path analyses revealed a mediating effect of social reactions (both initial and current) on the relation between identity development and self-disclosure.
Article
Lesbian, gay, and bisexual youngsters, aged 14-21 and living at home, were studied for patterns of disclosure of sexual orientation to families. Three-quarters had told at least one parent, more often the mother than the father. Those who had disclosed were generally more open about their sexual orientation than those who had not, and few of the nondisclosed expected parental acceptance. Those who had disclosed reported verbal and physical abuse by family members, and acknowledged more suicidality than those who had not "come out" to their families.
Article
‘Coming out’ as a life transition: homosexual identity formation and its implications for health care practice This paper explores the formation of homosexual identity through the complex transitional process of ‘coming out’. Linear developmental models are discussed as is the influence of societal norms on identity formation. In considering the implications for professional practice the author challenges the heterosexism in health care and suggests ways in which health care professionals can provide a supportive environment for gay men and lesbians.
Article
It is considered psychologically healthy for lesbians and gay men to come out and live outside of the closet. However, parents tend to react with shock, disappointment, and shame when they learn of a son's or daughter's gay sexual orientation. Disclosure often precipitates a painful family crisis, which can lead to cutoffs between members. This article describes family therapy theories and interventions that can aid therapists in sheparding families through the initial stages of the coming-out crisis. Family therapists are advised to acknowledge and address the distinct emotional needs of coming-out individuals and their parents. Parents must grieve and obtain accurate information about gay lifestyles. Lesbians and gay men need support as they struggle to cope with their parents' negative reactions. Family members should be coached to maintain non-combative communication following the disclosure, even if contacts are initially brief and superficial. Case examples, drawn from the author's clinical work, will demonstrate how to address the separate needs of lesbians, gay men, and their parents while maintaining (or rebuilding) family relationships and ultimately guiding families toward successful resolution of this crisis.
Article
This article challenges the popular assumption that coming out to family of origin is important for lesbians and gay men's mental health and couple relationships. First, I present theory emphasizing the unique position of lesbians/gays in families of origin and the significance of "families of choice." Second, I review the quantitative research on social support received by lesbians/gays from family of origin, friends, and other social network sources. Third, I demonstrate how the dominant clinical opinion about coming out to family is based on an unwarranted use of theory developed for heterosexuals and on overgeneralization of findings from studies of white, upper-middle-class, North American lesbians/gays. Fourth, I propose five determinants of lesbian/gay persons' decisions to come out to family-of-origin members. Fifth, I argue that such decisions are constrained by "realistic" costs/benefits in various sociocultural niches rather than being a simple function of individuals' levels of differentiation. Lastly, I offer an expanded contextual stance for the family therapist working with lesbian/gay clients.
Article
High-risk behaviors (e.g., physical inactivity, cigarette smoking, and drinking and driving) and lack of preventive health care (e.g., screening for cancer) are associated with morbidity and mortality from chronic disease and injury. The Behavioral Risk Factor Surveillance System (BRFSS) collects state-specific information to determine the prevalence of such behaviors and preventive practices. By using the BRFSS, states can gain a better understanding of the factors that have a major affect on the health of their adult populations. The BRFSS is also used to monitor progress toward national health objectives. 1996 and 1997. The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged 18 years) population. In both 1996 and 1997, 50 states, the District of Columbia, and the Commonwealth of Puerto Rico participated in the BRFSS. As in previous years, state- and sex-specific variations occurred in the prevalence of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. For example, in 1997, the percentage of adults who reported being current cigarette smokers ranged from 13.8% to 30.7% among states (median: 23.2%), and the percentage of adults who reported driving after drinking too much alcohol ranged from 0.6% to 5.3% (median: 1.9%). Binge drinking varied substantially not only by state (range: 6.3%-23.3%; median: 14.5%) but also by sex (men: 22.3%; women: 6.7%). Similarly, the prevalence of overweight varied considerably by sex: 62.2% of men and 44.5% of women were overweight in 1997. The 1996 and 1997 BRFSS data demonstrate that U.S. adults engage in behaviors that are detrimental to their health. The data also demonstrate that many adults are making efforts to prevent chronic disease and injury. The prevalence of certain behaviors and health practices differs between states and between men and women. The reasons for these differences by state and sex are subjects for further analysis, but only through continued surveillance can the areas that need further study be identified. Data from the BRFSS are useful in developing and guiding public health programs and policies. For many states, the BRFSS is the only source of state-level data on behaviors and practices related to chronic disease and injury; therefore, BRFSS data are vital for effective decision-making at the local level. States will continue to use these data to help prevent premature morbidity and mortality among their adult population and to assess progress toward national health objectives.
Article
This exploratory study applied grounded theory methodology to examine what coupled gay men thought were the relationship impacts of being out to parents and in-laws. Data were collected from an accidental sample of 40 men in 20 homosexual couples using a standardized, open-ended interview. Virtually all of the respondents who had come out to their parents experienced initial and ongoing parental and in-law disapproval for their lifestyles and relationships. However, most men believed that it benefitted their unions to be out to their parents and partner's parents. Not having to hide the relationship was seen as a primary relationship advantage. Inclusion of one's partner in family events also emerged as a significant benefit. In contrast to the existing literature, a large proportion of respondents believed that parental/in-law antagonism had no adverse impacts on their dyads. They shielded their relationships by maintaining a strong sense of independence and in turn solid intergenerational boundaries. This study provides evidence to suggest that disclosure of sexual orientation to parents may be a distinctive, important developmental task for gay men which is critical to their relationships with their partners. Based on the findings of this research, mental health practitioners would be advised to assist gay men in the establishment and maintenance of strong intergenerational boundaries to protect their unions from parental/in-law disapproval.
Article
In the United States, disparities in risks for chronic disease (e.g., diabetes, cardiovascular disease, and cancer) and injury exist among racial and ethnic groups. This report summarizes findings from the 1997 Behavioral Risk Factor Surveillance System (BRFSS) of the distribution of access to health care, health-status indicators, health-risk behaviors, and use of clinical preventive services across five racial and ethnic groups (i.e., whites, blacks, Hispanics, American Indians or Alaska Natives, and Asians or Pacific Islanders) and by state. 1997. The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged > or = 18 years) population. In 1997, all 50 states, the District of Columbia, and Puerto Rico participated in the BRFSS. Variations in risk for chronic disease and injury among racial and ethnic groups exist both within states and across states. For example, in Arizona, 11.0% of whites, 26.2% of Hispanics, and 50.5% of American Indians or Alaska Natives reported having no health insurance. Across states, the median percentage of adults who reported not having this insurance ranged from 10.8% for whites to 24.5% for American Indians or Alaska Natives. Other findings are as follows. Blacks, Hispanics, American Indians or Alaska Natives, and Asians or Pacific Islanders were more likely than whites to report poor access to health care (i.e., no health-care coverage and cost as a barrier to obtaining health care). Blacks, Hispanics, and American Indians or Alaska Natives were more likely than whites and Asians or Pacific Islanders to report fair or poor health status, obesity, diabetes, and no leisure-time physical activity. Blacks were substantially more likely than other racial or ethnic groups to report high blood pressure. Among all groups, American Indians or Alaska Natives were the most likely to report cigarette smoking. Except for Asians or Pacific Islanders, the median percentage of adults who reported not always wearing a safety belt while driving or riding in a car was > or = 30%. The Papanicolaou test was the most commonly reported screening measure: > or = 81% of white, black, and Hispanic women with an intact uterine cervix reported having had one in the past 3 years. Among white, black, and Hispanic women aged > or = 50 years, > or = 63% reported having had a mammogram in the past 2 years. Approximately two thirds of white, black, and Hispanic women aged > or = 50 years reported having had both a mammogram and a clinical breast examination in the past 2 years; this behavior was least common among Hispanics and most common among blacks. Screening for colorectal cancer was low among whites, blacks, and Hispanics aged > or = 50 years: in each racial or ethnic group, < or = 20% reported having used a home-kit blood stool test in the past year, and < or = 30% reported having had a sigmoidoscopy within the last 5 years. Differences in median percentages between racial and ethnic groups, as well as between states within each racial and ethnic group, are likely mediated by various factors. According to published literature, socioeconomic factors (e.g., age distribution, educational attainment, employment status, and poverty), lifestyle behaviors (e.g., lack of physical activity, alcohol intake, and cigarette smoking), aspects of the social environment (e.g., educational and economic opportunities, neighborhood and work conditions, and state and local laws enacted to discourage high-risk behaviors), and factors affecting the health-care system (e.g., access to health care, and cost and availability of screening for diseases and health-risk factors) may be associated with these differences. ACTION TAKEN: States will continue to use the BRFSS to collect information about health-risk behaviors among various racial and ethnic groups. (ABSTRACT TRUNCATED)
Article
A model is proposed and explored that links the coming-out process to the psychological functioning (i.e., self-esteem and distress) and sexual behaviors of gay, lesbian, and bisexual youths recruited from gay-focused community-based and college organizations in New York City. The coming-out process is multidimensional, consisting, as defined here, of involvement in gay/lesbian activities, attitudes toward homosexuality, comfort with homosexuality, self-disclosure of sexual identity to others, and sexual identity. The coming-out dimensions were related to self-esteem, distress, and unprotected sexual behaviors. In addition, the relations between the coming-out dimensions and unprotected sexual behaviors were explained by psychological functioning. In particular, limited involvement in gay/lesbian activities was associated with more unprotected sex. Negative attitudes toward homosexuality were related directly to more unprotected sex, and they were related indirectly to more unprotected sex by means of increasing emotional distress. These and other findings have implications for designing preventive interventions to increase the youths' psychological functioning and reduce their unprotected sexual behaviors.
Article
The longitudinal relations between gay-related stress (i.e., gay-related stressful events, negative attitudes toward homosexuality, and discomfort with homosexuality) and emotional distress (i.e., anxious symptoms, depressive symptoms, and conduct problems) were examined at 3 assessment periods (baseline, 6 months, and 12 months) among 140 gay, lesbian, and bisexual (GLB) youths. Although some findings were consistent with the hypothesis that stress would be associated with subsequent distress among GLB youths, the larger number of nonsignificant relations and the presence of relations between distress and subsequent gay-related stress indicate that the hypothesis was unsupported. The authors discuss the potential reasons for the lack of hypothesized relations and offer suggestions for future research.
Article
The decision whether to disclose same-sex attractions to parents was explored through in-depth interviews with 164 young women and men. Participants were more likely to disclose to mothers than fathers, usually around age 19 years and in a face-to-face encounter. Mothers were told before fathers, largely because mothers asked or because youth wanted to share their life with them; fathers were told by someone other than their child or by the youth because it was time. The reason participants did not disclose to mothers was because it was not the right developmental time; the reason they did not disclose to fathers was because they were not close to them. Sons, more than daughters, feared the negative reactions of parents, who generally reacted in the same manner--supportive or slightly negative. Relationships with parents since disclosure generally had not changed or had improved. Sex of parent mattered more than sex of child on most domains.
Two-hundred and twenty participants recruited through multiple sampling strategies completed a self-report questionnaire examining: (a) whether internalized homophobia predicts depressive and anxious symptoms, suicide, and substance abuse; and (b) the periods of gay-identity development which were particularly risky for suicide. Results indicate that internalized homophobia, particularly negative feelings towards one's own homosexuality (as measured by the Self subscale of the Nungesser Homosexual Attitudes Inventory), accounts for 18% of the variance in depressive scores and 13% of anxiety scores (using the Beck inventories). Internalized homophobia did not predict suicide independently from depression. The period of greatest risk for both suicidal ideation and suicide attempts was the period of disclosure of one's homosexuality to one's immediate family.