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Satisfaction and Health Within Four Sexual Identity Relationship Options

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Using a sample of 1,782 same-sex attracted (SSA) and lesbian, gay, and bisexual (LGB) identified participants, this study examined similarities and differences among those who are (a) single and celibate (SC); (b) single and not celibate (SNC); (c) in a heterosexual, mixed-orientation relationship (MOR); and (d) in a same-sex relationship (SSR). To reduce bias and increase generalizability, an ideologically diverse research team was formed. Participants in SSRs reported higher levels of some amount of satisfaction with their status (95%) compared to those in MORs (80%), those who are SC (42%) and those who are SNC (40%). The SSR group had the least depression and anxiety and the most life satisfaction and physical health, followed by the MOR group, followed by the two single groups. Results from a stepwise regression predicting satisfaction from important aspects of life and relationships identified that meeting needs for connection, intimacy, and mutual understanding was the strongest predictor of satisfaction across all options. Other significant variables included participant-defined authentic sexual expression, resolving conflicts with religion, and reducing depression and anxiety. Results may inform SSA/LGB individuals who are questioning which option fits best for them and help guide therapists who work with these individuals.
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Running Head: SATISFACTION WITHIN FOUR OPTIONS
Satisfaction within Four Sexual Identity Relationship Options
G. Tyler Lefevor,1 A. Lee Beckstead,2 Ron Schow,3 Marybeth Raynes,2
Ty R. Mansfield,2 & Christopher H. Rosik4,5
1 Rhodes College, 2 Independent Practice, 3 Idaho State University,
4Fresno Pacific University, 5Link Care Center
Author Note
Findings were previously presented at the August 2017 annual meeting of Sunstone
Education Foundation, Salt Lake City, Utah.
Correspondence concerning this article should be addressed to Lee Beckstead, 1433
South 1100 East, Salt Lake City, Utah 84105. Contact: leebeckst@yahoo.com
We would like to acknowledge the help of Jim Smithson and Gary Horlacher who were
part of our team effort in the beginning.
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ABSTRACT
Using a sample of 1782 same-sex attracted (SSA) and lesbian, gay, and bisexual (LGB)
identified participants, this study examined similarities and differences between those who
are (a) single and celibate (SC); (b) single and not celibate (SNC); (c) in a heterosexual, mixed-
orientation relationship (MOR); and (d) in a same-sex relationship (SSR). To reduce bias and
increase generalizability, an ideologically diverse research team was formed. Participants in
SSRs reported higher levels of some amount of satisfaction with their status (95%) compared to
those in MORs (80%), those who are SC (42%) and those who are SNC (40%). The SSR group
had the least depression and anxiety and the most life satisfaction and physical health, followed
by the MOR group, followed by the two single groups. Results from a stepwise regression
predicting satisfaction from important aspects of life and relationships identified that meeting
needs for connection, intimacy, and mutual understanding was the strongest predictor of
satisfaction across all options. Other significant variables included participant-defined authentic
sexual expression, resolving conflicts with religion, and reducing depression and anxiety. Results
may inform SSA/LGB individuals who are questioning which option fits best for them and help
guide therapists who work with these individuals.
Keywords: LGBTQ, celibacy, mixed orientation relationship, psychotherapy, religion
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Satisfaction and Health within Four Sexual Identity Relationship Options
Decision-making about relationship options can be difficult for sexual minorities who
experience conflict between their religious, racial/ethnic, and other cultural identities (American
Psychological Association [APA], 2009). Most cultures and families have rules about what is
sexually appropriate and inappropriate, and these norms may facilitate or inhibit exploration,
self-awareness, self-acceptance, health, and options (C. Ryan, Russell, Huebner, Diaz, &
Sanchez, 2010; W.S. Ryan, Legate, Weinstein, & Rahman, 2017). Some families and
communities maintain strict standards for membership. Currently, many traditional religions
expect heterosexual marriage or celibacy as the only acceptable options to maintain membership
and live in accordance with traditional ideals about sexual holiness. Some traditional religions
promise afterlife rewards only to those who are heterosexually married or who are single and
sexually abstinent. These expectations assume that all same-sex attracted (SSA) individuals can
live satisfactorily without a partner or within a heterosexual relationship. In contrast, many
people promote messages that all SSA individuals should be “true to themselves” and live openly
in same-sex relationships (Stack, 2018).
Many SSA individuals do not adopt a lesbian, gay, or bisexual (LGB) identity because
they prioritize their other-sex attractions, do not act on their same-sex attractions, and/or do not
see themselves reflected in the LGB social-identity labels (Yarhouse, Tan, & Pawlowski, 2005).
Limited information is available about SSA individuals who do not identify as LGB because
sexual minority research typically focuses on LGB-identified people and their lives (Bailey,
Vasey, Diamond, Breedlove, Vilain, & Epprecht, 2016). In this article, we will use SSA to
indicate all those who experience some degree of same-sex attraction, regardless of how they
identify, and LGB to indicate those who have adopted this social identity.
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Conflicts between a sexual minority identity and conservative social and religious
identities can create emotional pain (Bourn, Frantell, & Miles, 2018) and suicidal ideation (Gibbs
& Goldbach, 2015). This distress may be due to the internalization of negative attitudes and
discrimination toward homosexuality (Sowe, Brown, & Taylor, 2014) and the person’s inability
to deal effectively with rejection and stigma (Herek, Gillis, & Cogan, 2009). Often on their own,
those who experience SSA must determine whether to (a) identify openly as LGB, seek same-sex
relationships, and potentially be rejected by conservative communities or (b) variously identify
and hope to find someone to whom they are sufficiently attracted and enter into a heterosexual,
mixed-orientation relationship (MOR), or remain single and attempt sexual abstinence. These
may not be equal options; that is, not everyone may find a relationship that they prefer, feel safe
enough to choose to be in a same-sex relationship, or feel satisfied being single (Beckstead &
Morrow, 2004).
Although some SSA/LGB individuals can live satisfying lives in a mixed-orientation
marriage or celibacy, others do so only for a period of time (Kays, Yarhouse, & Ripley, 2014;
Shidlo & Schroeder, 2002). For some, trying to live up to marital or celibacy expectations, for
approval, belonging, and religious rewards, leads them to promise or attempt something that they
cannot obtain or maintain in the long-term (Beckstead & Morrow, 2004; Pachankis &
Hatzenbuehler, 2013). Some who do not adopt an LGB identity and are married heterosexually
may live secret and potentially dissociated lives to manage attractions and conservative norms
(Rosenmann & Safir, 2007). Some research suggests a high rate of infidelity and divorce for
those in mixed-orientation marriages (Dehlin, Galliher, Bradshaw, & Crowell, 2014), and those
in same-sex relationships may face unique problems from social stigma (Doyle & Molix, 2015).
Research has shown that there are potential mental health benefits of spiritual and
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religious beliefs and practices, particularly when they facilitate a positive identity, personal
agency, integrity, faithfulness in intimate relationship, kinship and belongingness, community,
and health and human welfare values (Richards & Bergin, 2000). Positive religious coping can
weaken the negative effects of internalized heterosexism on psychological well-being (Brewster,
Velez, Foster, Esposito, & Robinson, 2016). Negative religious coping in contrast can mediate
the relationship between internalized heterosexism and emotional suffering (Bourn et al., 2018).
Sample limitations in the existing literature make many research findings tentative and
not confidently generalizable to the population of religiously conservative persons with SSA
(Cranney, 2017a; Dehlin et al., 2014; Joseph & Cranney, in press). Bias or at least an incomplete
understanding can be introduced into the data because sample recruitment is often limited to the
social, clinical, and professional networks of the researchers, the overwhelming majority of
whom are politically left-of-center. These researchers are not likely to have access to the smaller
support and therapy networks of religiously conservative persons experiencing same-sex
attractions, particularly those for whom MORs and celibacy may be experienced as healthy,
adaptive, or satisfying options.
The need for more empirical support to inform the guidance offered to sexual minorities
across the ideological spectrum faced with relationship decisions cannot be overstated. The
present study seeks to offer additional guidance. The survey’s premise was based on the
grounded theory developed from the second author’s qualitative research (masked reference) that
described many variables that helped and harmed SSA/LGB individuals to resolve their distress
with their attractions. In this sample, the more variables related to self-acceptance and a positive
self-identity that participants endorsed, the more satisfied they seemed, regardless of relationship
option. The current study’s authors were interested in knowing which variables are important for
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satisfaction in being single and celibate (SC); single and not celibate (SNC); in a heterosexual,
mixed-orientation relationship (MOR); or in a same-sex relationship (SSR). Collectively, these
four sexual identity statuses will hereinafter be referred to as relationship options.
Method
Research Team
To reduce bias and increase generalizability, 30 diverse scholars provided feedback on
the questions and then two pilot studies were conducted (N = 81, N = 366). It was clear from this
feedback that the LGB-affirmative research team would likely not reach conservative SSA
communities unless conservative researchers were integrated into the research team at all stages
of the research. It was hoped that a respectful collaboration (Kahneman, 2003) and collaborative
inquiry of differing, even opposing, ideologies would increase critical thinking and reliability,
encourage a more diverse and representational sample of SSA individuals, and make coauthors
accountable for how results are shared (Rosik, Jones, & Byrd, 2012).
All authors uphold the APA’s position on working with sexual minorities and respecting
religious practices (APA, 2008, 2012). Most authors identify as SSA/LGB, and all authors value
self-determination for SSA/LGB individuals. Five authors were raised in traditional religions,
and five are currently active in a traditional religion. All authors work closely with SSA/LGB
individuals from traditional religious backgrounds in their professional and/or personal roles and
have been involved in supporting the SSA/LGB community.
Survey Design
Participants completed the survey online through a website designed for the survey
(4OptionsSurvey.com) that directed users to Survey Monkey to collect data securely. Upon entry
to the web platform, participants were told that they would be taking part in a survey that was
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designed to identify important aspects of life and relationships for those who experience (or have
experienced) same-sex attractions and identify as LGB, heterosexual, with another sexual
identity, or who reject a label, and compare experiences based on the four relationship options.
Participants were told that they could withdraw participation at any point in the survey and
provided informed consent to participate in the study.
The 4 Options Survey consisted of three sections. The first section comprised of 22
questions including basic demographics, sexual identity, religious affiliation, and ratings of
depression, and anxiety. The second section comprised of 75 questions covering 10 domains:
satisfaction with relationship option, companionship and sexuality, social support and group
resources, internal strength and self-direction, satisfaction in being single or in a relationship,
changes in sexuality, values, attitudes about SSA/LGB individuals, eroticism, and
religious/spiritual identity. The survey was advertised as taking about 30 to 40 minutes to
complete. An optional additional section comprised 112 questions examining elements of the 10
domains in greater detail as well as relationship skills and sexual orientation change efforts.
Procedure
Data collection and recruitment. We obtained approval from the Idaho State
Institutional Review Board prior to commencing this study. Data collection occurred over a 10-
month period (September 2016 to June 2017) during a polarized political time that included
President Donald J. Trump’s election. As previous studies of SSA/LGB individuals from socially
conservative backgrounds have been criticized for having small or biased samples, several
measures were employed to obtain a large and more representative sample. Study authors
collectively identified news outlets, affinity groups, and community centers that would reach
LGB/SSA individuals raised in conservative contexts. Although the selection of recruitment
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forums was inevitably biased by the research teams’ views and connections, the construction of a
politically diverse research team helped identify potential blind spots. Journalists were contacted,
and an article about the research was run in the Salt Lake Tribune, the LDS Living Magazine, and
the Online Religion News Source, with a recruitment invitation for participation. Overall, 18.9%
of our participants reported hearing about the study through these media.
Participants were obtained via recruitment announcements made in various fora for
SSA/LGB individuals with many having reported experiencing conservative social environments
including annual conventions of Affirmation, North Star, and the Alliance for Therapeutic
Choice and Scientific Integrity. Additional recruitment announcements were made in similarly
themed online groups including Gay Jehovah’s Witnesses, Mormons Building Bridges, and
Brothers on a Road Less Traveled (formerly known as People Can Change). Research team
members sent announcements through various email listservs and to personal connections to
increase the visibility of the study. Nonreligious organizations were also contacted, and many
sent out a request for participation in our study to their email lists, Facebook groups, or national
conventions. These included LGB student groups at universities in Utah, APA’s Society for the
Psychological Study of Sexual Orientation and Gender Diversity, the LGBTQ Therapist Guild of
Utah, the National Association for Social Work, the Utah Pride Center, and the Institute for the
Study of Sexual Identity. A total of 46.9% of our sample heard about our study through an
organization or website, and 14.2% reported hearing about the study from a mental health
provider. Snowball sampling was also used to alert additional potentially interested participants.
In total, 30.0% of our sample reported hearing about the study through a friend/family member.
Previous studies of SSA/LGB individuals from conservative social backgrounds have
primarily been conducted by heterosexual authors who contacted leaders of support groups to
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encourage participation. In contrast, the present study was conducted mostly by individuals who
have experienced SSA or identify as LGB. In addition, some members of the research team hold
leadership roles or are well respected in both liberal and conservative organizations such as
North Star, the Alliance for Therapeutic Choice and Scientific Integrity, Affirmation, and the
LGBTQ Therapist Guild of Utah. This representation may have encouraged participants to feel
like their perspectives would be represented and understood. Indeed, over half of our participants
(53.9%) reported current involvement in a conservative relationship option (single and celibate,
mixed-orientation relationship), which is underrepresented in the broader body of research.
Further, we asked at the end of the survey how much the study represented participants’
viewpoint and direction of life about being single or in a relationship. Of those who answered,
17% indicated “moderately,” 51% indicated “mostly,” and 15% indicated fully.
Participants
To be included in analyses, participants must have (a) been at least 18 years of age; (b)
experienced same-sex attractions at some point in their life; (c) identified their relationship
option as SC; SNC; in a MOR; or in a SSR; and (d) completed the first two sections of the
survey. We defined SC as “committed to not acting sexually with another person” and a MOR as
“one partner is heterosexual and the other is same-sex attracted/LGB.”
In total, 1782 participants met our first three inclusion criteria, but only 1499 participants
completed the required sections. Due to the large number of participants, we used listwise
deletion to account for missing data. We compared those who did and did not complete the
second section of the survey to see if those who completed the survey differed significantly from
those who started but dropped out of the survey. We found that these two samples did not differ
significantly on ethnicity (χ2(8) = 13.21, p = .11), urbanicity (χ2(4) = 5.86, p = .21), education
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(χ2(6) = 5.04, p = .54), relationship option (χ2(3) = .38, p = .94) or age (t(2327) = 1.41, p = .74).
The two groups differed significantly in gender (χ2(12) = 54.58, p < .01) with the baseline
sample having a higher percentage of women (36.5%) and a lower percentage of men (56.7%)
than the completer sample (women = 23.3%, men = 70.4%). As most analyses used only
variables from the first section of the survey, we use the sample of 1782 for all analyses unless
otherwise noted. Participant demographics are displayed in Table 1.
Measures
The survey included both measures specifically designed for this study as well as pre-
existing measures and was designed to provide data to inform several studies. Due to a desire to
understand the experiences of SSA/LGB from conservative social backgrounds, some questions
were created by the study authors as existing measures were not inclusive of individuals from
conservative backgrounds.
Internalized Homonegativity. Internalized homonegativity was assessed using the
three-item internalized homonegativity subscale from the Lesbian, Gay, and Bisexual Identity
Scale (Mohr & Kendra, 2011). The authors report an internal consistency of .86 and a test-retest
reliability of .92. Cronbach’s alpha for the present study was .89.
Depression. Current depression was measured using the Patient Health Questionnaire
(PHQ-9; Kroenke, Spitzer, & Williams, 2001). The PHQ-9 has good concurrent validity with the
Short Form-20 (SF-20) and diagnosis of major depressive disorder (Kroenke et al., 2001).
Cronbach’s alpha for the present study was .89
Anxiety. Current anxiety was measured using the Generalized Anxiety Disorder 7-item
(GAD-7) scale (Spitzer, Kroenke, Williams, & Löwe, 2006). The GAD-7 has good concurrent
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validity with the SF-20 and diagnosis of generalized anxiety disorder (Spitzer et al., 2006).
Cronbach’s alpha for the present study was .92.
Life Satisfaction. Life satisfaction was measured using the Satisfaction with Life Scale
(SWLS), which is a five-item scale with a two- month test-retest reliability of .82 (Diener,
Emmons, Larsen, & Griffin, 1985). Cronbach’s alpha for the present study was .89.
Sexual Attraction. Sexual attraction was measured through Kinsey, Pomeroy, and
Martin’s (1948) Heterosexual-Homosexual Rating Scale. Responses were scored on a 7-point
scale from “exclusively heterosexual” to “exclusively homosexual” with two additional non-
scored options of “asexual” and “you don’t have an option that applies to me.”
Physical Health. Physical health was assessed with a single item, “I am physically
healthy,” scored on a 7-point scale from “strongly disagree” to “strongly agree.”
Sense of Self. Participants indicated their agreement with the statement, “I have a clear
and definite sense of who I am and what I’m all about,(Flury & Ickes, 2007) on a 7-point scale
from “strongly disagree” to “strongly agree.”
Social Desirability. Social desirability was assessed through four true-false questions
commonly used to control for socially desirable responding (Schumm, 2015). True responses
were aggregated such that a higher score on these four items indicated greater social desirability.
Attitudes to Sexuality and Connection. Participants’ attitudes toward masturbation,
sexual expressivity, and sexual disgust were assessed through the following items: “I feel it’s
okay for me to masturbate”; “I express my sexuality in ways that feel best for me”; and “I think
sex, whether with a man or woman, is mostly dirty, scary, and/or disgusting.” Responses were
rated on a 7-point scale from “strongly disagree” to “strongly agree.” Participants’ subjective
sense of being resolved religiously was assessed by their agreement with “I feel resolved about
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my sexuality and religious issues”, rated from “strongly disagree” to “strongly agree” with the
option for “N/A.” Meeting connection needs was measured through agreement with the
statement, “I meet my needs for connection, intimacy, and mutual understanding” on a 7-point
scale from “never” to “always.”
Relationship Option and Satisfaction. Participants indicated their satisfaction with their
relationship option by responding to “How satisfied are you overall in the single or relationship
status indicated?” on a 7-point scale from “very dissatisfied” to “very satisfied.” If participants
were in a relationship, they were asked to differentiate their satisfaction with this relationship
from their satisfaction with the relationship option in general.
Results
Satisfaction in Relationship Options
We first examined whether a number of variables including age, gender, ethnicity, social
desirability, length of time in the option, and number of children, differed significantly between
relationship options. For those that differed, we examined their relationship with satisfaction to
determine if they should be used as covariates in subsequent analyses. Chi squared analyses
indicate that relationship options were equally distributed across ethnicity (χ2(24) = 27.45, p =
.28) and gender (χ2(9) = 12.87, p = .17). Social desirability (F(3, 1581) = 8.07, p < .01, η2 = .02),
age (F(3, 1778) = 23.47, p < .01, η2 = .04), Length of Time in Option (F(3, 1778) = 74.02, p <
.01, η2 = .11), and the number of children (F(3, 1778) = 203.28, p < .01, η2 = .26) were related to
relationship option. Post-hoc tests on number of children indicated that the MOR group reported
having substantially more children than all other groups (SC MD = 2.26, p < .01, d = 1.34; SNC
MD = 2.02, p < .01, d = 1.15; SSR MD = 1.87, p < .01, d = 1.04). Number of children, however,
was not included as a covariate due to its confound with relationship option. Age and social
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desirability were not related to satisfaction (Age: r = .04, p = .13; Social Desirability: r = .04, p =
.14), but Length of Time in Option was related to satisfaction (r = -.06, p < .05), and Length of
Time in Option is included as a covariate in subsequent analyses.
We then examined satisfaction, time in option, and the number of children in the four
relationship options (see Table 2). Analyses of variance indicate significant differences in
satisfaction levels between groups (F(4, 1777) = 185.78, p < .01, η2 = .30). Post-hoc analyses
using Tukey’s Highly Significant Differences (HSD) test indicated that all group means differed
significantly (p < .01) with the exception of the difference between the two single groups (MD =
.12, p = .71). Participants in same-sex relationships reported the greatest amount of satisfaction
with their option, followed by those in other-sex relationships, followed by single participants.
Note also that 61% of participants in same-sex relationships reported being “very satisfied”
compared to 28% of participants in other-sex relationships.
Kinsey Attraction by Relationship Option
As the question about sexual attraction was after the first section, the sample of 1499 is
used for these analyses. Kinsey scores differed by option (F(3, 1464) = 64.10, p < .01, η2 = .12;
see Table 3). Post-hoc analyses indicated that all group means differed significantly (p < .01)
with the exception of the means of those in SSRs and SNC individuals (MD = .11, p = .06).
Participants in SSRs and participants who were SNC reported the most same-sex attraction,
followed by those who were SC, followed by those in a MOR. The standard deviations for
participants in MOR and participants who were SC were larger than those of individuals in SSR
or who were SNC, evidencing greater within group variation in attraction in these groups.
Outcomes by Relationship Option
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We examined group differences in anxiety, depression, internalized homonegativity,
physical health, and life satisfaction (see Table 4). Where the omnibus values were significant,
Tukey’s HSD tests were conducted to examine which groups differed. Length of Time in Option
was significantly related to Anxiety (r = -.09, p < .01) and Depression (r = -.08, p < .01) but not
to Internalized Homonegativity (r = .01, p = .58), Life Satisfaction (r = -.02, p = .43), or Physical
Health (r = .03, p = .19). Consequently, Length of Time in Option is included as a covariate only
for analyses of Anxiety and Depression.
Group differences were observed for Anxiety (F(4, 1743) = 10.15, p < .01, η2 = .02).
Post-hoc analyses indicated significant differences only between the same-sex relationship group
and all other groups (SC MD = .26, p < .01; SNC MD = .24, p < .01, MOR MD = .17, p < .01) with
those in SSRs evidencing the lowest levels of Anxiety.
Group differences were observed for Depression (F(4, 1738) = 21.24, p < .01, η2 = .05).
Post-hoc analyses indicated significant differences between all groups except the two single
groups (MD = .04, p = .84) with those in SSRs showing the lowest levels of Depression, followed
by those in MORs, followed by the two single groups.
Group differences were observed for Internalized Homonegativity (F(3, 1508) = 110.98,
p < .01, η2 = .18). Post-hoc analyses indicated significant differences between all groups with
those in SSRs evidencing the lowest levels of Internalized Homonegativity, followed by those
who are SNC, followed by the MOR group, followed by those who are SC.
Group differences were observed for Life Satisfaction (F(3, 1747) = 61.70, p < .01, η2 =
.10). Post-hoc analyses indicated significant differences between all groups with those in SSRs
showing the highest levels of Life Satisfaction, followed by those in MORs, followed by those
identifying as SNC, followed by those identifying as SC.
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Group differences were observed for Physical Health (F(3, 1747) = 7.86, p < .01, η2 =
.01). Post-hoc analyses indicated significant differences between those in a SSR and the two
single groups (SNC MD = .43, p < .01; SC MD = .51, p < .01) as well as between those in a MOR
and those who are SC (MD = .33, p < .05). The trends generally supported those in same-sex or
mixed orientation relationships having higher levels of physical health than the single groups.
Explaining Relationship Option Satisfaction
As psychotherapists who work with SSA/LGB individuals from conservative social
backgrounds are often tasked with counseling individuals who express a strong desire to remain
within a chosen relationship option, we next examined specific variables that may relate to
relationship option satisfaction across options. We included variables representative of the
various aspects represented by the 10 major sections of our survey. Due to a desire to understand
the experiences of SSA/LGB from conservative social backgrounds, some of the questions used
in this section were created by the study authors as existing measures were not inclusive of
individuals from conservative backgrounds. We then examined how these variables may change
depending on the type of option that an individual endorses.
We conducted a simultaneous regression using relationship satisfaction as the dependent
variable and the following as independent variables: Depression, Physical Health, Sense of Self,
Sexual Disgust, Masturbation, Sexual Expression, Internalized Homonegativity, Resolved
Religiously, and Connection Needs Met. As many of these variables were found in the second
section of the survey, we used our sample of 1499 for these analyses. Anxiety was initially tested
as a predictor to include in the model; however, due to multicollinearity with Depression (VIF >
2.5), it was excluded from further analyses. All other variables did not evidence significant
multicollinearity (VIFs < 1.7).
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We tested an overall model for the four groups combined as well as separate models for
each of our relationship options. When testing models for specific relationship options, we
included Kinsey Attraction as an independent variable as an individual’s sexual attraction may
reasonably be believed to be related to satisfaction within a relationship option (i.e., those with
higher levels of other-sex attraction may be more likely to be satisfied in an MOR).
The model derived for the four groups combined explained 39.8% of the variation in
relationship option satisfaction (F(9, 1464) = 109.27, p < .01). Summaries of the overall and
relationship-option-specific models are presented in Table 5. Overall, higher levels of
Connection Needs Met, Resolved Religiously, and Sexual Expression with lower levels of
Depression and Masturbation Acceptable were significantly related to increased satisfaction in
all four relationship options.
The regression model for the SC group explained 35.6% of the variation in relationship
option satisfaction (F(10, 337) = 20.19, p < .01). Higher levels of Resolved Religiously,
Connection Needs Met with lower levels of Depression, Masturbation Acceptable, and
Internalized Homonegativity were related to increased satisfaction.
The regression model for the SNC group explained 29.7% of the variation in relationship
option satisfaction (F(10, 344) = 14.52, p < .01). Higher levels of Connection Needs Met and
Sexual Expression with lower levels of Depression and more other-sex attraction were related to
increased satisfaction.
The regression model for the MOR group explained 37.0% of the variation in relationship
option satisfaction (F(10, 412) = 25.74, p < .01). Higher levels of Connection Needs Met and
Resolved Religiously with lower levels of Depression, Masturbation Acceptable, and more
other-sex attraction were related to increased satisfaction.
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The regression model for the SSR group explained 24.7% of the variation in relationship
option satisfaction (F(10, 307) = 11.39, p < .01). Higher levels of Connection Needs Met and
Sexual Expression were related to increased satisfaction.
Discussion
As our aim is to better understand factors related to four relationship options, we divide
our discussion in two sections. In the first, we highlight the differences between the four
relationship options and discuss factors that may account for the group differences. In the
second, we highlight factors related to relationship option satisfaction across groups and discuss
factors that appear important for individuals in a given group. Done this way, we hope to provide
information both to individuals who want to make a decision about which relationship option fits
for them and to individuals who have already made commitments to a particular option.
Differences in Sexual Identity Relationship Options
Though participants reported all levels of satisfaction within all groups, nearly twice as
many in partnered groups reported feeling satisfied with their option than did participants in the
single groups. Positive romantic relationships have been linked with a host of positive outcomes
(Robles, Slatcher, Trombello, & McGinn, 2014). It is worth noting that participants in MORs
evidenced a relatively high amount of satisfaction in their option, though the amount of other-sex
attraction and having more children may moderate this effect (Cranney, 2017b). The single
groups did not differ significantly in satisfaction with their option.
Between the partnered groups, participants in SSRs reported higher levels of some
amount of satisfaction (95%) compared to participants in MORs (80%), with 61% of participants
in SSRs reporting being “very satisfied” compared to 28% of participants in a MORs. Although
being in a relationship appears to be more satisfying for participants than being single, being in a
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SSR was more satisfying for more of the participants in our sample. For both partnered groups,
the older participants were and longer they had been in a relationship, the less satisfied they were
in their relationship option. Although results indicate that being in a SSR was rated more
satisfactorily for our SSA sample (Table 2), this does not mean that all SSA individuals would be
more satisfied in a SSR or should be counseled to do so, especially as 28% of SSA individuals in
our sample reported being very satisfied in a MOR and 80% reported some level of satisfaction.
These findings contrast with research and social messages that promote one relationship option
for all same-sex attracted individuals (cf. Dehlin et al., 2014).
Satisfaction with one’s relationship option, though helpful, may also be somewhat limited
as it is altogether plausible that someone could be satisfied with an option that causes
psychological distress. For example, people may remain in a relationship that causes distress
because other benefits may outweigh the distress, such as religious faith, emotional or financial
attachments to the partner, and/or family and community benefits. Consequently, we also
examined between-group differences in relationship option satisfaction in anxiety, depression,
life satisfaction, and physical health. Of the four options, the SSR group had the lowest levels of
depression and anxiety and the highest levels of life satisfaction and physical health, followed by
the MOR group, followed by the two single groups. Where post-hoc analyses were significant
between the two single groups, the SNC evidenced better outcomes than the SC group. This
pattern is consistent with what we observed when examining satisfaction alone and supports
research that relationship option has health implications beyond satisfaction (Dehlin et al., 2014).
We examined differences between the four options in sexual attraction to understand
whether participants with a particular pattern of sexual attraction may be drawn to particular
options. We found that participants in SSRs evidenced the most same-sex attraction and
Satisfaction within Four Options
19
participants in MORs evidenced the most other-sex attraction. Further, those who were SNC
evidenced more same-sex attraction than those who were SC. It is possible that more bisexual
participants gravitate toward MORs and celibate lives while those who are exclusively same-sex
attracted may gravitate toward SSRs. Alternatively, this pattern could also be seen as a reporting
bias of participants such that those in SSRs report higher levels of same-sex attraction to
conform with their relationship choice and those in MORs report higher levels of other-sex
attraction to conform with their relationship choice. It is also possible that particular relationship
experiences altered participants’ understandings of their sexual attractions. Further research
needs to be done to better understand the directionality of these relationships.
Understanding Satisfaction within Options
From our regression analyses, we identified several variables that were closely related to
satisfaction across relationship options. Meeting needs for connection, intimacy, and mutual
understanding emerged as the single-most important predictor of satisfaction for all four
relationship options. All four options may face unique minority stigma and stress that can
destabilize relationships (Meyer, 2003) and consequently require their own safe spaces for
connection. Research has linked social support to psychological well-being among stigmatized
groups following the minority stress theory (Hsieh & Ruther, 2016). This support may be
particularly crucial for SSA/LGB individuals from conservative religious backgrounds as many
may have difficulty finding communities that affirm both their sexual and religious identities
(Cranney, 2017a).
Resolving conflict between sexual and religious identities and expressing sexuality in a
way that seems best to the individual were also closely related to satisfaction in our sample and
is unsurprising given the high level of conflict many SSA/LGB individual from conservative
Satisfaction within Four Options
20
religious background experience (Dehlin et al., 2014). Finally, resolving mental health concerns
appears closely related to satisfaction in relationships and is consistent with current literature on
relationships and health-related outcomes (Robles et al., 2014).
For individuals committed to celibacy, the variable most strongly related to satisfaction
with their option was resolving conflicts between their sexuality and religion. Perhaps because,
more than for any other group, a life of celibacy requires a clear understanding and commitment
to certain ideals, this resolution may be particularly paramount (Baumann, Jacobs, & Büssing,
2017). Given a commitment to celibacy in a conservative religious context in which
masturbation is typically not accepted, viewing masturbation as acceptable may constitute a
further religious conflict and may explain its negative relationship with satisfaction. It is also
noteworthy that having less internalized homonegativity emerged as an important predictor of
satisfaction.
For individuals who are SNC, expressing sexuality in ways that feel best and meeting
needs for connection, intimacy, and mutual understanding were related to satisfaction. Reducing
depression or anxiety also emerged as a significant predictor of satisfaction. These factors are
consistent with individuals who are likely seeking emotional intimacy and sexual activity in a
variety of relationships or seeking a primary relationship. Psychotherapists working with
individuals who are SNC may help them explore how to meet needs for connection and express
their sexuality in meaningful ways (Rosenau & Tan, 2002). Because Depression was significant
in our SNC sample, psychotherapists may assess clientsexperiences with depression and any
impact on relationship choices and satisfaction and how their relationship experiences affect their
mood (Spira & Richards, 2003).
Satisfaction within Four Options
21
Participants in MORs indicated that, similar to other groups, meeting needs for
connection, intimacy, and mutual understanding and reducing depression were important. Unlike
other groups, the MOR group evidenced the strongest effect for sexual attraction, with increased
other-sex attraction being related to increased satisfaction in option. Authentic sexual expression
was also strongly related to satisfaction. This is similar to Hernandez, Schwenke, and Wilson’s
(2011) conclusion of bisexual individuals in MORs reporting the greatest satisfaction in a MOR
but often feeling misunderstood by society. Individuals in MORs resembled SC individuals in
several important ways including the relationships between masturbation and resolving religious
conflict and satisfaction. Participants who felt masturbation was acceptable in their relationship
reported decreased satisfaction with their option, which may be because many of these MORs
may be undertaken in a conservative religious context where sexual fidelity may likely exclude
the possibility of solo sexual experiences. Psychotherapists working with clients in a MOR may
explore how much clients’ sexual attraction and ability to express themselves authentically in a
sexual manner, including masturbation, affect their satisfaction in being in a MOR.
For participants in SSRs, meeting needs for connection, intimacy, and mutual
understanding and having an authentic sexual expression were the only two variables uniquely
related to satisfaction. Similar to those in MORs, psychotherapists working with those in SSRs
can explore what constitutes an authentic sexual expression for each client and explore options to
improve relationship quality and examine how these options affect satisfaction and health.
Limitations
Though our study of SSA/LGB individuals is the first of its kind to our knowledge to
incorporate intentionally ideological diversity, the results are necessarily bounded by several
factors. First, our sampling method was not random and certain groups may have been more
Satisfaction within Four Options
22
likely to be included in our study. Although efforts were made to advertise in socially
conservative and liberal arenas as well as in national news sources, some potential participants
may not have participated due to shame around discussing sexuality, lack of involvement with
the groups to which the survey was advertised (Savin-Williams, 2016), and/or distrust of the
ability of psychological research to reflect their perspectives. Our survey necessarily used items
that were created by the authors to capture nuances within this population; future work should
seek to validate items and scales used to enhance the generalizability of the results.
Demographically, the generalizability of our sample is limited as it is comprised
primarily of white men, many of which are from Mormon backgrounds whose relationship
choices fit in one of the four relationship options. Future work should extend our sample and
examine those whose relationships do not fit in these four relationship options. Though the
effects of social desirability were minimal, we also acknowledge the possibility of participants
being motivated to justify their particular life situations to confirm their own ideologies. Finally,
we acknowledge the impossibility of drawing causal comparisons from survey data. It would be
impossible from our data to determine, for example, whether being single may lead to increased
depression or whether people who are more depressed/anxious tend to remain single longer.
Consequently, we strongly caution against a causal interpretation of our data.
Conclusions
With an ideologically diverse sample of 1782 SSA/LGB individuals, this study identified
salient variables that can be used to explore with SSA/LGB individuals who are questioning
which life situation best fits for them as well as help those who wish to remain in one of these
options consider other ways to increase their satisfaction in their current option. This study’s
results counter social assumptions that expect all SSA/LGB individuals to be dissatisfied and
Satisfaction within Four Options
23
unhealthy either in a same-sex relationship or a heterosexual relationship or single status. We
encourage more investigations that involve respectful collaboration between researchers who
hold differing ideological viewpoints about same-sex attractions, especially in understanding the
nuances and spectra of experiences of those who identify as LGB and those who do not.
According to these results, psychotherapy to increase sexual minorities’ satisfaction in
their relationship option, regardless of the option, might explore how to help such clients meet
these six needs: (a) connection, intimacy, and mutual understanding; (b) some form of
relationship commitment; (c) physical or sexual intimacy; (d) authentic sexual expression; (e)
resolution of conflicts with religion; and (f) reduction of depression and anxiety. Psychotherapist
and client can examine how important these six needs are for the client and address any other
concerns affecting satisfaction (e.g., family conflicts).
Satisfaction within Four Options
24
Table 1. Sample Demographics
Sample Size
1782
Current Religious Affiliation
None/Unaffiliated
Female
25.1%
Catholic/Christian
Male
68.7%
Latter-day Saint (Mormon)
Transgender
2.0%
Exploring
Other gender
4.2%
Multiple/Other
Race/ethnicity
Religion Raised In
African American/Black
0.9%
None/Unaffiliated
American Indian/Alaska Native
0.3%
Catholic/Christian
Asian American/Asian
1.3%
Latter-day Saint (Mormon)
Hispanic/Latino/a
3.5%
Multiple/Other
Native Hawaiian/Pacific Islander
0.4%
Sexual Identity
White
90.1%
Heterosexual/SSA/Ex-gay
Multi-ethnic/other
3.5%
Mostly Straight
State/Country of Residence
Bisexual
Northeast
5.8%
Mostly Gay/lesbian
Midwest
5.4%
Gay/lesbian
South
12.0%
Queer/questioning
West
67.4%
Asexual Spectrum
Utah
43.0%
Multiple Options/Other
International
9.3%
Relationship Option
Urbanicity
Single and Celibate
Rural
10.0%
Singe and Not Celibate
Urban
35.4%
Mixed Orientation Relationship
Suburban
44.7%
Same-sex Relationship
Metropolitan
9.8%
Age
Highest Level of Education
18-29
Less than High School Diploma
0.3%
30-39
High School Diploma
25.9%
40-49
Associates Degree
5.9%
50-59
Bachelor’s Degree
35.1%
60-69
Graduate Degree
32.8%
70+
Satisfaction within Four Options
25
Table 2. Satisfaction, Time in Option, and Number of Children by Relationship Option
Scale Value
SC
SNC
MOR
SSR
n = 434
n = 433
n = 522
n = 393
Very dissatisfied
1
7.4%
9.7%
3.4%
0.8%
Dissatisfied
2
21.0%
21.7%
5.4%
1.0%
Slightly dissatisfied
3
17.%
18.2%
7.7%
1.5%
Neutral
4
12.4%
9.9%
3.3%
1.5%
Slightly satisfied
5
12.9%
13.9%
15.5%
7.1%
Satisfied
6
22.6%
20.3%
36.8%
27.5%
Very satisfied
7
6.0%
6.2%
28.0%
60.6%
% Satisfied
41.5%
40.4%
80.3%
95.2%
Satisfaction Mean
3.94
3.82
5.44
6.38
Satisfaction SD
1.80
1.85
1.63
1.04
Age Mean
36.52
36.02
42.78
38.08
Age SD
14.27
14.92
13.45
13.13
Time in Option Mean
12.73
8.48
17.16
8.05
Time in Option SD
11.67
9.58
12.20
8.59
Number of Children Mean
0.35
0.59
2.61
0.73
Number of Children SD
1.26
1.43
2.03
1.55
Satisfaction within Four Options
26
Table 3. Percentages of Individuals in Each Option Endorsing Kinsey Positions
Kinsey position
SC
SNC
MOR
SSR
0. Exclusively heterosexual with no homosexual
4.3%
1.7%
2.3%
0.6%
1. Predominantly heterosexual, only incidentally homosexual
4.6%
2.2%
9.1%
1.2%
2. Predominantly heterosexual, but more than incidentally
homosexual
3.8%
3.9%
11.8%
0.9%
3. Equally heterosexual and homosexual
5.4%
4.1%
10.0%
4.9%
4. Predominantly homosexual, but more than incidentally
heterosexual
7.9%
8.3%
19.3%
6.4%
5. Predominantly homosexual, only incidentally heterosexual
33.7%
29.2%
28.0%
25.6%
6. Exclusively homosexual with no heterosexual
37.2%
49.3%
17.3%
58.8%
7. Asexual
1.4%
0.3%
1.4%
0.9%
8. “You don’t have an option that applies to me”
1.6%
1.1%
0.9%
0.6%
Mean (excluding 7s and 8s)
4.66
5.04
3.92
5.33
SD (excluding 7s and 8s)
1.68
1.37
1.67
1.09
Satisfaction within Four Options
27
Table 4. Outcomes by Relationship Option
Max Value
SC
SNC
MOR
SSR
M
SD
M
SD
M
SD
M
SD
Anxiety
4
1.98
0.83
1.96
0.77
1.89
0.76
1.72
0.72
Depression
4
1.94
0.72
1.90
0.69
1.76
0.66
1.57
0.59
Internalized Homonegativity
6
4.48
1.68
3.14
1.94
4.13
1.86
2.32
1.49
Life Satisfaction
7
3.98
1.43
4.15
1.44
4.76
1.31
5.10
1.24
Physical Health
7
5.00
1.60
5.11
1.65
5.31
1.52
5.49
1.43
Satisfaction within Four Options
28
Table 5. Regression Models
Overall Model
Variable
β
t
r
Variable
β
t
r
Connection Needs Met
.44
17.22**
.59
Sexual Disgust
-.01
-.41
-.20
Resolved Religiously
.14
5.73**
.40
Sense of Self
.01
0.37
.35
Depression
-.11
-4.35**
-.39
Internalized Homoneg
-.02
-.98
-.27
Masturbation Acceptable
-.08
-3.39**
.06
Physical Health
.02
0.89
.22
Sexual Expression
.09
3.46**
.35
SC
SNC
Variable
β
t
r
Variable
β
t
r
Resolved Religiously
.31
6.01**
.48
Connection Needs Met
.34
6.45**
.48
Connection Needs Met
.30
5.65**
.48
Sexual Expression
.15
2.61**
.32
Depression
-.14
-2.74**
-.34
Depression
-.16
-2.28**
-.35
Masturbation Acceptable
-.09
-1.99*
-.12
Kinsey Attraction
-.10
-2.09*
-.07
Internalized Homoneg
-.13
-2.84*
-.24
Religiously Resolved
.07
1.35
.26
Sexual Disgust
.08
1.70
-.06
Sexual Disgust
.08
1.55
-.10
Sexual Expression
-.04
-.81
.16
Masturbation Acceptable
-.05
-.90
.11
Physical Health
-.03
-.66
.16
Physical Health
.03
0.58
.20
Sense of Self
.03
0.47
.33
Internalized Homoneg
-.03
-.49
-.22
Kinsey Attraction
.02
0.47
-.02
Sense of Self
.01
0.16
.25
MOR
SSR
Variable
β
t
r
Variable
β
t
r
Connection Needs Met
.31
6.35**
.52
Connection Needs Met
.29
4.97**
.45
Masturbation Acceptable
-.19
-4.43**
-.25
Sexual Expression
.16
2.61*
.36
Sexual Expression
.11
2.67**
.30
Kinsey Attraction
-.11
-2.65**
-.32
Sense of Self
.12
1.87
.37
Depression
-.12
-2.64**
-.36
Internalized Homoneg
-.06
-1.03
-.31
Resolved Religiously
.12
2.42*
.40
Physical Health
-.05
-.87
.14
Depression
-.06
-.83
-.29
Physical Health
.08
1.91
.22
Kinsey Attraction
.03
0.60
.07
Internalized Homoneg
-.04
-.92
-.16
Resolved Religiously
.04
0.59
.26
Sexual Disgust
-.03
-.79
-.14
Masturbation Acceptable
-.03
-.49
.15
Sense of Self
<.01
-0.08
.33
Sexual Disgust
-.01
-.23
-.14
* p < .01; **p < .05
Satisfaction within Four Options
29
References
American Psychological Association. (2008). Resolution on religious, religion-related, and/or
religion-derived prejudice. Washington, DC: American Psychological Association.
Retrieved from https://www.apa.org/about/policy/religious-discrimination.pdf
American Psychological Association. (2009). Report of the APA Task Force on Appropriate
Therapeutic Response to Sexual Orientation. Washington, DC: American Psychological
Association. Retrieved from
http://www.apa.org.ezproxy.lib.utah.edu/pi/lgbt/resources/therapeutic-response.pdf
American Psychological Association. (2012). Guidelines for psychological practice with lesbian,
gay, and bisexual clients. American Psychologist, 67, 10–42. doi:10.1037/a0024659
Bailey, J. M., Vasey, P. L., Diamond, L. M., Breedlove, S. M., Vilain, E., & Epprecht, M.
(2016). Sexual orientation, controversy, and science. Psychological Science in the Public
Interest, 17(2) 45–101.
Baumann, K., Jacobs, C., & Büssing, A. (2017). Commitment to celibacy in German Catholic
priests: Its relation to religious practices, psychosomatic health, and psychosocial
resources. Journal of Religion and Health, 56(2), 649-668.
Beckstead, A. L., & Morrow, S. L. (2004). Mormon clients’ experiences of conversion therapy:
The need for a new treatment approach. The Counseling Psychologist, 32, 651-690.
doi.org.ezproxy.lib.utah.edu/10.1177/0011000004267555
Bourn, J., Frantell, K. A., & Miles, J. R. (2018). Internalized heterosexism, religious coping, and
psychache in LGB young adults who identify as religious. Psychology of Sexual
Orientation and Gender Diversity. Advance online publication.
doi.org/10.1037/sgd0000274
Satisfaction within Four Options
30
Brewster, M. E., Velez, B. L., Foster, A., Esposito, J., & Robinson, M. (2016). Minority stress
and the moderating role of religious coping among religious and spiritual sexual minority
individuals. Journal of Counseling Psychology, 63(1), 119-126.
doi.org.ezproxy.lib.utah.edu/10.1037/cou0000121
Cranney, S. (2017a). The LGB Mormon paradox: Mental, physical, and self-rated health among
Mormon and non-Mormon LGB individuals in the Utah Behavioral Risk Factor
Surveillance System. Journal of Homosexuality, 64(6), 731–744.
Cranney, S. (2017b). Is there a stronger association between children and happiness among the
religious? Religion as a moderator in the relationship between happiness and child
number. Journal of Happiness Studies, 18, 1713-1727. doi: 10.1007/s10902-016-9798-x
Dehlin, J. P., Galliher, R. V., Bradshaw, W. S., & Crowell, K. A. (2014). Psychological
correlates of religious approaches to same-sex attraction: A Mormon perspective. Journal
of Gay and Lesbian Mental Health, 18, 284-311. doi: 10.1080/19359705.2014.912970
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale.
Journal of Personality Assessment, 49, 71-75. doi: 10.1207/s15327752jpa4901_13
Doyle, D. M., & Molix, L. (2015). Social stigma and sexual minorities’ romantic relationship
functioning: A meta-analytic review. Personality and Social Psychology Bulletin, 41(10),
1363-1381. doi.org.ezproxy.lib.utah.edu/10.1177/0146167215594592
Flury, J. M., & Ickes, W. Having a weak versus strong sense of self: The Sense of Self Scale
(SOSS). Self and Identity, 6(4), 281-303.
doi.org.ezproxy.lib.utah.edu/10.1080/15298860601033208
Satisfaction within Four Options
31
Gibbs, J., & Goldbach, J. (2015). Religious conflict, sexual identity, and suicidal behaviors
among LGBT young adults. Archives of Suicide Research, 19(4), 472-488.
doi.org.ezproxy.lib.utah.edu/10.1080/13811118.2015.1004476
Hsieh, N., & Ruther, M. (2016). Sexual minority health and health risk factors: Intersection
effects of gender, race, and sexual identity. American Journal of Preventive Medicine,
50(6), 746-755. doi.org.ezproxy.lib.utah.edu/10.1016/j.amepre.2015.11.016
Herek, G. M., Gillis, J. R., & Cogan, J. C., (2009). Internalized stigma among sexual minority
adults: Insights from a social psychological perspective. Journal of Counseling
Psychology, 56(1), 32-34. doi.org.ezproxy.lib.utah.edu/10.1037/2376-6972.1.S.18
Hernandez, B. C., Schwenke, N. J. & Wilson, C. M. (2011). Spouses in mixed-orientation
marriage: A 20-year review of empirical studies. Journal of Marital and Family Therapy,
37, 307–318. doi:10.1111/j.1752-0606.2010.00202.x
Joseph, L. J., & Cranney, S. (in press). Self-esteem among lesbian, gay, bisexual and same-sex-
attracted Mormons and ex-Mormons. Mental Health, Religion & Culture.
Kahneman, D. (2003). Experiences of collaborative research. American Psychologist, 58, 723-
730. doi: 10.1037/0003-066X.58.9.723
Kays, J. L., Yarhouse, M. A., & Ripley, J. S. (2014). Relationship factors and quality among
mixed-orientation couples. Journal of Sex & Marital Therapy, 40(6), 512-528.
doi.org.ezproxy.lib.utah.edu/10.1080/0092623X.2013.788107
Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male.
Philadelphia, PA: W.B. Saunders.
Satisfaction within Four Options
32
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). Validity of a brief depression severity
measure. Journal of General Internal Medicine, 16, 606-613. doi:
10.1046/j.15251497.2001.016009606.x
Meyer, I.H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual
populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674-
697. doi: 10.1037/0033-2909.129.5.674
Mohr, J. J., & Kendra, M. S. (2011). Revision and extension of a multidimensional measure of
sexual minority identity: The Lesbian, Gay, and Bisexual Identity Scale. Journal of
Counseling Psychology, 58, 234-45. doi: 10.13072/midss.150
Pachankis, J. E., & Hatzenbuehler, M. L. (2013). The social development of contingent self-
worth among sexual minority young men: An empirical test of the "Best Little Boy in the
World" hypothesis. Basic and Applied Social Psychology, 35, 176-190.
doi.org.ezproxy.lib.utah.edu/10.1080/01973533.2013.764304
Richards, P. S., & Bergin, A. E. (Eds.) (2000). Handbook of psychotherapy and religious
diversity. Washington, DC: American Psychological Association.
Robles, T. F., Slatcher, R. B., Trombello, J. M., McGinn, M. M. (2014). Marital quality and
health: A meta-analytic review. Psychological Bulletin, 140, 140-187. doi:
10.1037/a0031859
Rosenau, D. E., & Tan, E. S. N. (2018). Single and sexual: The church's neglected dilemma.
Journal of Psychology and Theology, 30(3), 185-194.
Rosenmann, A., & Safir, M. (2007). Gay identity nonendorsement and the role of dissociative
characteristics in a culturally diverse online sample of men who have sex with men.
Sexuality Research & Social Policy: A Journal of the NSRC, 4(2), Jun 2007.
Satisfaction within Four Options
33
Rosik, C. H., Jones, S. L., & Byrd, A. D. (2012). Knowing what we do not know about sexual
orientation change efforts. American Psychologist, 67, 498–499. doi:10.1037/a0029683
Ryan, C., Russell, S. T., Huebner, D. M., Diaz, R., & Sanchez, J. (2010). Family acceptance in
adolescence and the health of LGBT young adults. Journal of Child and Adolescent
Psychiatric Nursing, 23(4), 205-213. doi.org.ezproxy.lib.utah.edu/10.1111/j.1744-
6171.2010.00246.x
Ryan, W. S., Legate, N., Weinstein, N., & Rahman, Q. (2017). Autonomy support fosters
lesbian, gay, and bisexual identity disclosure and wellness, especially for those with
internalized homophobia. Journal of Social Issues, 73(2), 289-306.
doi.org.ezproxy.lib.utah.edu/10.1111/josi.12217
Savin-Williams, R. C. (2016). Sexual orientation: Categories or continuum? Commentary on
Bailey et al. (2016). Psychological Science in the Public Interest, Vol 17(2), 37-44.
doi.org.ezproxy.lib.utah.edu/10.1177/1529100616637618
Schumm, W. R. (2015). Navigating treacherous waters--one researcher's 40 years of experience
with controversial scientific research. Comprehensive Psychology, 4, 1-40.
doi: 10.2466/17.CP.4.24
Shidlo, A., & Schroeder, M. (2002). Changing sexual orientation: A consumers’ report.
Professional Psychology: Research and Practice, 33, 249-259.
doi.org.ezproxy.lib.utah.edu/10.1037/0735-7028.33.3.249
Sowe, B. J., Brown, J., & Taylor, A. J. (2014). Sex and the sinner: Comparing religious and
nonreligious same-sex attracted adults on internalized homonegativity and distress.
American Journal of Orthopsychiatry, 84(5), 530-544.
Satisfaction within Four Options
34
Spira, L., Richards, A. K. (2003). On being lonely, socially isolated, and single: Multiple
perspectives. Psychoanalysis & Psychotherapy, 20(1), 3-21.
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for
assessing generalized anxiety disorder Archives of Internal Medicine, 166, 1092-1097.
doi: 10.1001/archinte.166.10.1092
Stack, P. F. (2018, January 30). Yearning for a ‘romantic attachment’ they never had — gay
Mormon Josh Weed and his wife of 15 years are divorcing. Salt Lake Tribune. Found
online https://www.sltrib.com/religion/local/2018/01/30/yearning-for-a-romantic-
attachment-they-never-had-gay-mormon-josh-weed-and-his-straight-wife-are-divorcing-
after-15-years/
Yarhouse, M. A, Tan, E. S. N., & Pawlowski, L. M. (2005). Sexual identity development and
synthesis among LGB-identified and LGB dis-identified persons. Journal of Psychology
and Theology, 33(1), 3-16.
... Feelings of belongingness and connection have been found to alleviate stress and bolster mental health outcomes (Barr et al., 2016;Yen-Jui & Israel, 2012). This sense of belongingness may come from either a religious or lesbian, gay, bisexual, and queer/questioning (LGBQ) community, and may consequently increase self-esteem and decrease self-loathing (Lefevor et al., 2019;Snapp et al., 2015). A sense of belongingness may be particularly important for sexual minorities who mature in a nonaffirming religious community-defined as communities that do not support the full expression of sexual minorities' sexual identity-as they typically report experiencing increased internalized homonegativity and depressive symptomology (Barnes & Meyer, 2012;Hatzenbuehler, 2009;Shilo & Savaya, 2012). ...
... Whereas religious belongingness is clearly protective for individuals generally, it may be less protective for sexual minority LDS. Because the LDS church has clear teachings that prohibit same-sex relationships, a sense of belongingness may stop sexual minority LDS from seeking these health-promoting relationships (Lefevor et al., 2019). Further, a sense of belonging in the CJCLDS may also enhance conflict, which could result in additional distress (Festinger, 1957). ...
... Given that many sexual minorities affiliate with conservative religions, additional insight is needed to explore the relationship between sexual identity, belongingness, and mental health for this population (Lefevor et al., 2019). Focusing on both LGBQ community belongingness and conservative religious (CJCLDS) belongingness may help detail how belongingness relates to health. ...
... LGBTQ Utah youth who are affiliated with The Church of Jesus Christ of Latter-day Saints may be at particular risk given potential challenges in their religious home environments. Previous researchers have struggled to examine negative familial encounters, mental health concerns, and STBs among LDS LGBTQ samples because of sampling issues, such as inadvertently recruiting LGBTQ LDS folx who have had more negative experiences (e.g., Dehlin et al., 2014), a point brought up by recent examinations of LDS LGBTQ mental health issues (e.g., Lefevor et al., 2019;). ...
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Utah ranks fifth in the nation for suicide and has experienced a rapid increase in youth deaths by suicide over the last decade. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth in Utah may be at heightened risk, given the major presence and stances of The Church of Jesus Christ of Latter-day Saints regarding LGBTQ identities and relationships. However, no research has yet examined the differences in or predictors of suicidal thoughts and behaviors (STBs; i.e., suicidal thoughts, plans, and attempts) among LGBTQ youth in Utah. Using a large representative sample of Utah middle and high schoolers (n = 73,982), we found that Latter-day Saint (LDS) and non-LDS LGBTQ groups reported greater levels of STBs than heterosexual/cisgender youth, with non-LDS LGBTQ youth reporting the highest levels of STBs, followed by LDS LGBTQ youth. Path-analyses demonstrated that LGBTQ participants’ reports of higher family conflict and lower parental closeness were tied to higher depression, self-harm, and substance misuse, and these three factors were, in turn, associated with higher levels of STBs for LGBTQ youth in Utah. This path model did not differ significantly due to LDS versus non-LDS religious affiliation. Findings suggest that LGBTQ youth in Utah would be well served if clinicians and advocacy groups pay attention to the ways that religious affiliation and family dynamics might indirectly lead to STBs among adolescents. Public Significance Statement: This study found that both Latter-day Saint and non-Latter-day Saint LGBTQ youth are at higher risk for experiencing suicidal thoughts and behaviors than their heterosexual or cisgender peers. Additionally, for LGBTQ youth, higher levels of family conflict and lower levels of parental closeness were related to more depression, substance misuse, self-harm, suicidal thoughts, and suicide attempts. These findings demonstrate the potential familial and religious risks that LGBTQ youth may experience in Utah.
... e., a relationship in which at least one of the partners is not sexually attracted to their partner's gender, e.g., a heterosexual woman and a gay man). Thus far, these types of relationships have primarily been studied socio-culturally (Vencill and Wiljamaa, 2016;Yarhouse et al., 2011) or clinically (Bridges et al., 2019;Lefevor et al., 2019). One study found that, in a sample of religious people who experienced same-gender attraction, people in mixed-orientation marriages had greater life satisfaction and less depression than those who were single and celibate and those who were single and not celibate, but they had less life satisfaction and more depression than those in same-sex partnerships . ...
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We examined psychache, or intolerable emotional suffering, in a sample of lesbian, gay, and bisexual (LGB) young adults who identified as religious. Using a minority stress framework, we hypothesized internalized heterosexism (IH) would positively relate to psychache. We also hypothesized that positive religious coping (PRC) would moderate or lessen this association. Finally, we examined whether negative religious coping (NRC) moderated or mediated the relation between IH and psychache. A sample of 617 LGB young adults who identified as religious completed an online survey assessing IH, religious coping, and psychache. Consistent with our hypothesis, IH was significantly related to psychache. IH was also significantly, positively correlated with both PRC and NRC, suggesting that individuals use both forms of religious coping in relation to experiencing IH. Results suggested that NRC, but not PRC, was correlated with psychache. Contrary to our hypotheses, neither PRC nor NRC moderated the relation between IH and psychache. NRC did, however, mediate the relation between IH and psychache. Results suggest clinicians working with LGB individuals may want to attend psychache, in addition to other types of psychological distress, and that they may target their interventions toward reducing the use of NRC.
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Lesbian, gay, and bisexual (LGB) individuals experience disparities in psychological well-being, including greater symptoms of depression and anxiety, relative to their heterosexual peers. One group of LGB individuals is particularly vulnerable—those with high levels of internalized homophobia, or sexual prejudice directed toward the self. The current research explored whether a supportive social environment might be especially beneficial for this group. Specifically, we tested whether autonomy support within a given social environment (e.g., with family, friends, and peers or coworkers) is associated with greater identity disclosure and well-being in that environment, especially for those high in internalized homophobia. Using within-person analyses, we found support for this: perceptions of autonomy support predicted greater disclosure (outness) and well-being, and this relation was particularly strong for those high in internalized homophobia. Implications of these findings for promoting well-being among LGB individuals, a critical social issue, are discussed. © 2017 The Society for the Psychological Study of Social Issues
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Review of book, P. Scott Richards and Allen E. Bergin (Au.) Handbook of Psychotherapy and Religious Diversity. Washington, DC: American Psychological Association, 2000, 518 pp., ISBN 1-557-98624-X. Reviewed by Timothy B. Smith.
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Much of the literature on mental and physical health among religious LGB individuals has relied on small-N convenience samples. This study takes advantage of a unique, large-N, population-based dataset to test the relationship between religious identity, religious activity, and health, with a specific emphasis on Utah Mormons. In a surprising finding, Mormon LGBs report better mental health than non-Mormon LGBs, while their self-rated and physical health is not significantly different. However, there is some evidence that Mormon LGBs derive less health benefits from church attendance than their non-LGB Mormon counterparts. These results may nuance the conventional wisdom regarding the health dynamics of LGB individuals who identify with a conservative, heteronormative religious tradition, and plausible explanations are discussed.
Bailey et al. (2016) have provided an excellent, state-of-the-art overview that is a major contribution to our understanding of sexual orientation. However, whereas Bailey and his coauthors have examined the physiological, behavioral, and self-report data of sexual orientation and see categories, I see a sexual and romantic continuum. After noting several objections concerning the limitations of the review and methodological shortcomings characteristic of sexual-orientation research in general, I present evidence from research investigating in-between sexualities to support an alternative, continuum-based perspective regarding the nature of sexual orientation for both women and men. A continuum conceptualization has potential implications for investigating the prevalence of nonheterosexuals, sexual-orientation differences in gender nonconformity, causes of sexual orientation, and political issues.
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Introduction: Although population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities. Methods: Using ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (n=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care. Results: Conditional on sociodemographic factors, all sexual, gender, and racial minority groups, except straight white women, gay white men, and bisexual non-white men, reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual, gender, and racial minority groups. Conclusions: Sexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities.