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Transgender individuals face barriers to accessing gender-affirming hormone therapy, yet little is known about gynecological providers' willingness to provide such care.We surveyed gynecological providers in one healthcare system to determine their willingness to prescribe hormone therapy (HT) for transgender patients and factors associated with willingness to both initiate and refill HT.Among respondents (While gynecological providers are qualified to prescribe HT for transgender patients, willingness to do so may be influenced by both personal and educational/training factors. Encouraging and training gynecological providers to provide gender-affirming HT will help to increase access for transgender individuals. more...

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, plus) people, compared to their heterosexual and/or cisgender (non-transgender) counterparts, are more likely to be discriminated against based o... more...

While considerable knowledge exists about blatant gender discrimination and violence targeting women, less is known about gender microaggressions. To understand gender microaggressions’ frequency, prevalence, and effects, researchers need robust quantitative measures. To advance gender microaggressions scholarship and support researchers’ efforts to identify high-quality measures, we conducted a psychometric scoping review. We identified 24 original, quantitative, multi-item measures designed to assess gender microaggressions or related constructs. Included measures needed at least one item assessing gender microaggressions and be used with adult women in the United States. Results indicated an increase in the number of measures including gender microaggressions’ items in recent years, with a major expansion in the number of named gender microaggressions’ measures. We found limited reporting of demographic information. Psychometric testing and characteristics varied across measures. While most ( n = 20) reported internal consistency reliability, only two-thirds ( n = 16) reported undergoing validity testing. When examining microaggressions named measures ( n = 10), we found inconsistent adherence to microaggressions’ theoretical and conceptual foundations. Substantial work remains to develop a “gold standard” measure that does not conflate subtle and blatant acts, assesses the full thematic range of gender microaggressions, and is psychometrically valid across different social contexts and diverse groups of women. more...

Purpose: Even in cases of medical emergency, mistreatment and negative experiences in life or in medical settings can deter trans patients from seeking necessary care. The purpose of this study was to identify factors associated with trans persons' emergency department (ED) avoidance in the mixed urban-rural Region of Waterloo, Ontario, Canada. Methods: The OutLook Study was a community-based partnership that created an online, cross-sectional questionnaire for lesbian, gay, bisexual, transgender, and other sexual and gender minority community members. Participants in this analysis were 16 years of age or older, lived, worked, or attended school in Waterloo Region, and identified as trans (n=112). Binary logistic regression was used to test associations between sociodemographic, resilience, and risk variables, and ED avoidance. Sociodemographic variables statistically significant at p more...

Few scholars have examined the experiences of LGBTQ+ college students with disabilities, but the available evidence indicating poor mental and physical health, underutilization of disability accomm... more...

Heterosexist phrases on college campuses can contribute to negative consequences among lesbian, gay, bisexual, queer, and other sexual minority students (LGBQ+), however, their relationship to acad... more...

Sexual orientation microaggressions are common on college campuses and can contribute to negative outcomes; yet little is known about their relationship with substance use outcomes. Among a convenience sample of cisgender sexual minority college students ( more...

Although the notion of queer kinship has been well discussed within literature on queer individuals, it has not been used as a lens to make sense of how trans* college students successfully navigate rigidly gender dichotomous collegiate environments. Using interview data from the National Study of LGBTQ Student Success, this study explores the narratives of 18 trans* students concerning their experiences of success in college and the role of queer kinship in supporting their success. Analysis documented three domains of kinship (i.e. material, virtual, and affective), which promoted students’ success. more...

Professional ethics compel social workers to address all forms of discrimination and oppression. Microaggressions can contribute to health disparities for marginalized groups; yet, little is known about the frequency, mechanisms, and impact of microaggressions on sexual minorities, cisgender women, and gender minorities—particularly for those with intersecting marginalized identities. This article extends microaggression literature by exploring interrelated constructs of sexual orientation, gender, and gender identity microaggressions, and offering recommendations for future research using an intersectional lens to foster an integrated and complex understanding of microaggressions. Implications of an intersectional microaggression framework for social work education and practice are discussed. more...

Competent social work practice with sexual minorities requires educators to identify factors that can be addressed in the graduate social work curriculum to foster affirming attitudes among students. This study explored the attitudes incoming master of social work (MSW) students hold toward sexual minorities, utilizing a scale that addresses contemporary subtle biases toward lesbian, gay, and bisexual (LGB) people, rather than overt, fear- and morality-based objections measured in previous studies. We explored the role of race/ethnicity, age, sex, sexual orientation, religiosity, political ideology, perceived biological causation of sexual orientation, and LGB social contacts on students' attitudes toward sexual minorities. Multivariable linear regression results suggest that being African American/Black (versus White), older, and heterosexual (versus sexual minority), and greater religiosity (importance of religion and frequency of service attendance) and conservative political ideology, predicte... more...

A tension between the lesbian, gay, and bisexual (LGB) and (heterosexual) conservative Christian communities has been documented within social work. This qualitative study explores students’ experiences in a Christianity and LGB sexuality intergroup dialogue at an American graduate social work program. This dialogue was the first known case of intergroup dialogue being used to address these topics in a social work program. Students’ motivations for participating in the dialogue, challenges faced throughout the dialogue, and what they learned are discussed. Pedagogical implications for schools of social work and intergroup dialogue are outlined. more...

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents face a number of challenges in their lives related to heterosexism and cissexism. Drawing on the microaggressions framework, we conducted two focus groups with LGBTQ adolescents ( more...

Understanding the nature and consequences of LGBTQ microaggressions is critical to fostering equity and wellbeing among sexual and gender minorities. Yet little guidance is available for researchers seeking psychometrically robust measures of subtle LGBTQ slights, invalidations, and insults. To address this gap, we conducted a scoping review of multi-item quantitative measures that included at least one question addressing LGBTQ microaggressions. This article reports the study characteristics and psychometric properties of 27 original measures we identified and their subsequent adaptations. The article concludes with an assessment of strengths and limitations of LGBTQ microaggression measurement, highlighting aspects of measurement innovation on which future researchers can build. As microaggressions remain a powerful and underexplored mechanism of sexual and gender minority oppression, this review will help to both advance methodological quality in this critical research area and enhance our understanding of how microaggressions manifest in the lives of LGBTQ individuals. more...

This study, drawn from a subset of qualitative data from a national study of LGBTQ (lesbian, gay, bisexual, transgender, queer) student success, explores the role of faculty support in promoting LGBTQ student success. Six aspects of faculty support are identified and illuminated within formal and informal contexts. Students' voices show how LGBTQ students interact with faculty and what kinds of interactions students experience as supportive. more...

Although LGBQ students experience blatant forms of heterosexism on college campuses, subtle manifestations such as sexual orientation microaggressions are more common. Similar to overt heterosexism, sexual orientation microaggressions may threaten LGBQ students' academic development and psychological wellbeing. Limited research exists in this area, in part due to lack of a psychometrically sound instrument measuring the prevalence of LGBQ microaggressions on college campuses. To address this gap, we created and tested the LGBQ Microaggressions on College Campuses Scale. Two correlated subscales were generated: Interpersonal LGBQ Microaggressions and Environmental LGBQ Microaggressions. The results indicated that the subscales demonstrate strong reliability and validity. more...

Sexual minority youth, including emerging adults, are at risk for negative health outcomes. Minority stress theory posits that heterosexism can contribute to these outcomes among sexual minorities. Researchers have tested this theory with respect to interpersonal heterosexism; however, little attention has been given to macro-level and environmental forms of heterosexism, especially among lesbian, gay, bisexual, and queer (LGBQ) youth. In this study, we examine the role of objective social climate (LGB state-level policies) and experiential distal and proximal environmental microaggressions on the psychological well-being of LGBQ emerging adults. Furthermore, we examine the role of LGBQ identity salience as a moderating factor on the macro/environmental-heterosexism and well-being relationship. Multivariable linear regression results suggest that living in a state without same-sex marriage laws is associated with greater self-esteem, whereas both distal and proximal environmental microaggressions are risk... more...

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This study explores the differential impact of religious tradition, religiosity, and everyday theologies on support for legalizing same-sex marriage among a sample of undergraduate college students. The findings suggest that among college students in the United States the group of everyday theologies—personal religious beliefs that emerge through individuals’ lived experiences and social interactions—that we examine has a larger influence on attitudes about legalizing same-sex marriage than do either religious tradition or religiosity (measured as attendance, prayer, and guidance). We operationalize the concept of everyday theologies as levels of endorsement for six different religious themes. Implications for social movements promoting same-sex marriage and future research are discussed. more...

Utilizing the resource model of political participation, we identify the antecedents of willingness to sign a petition supporting employment protections for lesbian, gay, bisexual, and transgender (LGBT) people among sexual minority and heterosexual college students. Through secondary data analysis, we investigate the role of sociodemographic, mobilizing context, and framing variables, including various LGBT-related attitudes that have never been integrated in a single regression of LGBT activism. Results from a sample of sexual minority (n = 367) and heterosexual (n = 1,707) college students suggest that the majority of students from both sexual orientation groups are willing to sign a petition for LGBT rights. Although the impact of framing variables, such as transphobia and liberal identity, were most influential among both groups, the relevance of some framing antecedents (i.e., heterosexist attitudes and the disclosure of sexual identities) was specific to each sexuality. Before the inclusion of framing factors, knowing LGBT peers and observing heterosexist discrimination inspired greater activism among both sexuality groups as did being female and a graduate student; however, the significance of religious factors were only important among heterosexual students. Implications for future research are discussed. more...

This study explores religious teachings about same-sex sexuality, religiosity, and contact with gay, lesbian, or bisexual (GLB) friends on attitudes toward lesbians and gay men among Catholic and Protestant social work students. Data from a convenience sample (n = 383) from four universities were analyzed. Hierarchical multiple regression results indicate that age, Protestant religious affiliation, religiosity, religious message about homosexuality, contact with GLB, and the cross product of religiosity and religious message were significant. The adjusted analysis for the latter variable indicates that those exposed to more accepting messages reported less bias, and the effect of antigay messages was greatest among highly religious students. Refereed/Peer-reviewed more...

Heterosexism contributes to an unsafe campus climate for lesbian, gay, and bisexual (LGB) college students. Intergroup dialogue courses about sexual orientation seek to build awareness, cross-group relationships, and commitment to social action to address anti-LGB prejudice and discrimination. Although dialogue courses are growing in popularity, few courses address sexual orientation. To advance knowledge of these dialogues, this qualitative study explores heterosexual students' motivations and expectations, challenges, and learning outcomes related to their participation in intergroup dialogue courses on sexual orientation. Core themes include desire to learn about the LGB community, concerns about offending classmates, anxiety around LGB stigma, conflict with classmates around controversial topics, affirming LGB people, and learning about heterosexism, privilege, and intersectionality of identity. Implications for intergroup dialogue pedagogy and research are discussed. more...

In the past decade, advocacy efforts to establish social policies that legally recognize same-sex relationships and protect lesbian, gay, bisexual, and transgender (LGBT) people from employment discrimination have increased considerably throughout the country. To inform these advocacy campaigns, we investigate endorsement for LGBT civil rights among heterosexual college students (n = 1,714). Students, overall, were moderately supportive of LGBT rights. Twenty-one variables were found to be significant in the initial analyses; however, only seven retained significance in the final analysis which controlled for all variables. Results suggest that political ideology and specific LGBT attitudes are most influential. Religiosity and having LGBT extended family members are also important. Implications for LGBT advocacy efforts are discussed. more...

Social workers are expected to promote social justice for lesbian, gay, bisexual, and transgender (LGBT) people, and social work programs and their faculty are expected to prepare students for competent and ethical practice with LGBT people and communities. Faculty's LGBT social attitudes can play a central role in developing students’ competencies. Minimal attention has been given to the nature of faculty's LGBT social attitudes. This article presents the results of a national survey conducted in the United States with a random sample of graduate teaching faculty concerning their LGBT social attitudes (n = 161). Bivariate and multivariate predictors of LGBT social attitudes were identified. Although a number of factors were significant in bivariate analyses and initial multivariate analysis (controlling only for sociodemographics), the final estimated model suggests race and social attitudes about women and critical consciousness are significant. The authors outline recommendations to enhance fa... more...

Research suggests that contact with sexual minorities and etiology beliefs regarding the origins of homosexuality are associated with antigay bias; however, factors related to etiology beliefs have received little empirical attention. Our primary research question is: does closeness to someone who is gay, lesbian, or bisexual influence etiology beliefs? Students (n = 851) from four US universities completed an anonymous survey, and regression results indicated that contact and closeness were not significantly associated with etiology beliefs. Because both contact and relationship closeness were associated with antigay attitudes, and closeness demonstrated the largest effect, we tested three alternative structural equation models to determine if contact and closeness mediated etiology beliefs. Results suggested that contact and the degree of closeness are indirectly associated with students' etiology beliefs through antigay bias. Refereed/Peer-reviewed more...

Attention to same-sex marriage has increased in the past decade. This study examines the perceptions of same-sex marriage among social work faculty. Faculty play a critical role in preparing future social workers for competent, ethical practice--including advocacy for social policies inclusive of sexual minorities. The present study investigates endorsement of same-sex marriage among teaching faculty in U.S. and English-speaking Canadian MSW programs. Twelve factors were found to be significant in the bivariate analyses; however, only four retained significance in the multivariate analysis. Specifically, the multivariate analysis found "other race" and religiosity to be negatively associated with support for same-sex marriage, whereas acceptance of same-sex relationships and understanding gender-based oppression as the root cause of domestic and sexual violence were positively associated with same-sex marriage support. The results highlight the importance of social attitudes concerning same-sex relationships and gender-based oppression for endorsement of same-sex marriage. Implications for social work education and future research are discussed. KEY WORDS: gay and lesbian people; heterosexism; same-sex marriage; social work faculty ********** Same-sex marriage is a controversial policy issue around the world. Currently, same-sex marriage is legal in 11 countries, nine U.S. states, and the District of Columbia. Given the legal and social significance that marriage holds in society, the issue of same-sex marriage raises many social justice and human fights questions for same-sex couples and the social work profession (Fredriksen-Goldsen, Hyun-Jun, Murraco, & Mincer, 2009; Woodford, 2010). Social workers have an ethical responsibility to advocate for social justice for sexual minorities (Canadian Association of Social Workers [CASW], 2005; NASW, 2000). Moreover, social work program educational accreditation standards mandate inclusion of content regarding sexual minorities and oppression related to sexuality (Canadian Association of Schools of Social Work, 2007; Council on Social Work Education [CASWE] Gay, Lesbian, Bisexual, Transgendered Caucus, 2008). However, recent research in the United States demonstrates that content on sexual orientation (and gender identity and expression) needs to be more comprehensively integrated into social work curriculums (Martin et al., 2009). Similar conclusions have been drawn in Canada (CASWE Gay, Lesbian, Bisexual, Transgendered Caucus, 2008). Researchers have devoted attention to social workers' (Berkman & Zinberg, 1997; Crisp, 2006; Green, 2005; Krieglstein, 2003), social work students' (Brownlee et al., 2005; Logie, Bridge, & Bridge, 2007), and social work educators' (Ben-Ari, 2001; Fredriksen-Goldsen, Woodford, Luke, & Gutierrez, 2011) attitudes toward homosexuality. However, minimal attention has been given to attitudes about same-sex marriage. Both CASW (Newman, Brotman, Ryan, & OASW, 2003) and NASW (Webb, n.d.) publicly support same-sex marriage. Although endorsement of same-sex marriage by these organizations is important in advancing same-sex couples' access to marriage, support for same-sex marriage among social work faculty is likely more important, as faculty play a central role in preparing students for competent and ethical practice--including advocacy for and with same-sex couples. Faculty who oppose or are unsure about same-sex marriage may avoid the topic in their courses, thereby negatively affecting students' preparedness to advocate for inclusive marriage policies and related social policies. Furthermore, faculty who oppose same-sex marriage may minimize its importance or advocate to students that marriage remain a heterosexual institution. Also, anti-gay marriage views among faculty may foster an unwelcoming, "chilly" learning environment for sexual-minority students. Given the role faculty play in developing students' professional values, knowledge, and skills, it is important to understand faculty's views about same-sex marriage. … more...

This study identifies the predictors of U.S. heterosexual undergraduate and graduate college students’ attitudes toward lesbian, gay, bisexual, and transgender (LGBT) people as a group rather than toward individual identities. Findings suggest that affirming LGBT attitudes are most strongly associated with liberal political ideology and whether one believes in biological causation of transgender identity. Understanding sexual orientation as biological and having LGB friends, LGB immediate family members, and transgender friends are also important, but to a lesser degree. Age, gender, and select races/ethnicities and select religious affiliations are marginally associated with LGBT attitudes. These findings clarify areas to target for improvement in campus climate for LGBT persons, and implications for campus programs and research are discussed. more...

Social work faculty's attitudes contribute to creating inclusive and productive classroom climates when discussing racism, sexism, and heterosexism. Little is known about faculty's attitudes toward marginalized groups and the intersection of these attitudes with religion. This study describes social work faculty's attitudes about people of Color, women, and lesbian and gay people, and the relationship among these attitudes, religious affiliation, and religiosity. Results indicate religiosity predicts less accepting attitudes towards lesbian and gay people for Christian faculty; religious affiliation and religiosity did not predict attitudes towards women or people of Color. Intergroup dialogue is recommended for social work faculty learning. more...

The acceleration of research with lesbian, gay, and bisexual (LGB) populations amid existing sexual prejudice and advancing human rights leads to sometime conflicting stances between researchers and ethics boards over acceptable methodological practices. Ethics boards, charged with ensuring the safety of research participants, may engage in ostensibly protective stances regarding potential risks and informed consent that are unwittingly founded upon negative stereotypes of LGB populations. We examine four case studies that demonstrate divergent stances between researchers and ethics boards, researchers’ responses to ethics reviews and their resolution. Based on these cases, we describe themes and strategies for researchers working with LGB populations in responsibly navigating ethics board concerns. more...

Although numerous studies have examined the role of religious tradition and religiosity on attitudes toward lesbian, gay, and bisexual people, the role of endorsement of denominational teachings has largely been overlooked, even though such teachings are often cited to explain study findings. To better understand the complex relationship between religion and sexual prejudice, this study explores the unique contributions of religious tradition, religiosity, and individual endorsement of denominational doctrine about same-sex sexuality in shaping these attitudes. Findings indicate that endorsement of denominational doctrine concerning same-sex sexuality is more influential than religiosity, and that endorsement of denominational doctrine is not simply a proxy for believing that same-sex sexuality is a sin. Implications for future research are discussed. more...

This article presents findings from the first national surveys of United States and English- speaking Canadian MSW social work faculty examining their support of curriculum content on sexual orientation and gender identity. Faculty in either country are generally supportive of including LGBT content but report significantly more support for content on LGBT populations as compared to the types of oppression experienced. Significant predictors of support for LGBT content include being female, younger, non-White/non-European, having positive LGBT social attitudes, and the availability of resources on transgenderrelated issues. The findings suggest that faculty development should address the social attitudes among faculty as well as integrate gender identity into diversity discourse in social work education. more...

Lesbian families are marginalized in contemporary society. Yet, shifting social mores and recent policy changes enable some lesbian couples to adopt children as a couple. Research is lacking about these unique families. The qualitative study presented here extends knowledge about lesbian couples’ internal and social experiences as they become adoptive parents. The findings indicate that these couples face unique challenges to internally held identities and in social relationships. They use, often simultaneously, normalizing and resisting strategies to address the challenges they face. The employment of strategies varies over time and across social contexts, adding to the complexity of tactics that lesbian families use to address heterosexism. more...

Social workers have an ethical and professional responsibility to promote social justice and equality for oppressed groups, including sexual minorities. Advocating for the legal recognition of same-sex marriage is one way to enact this responsibility. The legal recognition of same-sex marriage is a significant accomplishment toward equality for gay and lesbian Canadians—one in which the social work profession played a role by presenting a legislative brief to policymakers. Although legislative advocacy is cited as a social policy change tool, the literature gives little attention to it, especially in regard to equality and social justice for LGBT people. This statement, subsequently adopted by the Canadian Association of Social Workers, is presented here to help social service workers better understand the significance of legal recognition of same-sex marriage, particularly as a minority rights issue. It is also presented as an example of a legislative advocacy tool. To inform policy change efforts elsewh... more...

As part of the mystique associated with the concept of marriage is the myth of the “heterosexual assumption” that underpins all of the American legal and religious tenets and perpetuates the idea t... more...

Intergroup dialogue is a method of social justice education. Most intergroup dialogue research explores race and gender identities. Sexual orientation dialogues are uncommon and not yet examined empirically. This qualitative study explores sexual orientation dialogue courses from the perspective of lesbian, gay, and bisexual (LGB) student participants. Understanding target, or marginalized, group perspective of planned intergroup experiences is important given concerns raised in the literature. We document student motivations for participating in dialogues, core outcomes, and main challenges that arose in dialogue. Core outcomes include learning about and accepting one's sexual identity and empowerment. Challenges include those stemming from invisibility of sexual orientation identity. Recommendations are made for intergroup dialogue practice and research. more...