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This study investigates the challenges faced by LGBT Myanmar migrants in Thailand, including discrimination and abuse due to their gender identity or sexual orientation, and their coping strategies. Through qualitative interviews with 20 self-identified LGBT Myanmar migrants aged over 18 years who experienced discrimination or abuse in Thailand, the findings underscore the presence of a segment within the Myanmar LGBT migrant community in Thailand subject to discrimination and violence across diverse settings, including workplaces, public areas, and even within their homes. Additionally, the research identified healthy coping strategies like self-soothing thoughts, relaxation activities, and seeking support, contrasted with unhealthy coping strategies such as negative self-talk, rumination, and suppressing one’s identity, leading to harmful behaviors and even suicidality. The experiences of severe discrimination and violence among LGBT migrants help this study advocate for policy interventions, such as extending the coverage of the Gender Equality Act to encompass LGBT migrants and implementing mental health support services as a form of secondary prevention. Given the significant contribution of LGBT migrants to various sectors of Thailand’s workforce, these measures are essential. However, the existing legislation concerning gender equality in Thailand inadequately addresses the specific concerns of this demographic group. [ABSTRACT FROM AUTHOR]

Not enough is known about the labels that transgender and gender diverse (TGD) individuals – and especially adolescents and young adults – use to describe their sexual orientation. This is likely due to a historical conflation of sexual orientation and gender identity, where both researchers and the public have failed to examine the ways that these constructs differ. Consequentially, there are few statistics about TGD young people's sexual orientations. The present study aims to help address this gap by examining the sexual orientation labels 208 TGD young people (13–22 years old) used at time of an assessment for readiness to start gender affirming hormones. Results indicate that the vast majority of youth in the sample used non-heterosexual orientation labels, with the most commonly endorsed label being "bisexual". Fischer's exact tests reveal that participants who affirmed a male/transmasculine gender were more likely to use the label "heterosexual" compared to female/transfeminine and non-binary young people. Findings underscore the importance of mindful sexual orientation and gender identity demographic information collection for TGD young people. [ABSTRACT FROM AUTHOR]

AbstractObjective: There has been an ongoing mental health crisis among sexual and gender minority (SGM) populations. This continues amidst rising population-level depression and suicide rates, especially among students in higher education. This work aims to understand changes in SGM student mental health over time. Participants: N = 483,574 responses to the Healthy Minds Study (2007C2022) were examined from 18 to 35-year-old U.S. college and university students. Methods: Linear and logistic regressions were used to examine associations between SGM identity and mental health. Mediation and structural equation modeling were used to examine potential links among risk factors. Results: On average, ∼18% of students identified as SGM, which included a 6-fold increase in SGM self-identification across this 15-year period. Depression rates increased over time; ∼12% of students reported major depression. SGM students were 3.18 times (z = 111.16, p < .001) more likely to report depression than non-SGM students (26.85% vs. 8.53%). Disproportionate discrimination and lack of school belonging partially explained SGM disparities in depression. SGM students were twice as likely to utilize therapy (z = 115.42, p < .001) but half as likely seek help from family (z = 55.48, p ≤ .001). Conclusions: Academic institutions must take concrete steps to reduce barriers mental health care, combat discrimination, and bolster community belonging and interpersonal support for SGM students. [ABSTRACT FROM AUTHOR]

Introduction: Until 12 January 2000, the UK Armed Forces retained a policy of discharging all gay, lesbian, bisexual, and transgender personnel under exemptive military laws. The so-called 'gay ban' was enforced with the rationale that homosexuality was incompatible with military service. Little research has explored the experiences of LGBT + veterans or the impact of the 'gay ban' policy. Methods: In 2021, 15 LGBT + veterans who had been affected by the 'gay ban' participated in semi-structured interviews lasting around 90 minutes. Interview transcripts were analysed using thematic analysis. Results: Five overarching themes were identified in exploring the experiences and impact of the 'gay ban' policy: LGBT + identity struggle; camouflage; intense investigative process; extraction, exclusion and loss; and the personal impact. Conclusions: Serving in the UK Armed Forces during this homosexuality ban policy affected the social, health and well-being of LGBT + veterans. The necessity for LGBT + veterans to hide their sexual orientation and/or gender identity, the impact of investigations, loss of careers and alienation have led to long-term experiences of social isolation, loneliness due to barriers to connecting to others and difficulties around health and well-being. Policy Implications: LGBT + veteran vulnerability and traumatic experiences need to be understood in the context of help-seeking behaviour and service provision. The implications for policy change include achieving health and social care equity in relation to access to support services. Support services need to ensure that there is an awareness of the impact of serving under the discriminatory 'gay ban' policy. [ABSTRACT FROM AUTHOR]

People identifying as lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, or other gender identities or sexual orientations (LGBTQIA+) often face workplace bias or discrimination. Unique dynamics in academic neuroscience, psychology, and psychiatry departments warrant specific investigation. Trainee, staff, and faculty participants (N = 534) completed an online survey assessing identity and workplace experiences. Many respondents were not out about their identity at work (46%) despite most being out personally (81%). A positive workplace climate is critical to outness, career satisfaction, and mental health. Experiences of exclusionary behaviour (24%) and depression (37%) were common. Qualitative responses called for explicit LGBTQIA+ inclusion in diversity and classroom curricula, structural and financial support for LGBTQIA+ people, and greater support for individuals of colour and/or identifying as trans. Respondents expressed a pervasive sentiment that academic institutions should avoid putting undue, unpaid burden of diversity work on minoritized individuals and should aim to promote meaningful structural change rather than creating the appearance of inclusivity. [ABSTRACT FROM AUTHOR]

Abstract Background Patients from the lesbian, gay, bisexual, transgender, queer plus (LGBTQ +) community face various health inequalities and report poor healthcare experiences. Little is known about how knowledgeable and confident UK doctors are around LGBTQ + health, and previous research demonstrates that UK medical schools rarely deliver teaching in this area. This research evaluated the level of knowledge, awareness and confidence of LGBTQ + health among Internal Medical Trainees (IMTs) in London. Methods London IMTs were invited to complete an online questionnaire evaluating knowledge, awareness and confidence in LGBTQ + health. Stratified analysis of results by demographics was performed. Results Three hundred and fifteen surveys were analysed from 796 eligible trainees (40%). Confidence in caring for LGBTQ + patients was variable. Confidence in discussing gender identity was lower than for sexual orientation. Knowledge of health issues affecting LGBTQ + patients varied. Most participants had never received training on LGBTQ + health at undergraduate (n = 201, 64%) or postgraduate level (n = 252, 80%), but the majority of participants felt that training would be useful (n = 233, 74%). Stratified analysis revealed that IMTs who received previous LGBTQ + teaching at undergraduate or postgraduate level were considerably more confident discussing sexual orientation with patients, compared to those who received no previous teaching. Conclusions There is a clear need for education on LGBTQ + health, given the varied levels of knowledge and confidence identified. A significant majority of IMTs in London have never received teaching on LGBTQ + health, although there exists a strong desire for this. LGBTQ + health topics should be integrated into undergraduate and postgraduate training and examinations for IMTs. This would support IMTs in delivering high quality and inclusive care for all patients, particularly those of sexual orientation and gender identity minorities. There are relatively few published studies exploring competency in LGBTQ + health among doctors, and this is the first among UK Internal Medicine Trainees.

Family reactions to coming out can affect the mental health of individuals who disclose their sexual orientation or gender identity. Therefore, it is important to have an appropriate tool to assess them. The Perceived Parental Reactions Scale (PPRS) assessed perceived parental reactions to the disclosure of gay, lesbian, or bisexual sexual orientation by their children. We adapted the PPRS so that it can be answered by any individual belonging to a sexual or gender minority, and can be answered regarding any member of the family, not just parents. A total of 2627 individuals from Spain participated in this study, with a mean age of 31.59 (SD = 11.26). Participants completed the adapted PPRS questionnaire, now named the Family Reaction to Coming Out (FRCO). The FRCO assessed family reactions when disclosing their sexual orientation or gender identity. The majority of participants identified as cisgender men (47.5%) or cisgender women (44.9%), and as gay/lesbian (51.9%). A one‐factor model emerged through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The FRCO displayed excellent internal consistency and demonstrated good levels of invariance for participants' gender (male vs female vs nonbinary gender), family member's gender (male vs female), and type of family member (parents vs other family member). Supporting convergent validity, the FRCO has shown a positive correlation with fear of family reaction to coming out. These findings support the validity and reliability of the FRCO tool in assessing the reactions of any family member within the Spanish context. [ABSTRACT FROM AUTHOR]

Background: Patients from the lesbian, gay, bisexual, transgender, queer plus (LGBTQ +) community face various health inequalities and report poor healthcare experiences. Little is known about how knowledgeable and confident UK doctors are around LGBTQ + health, and previous research demonstrates that UK medical schools rarely deliver teaching in this area. This research evaluated the level of knowledge, awareness and confidence of LGBTQ + health among Internal Medical Trainees (IMTs) in London. Methods: London IMTs were invited to complete an online questionnaire evaluating knowledge, awareness and confidence in LGBTQ + health. Stratified analysis of results by demographics was performed. Results: Three hundred and fifteen surveys were analysed from 796 eligible trainees (40%). Confidence in caring for LGBTQ + patients was variable. Confidence in discussing gender identity was lower than for sexual orientation. Knowledge of health issues affecting LGBTQ + patients varied. Most participants had never received training on LGBTQ + health at undergraduate (n = 201, 64%) or postgraduate level (n = 252, 80%), but the majority of participants felt that training would be useful (n = 233, 74%). Stratified analysis revealed that IMTs who received previous LGBTQ + teaching at undergraduate or postgraduate level were considerably more confident discussing sexual orientation with patients, compared to those who received no previous teaching. Conclusions: There is a clear need for education on LGBTQ + health, given the varied levels of knowledge and confidence identified. A significant majority of IMTs in London have never received teaching on LGBTQ + health, although there exists a strong desire for this. LGBTQ + health topics should be integrated into undergraduate and postgraduate training and examinations for IMTs. This would support IMTs in delivering high quality and inclusive care for all patients, particularly those of sexual orientation and gender identity minorities. There are relatively few published studies exploring competency in LGBTQ + health among doctors, and this is the first among UK Internal Medicine Trainees. [ABSTRACT FROM AUTHOR]

Takatāpui/LGBTIQ + people's experiences of homelessness remain poorly understood in Aotearoa New Zealand. Using data from semi-structured interviews with eight people who identified as Takatāpui/LGBTIQ + and had experienced homelessness, this paper explores their experiences while homeless. The analysis showed the necessity of strength of character, how Takatāpui/LGBTIQ + people presented a different self in order to be accepted, the different strategies used to survive, the importance of implementing boundaries for self-protection, and missed points of intervention and support. Our findings show how participants were failed by the housing support system, and had to rely on themselves and their communities during periods of homelessness. [ABSTRACT FROM AUTHOR]

This qualitative study examined the sporting experiences of individuals of diverse sexual orientation and gender identity (SOGI) in rural and remote areas of Australia - contexts where marginalised groups can feel excluded based on gender or sexuality, and where physical activity options may be limited. Twelve participants (aged 29-73 years) identifying as female or gender fluid, and as queer, bisexual, gay, lesbian or pansexual, completed an online, qualitative survey. Thematic analysis and an integrative theory of belonging were used to interpret the experiences and feelings of belonging, exclusion and resistance to heteronormativity found in the data. The development of viable opportunities for sport participation and physical activities that foster a sense of belonging and health in rural or remote Australian communities requires strategies based on a deep understanding of the needs and identities of individuals of diverse SOGI, as well as the cultural and social contexts in which people live. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine associations between sexual minority status (e.g., gay or bisexual) and sleep problems in a demographically diverse, national sample of U.S. early adolescents. Methods: We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020) to estimate associations between sexual orientation and sleep problems or disturbance, adjusting for confounders and testing potential mediators (depressive problems, stress problems, family conflict, and parental monitoring). Results: In a sample of 8563 adolescents 10- to 14-years-old, 4.4% identified as sexual minority individuals. Sexual minority status was associated with self-reported trouble falling or staying asleep (risk ratio [RR] = 2.24, 95% confidence interval [CI] = 1.88-2.68) and caregiver-reported sleep disturbance (RR = 1.50, 95% CI = 1.29-1.75). The association between sexual minority status and trouble falling or staying asleep was partially mediated by greater depressive problems, more family conflict, and less parental monitoring, whereas the association between sexual minority status and caregiver-reported sleep disturbance was partially mediated by greater depressive problems, higher stress, and greater family conflict. Conclusions: Our results indicate that sexual minority status may be linked to sleep disturbance in early adolescence. Depressive problems, stress, family conflict, and less parental monitoring partially mediate disparities in sleep health for sexual minority youth. Future research could test interventions to promote family and caregiver acceptance and mental health support for sexual minority youth to improve their sleep and other health outcomes.

Lesbian, gay, bisexual, trans, queer, and asexual (LGBTQA+) young people with disability are known to experience higher rates of harassment or abuse than LGBTQA+ young people without disability. This study focused on participants in Australia and identified factors associated with harassment or abuse among LGBTQA+ adolescents and young adults who reported a disability as well as associations with mental health outcomes. Analyses were conducted from a national survey that included 2,500 LGBTQA+ people who reported a disability and were aged 14 to 21 years. Measures included experiences in the past 12 months of verbal and physical harassment or abuse due to one's sexual orientation or gender identity, sexual harassment or abuse, mental health, suicidality, and sociodemographic traits. Overall, 48.4% of participants with disability reported experiencing verbal harassment or abuse, 12.4% physical harassment or abuse, and 29.7% sexual assault or harassment. In multivariable regression analyses, verbal harassment or abuse was significantly more likely among trans men, participants with an intellectual disability, and those who were "out" to most or all of their family. Physical harassment or abuse was significantly more likely among participants with a physical or sensory disability. Sexual harassment or abuse was significantly more likely among trans women and participants with a physical or sensory disability. Participants who experienced harassment or abuse were also significantly more likely to have attempted suicide in the past 12 months. These findings will assist policymakers and practitioners in identifying contexts linked to a heightened risk of abuse among LGBTQA+ young people with disability and further underscore an immediate need to address and prevent harm in this population. [ABSTRACT FROM AUTHOR]

Sexual and gender minority stress is associated with negative physical and mental health outcomes, such as hypertension and depression. Expanding on previous reviews of the literature on cross-sectional and long-term prospective associations between sexual and gender minority stress and health outcomes, the current systematic review synthesizes the evidence on how everyday sexual and gender minority stress relates to momentary changes in health. The findings of 53 experience sampling studies published between 2007 and 2022 suggest that daily and momentary within-persons fluctuations in minority stressors are associated with cognitive–emotional (e.g., affect, suicidality), behavioral (e.g., substance use), social (e.g., relationship satisfaction), and physical health outcomes (e.g., somatic symptoms). These findings suggest that sexual and gender minority stress is a dynamic process that can vary within individuals over time and significantly impact everyday mental and physical health. We discuss the implications of these findings for minority stress theory, LGBTQ+ health research, LGBTQ+ affirming therapy, and prevention initiatives. The current experience sampling literature is limited by a lack of attention to gender minority stress and a focus on a limited range of health outcomes. Methodological and theoretical considerations for future experience sampling research are discussed in light of these limitations. [ABSTRACT FROM AUTHOR]

Sexual and gender minority adolescents face specific stressors associated with their minority status, leading to compromised socioemotional outcomes and sleep. Sleep patterns have, in turn, been found to predict socioemotional outcomes. As such, we aimed to investigate whether healthy sleep patterns prospectively predicted socioemotional outcomes, and whether associations varied as a function of sexual and gender minority status. We conducted a secondary data analysis among adolescents at age 14 to 17, from a nationally representative prospective cohort in the United Kingdom (N = 8923, mean age = 13.8), with 7021 cisgender heterosexual, 1801 sexual minority, and 101 gender minority adolescents. Indicators of socioemotional outcomes included self-esteem, emotional well-being, peer relationships, and relationship with parents. The results showed that gender minority adolescents reported the worst sleep patterns and socioemotional outcomes, followed by sexual minority and cisgender heterosexual adolescents. Results from multi-group path analyses showed that emotional well-being, self-esteem, and peer relationships at age 17 were prospectively predicted by sleep patterns and the associations were moderated by sexual and gender minority status. Influence of sleep patterns, particularly sleep initiation problems and frequent awakening, on socioemotional outcomes was greater among gender minority adolescents, when compared to cisgender heterosexual adolescents. In conclusion, positive socioemotional outcomes were predicted by healthy sleep patterns. The potential role of sleep health in optimizing socioemotional outcomes among sexual and gender minority adolescents might warrant further investigation in prevention or intervention studies. [ABSTRACT FROM AUTHOR]

We aim to quantify disparities in substance-related acute events (i.e. hospitalizations and deaths for substances, including alcohol, cannabis, opioids, narcotics, and/or illicit drugs) across sexual orientations based on health administrative data. This was a longitudinal analysis from six waves of the Canadian Community Health Survey (2009–2014) linked to hospitalization/mortality data in Ontario, Canada. The study sample consisted of survey respondents aged ≥15 (weighted n = 15,406,000) who provided a valid response to the question about sexual orientation. The primary outcome was substance-related acute events, including hospitalizations and deaths due to alcohol, cannabis, opioids, narcotics, and/or illicit drugs. Disparities in substance-related acute events across sexual orientation and gender were examined using flexible parametric survival analysis. Bisexual women had hazard ratios of 2.46 (95% confidence interval: 1.46–4.15) for any substance-related acute event and 2.67 (95% confidence interval: 1.42–5.00) for non-alcohol substance acute events compared to heterosexual women. Lesbian women did not exhibit significant differences in acute event risk compared to heterosexual women. Gay and bisexual men demonstrated elevated but not statistically significant risks compared to heterosexual men. Bisexual women face higher risks of substance-related acute events, potentially due to self-medication of unique stressors brought on by discrimination and isolation. Enhanced education and training for healthcare professionals are essential to increase awareness and sensitivity toward the heightened substance use risk among lesbian, gay, and bisexual individuals. Targeted interventions aimed at reducing substance use problems among bisexual individuals warrant increased funding and research. [ABSTRACT FROM AUTHOR]

Background: Health inequality among lesbian, gay, bisexual and transgender people has been highlighted in several reports. Ambulance services have been advised to record the gender identity and sexuality of all patients treated to support monitoring of health equity. Method: Four NHS ambulance services in England were asked for their data showing whether the completed patient record for each incident included gender identity and sexuality. Results: All services responded; data from three were used in the analysis. Only one service had the means to record a patient's sexual orientation. Gender identity was recorded by all services but the rate of data capture as well as potential responses varied between organisations. Discussion: There was little consistency between the three services regarding rates of data being captured, responses and potential answers. These variations could not be explained, although introduction of electronic patient records may impact data capture and quality. [ABSTRACT FROM AUTHOR]

The research team carried out a study of parental' attitudes and behaviors towards their children's "coming-out" and gender identity. The study was conducted in Ho Chi Minh City in Vietnam with a group of respondents who are parents of the FPT students. The study was conducted through quantitative methods using questionnaires modified from previous qualitative studies of the researchers. The results show that the group of respondents had low rates of shock or devastation because of their children's sexual orientation, but they still had a worried attitude. While their behavior is largely non-violent towards their children, they still try to encourage their children to conform to the biological sex they were born with. Parents are also more inclined to accept their children's sexual orientation if society and its laws accept it. The research results have and will contribute to the implementation of many campaigns and activities related to the topic of LGBT parents and children. [ABSTRACT FROM AUTHOR]

Sexual and gender minorities face high levels of stigma, discrimination, and violence. In many countries, they are often criminalized and are at risk of mental health challenges. In Zambia, little is known about the psychosocial challenges and coping strategies of sexual and gender minorities. This study sought to explore psychosocial challenges and coping strategies among sexual and gender minority populations in Lusaka, Zambia to inform mental health and human rights promotion for this population. The study used a qualitative phenomenological study design. Data were collected through in-depth interviews with 16 sexual and gender minority participants (lesbian, gay, bisexual, and transgender) and four key informants. The sexual minorities included four lesbian, five gay, and three bisexual participants while the gender minorities included two transgender men and two transgender women. Interviews with gender and sexual minorities were mostly focused on the lived experiences of participants, while those of key informants focused on their work with sexual and gender minorities. Snowball strategy was used to recruit participants, while purposive sampling was used to select key informants. All interviews were recorded and transcribed verbatim. Thematic analysis was carried out with the aid of Nvivo 12 software. Psychosocial challenges included victimization in the form of threats and physical assault. Stigma and discrimination were experienced in different settings such as healthcare, the workplace, and school. Participants reported having experienced feelings of depression. Rejection from family members was experienced by those who revealed their sexual or gender minority status. Reported coping strategies included social support, self-concealment, listening to music, and substance use. This study suggests that sexual and gender minorities in Zambia experience various psychosocial challenges related to their sexuality and gender identity. To assist them cope better with the obstacles they experience, improved psychosocial counseling and mental health services are needed. [ABSTRACT FROM AUTHOR]

Abstract Background While various consequences of belonging to sexual minorities have been examined – it remains completely unclear whether sexual minorities believe that they die earlier. Thus, our aim was to investigate the association between sexual orientation and expected longevity. Methods Data from the German Ageing Survey, a nationally representative sample, were used (year 2014, n = 6,424 individuals; mean age: 63.6 years). It included individuals residing in private households aged 40 years and over in Germany. Sexual orientation (heterosexual; sexual minorities including homosexual, bisexual, or other) served as key independent variable. As outcome, we used the expected life expectancy. In multiple linear regressions it was adjusted for gender, age, education, marital status, labour force participation, BMI, smoking status, alcohol intake, sports activities, physical functioning, self-rated health and the number of chronic conditions. Results Adjusting for sociodemographic, lifestyle-related and health-related factors, our study showed that sexual minorities reported a lower expected longevity (β=-0.69, p = .02) compared to heterosexuals. This association remained nearly the same in robustness checks. Conclusion After adjusting for various other factors, our findings showed a lower life expectancy among sexual minorities compared to heterosexuals. Efforts are required to make sexual minorities believe in a high life expectancy (e.g., increased optimism or reduced perceived discrimination) – which in turn can help to increase their actual longevity and successful ageing. Future research is required to explore underlying mechanisms (such as expected stigma in later life).

ABSTRACTBackground Sexual and gender minorities face high levels of stigma, discrimination, and violence. In many countries, they are often criminalized and are at risk of mental health challenges. In Zambia, little is known about the psychosocial challenges and coping strategies of sexual and gender minorities. This study sought to explore psychosocial challenges and coping strategies among sexual and gender minority populations in Lusaka, Zambia to inform mental health and human rights promotion for this population.Methods The study used a qualitative phenomenological study design. Data were collected through in-depth interviews with 16 sexual and gender minority participants (lesbian, gay, bisexual, and transgender) and four key informants. The sexual minorities included four lesbian, five gay, and three bisexual participants while the gender minorities included two transgender men and two transgender women. Interviews with gender and sexual minorities were mostly focused on the lived experiences of participants, while those of key informants focused on their work with sexual and gender minorities. Snowball strategy was used to recruit participants, while purposive sampling was used to select key informants. All interviews were recorded and transcribed verbatim. Thematic analysis was carried out with the aid of Nvivo 12 software.Results Psychosocial challenges included victimization in the form of threats and physical assault. Stigma and discrimination were experienced in different settings such as healthcare, the workplace, and school. Participants reported having experienced feelings of depression. Rejection from family members was experienced by those who revealed their sexual or gender minority status. Reported coping strategies included social support, self-concealment, listening to music, and substance use.Conclusion This study suggests that sexual and gender minorities in Zambia experience various psychosocial challenges related to their sexuality and gender identity. To assist them cope better with the obstacles they experience, improved psychosocial counseling and mental health services are needed.

Background: While various consequences of belonging to sexual minorities have been examined – it remains completely unclear whether sexual minorities believe that they die earlier. Thus, our aim was to investigate the association between sexual orientation and expected longevity. Methods: Data from the German Ageing Survey, a nationally representative sample, were used (year 2014, n = 6,424 individuals; mean age: 63.6 years). It included individuals residing in private households aged 40 years and over in Germany. Sexual orientation (heterosexual; sexual minorities including homosexual, bisexual, or other) served as key independent variable. As outcome, we used the expected life expectancy. In multiple linear regressions it was adjusted for gender, age, education, marital status, labour force participation, BMI, smoking status, alcohol intake, sports activities, physical functioning, self-rated health and the number of chronic conditions. Results: Adjusting for sociodemographic, lifestyle-related and health-related factors, our study showed that sexual minorities reported a lower expected longevity (β=-0.69, p =.02) compared to heterosexuals. This association remained nearly the same in robustness checks. Conclusion: After adjusting for various other factors, our findings showed a lower life expectancy among sexual minorities compared to heterosexuals. Efforts are required to make sexual minorities believe in a high life expectancy (e.g., increased optimism or reduced perceived discrimination) – which in turn can help to increase their actual longevity and successful ageing. Future research is required to explore underlying mechanisms (such as expected stigma in later life). [ABSTRACT FROM AUTHOR]

Introduction: Studies have found that sexual minorities, including gay and bisexual men, have more mental health problems than the heterosexual population. The aim of this study is to examine the prevalence of depression in gay and bisexual men and its relationship with some socio-demographic variables. Methods: Participants were recruited from groups on social media such as "Facebook," "Instagram," and an LGBT app. Only homosexual and bisexual men were included in the study. Each participant completed the personal information form and the Beck Depression Inventory. Results: It was found that 28.7% of the 418 homosexual and bisexual men included in the study had mild depression, 29.7% had moderate depression, and 9.1% had severe depression. No statistically significant difference was found between the depression rates of homosexual and bisexual men. Discussion and Conclusion: At the end of the study, it was determined that the rate of depression in homosexual and bisexual men was higher than in the general population. Smoking, alcohol, and substance abuse rates are also higher in this group than in the general population. The limitations of this study are that only gay and bisexual men were included in the study, and there was no control group. [ABSTRACT FROM AUTHOR]

ObjectiveCombine National Collegiate Health Assessment (NCHA) measures indicating LGBTQ + membership into a single variable in order to analyze health responses of this group as compared to their cisgender, heterosexual (cis-het) peers. Participants: Students at a liberal arts university who completed the Spring 2019 NCHA-II study (n = 1107). Methods: Four different NCHA sexual orientation and gender identification variables were combined, creating a new variable to examine the campus LGBTQ + student sub-sample as a single, complete group. That group was then compared to cis-het students across multiple variables. Results: LGBTQ + students reported statistically significant differences for key variables such as suicide attempts, suicidal ideation, and self-harm, as well as for stressors that impact academic success such as discrimination. Conclusions: This analysis indicates that the challenges campus LGBTQ + students face are much different than their cis-het peers. Support from campus community members is suggested to reduce negative impacts for these students. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyze the reliability and validity of a Korean version of the Nursing Student Attitudes and Knowledge Toward Lesbian, Gay, Bisexual, and Transgender Patients (K-NAKL) Scale, which measures health and heterosexual attitudes toward LGBT individuals. Background: Lesbian, gay, bisexual, and transgender (LGBT) individuals often face discrimination and a lack of care experience on the part of healthcare professionals. Introduction: In South Korea, the current knowledge and attitude measurement tools for medical staff regarding LGBT individuals are limited, as they only focus on homosexuality and do not account for different sexual orientations. Methods: The participants were 217 nursing college students aged 18–25. The item–total correlations method and Cronbach's alpha coefficient were used to analyze internal consistency reliability. Face validity, content validity, construct validity, and criterion validity testing were conducted to establish scale validity. We made sure to follow STROBE guidelines when carrying out this research. Results: The K-NAKL is a culturally appropriate instrument used to measure the attitudes and knowledge of Korean nursing students when it comes to LGBT health. Discussion: As LGBT health is increasingly gaining social interest, the nursing education curriculum needs to produce culturally competent graduates to meet the health needs of this vulnerable and marginalized population. The current study contributes to that goal. Conclusion: The K-NAKL is a valid and reliable tool with which to measure attitudes and knowledge regarding LGBT health among Korean nursing students. Implications for nursing: The K-NAKL can enable Korean nursing students to increase their knowledge and improve their attitudes when caring for the LGBT population. Implications for nursing policy and health policy: The study highlights the importance of incorporating LGBT-related health education into nursing curricula and developing inclusive policies to improve the quality of care and health outcomes for LGBT individuals. [ABSTRACT FROM AUTHOR]

BackgroundThis study examined associations of sexual orientation and gender identity with prevalence of substance use disorders (SUDs) and co-occurring multiple SUDs in the past 12-months during young adulthood in a United States longitudinal cohort.MethodsQuestionnaires self-administered in 2010 and 2015 assessed probable past 12-month nicotine dependence, alcohol abuse and dependence, and drug abuse and dependence among 12,428 participants of an ongoing cohort study when they were ages 20-35 years. Binary or multinomial logistic regressions using generalized estimating equations were used to estimate differences by sexual orientation and gender identity in the odds of SUDs and multiple SUDs, stratified by sex assigned at birth.ResultsCompared with completely heterosexuals (CH), sexual minority (SM; i.e., mostly heterosexual, bisexual, lesbian/gay) participants were generally more likely to have a SUD, including multiple SUDs. Among participants assigned female at birth, adjusted odds ratios (AORs) for SUDs comparing SMs to CHs ranged from 1.61 to 6.97 (ps

Abstract Background Previous studies report vast mental health problems in sexual minority people. Representative national proportion estimates on self-identifying LGB+ persons are missing in Belgium. Lacking data collection regarding sexual orientation in either census or governmental survey data limits our understanding of the true population sizes of different sexual orientation groups and their respective health outcomes. This study assessed the proportion of LGB+ and heterosexual persons in Belgium, LGB+ persons’ self-identification as sexual minority, mental health, and experienced minority stress. Method A representative sample of 4632 individuals drawn from the Belgian National Register completed measures of sexual orientation, subjective minority status, and its importance for their identity as well as a range of mental-health measures. Results LGB+ participants made up 10.02% of the total sample and 52.59% of LGB+ participants self-identified as sexual minority. Most sexual minority participants considered sexual minority characteristics important for their identity. LGB+ persons reported significantly worse mental health than heterosexual persons. Sexual minority participants did not report high levels of minority stress, but those who considered minority characteristics key for their identity reported higher levels of minority stress. LGB+ participants who did not identify as minority reported fewer persons they trust. Conclusions The proportion of persons who identified as LGB+ was twice as large as the proportion of persons who identified as a minority based on their sexual orientation. LGB+ persons show poorer mental health compared to heterosexual persons. This difference was unrelated to minority stress, sociodemographic differences, minority identification, or the importance attached to minority characteristics.

The objective of this study was to examine sexual orientation-based disparities in six self-reported health outcomes among millennial aged military veterans. We collected data using The Millennial Veteran Health Study, a cross-sectional internet-based survey with extensive quality control measures. The survey was fielded April through December 2020 and targeted millennial aged veterans across the United States. A total of 680 eligible respondents completed the survey. We assessed six binary health outcomes: alcohol use, marijuana use, frequent chronic pain, opioid misuse, high psychological distress, and fair or poor health status. Using logistic regression adjusted for a range of demographic, socioeconomic, and military-based covariates, we find that bisexual veterans consistently report worse health than straight veterans for all six health outcomes tested. Results for gay or lesbian, compared to straight veterans, were less consistent. Sensitivity models with continuous outcomes, and stratified by gender, found similar results. These results have implications for improving the health of bisexual individuals, including addressing discrimination, belonging, and social identity, particularly in institutional settings that have traditionally heteronormative and masculine cultures such as the military. [ABSTRACT FROM AUTHOR]

Non-exclusive sexuality identity labels such as "mostly straight" and "mostly gay" describe distinct sexualities. While research documents their existence and distinctiveness, little focus has been given to friendship dynamics with these groups and research on friendship has a heteronormative bias. In this study, we use data collected with 25 men with non-exclusive sexualities from a university in the northeastern United States to examine their friendship dynamics and intimacy practices in order to advance understanding of friendship beyond binary frameworks of straight and gay friendship groups. We document the friendship practices of men who are mostly straight, "bisexual-leaning," and mostly gay, and develop understanding of bromance as a term that has extended to cross-sexuality and cross-gender friendships. We call for greater engagement with these sexuality labels and greater recognition of fluidity as a concept that extends beyond sexology and debates about heterosexual privilege to understand the complex dynamics of intimacy and friendship and a broader range of friendship practices among men that such understandings facilitate. [ABSTRACT FROM AUTHOR]

What are the attitudes, beliefs and knowledge gaps of physiotherapists in Australia regarding working with patients who identify as LGBTQIA+? Qualitative design using a custom online survey. Physiotherapists currently practising in Australia. Data were analysed using reflexive thematic analysis. A total of 273 participants met the eligibility criteria. Participating physiotherapists were predominantly female (73%), aged between 22 and 67 years, residing in a large Australian city (77%) and working in musculoskeletal physiotherapy (57%), in private practice (50%) and hospital (33%) settings. Almost 6% self-identified as part of the LGBTQIA+ community. Only 4% of the participants had received training related to healthcare interactions or cultural safety for working with patients who identify as LGBTQIA+ in the context of physiotherapy. Three main themes regarding approaches to physiotherapy management were identified: treating the whole person in context, treating everyone the same, and treating the body part. Gaps in knowledge were primarily related to understandings of the relevance of sexual orientation and gender identity to physiotherapy and health issues specific to LGBTQIA+ patients. Physiotherapists can be considered to approach gender identity and sexual orientation in three distinct ways and suggest a range of knowledge and attitudes about working with patients who identify as LGBTQIA+. Physiotherapists who consider gender identity and sexual orientation to be relevant to physiotherapy consultations appear to have higher levels of knowledge and understanding of this topic and may also understand physiotherapy as multifactorial and not only biomedical. [ABSTRACT FROM AUTHOR]

The main goal of this research is to analyze how the Eurovision Song Contest (ESC) audience perceives the competition's impact on the LGBT community and to identify whether being part of the ESC fandom conditions that perception. Most of the existing research on the topic uses a qualitative approach and focuses on a specific audience profile; however, this study adopts a quantitative approach conducted in an exploratory manner and focuses on general audience perceptions, identifying differences among them based on age, gender, sexual orientation, and especially involvement with the contest, analyzing the role that being a fan can play. Utilizing a sample of 238 individuals, the research mainly concludes that the contest audience perceives the ESC as favoring merely the visibility of the LGBT collective; however, highly involved fans perceive not only that visibility but also a greater contribution of the ESC to the defense and acceptance of the rights associated with the LGBT community. [ABSTRACT FROM AUTHOR]

Research on the mental health of people who identify as lesbian, gay, bisexual or transgender (LGBT) often emphasises individual vulnerability to mental health issues. However, attitudes towards LGBT individuals may also contribute to their experiences of minority stress. In the present study, the relationship between mental health literacy (MHL) and attitudes towards LGBT individuals in Australia and India was investigated. Seven-hundred and eleven participants (355 male) from Australia (n = 303) and India (n = 408) completed an online survey which included questionnaires indexing the participants' MHL and their attitudes towards LGBT individuals. MHL was associated with attitude scores, such that participants with higher levels of MHL tended to report more positive attitudes towards LGBT individuals. These relationships were stronger for Australian participants compared to Indian participants. These findings suggest that minority stress may be intensified for LGBT individuals when the MHL of the people they interact with is low. Alternatively, MHL may signal how willing an individual is to offer mental health support to a LGBT person. The present results also highlight the influence of cultural context on MHL and the need to consider this when examining attitudes towards LGBT individuals. [ABSTRACT FROM AUTHOR]

Background and Objectives The aim of our study was to fill the gap in knowledge regarding the association between sexual orientation and psychosocial outcomes (loneliness and subjective well-being) based on nationally representative samples. Research Design and Methods Cross-sectional data collected in 2017 were taken from a nationally representative sample of individuals in the second half of life (>40 years) in Germany (n = 4,785, average age 66.4 years, standard deviation [ SD ]: 10.5 years). Outcomes were assessed using well-established tools (life satisfaction: Satisfaction with Life Scale; positive and negative affect: Positive and Negative Affect Schedule; loneliness: De Jong Gierveld Loneliness Scale). Sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual, and other). Analyses were adjusted for socioeconomic factors, lifestyle-related factors, and health-related factors. Results In total, around 7.8% of respondents belonged to sexual minorities. Adjusted for various several socioeconomic, lifestyle-related and health-related covariates, linear regressions showed that sexual minority older adults reported higher loneliness scores (β = 0.07, p <.05), whereas sexual orientation was not associated with subjective well-being (life satisfaction, as well as positive and negative affect). Furthermore, our analysis showed that gender, age, marital status, and depressive symptoms were consistently associated with loneliness and subjective well-being. Discussion and Implications In accordance with minority stress theory, our study showed that sexual minority older adults report higher loneliness scores. This finding is important as loneliness has become widely acknowledged as a new geriatric giant, which could increase, for example, the risk of morbidity and mortality. Moreover, reducing loneliness is important for successful aging. [ABSTRACT FROM AUTHOR]

Background and Objectives Sexual satisfaction is an important part of sexual health and overall well-being. A large number of older people continue to be sexually active, and many are satisfied with their sex life. However, little is known about whether sexual satisfaction differs according to sexual orientation. Therefore, the aim of the study was to investigate whether sexual satisfaction differs according to sexual orientation in later life. Research Design and Methods The German Ageing Survey is a nationally representative study of the German population aged 40+. In the third wave (2008), data on both sexual orientation (heterosexual, homosexual, bisexual, other) and sexual satisfaction (1—very dissatisfied to 5—very satisfied) were collected. Multiple regression analyses with sampling weights were performed (stratified by age: 40–64; 65+). Results We included 4,856 individuals in our analysis (mean age 57.6 ± 11.6; 40–85 years, 50.4% were women, 92.3% (n = 4,483) were heterosexual, and 7.7% (n = 373) were sexual minority adults). In sum, 55.9% of heterosexual individuals and 52.3% of sexual minority adults were satisfied or very satisfied with their sex life. Multiple regression analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged (β = 0.07; p =.45) and older adults (β = 0.01; p =.87). Higher sexual satisfaction was associated with lower loneliness scores, partnership satisfaction, importance of sexuality and intimacy, and better health status. Discussion and Implications Our analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged and older adults. Lower loneliness, better health status, and partnership satisfaction significantly contributed to higher sexual satisfaction. Approximately 45% of older individuals (aged 65 years and older), regardless of their sexual orientation, were still satisfied with their sex life. [ABSTRACT FROM AUTHOR]

BackgroundLittle is known about sexual problems and genitourinary health of older sexual minority adults, who comprise up to 4% of the adult population but may differ in experiences of genitourinary aging, given known health disparities and behavior differences.AimTo examine and compare genitourinary and sexual complaints among older sexual minority and sexual majority adults.MethodsWe analyzed data from the 2010-2011 National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of older community-dwelling U.S. adults. Sexual minority men were defined as those who have sex with men or with both women and men. Sexual minority women were those who have sex with women or with both women and men. Descriptive statistics, weighted frequencies, and the chi-square test were used to compare outcomes by sexual orientation group and gender.Main outcome measuresStructured questionnaires examined sexual activity, practices, and genitourinary problems such as erectile dysfunction, insufficient vaginal lubrication, and urinary incontinence (UI).ResultsOf 2,813 participants (median age 69.6 years), 4.2% were sexual minorities (5.3% of men, 3.5% of women). Among men, sexual minorities were more likely to report UI (35.6% vs 21.8%; P = .029), but otherwise the 2 groups had similar prevalences of other urinary symptoms, importance of sexual activity, sexual practices, sexual activity within the last 3 months, and erectile difficulty (P > .10 for all). Among women, sexual minorities were more likely to report receiving oral sex (42.5% vs. 21.2%; P = .004), but otherwise the 2 groups had similar prevalences of UI, other urinary symptoms, importance of sexual activity, sexual activity within the last 3 months, and difficulty with lubrication (P > .10 for all).Clinical implicationsSexual activity and sexual problems may be as common among older sexual minority adults as in their sexual majority counterparts, whereas UI may be more common in sexual minority men compared with sexual majority men. Therefore, clinicians should employ culturally-relevant health screening, diagnosis, and treatment to ensure reaching all adults regardless of sexual orientation.Strengths & limitationsStrengths include a national population-based sample of older adults that describes sexual and genitourinary health. Statistical power was limited by the small numbers of sexual minority individuals.ConclusionHere we provide new evidence that older sexual minority men may experience UI more often than sexual majority men, and that sexual practices may differ between sexual minority and majority women, but frequency of sexual problems is similar. Given the challenges faced by sexual minority individuals in accessing equitable health care, clinicians must ensure that diagnosis and treatment are relevant to people of all sexual orientations. Obedin-Maliver J, Lisha N, Breyer BN. More Similarities Than Differences? An Exploratory Analysis Comparing the Sexual Complaints, Sexual Experiences, and Genitourinary Health of Older Sexual Minority and Sexual Majority Adults. J Sex Med 2019;16:347-350.

During the COVID‐19 pandemic, physical distancing measures to prevent transmission of the virus have been implemented. The effect of physical distancing measures on loneliness especially for vulnerable groups remained unclear. Thus, we aimed to investigate loneliness in relation with depressive symptoms among lesbian, gay, bisexual, trans, inter, asexual, and queer (LGBT) persons compared with cis‐heterosexual persons during the pandemic. We conducted an online survey during the first two waves of the COVID‐19 pandemic in Germany. The survey contained self‐categorizations regarding sexual orientation and gender identity, questions on loneliness, social contacts, depressive symptoms, and healthcare. Descriptive and regression analysis and propensity score matching across cohorts was conducted using R; 2641 participants took part in first wave of the survey and 4143 participants in the second wave. The proportion of lonely people was higher in the second wave compared with the first wave. LGBT persons were more lonely than cis‐heterosexual persons. In both waves, being LGBT was associated with depressive symptoms, but loneliness mediated the effect, even when adjusting for social contacts. Psychologists and other practitioners should be aware that LGBT clients might have an increased risk for loneliness and depressive symptoms and of the potential burden of the pandemic measures. [ABSTRACT FROM AUTHOR]

This article examines the incidents of discrimination, harassment and violence experienced by lesbian, gay, bisexual and trans (LGBT) individuals in Germany, Portugal and the UK. Using a large cross-national survey and adopting an intra-categorical intersectional approach, it documents how the likelihood of experiencing discrimination, harassment and violence changes within LGBT communities across three national contexts. Moreover, it explores how individual characteristics are associated with the likelihood of experiencing such incidents. The results show that trans people are more at risk compared to cisgender gay, lesbian and bisexual individuals to experience discrimination, harassment and violence. However, other factors, such as socioeconomic resources, also affect the likelihood of individuals experiencing such incidents. The three countries in our study show some nuanced differences in likelihood levels of experiencing discrimination, harassment and violence with regard to differential categories of sexual orientation and gender identity. [ABSTRACT FROM AUTHOR]

Refugees from sexual and gender minorities (SGMs) face particular hardships, which demand adaptive responses. This pilot study explored SGM refugees' experiences of resilience within the context of hardship from pre- to postmigration. Eleven semi-structured interviews with SGM refugees who had migrated to Sweden were analysed using thematic analysis. Four themes were identified: (1) Concealing Identity in Response to Pervasive Oppression, (2) Living in Suspension, (3) External Sources of Support and (4) Strength from Within. Respondents reported utilising limited external resources and employing considerable internal resources in order to navigate and survive in the face of hardships that carried over and shifted across time. A more nuanced understanding of the connections between resilience and hardship is needed to inform post-migration reception practices and service provision in order to facilitate resilience in SGM refugees. [ABSTRACT FROM AUTHOR]

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Intimate partner violence (IPV) is as prevalent or more so as reported by lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals compared with non-LGBTQ individuals. Yet largely due to prior harmful and nonaffirming experiences with service providers, they are reluctant to seek services from domestic violence service providers (DVSP). These factors, combined with the reality that those who do seek services may not be provided with safe, affirming, and effective responses, exacerbate the impact of IPV on LGBTQ health and recovery. The North Carolina (NC) LGBTQ Domestic Violence Response Initiative (NC Initiative) was developed to increase DVSP capacity to serve LGBTQ survivors. This article describes the first four phases of the Initiative's development: (1) formative focus group research with DVSPs statewide, identifying agencies' interest in improving their responses to LGBTQ survivors; (2) Initiative launch, including funding and identification of partners; (3) development of capacity assessment tools; and (4) review of baseline capacity assessment findings. The development of tools, specifically designed to assess capacity of DVSPs to serve LGBTQ survivors, is a unique contribution as no tools existed to do so. The common capacity-building needs and data-informed recommendations identified provide a starting point for agencies expanding into LGBTQ-focused work, who may not have the benefit of grant funding, tools, or evaluators to assist. Our findings, lessons learned, and tools may be used by agencies to evaluate and inform their own practices, thereby creating safer, more affirming agencies that are capable provide effective care to meet unique needs of LGBTQ survivors. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate the process of change in the sexual intentions of LGBT (lesbian, gay, bisexual, transgender) individuals and their experiences pertaining to adaptation to social life. Design and Methods: The participant introduction form and semi‐structured interview form were administered to 18 LGBT people. Findings: Codes were classified by LGBT persons' "environment of birth and childhood," "experience of noticing changes in sexual intentions," "disclosing the change in sexual intentions for the first time," "reactions of the family and close circle," "problems experienced," "efforts made to solve the problems," "thoughts on having different sexual intentions in Turkey," and "future expectations." Practice Implications: Nurses should provide support for LGBT people to use effective resources that would assist them with their sexual intentions and the adjustment process. [ABSTRACT FROM AUTHOR]

Purpose: Thailand has one of the highest suicide rates in Southeast Asia; yet, little is known about suicidality among lesbian, gay, bisexual, trans, queer, intersex, and other gender and sexually diverse (LGBTQI +) people living in the region, who may experience elevated risk for suicide. We sought to identify the prevalence of lifetime suicidal attempts and ideation among a nationally recruited sample of LGBTQI + people in Thailand. We further examined the relationship between levels of sexual/gender stigma and suicidal attempt and ideation. Methods: Data were derived from a national online survey of Thai LGBTQI + individuals between January and March 2018. Multivariable logistic regression was used to examine the relationship between sexual/gender stigma scales, adapting a previously validated instrument, and suicide attempt and ideation. Results: Among 1,290 LGBTQI + participants, the median age was 27 years. The prevalence of suicide attempt and ideation was 16.8% and 50.7%, respectively. In multivariable analyses, after adjusting for potential confounders, experiences of perceived and enacted sexual/gender stigma were independently and positively associated with suicide attempt (adjusted odds ratio [AOR] = 1.25; 95% confidence interval CI:1.10–1.41 and AOR = 1.31; 95% CI:1.11–1.55, respectively) and ideation (AOR = 1.30; 95% CI:1.17–1.43 and AOR = 1.34; 95% CI:1.14–1.58, respectively). Conclusion: One-sixth of the sample reported a suicide attempt, while a half reported ever contemplating suicide. Both experiences of perceived and enacted sexual/gender stigma were associated with lifetime suicide attempt and ideation. Multi-level interventions are needed to decrease stigma and in turn suicide among LGBTQ + people in Thailand, including anti-discrimination policies and support for mental health and well-being. [ABSTRACT FROM AUTHOR]