LGBT health最新文献

{"title":"Adverse Childhood Experiences and Mental Health Outcomes Among Sexual Minority Women: A Population-Based Study.","authors":"Fenfen Ge, Arna Hauksdóttir, Huan Song, Donghao Lu, Gunnar Tómasson, Harpa Rúnarsdóttir, Marín Dögg Bjarnadóttir, Jóhanna Jakobsdóttir, Fang Fang, Thor Aspelund, Unnur Anna Valdimarsdóttir, Edda Bjork Thordardottir","doi":"10.1177/23258292251376565","DOIUrl":"10.1177/23258292251376565","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We aimed to investigate the association between sexual orientation and multiple types of adverse childhood experiences (ACEs) and to what extent ACEs mediate the association between sexual orientation and symptoms of depression and anxiety among sexual minority women (SMW). <b><i>Methods:</i></b> This was a cross-sectional analysis nested within the nationally representative Icelandic Stress-And-Gene-Analysis cohort. Data were collected from March 2018 to June 2019. Participants included 11,007 women, aged 18-69, with data on sexual orientation and ACEs. Self-reported data were obtained on 13 different ACEs, and current symptoms of depression and anxiety. <b><i>Results:</i></b> Overall, 724 (6.6%) identified as sexual minority. The mean age of SMW was 34.0 years (standard deviation [SD] 14.0) and 44.7 years (SD 14.0) for heterosexual women. SMW were more likely to report six or more ACEs than heterosexual women (21.7% vs. 11.3%, respectively), yielding an adjusted odds ratio (aOR) of 2.26 (95% confidence interval [CI] 1.76-2.91). SMW were more likely than heterosexual women to report four types of ACEs: specifically bullying, emotional abuse, sexual abuse, and mental illness in the household (aOR ranging from 1.36 to 1.71). SMW reported higher odds of current symptoms of depression (aOR = 2.10, 95% CI 1.77-2.49) and anxiety (aOR = 1.69, 95% CI 1.41-2.02). The total number of ACEs mediated 32.6% of the association between sexual orientation and depression, and 43.2% of the association between sexual orientation and anxiety. <b><i>Conclusion:</i></b> These findings suggest that ACEs are a major contributor to the mental health disparities observed among SMW.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"574-582"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Dysphoria and Transition in a Patient with Kallmann Syndrome: A Case Report.","authors":"Emilia Doda-Nowak, Anna Cykowska, Remigiusz Domin, Marek Ruchała, Katarzyna Ziemnicka","doi":"10.1177/23258292251378150","DOIUrl":"10.1177/23258292251378150","url":null,"abstract":"","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"619-620"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Influence of Sexual Orientation-Related Nondiscrimination Laws on 30-Year Cardiovascular Disease Risk.","authors":"Yashika Sharma, Morgan Philbin, Bethany Everett, Caleigh Dwyer, Anisha Bhargava, Danny Doan, Lauren B Beach, Lisa Pardee, Billy A Caceres","doi":"10.1089/LGBT.2024.0268","DOIUrl":"10.1089/LGBT.2024.0268","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Our aim was to expand existing evidence on structural determinants of cardiovascular health disparities among lesbian, gay, and bisexual (LGB) adults by examining sexual orientation differences in the impact of sexual orientation-related nondiscrimination laws on 30-year cardiovascular disease (CVD) risk. <b><i>Methods:</i></b> We analyzed data from Waves III (2001-2002), IV (2008-2009), and V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health. Sexual orientation was categorized as exclusively heterosexual, mostly heterosexual, bisexual, or gay/lesbian. We categorized changes in sexual orientation-related nondiscrimination laws between Waves III-IV as no change (reference group), increased, or decreased. We assessed 30-year CVD risk at Wave V using the Framingham Risk Score. We ran sex-stratified regression models to examine whether the association between changes in sexual orientation-related nondiscrimination laws and 30-year CVD risk was moderated by sexual orientation. <b><i>Results:</i></b> The sample included 3768 participants (mean age [standard deviation] = 28.7 [±1.72] years) of whom approximately 77% were White, 11% Hispanic, and 51% female. Compared with exclusively heterosexual participants, an increase in nondiscrimination laws was associated with lower CVD risk among mostly heterosexual women (<i>B =</i> -5.05, 95% confidence interval [CI] = -8.50 to -1.59) and gay men (<i>B =</i> -10.22, 95% CI = -19.05 to -1.39). There were no significant differences for other LGB subgroups when compared with exclusively heterosexual adults. <b><i>Conclusions:</i></b> Increasing laws that prohibit sexual orientation-related discrimination may play an important role in reducing CVD risk among some LGB subgroups. These findings can inform structural-level interventions to reduce CVD risk among LGB adults.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"562-573"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting What We Built: A Reflection on Sexual and Gender Minority Research Achievements, What We Stand to Lose, and How to Sustain the Work Ahead.","authors":"Katrina S Kennedy, Harry Barbee, Danielle German","doi":"10.1177/23258292251376566","DOIUrl":"10.1177/23258292251376566","url":null,"abstract":"<p><p>Amid increasing political threats to sexual and gender minority (SGM) research, this perspective reflects on the evolution of SGM research from the margins of public health to a robust field and assesses the unique vulnerabilities facing SGM researchers across career stages. We discuss how the field can protect its infrastructure, sustain its workforce, and preserve its impact, drawing inspiration from the harm reduction movement and our individual and collective experiences. This is both a reflection and a call to action grounded in care, intergenerational knowledge and solidarity, and the refusal to be erased.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"559-561"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Well-Woman Visits and Cervical Cancer Screening at the Intersection of Sexual Orientation and Race/Ethnicity Among Illinois Women.","authors":"Caitlin M Meyer, Kristin Rankin, Arden Handler, William Barshop, Madison Levecke, Brenikki Floyd","doi":"10.1177/23258292251379503","DOIUrl":"10.1177/23258292251379503","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study examined receipt of a well-woman visit (WWV) and cervical cancer screening (CCS) at the intersection of sexual orientation and race/ethnicity among Illinois women aged 21-65. <b><i>Methods:</i></b> This study used 2016, 2018, and 2020 Illinois Behavioral Risk Factor Surveillance System (BRFSS) data for women aged 21-65 to examine rates of CCS (<i>n</i> = 2848) and 2016-2018, 2020, and 2021 Illinois BRFSS data to examine WWV receipt (<i>n</i> = 5863) by sexual orientation (heterosexual vs. lesbian, gay, and bisexual [LGB]). Self-reported race/ethnicity was tested as an effect modifier to assess intersectionality. Using binomial regression, adjusted prevalence differences (aPD) and 95% confidence intervals (CIs) were estimated. Covariates included age, education, marital status, employment, and health insurance coverage. <b><i>Results:</i></b> Overall, 4.6% of Illinois women aged 21-65 self-identified as LGB. Heterosexual and LGB women had a similar prevalence of receipt of both a WWV (77.1% and 71.7%, respectively; aPD = 3.22, 95% CI: -3.62 to 10.06) and CCS (85.3% and 83.4%, respectively; aPD = 2.13, 95% CI: -4.77 to 9.04). Among non-Hispanic (NH) Black women, heterosexual compared with LGB women had a higher prevalence of receiving both types of care; however, adjusted associations included the null. Hispanic women had similar prevalence estimates by sexual orientation for both outcomes, and NH White heterosexual compared with LGB women had a higher prevalence of CCS, but not WWV. <b><i>Conclusion:</i></b> In Illinois overall, heterosexual and LGB women received preventive care at similar rates. However, when stratified by race/ethnicity, WWV and CCS receipt rates may be higher for heterosexual compared with LGB women, indicating potential missed opportunities for preventive care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"601-609"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of and Recommendations for Asynchronous Online Focus Group Methodology for Sexual and Reproductive Health Research with Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and Other Sexuality- and Gender-Expansive People with a Cervix.","authors":"Madeline C Montgomery, Melissa A Clark, Don Operario, Madina Agénor","doi":"10.1177/23258292251367454","DOIUrl":"10.1177/23258292251367454","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aimed to characterize benefits of asynchronous online focus groups (AOFGs) for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexuality- and gender-expansive (LGBTQIA+) young adults with a cervix and to identify strategies for maximizing those benefits and optimizing data collection in order to increase equitable representation of this population in health research. <b><i>Methods:</i></b> From March to September 2022, we conducted six gender-stratified AOFGs with cisgender women, nonbinary people, and transgender men with a cervix ages 21-29 living in Massachusetts and Rhode Island. Participants completed a questionnaire to evaluate AOFG procedures and experiences. Based on these data and our observations of AOFG engagement, we developed and evaluated strategies to optimize both data collection and participant benefit. <b><i>Results:</i></b> AOFGs provided participants with informational and instrumental support, connection through shared experiences, and opportunity for introspection. Participants expressed a strong desire for social interaction within AOFG discussions, and we identified several strategies that were effective in promoting engagement and interaction in AOFGs. <b><i>Conclusion:</i></b> AOFGs can facilitate inclusion in research of LGBTQIA+ individuals for whom other data collection methods are inaccessible, and may offer direct social and emotional benefits to participants. Promoting social interaction among participants is essential for optimizing these benefits. These findings offer important insight for AOFG methodology as a means of increasing equitable representation of LGBTQIA+ people in health research while offering direct and immediate benefits to participants.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"610-618"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Self-Reassurance in the Relation Between Internalized Gender Stigma, Self-Criticism, and Depression Among Transgender and Nonbinary Patients.","authors":"Roberto Baiocco, Fulvio Gregori, Fau Rosati, Nicola Petrocchi, Jessica Pistella","doi":"10.1177/23258292251371064","DOIUrl":"10.1177/23258292251371064","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This cross-sectional study investigated self-reassurance as a protective factor in mitigating depression related to internalized gender stigma and enhancing overall well-being among transgender and nonbinary (TNB) individuals during the first step of the gender-affirmation process. <b><i>Methods:</i></b> The study included 101 TNB individuals (mean age = 26.42, standard deviation = 8.83) accessing the \"Be as You Are\" Clinical and Research Center at Sapienza University of Rome, Italy, which offers psychological support for individuals undergoing gender-affirmation processes, from 2021 to 2024. Participants completed the Gender Minority Stress and Resilience Scale to assess internalized gender stigma; the Self-Criticizing/Attacking and Self-Reassuring Scale to evaluate self-criticism (i.e., hated-self and inadequate-self), and self-reassurance; and the Symptom Checklist-90 to measure depressive symptoms. Mediation and moderated mediation models were tested. <b><i>Results:</i></b> Mediation models indicated that inadequate-self significantly mediated the relationship between internalized gender stigma and depressive symptoms. The moderated mediation analysis revealed a complex pattern: higher levels of self-reassurance were associated with a more pronounced mediating effect of inadequate-self, suggesting that self-reassurance may facilitate awareness and processing of self-critical thoughts rather than simply buffer their impact. These findings suggest that self-reassurance is a complex psychological resource that may facilitate recognizing self-critical processes and contribute to emotional regulation during the gender-affirming process. <b><i>Conclusion:</i></b> These results underscore the dynamic role of self-reassurance in the initial stages of the gender-affirming process. Clinical approaches such as compassion-focused therapy may help foster self-reassurance and alleviate the psychological burden of minority stress, particularly during the vulnerable period of accessing gender-affirming care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"583-591"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Sexual Orientation and the Impact, Diagnosis, and Treatment of Endometriosis.","authors":"Shea E O'Donnell, Linda Abarbanell","doi":"10.1177/23258292251374717","DOIUrl":"10.1177/23258292251374717","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study examined the association between sexual orientation and the impact, diagnosis, and treatment of endometriosis. <b><i>Methods:</i></b> An online survey was conducted in 2023 with 150 adults in the United States diagnosed with endometriosis, 119 of whom identified as heterosexual and 31 with a minority sexual orientation. The impact of endometriosis was measured using the Endometriosis Impact Questionnaire (EIQ), consisting of eight subscales. We also assessed factors related to diagnosis and treatment satisfaction. Data were analyzed using independent samples <i>t</i>-tests and multiple linear regression. <b><i>Results:</i></b> Participants with a minority sexual orientation had a higher average impact of endometriosis on the EIQ physical, psychological, and social subscales than heterosexual participants but a lower impact on the fertility subscale, all with medium effect sizes. They took an average of 5 years longer to be diagnosed, with 83.9% of sexual minority versus 45.4% of heterosexual participants receiving at least one misdiagnosis. More sexual minority versus heterosexual participants also reported feeling dismissed or disbelieved (96.8% vs. 64.4%), not feeling listened to by providers (96.8% vs. 62.2%), and having difficulty communicating with providers (90.3% vs. 55.5%). The association between sexual orientation and the EIQ physical, psychological, and social subscales could be explained, in particular, by having been misdiagnosed. <b><i>Conclusions:</i></b> These results highlight the need for better medical education and inclusive gynecological care to promote timely diagnosis and treatment of endometriosis. They also suggest that provider biases and discrimination may contribute to a greater impact of endometriosis on sexual minority patients.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"592-600"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges Faced by Sexual Minority and Heterosexual People Seeking Abortion Care.","authors":"Marta Bornstein, Abigail Norris Turner, Katherine Rivlin, Sarah Bostic, Tamika Odum, Danielle Bessett","doi":"10.1089/lgbt.2024.0304","DOIUrl":"10.1089/lgbt.2024.0304","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study assessed and compared the number and types of challenges and expense delays experienced by sexual minority and heterosexual individuals seeking abortion care. <b><i>Methods:</i></b> We analyzed cross-sectional survey data from 1953 individuals who sought an abortion at 25 clinics in five US states from April 2020 to February 2023. The survey asked about 12 challenges (e.g., transportation, emotional burden, cost) and 4 expense delays (e.g., rent, food) associated with obtaining an abortion. We examined types and number of challenges and expense delays by sexual identity. We conducted negative binomial regression (number of challenges) and logistic regression (any expense delay) to quantify differences. <b><i>Results:</i></b> Most participants in the analytic sample (<i>N</i> = 1833) experienced at least one challenge to obtaining an abortion (90%), with sexual minority participants (<i>n =</i> 349) experiencing a greater median number of challenges than heterosexual participants (<i>n =</i> 1484) (4 [interquartile range = 2-6] vs. 3 [1-4]; <i>p</i> < 0.001). Sexual minority participants were also more likely to delay an expense (40% vs. 28%; <i>p</i> < 0.001). Adjusting for other factors, sexual minority participants experienced significantly increased challenges (adjusted incident risk ratio = 1.2; 95% confidence interval [CI] = 1.1-1.3) and had greater odds of delaying an expense (adjusted odds ratio = 1.6; 95% CI = 1.2-2.1). <b><i>Conclusions:</i></b> Sexual minority individuals face more challenges and are more likely to delay expenses to obtain an abortion. Thus, sexual minority individuals may need additional support specific to the challenges they face, including financial assistance, transportation, and psychosocial support. Addressing inequalities that disproportionately impact sexual minority individuals within society and reproductive health care will help ensure that abortion is more accessible.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"520-531"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"No Man's Land\": A Qualitative Exploration of Perceptions of Structural Stigma Among Bisexual Men Compared with Gay Men.","authors":"Jessie V Ford, Aarushi H Shah, Brian Dodge","doi":"10.1177/23258292251361314","DOIUrl":"10.1177/23258292251361314","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Recent research suggests that the benefits of minimized structural stigma experienced by gay men are not matched in bisexual men. The purpose of this study was to explore how bisexual men perceive structural stigma compared with gay men in hopes of understanding why improvements in structural stigma among sexual minority individuals may not equally benefit bisexual people. <b><i>Methods:</i></b> In 2020-2021, we conducted in-depth interviews with 19 bisexual men and 40 gay men recruited from a larger longitudinal cohort study of 502 men. Interviews were conducted by phone or Zoom (camera off). The interview guides for gay and bisexual men were nearly identical, except that bisexual men were asked specifically about structural stigma related to bisexuality. All interviews were recorded digitally, transcribed verbatim, and analyzed using grounded theory as an analytic strategy. <b><i>Results:</i></b> Emergent findings show that three interrelated forces complicate the relationship between structural stigma and outcomes for bisexual men: assumed heterosexuality, invisibility and erasure of bisexuality, and the blurring of interpersonal and structural stigma. In particular, bisexual men had trouble identifying structural stigma, reflecting the difficulty of fully pinning down this type of stigma. <b><i>Conclusion:</i></b> To understand the disparate effects of structural stigma for bisexual and gay men, we encourage scholars to take these dynamics into account. We suggest new concrete ways to measure structural stigma against bisexual people and better incorporate perspectives from bisexual men into future structural stigma research and interventions.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"543-550"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}