LGBT health最新文献

{"title":"Association of Self-Reported Sexual Orientation Fluidity with Health and Behavior of Adults: Analysis of the Research Program on Genes, Environment, and Health Cohort.","authors":"Adovich S Rivera, Chun R Chao, Rulin C Hechter","doi":"10.1177/23258292251364913","DOIUrl":"10.1177/23258292251364913","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Health disparities by sexual orientation fluidity are relatively unexplored in middle or late adulthood. We assessed differences in self-reported health and health behaviors according to fluidity status. <b><i>Methods:</i></b> We analyzed baseline (2002-2010) and follow-up (2015-2023) survey data of Research Program on Genes, Environment, and Health participants. We classified people based on responses to sexual orientation questions: consistently heterosexual, consistently sexual minority, and fluid (changed reported orientation). We then compared health behavior (smoking, binge drinking, and physical activity) and self-rated health (Patient-Reported Outcomes Measurement Information System and EuroQol EQ-5D-3L) across groups using linear or logistic regression with or without weights for attrition using complete case data and after multiple imputation. <b><i>Results:</i></b> Of the 32,058 adults (mean age: 56 years, male: 39.6%), 378 (1.2%) were fluid. Compared with consistently heterosexual adults, fluid individuals had significantly worse self-rated health scores after adjustment for demographics and attrition, although most differences were not clinically meaningful. No differences in health behavior were noted in adjusted analyses. <b><i>Conclusion:</i></b> Sexual orientation fluidity occurs in older adults, and this group may have worse health than their heterosexual counterparts.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"511-519"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959572","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":"Investigating the Relationship Between Social Support and Health Care Barriers Among Sexually and Gender Diverse Young Adults in the United States.","authors":"Vincenzo F Malo, Vaughn J Armbrister, Trey-Rashad Hawkins, Stefanee Tillman, Javan K Carter, Megan A Lewis","doi":"10.1089/lgbt.2024.0341","DOIUrl":"10.1089/lgbt.2024.0341","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Recognizing the necessity of supportive health care systems, we used strengths-based approaches to explore the potential protective nature of social support against health care barriers among sexually and gender diverse (SGD) young adults. <b><i>Methods:</i></b> Using data spanning May 2018 to July 2022 from the National Institutes of Health's <i>All of Us</i> Research Program, we created a sample of and produced descriptive estimates for 2417 SGD young adults between 20 and 35 years of age. Using logistic regressions, we calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to measure the association between two outcomes-delaying health care and reported discrimination in medical settings-and instrumental/emotional social support. We adjusted for age, gender identity, race and ethnicity, housing stability, and income. <b><i>Results:</i></b> Of our sample, 70.8% endorsed at least one reason for delaying care, and 45.0% reported discrimination in medical settings \"rarely\" or more frequently, with significant differences by gender identity, sexual orientation, race and ethnicity, housing stability, income, and education for both outcomes. More social support was associated with fewer reasons for delaying health care (instrumental: aOR = 0.78, 95% CI 0.71-0.86; emotional: aOR = 0.71, 95% CI 0.63-0.79) and fewer reports of discrimination in medical settings (instrumental: aOR = 0.72, 95% CI 0.66-0.78; emotional: aOR = 0.64, 95% CI 0.58-0.70). <b><i>Conclusion:</i></b> Our results suggest that social support might serve as a protective factor against health care barriers for SGD young adults. More strengths-based research is needed to understand intersectionality in SGD health care.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"499-510"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317340","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":"Sexual Orientation and Gender Identity Measures for Cancer Research: Feedback from Older Americans.","authors":"Mandi L Pratt-Chapman, Bethany Tennant, Casey Langer Tesfaye, Christopher W Wheldon, Nfn Scout, Carl G Streed, Kristi Tredway, Sarah S Jackson","doi":"10.1177/23258292251362128","DOIUrl":"10.1177/23258292251362128","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To improve upon measures of sexual orientation and gender identity (SOGI) used in previous studies, we created and tested seven measures for inclusion in cancer research and refined them based on input from study participants. <b><i>Methods:</i></b> Between February and March 2024, cognitive interviews were conducted virtually with a purposive sample of 18 adults ≥50 years old. Equal numbers of participants identified as LGBTQ+ (<i>n</i> = 9) and cisgender heterosexual (<i>n</i> = 9). We chose older adults because-for the most part-participants in past studies on SOGI data acceptability have been younger than those typically recruited in cancer-related studies. Participants were selected for maximum diversity in age, race/ethnicity, U.S. geographic region, and political ideology. Descriptive themes and patterns for each measure were organized, evaluated, synthesized, and summarized. <b><i>Results:</i></b> Most participants found six of seven tested measures easy to answer. Respondents were satisfied with being able to choose more than one response option for each item. Some terms, (e.g., response options \"cisgender\" and \"non-binary\" for gender identity measure) were new to some respondents. Revisions to measures were made based on respondent feedback. The breast/chest tissue item confused most respondents, so it was withdrawn. <b><i>Conclusions:</i></b> This study found that most tested SOGI measures were easy to understand, and the response options were appropriate. Refined measures can serve as a resource for investigators and clinicians to employ who wish to improve SOGI data collection.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"532-542"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731977","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":"Estradiol Concentrations for Adequate Gender-Affirming Feminizing Therapy: A Systematic Review.","authors":"Gabrielle N Winston-McPherson, Tiffany A Thomas, Matthew D Krasowski, Sofia B Ahmed, Lauren R Cirrincione, Brooke M Katzman, Christina C Pierre, Chantal L Rytz, Keila Turino Miranda, Zil Goldstein, Dina N Greene","doi":"10.1089/lgbt.2024.0407","DOIUrl":"10.1089/lgbt.2024.0407","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Guidelines recommend serum estradiol concentrations of 100-200 pg/mL for transgender women prescribed oral, subcutaneous, or transdermal estradiol with or without adjunct antiandrogen as gender-affirming feminizing hormone therapy (HT). The purpose of this systematic review was to evaluate if the guideline range of 100-200 pg/mL for estradiol concentration is associated with indicators of adequate gender-affirming feminizing HT, specifically feminizing sufficiency, insufficiency, testosterone suppression, or toxicity in transgender women. <b><i>Methods:</i></b> The Populations/Intervention/Comparator/Outcome model was applied to the study question, whereby the target population included transgender, gender-diverse, and nonbinary adults using gender-affirming feminizing HT by any route of administration, with or without adjunct antiandrogen use. The comparator was defined as estradiol concentrations within (100-200 pg/mL or 367-734 pM) versus outside (</>100-200 pg/mL) the guideline range; evaluated outcomes were listed by the same clinical guidelines that recommend using the 100-200 pg/mL range. Embase, MEDLINE, and Web of Science were queried over a 24-year time frame (January 1, 1999-April 20, 2023); the search was restricted to English. The extracted outcomes were categorized as indicators of therapeutic insufficiency, sufficiency, toxicity, or hormone concentration. <b><i>Results:</i></b> There were 49 studies that met the inclusion criteria, of which 9, 42, 25, and 5 studies included indicators of therapeutic insufficiency, sufficiency, toxicity, or hormone concentration, respectively. The search did not identify articles demonstrating that the 100-200 pg/mL guideline range provides optimal feminizing outcomes or reduces adverse events. <b><i>Conclusions</i></b>: Evidence does not support using the guideline range of 100-200 pg/mL to indicate sufficient feminization in transgender women using gender-affirming feminizing HT.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"477-489"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475833","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":"Side Effect Profiles of Nonhormonal, Nonsurgical Gender-Affirming Body Modifications.","authors":"Ben L Schwartz, Nguyen K Tran, Jonathan A Mayo, Sarah M Peitzmeier, Tonia C Poteat, Micah E Lubensky, Annesa Flentje, Juno Obedin-Maliver, Mitchell R Lunn","doi":"10.1089/lgbt.2024.0319","DOIUrl":"10.1089/lgbt.2024.0319","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Binding, packing, using stand-to-pee (STP) devices, and tucking are nonhormonal, nonsurgical gender-affirming body modifications (GABMs) that are used to affirm gender expression. This study sought to describe the sociodemographic characteristics of and side effects experienced by those using GABMs. <b><i>Methods:</i></b> We conducted a cross-sectional study of The Population Research in Identity and Disparities for Equality Study participants who completed the 2023 Annual Questionnaire. Data on sociodemographics and self-reported side effects were collected and analyzed using descriptive statistics. <b><i>Results:</i></b> Of 6296 participants, 1694 reported GABMs including binding (<i>n</i> = 995), packing (<i>n</i> = 590), using an STP device (<i>n</i> = 351), and tucking (<i>n</i> = 265). Each GABM had a distinct side effect profile. Pain (2.0%-48.2% past-year prevalence) and dermatologic concerns (0.5%-23.2% past-year prevalence) were reported across GABMs. <b><i>Conclusion:</i></b> While GABMs promote mental health and patient safety, they carry a risk of adverse physical health effects. Providers play a vital role in managing GABM-associated side effects to ensure patients can continue to affirm their gender identities.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"551-558"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174341","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":"Protective Effects of Online Safety and Parental Acceptance for Sexual and Gender Minority Latinx Youth: A Quantitative Analysis of Cyberbullying, Psychological Distress, and Coping with Alcohol.","authors":"Aldo M Barrita, Roberto L Abreu, Joshua G Parmenter, Ryan J Watson","doi":"10.1089/lgbt.2024.0396","DOIUrl":"10.1089/lgbt.2024.0396","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study explored the relation between intersectional cyberbullying (racism and cis heterosexism) and alcohol use as a coping strategy among sexual and gender minority (SGM) Latinx youth and assessed the psychological impact of these experiences and protective factors such as online safety and parental acceptance. <b><i>Methods:</i></b> Focusing on SGM Latinx youth (<i>N</i> = 1145) from the 2022 LGBTQ National Teen Survey collected within the United States, we explored the effects of intersectional cyberbullying (predictor; adapted version of the Bullying and Victimization Scale) on coping strategies involving alcohol use (outcome; Drinking Motive Questionnaire Revised Short Form) and psychological distress (mediator; Patient Health Questionnaire) and its interaction with online safety and parental acceptance (moderators; LGBTQ Parents Support Scale) using a mediation and a moderated mediation analyses (Hayes Models 4 and 21). <b><i>Results:</i></b> Intersectional cyberbullying was associated with alcohol use to cope, and psychological distress mediated this relation. Furthermore, both online safety and parental acceptance were significant moderators in this mediated relation, where higher levels of either moderator were associated with lower psychological distress or use of alcohol as a coping strategy. <b><i>Conclusions:</i></b> Our findings present key clinical and public health implications for SGM Latinx youth experiencing virtual forms of oppression.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"490-498"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584288","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":"Sex, Sexual Orientation, and Gender Identity Measurement in Health Research: A Systematic Review and Narrative Synthesis.","authors":"Ashleigh J Rich, Emma L McGorray, Dylan Felt, Maddie Kerr, Carrie Baldwin-SoRelle, Lauren B Beach, Gregory Phillips, Tonia Poteat","doi":"10.1089/lgbt.2024.0105","DOIUrl":"10.1089/lgbt.2024.0105","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Toward the goal of developing standardized sex, sexual orientation, and gender identity (SSOGI) measures that can be used across demographics and regions, this review aimed to synthesize and summarize how SSOGI have been assessed within health research, including the quality and validity of these measures. <b><i>Methods:</i></b> We conducted a systematic review of peer-reviewed research developing or evaluating SSOGI measures in PubMed, PsycInfo, CINAHL, and Health and Psychosocial Instruments bibliographic databases. Eligible studies reported original peer-reviewed research focused on SSOGI measurement in adult populations in the United States from 2012 through June 7, 2022. In consultation with librarians, search results were screened for inclusion using an innovative multiple-phase method of stratification, supervised clustering, and supervised machine learning. We conducted manual screening and data extraction in Covidence. <b><i>Results:</i></b> In total, 17,814 citations were returned from all databases, with 30 studies eligible for final inclusion in the review. Gender identity measurement was the focus of half of the included studies (51%), followed by sexual orientation (40%), with little asexuality-specific measurement research (<i>n</i> = 1 study), and beyond sexual orientation, research on sex or variations in sexual characteristics (<i>n</i> = 1 study, each). <b><i>Conclusions:</i></b> Although the field of sexual and gender minority health research has grown exponentially over the past decade, there remains a dearth of literature focused on the development and evaluation of SSOGI measures. We found heterogeneity across the SSOGI measurement literature including by study design, sampling strategy, and study population. Important identified gaps include the need for attention to the measurement of sex, variations in sex characteristics, and asexuality-inclusive sexual orientation measures.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"395-406"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573437","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":"Phenotyping to Identify Mental Health Trends of Transgender Individuals Using Private Commercial Insurance Data in the United States.","authors":"Theo G Beltran, Tonia Poteat, Virginia Pate, Jennifer L Lund, Kathleen C Thomas, Shabbar I Ranapurwala, Brian Pence","doi":"10.1089/lgbt.2024.0250","DOIUrl":"10.1089/lgbt.2024.0250","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We evaluated the performance of computational phenotypes (CPs) in commercial insurance claims for identifying transgender (TG) individuals and assessed trends in population size and depression and anxiety prevalence of the TG population. <b><i>Methods:</i></b> We compared two previously defined CPs by measuring their concordance. We combined CPs to establish a cohort of TG individuals from Merative^TM MarketScan® commercial insurance claims (2007-2021) to measure population and mental health trends using joinpoint regression. <b><i>Results:</i></b> Due to high levels of overlap between CPs, we combined CPs to reach our sample size of 67,809 unique individuals. TG-related International Classification of Diseases (ICD) diagnoses codes increased from 59% of TG claims in 2007 to 97% in 2021. We observed a sharp increase in the prevalence of TG-related claims in 2012 by 42.3% (95% confidence interval [CI] = 35.8-56.8) per year then by 17.0% per year (95% CI = 6.1-23.7) from 2017 to 2021. Among TG individuals there was a gradual increase in mental health-related claims from 2007 to 2015, which remained stable until there was a 10% decrease in 2021. <b><i>Conclusion:</i></b> The combined CP identified the largest TG population in commercial insurance claims to date. Most TG individuals were identified through TG-related ICD codes for both CPs. Increases over calendar time may represent an increased access to insurance-covered gender-affirming services. Persistently high depression and anxiety-related claims suggest an ongoing need to reduce the burden of psychiatric-related claims in this population.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"407-415"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000811","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":"Associations of Racial Discrimination with Depression/Suicidality and Substance Use Among Black Youth: The Moderating Roles of Sexual Identity and School Connectedness.","authors":"Jay'ana S King, Stephanie S Fredrick, Weijun Wang","doi":"10.1089/lgbt.2024.0096","DOIUrl":"10.1089/lgbt.2024.0096","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The current study examined relations among racial discrimination (RD), depression/suicidality, substance use, and school connectedness among Black youth who identified as lesbian, gay, bisexual, some other way, or not sure (LGBQ) and heterosexual youth. <b><i>Methods:</i></b> Data were obtained from the Adolescent Behaviors and Experiences Survey (ABES) conducted by the Centers for Disease Control and Prevention during January-June 2021. ABES was a one-time, online survey given to a nationally representative sample of U.S. high school students. Data for the current study included 1189 Black 9th-12th graders (50.0% female and 18.8% LGBQ). Measures included self-reports of depression/suicidality during the past year, substance use in the past 30 days, current feelings of school connectedness, RD in school across the lifespan, and sexual identity. Structural equation modeling was utilized to examine study aims. <b><i>Results:</i></b> Black LGBQ youth reported higher levels of RD, depression/suicidality, and substance use but lower school connectedness compared with heterosexual Black youth. RD was positively associated with depression/suicidality (<i>b</i> = 0.876, standard error = 0.197, <i>p</i> < 0.001) but not with substance use (<i>p</i> = 0.366). Sexual identity and school connectedness did not moderate the relationships between RD and depression/suicidality or RD and substance use. <b><i>Conclusion:</i></b> RD's positive association with depression/suicidality and lack of association with substance use was similar for Black heterosexual and LGBQ youth. Future research should expand on the role of intersectionality with other identity groups and protective factors for school-based RD experiences. Educators should explore interventions beyond only school connectedness for reducing school-based RD for Black youth.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"439-446"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030172","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":"Sexual Orientation Disparities in Subjective Cognitive Decline in a Large Cohort of Female Nurses.","authors":"Sarah McKetta, Isa Berzansky, Colleen A Reynolds, Francine Grodstein, Deborah Blacker, Brittany M Charlton","doi":"10.1089/lgbt.2024.0183","DOIUrl":"10.1089/lgbt.2024.0183","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Sexual minority (SM) women have more dementia risk factors than heterosexual women, but it remains unknown whether they experience increased symptoms of subjective cognitive decline (SCD)-a key predictor of dementia. <b><i>Methods:</i></b> We investigated sexual orientation-related disparities in SCD in Nurses' Health Study II (<i>N</i> = 70,772). Sexual orientation subgroups included completely heterosexual (<i>n</i> = 62,884); participants identifying as heterosexual with same-sex experience (\"heterosexual-SM\", <i>n</i> = 5017); and participants identifying as mostly heterosexual (<i>n</i> = 1825), bisexual (<i>n</i> = 287), or lesbian/gay (<i>n</i> = 759). SCD was measured using seven symptoms from the Structured Telephone Interview for Dementia Assessment, controlling for demographics with Poisson regression models. <b><i>Results:</i></b> Relative to completely heterosexual participants, SM participants had 29% more SCD symptoms (95% confidence interval [CI] = 1.26-1.32). Symptoms were elevated in every SM subgroup; the largest disparities were among bisexual and mostly heterosexual subgroups (adjusted risk ratios for 1-unit increment in symptoms [aRR]: 1.60, 95% CI = 1.45-1.77; 1.48, 95% CI = 1.42-1.54, respectively) followed by lesbian/gay (aRR: 1.22, 95% CI = 1.14-1.31) and heterosexual-SM participants (aRR: 1.21, 95% CI = 1.18-1.25). <b><i>Conclusion:</i></b> SM women-particularly bisexual and mostly heterosexual women-had more symptoms of SCD than completely heterosexual women. These findings align with known sexual orientation-related disparities in dementia risk factors (e.g., mental health, substance use), and indicate that better understanding and closer monitoring of cognitive health in SM groups remains important for prevention efforts as an increasing proportion of aging Americans identifies as SM.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"428-438"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657644","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}