scholarly journals Are “Gay” and “Queer-Friendly” Neighborhoods Healthy? Assessing How Areas with High Densities of Same-Sex Couples Impact the Mental Health of Sexual Minority and Majority Young Adults

Author(s):  
Chris Wienke ◽  
Rachel B. Whaley ◽  
Rick Braatz

AbstractNeighborhoods with large concentrations of gay men, lesbians, and other sexual minorities have long served as places where sexual minority young adults find self-enhancing resources. Yet, it is unclear whether such neighborhood environments also confer health benefits. Using data from the National Longitudinal Study of Adolescent Health, we explored the relationship between the proportion of same-sex couples in neighborhoods and the mental health of sexual minority and majority young adults, controlling for other neighborhood- and individual-level factors. Results indicate that for sexual minorities, neighborhoods with higher percentages of same-sex couples are associated with lower levels of depression symptoms and higher levels of self-esteem. Conversely, for heterosexuals, there are no differences in health outcomes across neighborhood contexts. Taken together, the findings highlight the importance of striving for neighborhood-level understandings of sexual minority young adults and their mental health problems.

2019 ◽  
Vol 10 (3) ◽  
pp. 276-290 ◽  
Author(s):  
Allen J. LeBlanc ◽  
David M. Frost

We simultaneously examined the effects of individual- and couple-level minority stressors on mental health among people in same-sex relationships. Individual-level minority stressors emerge from the stigmatization of sexual minority individuals; couple-level minority stressors emerge from the stigmatization of same-sex relationships. Dyadic data from 100 same-sex couples from across the United States were analyzed with actor–partner interdependence models. Couple-level stigma was uniquely associated with nonspecific psychological distress, depressive symptomatology, and problematic drinking, net the effects of individual-level stigma and relevant sociodemographic controls. Analyses also show that couple-level minority stress played unique roles in critical stress processes of minority stress proliferation: minority stress expansion and minority stress contagion. The inclusion of couple-level stress constructs represents a useful extension of minority stress theory, enriching our capacity to deepen understandings of minority stress experience and its application in the study of well-being and health inequalities faced by vulnerable populations.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Irish ◽  
F Solmi ◽  
B Mars ◽  
M King ◽  
G Lewis ◽  
...  

Abstract Background There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared with heterosexuals. We compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from when they were aged 10 to 21 years, and examined self-harm at ages 16 and 21 years. Methods The study included 4828 adolescents born between April 1, 1991, and Dec 31, 1992, from the Avon Longitudinal Study of Parents and Children birth cohort (Bristol, UK) who reported their sexual orientation when aged 16 years. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire at seven timepoints between ages 10 and 21 years. A self-harm questionnaire was completed at ages 16 and 21 years. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the previous year at ages 16 and 21 years), and multinomial regression (lifetime self-harm with and without suicidal intent at age 21 years). Findings At age 10, depressive symptoms were higher in sexual minorities than in heterosexuals and increased with age to a larger extent. Depressive symptoms increased at each timepoint by 0·31 points in hetereosexuals, and by 0·49 points in sexual minorities. Sexual-minority adolescents were more likely than heterosexual adolescents to report self-harm in the previous year at ages 16 and 21 years, with no evidence that this estimate decreased with age. At aged 21, sexual minorities were more likely to report lifetime self-harm (ie, on at least one previous occasion) with suicidal intent than heterosexuals. Interpretation Mental health disparities between heterosexuals and sexual minorities are present early in adolescence and increase throughout the school years, persisting to young adulthood. Prevention of these mental health problems and early intervention must be a priority.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  

Abstract As consistently shown across studies from various parts of the world, sexual minority individuals (e.g., those identifying as lesbian, gay, and bisexual [LGB]) are significantly at a higher risk for depression, anxiety, and suicidal thoughts and behavior when compared to heterosexuals. The increased risk for poor mental health among sexual minority populations is believed to be a consequence of LGB individuals’ increased exposure to specific social stressors related to navigating a stigmatized minority identity. Studies trying to explain health inequalities based on sexual orientation have mainly focused on so-called minority stress processes, such as discrimination, internalized homophobia, expectations of rejection, and stress of concealing one’s sexual orientation. This workshop will give examples of studies from various European countries on mental health predictors and trajectories by using various approaches such as population-based sampling, longitudinal data collection, and comprehensive theoretical frameworks. Dr. Gemma Lewis (University College London, UK) will present results showing that sexual orientation-based disparities in mental health are present already in early adolescence and increase throughout the school years. Arjan van der Star (Karolinska Institutet, Sweden) will present population-based data suggesting that openness about sexual orientation is not directly linked to lower risk of depression among sexual minorities, but is instead dependent on access to social support. Conor Mahon (Dublin City University, Ireland) will present results showing minority stressors as predictors of social anxiety among sexual minority men. Associate professor John Pachankis (Yale University, USA) will present results showing that, in addition to increased exposure to social stressors, barriers to societal integration can partially explain the elevated risk of suicidality among sexual minorities. Key messages Sexual minorities are a higher risk of mental health problems, such as depression, social anxiety, and suicidality, as compared to heterosexuals and these disparities can be identified early in life. Sexual orientation-based mental health disparities seem to be based both on disproportionate stigma-related stress and a higher prevalence of general risk factors for poor mental health.


Demography ◽  
2021 ◽  
Author(s):  
Christopher S. Carpenter ◽  
Gilbert Gonzales ◽  
Tara McKay ◽  
Dario Sansone

Abstract A large body of research documents that the 2010 dependent coverage mandate of the U.S. Affordable Care Act was responsible for significantly increasing health insurance coverage among young adults. No prior research has examined whether sexual minority young adults also benefitted from the dependent coverage mandate despite previous studies showing lower health insurance coverage among sexual minorities. Our estimates from the American Community Survey, using difference-in-differences and event study models, show that men in same-sex couples aged 21–25 experienced a significantly greater increase in the likelihood of having any health insurance after 2010 than older, 27- to 31-year-old men in same-sex couples. This increase is concentrated among employer-sponsored insurance, and it is robust to permutations of periods and age groups. Effects for women in same-sex couples and men in different-sex couples are smaller than the associated effects for men in same-sex couples. These findings confirm the broad effects of expanded dependent coverage and suggest that eliminating the federal dependent mandate could reduce health insurance coverage among young adult sexual minorities in same-sex couples.


Author(s):  
Sarah Keller ◽  
Vanessa McNeill ◽  
Tan Tran

Evidence indicates that stigma impedes an individual’s chance of seeking professional help for a mental health crisis. Commonly reported aggregate-level results for stigma-reduction efforts obfuscate how much stigma reduction is needed to incur a practically meaningful change within an individual, defined here as an attitudinal shift and openness towards seeking mental health for oneself and/or support for others. When basing conclusions and recommendations about stigma-reducing interventions on aggregate scales, it is unclear how much stigma reduction is needed to incur meaningful change within an individual. We explored the impact of reductions in stigma of help-seeking scores in response to an online suicide prevention video among young adults in the United States, using online surveys to collect qualitative and quantitative data. We compared mean changes in the stigma scores from pre- to post-test (video exposure) of 371 young U.S. adults using standard t-tests and individual level analysis. A separate thematic analysis of free-text responses was also conducted from a smaller, randomly-selected subgroup, capturing individuals’ attitudes towards help-seeking for mental health problems. Great attention was given to participants to ensure that they were in a campus setting where counseling services were available. Four main themes emerged: (1) small changes in stigma scores were associated with individual reports of meaningful reductions in their attitudes towards professional counseling; (2) increased empathy towards victims of suicide and other mental health problems sometimes indicated increased empathy for victims of suicide and decreased openness in professional help; (3) empathy towards victims sometimes took the form of increased scores and grief or sadness, possibly thwarting the potential for help-seeking; and (4) self-reports of decreased stigma were not always associated with increased openness towards help-seeking. Results also indicated that small stigma score charges, not meeting statistical significance, were often associated with increased openness towards seeking help. These findings, discovered using mixed-methods, contribute to the body of literature regarding stigma towards suicide and help-seeking by demonstrating deficits in the aggregate-only analysis of stigma-reducing interventions specifically aimed at suicide prevention. Such individuation in stigma experiences indicates that public education on how to reduce the stigma of help-seeking for suicide prevention needs to consider individual-level analyses for improving target populations. Recommendations for future research include additional studies prior to releasing suicide prevention videos to public forums where they may be seen by individuals without access to help.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Over the past decades, public health research has started to examine the higher risk of mental health concerns among sexual minorities (e.g., lesbian, gay, or bisexual individuals) when compared with heterosexual individuals. Until more recently, most of this research has been coming from North America and focused on theories of stigma and minority stress in their attempt to explain these elevated rates of mental health problems. Minority stress theory posit stigma to be a root cause of the higher risk of mental health problems among sexual minorities and that stigma results in victimization, discrimination, internalized homonegativity, and identity concealment, which erodes mental health. Exposure to such minority stressors may differ across structural climates, based on population attitudes, discriminatory legislation, and unequal policies. In this way, such structural forms of stigma toward sexual minorities may foster increased exposure to minority stressors and elevated levels of mental health problems among sexual minorities. However, the evidence on these mechanisms remains limited as they have only recently become a topic of research. This workshop includes five empirical presentations from various structural contexts. It focuses on the elevated risk of mental health problems among sexual minorities across these settings, on identifying minority stressors in high-stigma countries, and on linking country-level structural stigma to experiences of minority stressors to explain poor mental health among sexual minorities. First, Michal Pitonak will present results from the first Czech population-based study showing higher rates of substance use, psychological distress, and low life satisfaction among sexual minorities compared to heterosexual individuals. Second, Giuseppina Lo Moro will present results from Italy showing a higher likelihood of depressive symptoms and mental health treatment among sexual minority medical students compared to their heterosexual peers. Next, Guillermo Martínez-Pérez will present findings on experiences of minority stress among Senegalese bisexual men and linkages to mental health. Finally, Arjan van der Star will extend these findings with data showing how the mental health effects of structural stigma and minority stress may be related to time both before and since migrating among migrant sexual minority men in the low-structural-stigma context of Sweden. Key messages Sexual minorities across the globe are at an increased risk for mental health problems and stigma-based minority stress experiences compared with heterosexual individuals. Structural forms of stigma, such as country-specific negative societal attitudes and discriminatory laws, may drive this elevated risk depending on length of exposure.


2021 ◽  
Vol 13 ◽  
Author(s):  
Christopher E. M. Lloyd ◽  
Katharine A. Rimes ◽  
David G. Hambrook

Abstract Sexual minorities, including those identifying as lesbian, gay, bisexual or queer (LGBQ) are at heightened risk of experiencing mental health problems. Nationally, treatment outcomes within England’s Improving Access to Psychological Therapies (IAPT) services are worse for sexual minority patients than for heterosexuals. An IAPT service in London developed a cognitive behavioural therapy (CBT) group specifically for sexual minority patients to provide a safe, affirmative intervention to learn skills for overcoming depression, anxiety and stress. A qualitative online survey was emailed to all 59 service users who had completed the eight-session intervention, to explore their experiences inductively. Survey data were analysed using qualitative content analysis. Themes were identified in participants’ responses in order to establish which aspects of the group intervention were deemed to be helpful and unhelpful, and to explore suggestions for group improvement. Eighteen people completed the survey (response rate 30.5%). Respondents reported that they found the CBT frame of the group useful, with the LGBQ focus experienced as particularly beneficial, often enhancing engagement with CBT concepts and tools. In addition to generic elements of group therapy that some found difficult, others reported that intragroup diversity, such as generational differences, could lead to a reduced sense of connection. Several suggestions for group improvement were made, including incorporating more diverse perspectives and examples in session content and focusing more on issues relating to intersectionality. These results provide preliminary evidence that a culturally adapted CBT group intervention developed specifically for sexual minorities is acceptable and perceived as offering something unique and helpful. Key learning aims (1) To identify the unique experiences and particular mental health disparities that LGBQ people face in life and why a culturally adapted LGBQ CBT group offers both a necessary and unique therapeutic tool to support sexual minorities. (2) To explore how a culturally adapted CBT group intervention for LGBQ people is experienced in practice, from the service user perspective. In particular, what aspects do LGBQ people find helpful, unhelpful and what might they suggest for future group improvement. (3) To consider how such CBT groups may be culturally adapted to benefit sexual minorities, including: what actions should be taken in future clinical practice to ensure improvements in the psychological treatment experiences of LGBQ people. Specifically, including the need to incorporate more inclusive and intersectional examples that engage and support recovery from psychological distress.


Author(s):  
Kennedy Amone-P'Olak ◽  
Boniface Kealeboga Ramotuana

In Africa, the structure of the family is changing rapidly. The effects of this change on mental health remain unknown. This study investigated the extent to which different family types (intact, single-mother, and multiple) predict mental health problems in young adults in Botswana (N = 264, mean age = 21.31, SD = 2.40). In a cross-sectional design, the study sampled students registered at various faculties at the University of Botswana. The revised symptoms checklist (SCL-90-R) was used to assess symptoms of mental health problems (depression, anxiety and hostility). Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95 per cent confidence intervals (CIs) of mental health problems for mother-only and multiple family types relative to the intact family type. Compared to the intact family type, single-mother (OR = 2.34; 95% CI: 1.21, 4.51) and multiple family types (OR = 1.56; CI: 0.88, 2.78) were associated with an increased risk of depression. For anxiety, the ORs were 2.27 (CI: 1.18, 4.38) and 1.10 (CI: 0.56, 1.82) for single-mother and multiple family types respectively. For hostility, the ORs were 2.60 (CI: 1.34, 5.04), and 0.79 (CI: 0.44, 1.42) for single-mother and multiple family types, respectively. Family types predict mental health problems in young adults and therefore the interventions to mitigate the effects should consider family backgrounds and the ramifications of family types for treatment and care.


Author(s):  
Lisa M. Diamond ◽  
Molly R. Butterworth ◽  
Ritch C. Savin-Williams

The present chapter provides a review of some of the primary psychological issues confronting sexual minorities (i.e., individuals with same-sex attractions and relationships). Our goal is to provide a flexible set of preliminary questions that can be used to help sexual-minority clients to articulate their own idiosyncratic experiences and give voice to their own unique needs. We begin by addressing two of the most common and important clinical issues faced by sexual minorities: generalized “minority stress” and acceptance and validation from the family of origin. We then turn attention to the vast—and vastly underinvestigated—population of individuals with bisexual attractions and behavior, who actually constitute the majority of the sexual-minority population, despite having been systematically excluded from most prior research. We review the increasing body of research suggesting that individuals with bisexual patterns of attraction and behavior actually face greater mental health risks than those with exclusive same-sex attractions and behavior, and we explore potential processes and mechanisms underlying this phenomenon, focusing particular attention on issues of identity development and transition over the life span. We conclude by outlining a number of areas for future clinically oriented research.


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