scholarly journals Country-Level Structural Stigma, School-Based and Adulthood Victimization, and Life Satisfaction Among Sexual Minority Adults: A Life Course Approach

2020 ◽  
Author(s):  
Arjan van der Star ◽  
John E. Pachankis ◽  
Richard Bränström
Keyword(s):  
Life Satisfaction ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
School Bullying ◽  
Country Level ◽  
School Based ◽  
Increased Risk ◽  
Identity Concealment ◽  
Mental Health Costs ◽  
Population Attitudes

AbstractCountry-level structural stigma, defined as prejudiced population attitudes and discriminatory legislation and policies, has been suggested to compromise the wellbeing of sexual minority adults. This study explores whether and how structural stigma might be associated with sexual minorities’ school-based and adulthood experiences of victimization and adulthood life satisfaction. Using a sample of 55,263 sexual minority individuals (22% female; 53% 18–29 years old; 85% lesbian/gay, 15% bisexual) living across 28 European countries and a country-level index of structural stigma, results show that sexual minorities, especially men, reported school bullying in both higher- and lower-stigma countries. Higher rates of school bullying were found among sexual minorities living in higher-stigma countries when open about their identity at school. Past exposure to school bullying was associated with lower adulthood life satisfaction, an association partially explained by an increased risk of adulthood victimization. These findings suggest that sexual minorities living in higher-stigma countries might benefit from not being open about their sexual identity at school, despite previously established mental health costs of identity concealment, because of the reduced risk of school bullying and adverse adulthood experiences. These results provide one of the first indications that structural stigma is associated with sexual minority adults’ wellbeing through both contemporaneous and historical experiences of victimization.

scholarly journals Country-level structural stigma, identity concealment, and day-to-day discrimination as determinants of transgender people’s life satisfaction

2021 ◽  
Author(s):  
Richard Bränström ◽  
John E. Pachankis
Keyword(s):  
Life Satisfaction ◽  
Multilevel Models ◽  
Well Being ◽  
Transgender People ◽  
Country Level ◽  
Identity Concealment ◽  
Population Attitudes ◽  
Health And Well Being ◽  
Lower Life Satisfaction ◽  
Negative Population

Abstract Purpose Discriminatory laws, policies, and population attitudes, surrounding transgender people vary greatly across countries, from equal protection under the law and full acceptance to lack of legal recognition and open bias. The consequences of this substantial between-country variation on transgender people’s health and well-being is poorly understood. We therefore examined the association between structural stigma and transgender people’s life satisfaction across 28 countries. Methods Data from transgender participants (n = 6771) in the 2012 EU-LGBT-survey regarding identity concealment, day-to-day discrimination, and life satisfaction were assessed. Structural stigma was measured using publicly available data regarding each country’s discriminatory laws, policies, and population attitudes towards transgender people. Results Multilevel models showed that country-level structural stigma was associated with lower life satisfaction, an association largely explained by higher levels of identity concealment in higher-structural-stigma countries. Yet identity concealment was also associated with lower day-to-day discrimination and therefore protected against even lower life satisfaction. Conclusion The results emphasize the importance of changing discriminatory legislation and negative population attitudes to improve transgender people’s life satisfaction, and also highlight targets for intervention at interpersonal and individual levels.

scholarly journals 5.M. Workshop: Sexual minorities' mental health and their experiences of stigma and minority stress across settings

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Mental Health ◽  
Sexual Minority ◽  
Minority Stress ◽  
Sexual Minorities ◽  
Mental Health Problems ◽  
Health Problems ◽  
Elevated Risk ◽  
Bisexual Men ◽  
Increased Risk ◽  
Population Attitudes

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.

scholarly journals The role of country-level structural stigma on sexual orientation disclosure and discrimination in health care settings among lesbian, gay, and bisexuals across Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Bränström ◽  
J E Pachankis
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Health Care Providers ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Care Providers ◽  
Health Care Settings ◽  
Country Level ◽  
Disclosure Of Sexual Orientation ◽  
Sexual Orientation Disclosure

Abstract Background The national climate surrounding sexual minorities (i.e., those self-identifying as lesbian, gay, or bisexual [LGB]) varies greatly worldwide. Recent Cross-European studies have shown that country-level structural stigma is a strong determinant of sexual minority individuals health risk behaviors and mental health. The consequences of the significant country-level variation in structural stigma on sexual minorities’ experiences of health care discrimination and disclosure of sexual orientation to health care providers have not been previously investigated. Methods In 2012, 86 000 sexual minority individuals (aged 18 years and older) from all 28 European Union countries responded to questions concerning discrimination in health care settings and sexual orientation disclosure to health care providers (EU LGBT survey). Structural stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of sexual minority acceptance among citizens of each country. Results Disclosure of sexual orientation to health care providers were much more common in low stigma coutries (e.g., the Netherlands, Sweden, UK) compared to high stigma coutries (e.g., Lithuania, Latvia, Slovakia). Experiences of discrimination in health care settings were more common among LGB indiviudals who were open about their sexual orientaiton and increased by degree of country-level structural stigma. Conclusions Disclosure of sexual orientation and experiences of discrimination in health care settings varies greatly among LGB individuals in Europe largely due to structural stigma surrounding sexual minorities. Main messages These findings highlight the importance of eliminating legislation, policies, and national attitudes that promote the unequal treatment of sexual minorities in currently unsupportive European countries.

scholarly journals Do Sexual Minorities Face Greater Risk for Sexual Harassment, Ever and at School, in Adolescence?

2020 ◽  
pp. 088626052092631
Author(s):  
Davey M. Smith ◽  
Nicole E. Johns ◽  
Anita Raj
Keyword(s):  
High School ◽  
Sexual Harassment ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Reference Group ◽  
The United States ◽  
Cross Sectional ◽  
Sexual Minority Men ◽  
Cyber Harassment ◽  
Increased Risk

Bullying of sexual minorities in the United States is common and often begins in middle and high school, yet research that examines sexual harassment of sexual minorities is limited. This study examines whether sexual minorities are more likely than straight people to (a) report sexual harassment and (b) report sexual harassment as adolescents at middle or high school. We analyzed survey data from a cross-sectional study of sexual harassment and assault, conducted with nationally representative samples of adults in 2019 ( N = 2,205). Sexual harassment was categorized as non-physically aggressive sexual harassment only (NPSH; e.g., verbal or cyber harassment), physically aggressive sexual harassment (PSH; e.g., stalking, rubbing up against you; with or without NPSH), sexual assault (SA; i.e., forced sex; with or without NPSH or PSH), or no sexual harassment (none). In total, 6% of female and male respondents identified as a sexual minority. A history of sexual harassment or assault was reported by 95.0% of sexual minority women and 80.3% of straight women ( p = .001), and by 77.3% of sexual minority men and 41.3% of straight men ( p = .001). Multivariable multinomial models demonstrate that sexual minorities were more likely than straight individuals to report NPSH (Adjusted Odds Ratio [AOR] = 2.88, 95% [Confidence Interval] CI = [1.33, 6.20]), PSH (AOR = 4.15, 95% CI: [1.77, 9.77]), and SA (AOR = 5.48, 95% CI = [2.56, 11.73]; reference group: no harassment), as well as to report PSH (AOR = 2.67, 95% CI = [1.30, 5.47]) at school in middle or high school. These abuses demonstrate increased risk for sexual harassment among sexual minorities, including increased risk for physically aggressive sexual harassment when in middle and high school.

Substance use, mental health, and life satisfaction in Czech straight and sexual-minority population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Pitonak ◽  
P Chomynová ◽  
V Mravčík
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Life Satisfaction ◽  
Psychological Distress ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Minority Population ◽  
Illicit Substance ◽  
Illicit Substance Use ◽  
Minority People

Abstract Background Evidence shows that sexual minorities are more vulnerable to substance use and psychological distress as a result of minority stress compared with heterosexuals. So far, research conducted outside North America or Western Europe has been underrepresented. This research compares for the first time the substance use, quality of mental health and life satisfaction between the sexual minority people and heterosexuals using a nationally representative probability sample in the Czech population. Methods Sample of the general population aged 15+ years surveyed within the National Survey on Substance Use in 2016 in randomly selected households (N = 3,601, F2F interviews). Prevalence of licit and illicit substance use, psychological distress (MHI-5 scale) and life satisfaction (SWLS scale) were analyzed by respondents' self-reported sexual identity and behaviors. Logistic regressions were applied to evaluate the differences between groups. Adjustment for basic sociodemographic characteristics was performed. Results 2.8% of adults identified as sexual minorities, including 0.5% lesbians or gays and 2.3% bisexuals. Sexual minorities were more likely to experiment with (illicit) substance use in the last 12 months (OR = 1.74, 95% CI: 1.03-2.94), more often experience psychological distress (OR = 2.56, 95% CI: 1.50-4.38), and were slightly less often satisfied with their lives (OR = 0.79, 95% CI: 0.46-1.37) compared to heterosexuals. Sexual minority status was not found as a significant predictor for daily tobacco smoking nor for frequent excessive/binge alcohol consumption. Conclusions In accordance with international evidence, sexual minorities represent a vulnerable group from the perspective of substance use and psychological distress. Factors influencing life satisfaction of sexual minority people living in geographically underrepresented regions need to be further investigated using measures more sensitive to local cultural circumstances.

scholarly journals Association between same-sex marriage introduction and attitudes towards homosexuality in Europe

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Hagen ◽  
E Goldmann
Keyword(s):  
Sexual Minority ◽  
Sexual Minorities ◽  
Public Attitudes ◽  
Well Being ◽  
Social Determinant ◽  
European Countries ◽  
Same Sex ◽  
Same Sex Marriage ◽  
Country Level ◽  
Marriage Laws

Abstract Background Existing research suggests a positive relationship between the introduction of same-sex marriage and country-level acceptance of homosexuality across Europe in the first decade of the 21st century. Between 2010 and 2018, another 8 countries in Europe introduced same-sex marriage. Given the well-established association between greater social acceptance of sexual minorities and LGBT health, it is important to continue to monitor the effect of same-sex marriage policies on public attitudes. Methods Using data from waves 1 through 9 of the European Social Survey (ESS), the lagged association between same-sex marriage and acceptance of homosexuality in the subsequent wave was analysed for 12 European countries that introduced same-sex marriage between 2002 and 2018. Acceptance of sexual minorities was assessed using the statement, “Gay men and lesbians should be free to live their own life as they wish”, which was dichotomised into two groups: “agree strongly” or “agree” vs. “neither agree nor disagree”, “disagree”, or “disagree strongly”. The association between same-sex marriage laws and acceptance was analysed in mixed-effects logistic regression models adjusting for country-level and individual-level confounders and survey year. Results On the country level, acceptance of homosexuality ranged from 61% in Portugal in 2006 to 96% in Iceland in 2016. Based on the total sample of 171,683 observations, acceptance increased from 77% in 2002 to 88% in 2018. Preliminary analyses indicate that existence of same-sex marriage at the time of data collection was associated with 24% increased odds of acceptance of homosexuality in fully adjusted models (95% CI: 1.05-1.48). Conclusions This study provides further evidence of an association between same-sex marriage laws and public acceptance of homosexuality. Additional research will be needed in order to further investigate this relationship beyond Western Europe and in relation to sexual minority health and well-being. Key messages For 12 European countries, evidence of an association between the introduction of same-sex marriage between 2002 and 2018, and subsequent accepting public attitudes towards homosexuality was found. Given their role as a key social determinant of health, further research on the association between social norms accepting of sexual minority populations and inclusive social policies is warranted.

scholarly journals Investigating Differential Protective Effects of Marriage on Substance Use by Sexual Identity Status

2020 ◽  
Vol 8 (2) ◽  
pp. 69-80
Author(s):  
Karen Trocki ◽  
Amy Mericle ◽  
Laurie A. Drabble ◽  
Jamie L. Klinger ◽  
Cindy B. Veldhuis ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexual Identity ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Marijuana Use ◽  
Identity Status ◽  
Interactive Effects ◽  
Protective Effects ◽  
Minority Status ◽  
Increased Risk

Background: Research suggests that marriage is protective against substance use. However, few studies have examined whether this protective effect differs for sexual minorities, a population at increased risk for substance use. Using data from four waves of the cross-sectional U.S. National Alcohol Survey (NAS; 2000, 2005, 2010, and 2015), we investigated whether the protective effects of marriage varied by sexual identity. Methods: Sex-stratified logistic regression models were used to examine independent and interactive effects of current marital status (being married vs. not) and sexual minority status (lesbian/gay/bisexual vs. heterosexual) on high-intensity drinking, alcohol use disorder, and marijuana use in the past year. Results: Among both women and men, sexual minority status was generally associated with higher odds of these outcomes and marriage was consistently associated with lower odds. Differential effects of marriage by sexual identity with respect to marijuana use were found only among men; marriage was significantly associated with decreased odds of marijuana use among heterosexual men but increased odds among sexual minority men. Conclusions: Marriage may be less consistently protective against hazardous drinking and marijuana use among sexual minorities than heterosexuals. Findings underscore the importance of both quantitative and qualitative studies designed to better understand disparities in substance use across both sexual identity and relationship statuses.

scholarly journals Lifecourse-varying exposure to structural stigma, minority stress reactions, and mental health among sexual minority male migrants

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A van der Star ◽  
R Bränström ◽  
J Pachankis
Keyword(s):  
Mental Health ◽  
Sexual Minority ◽  
Minority Stress ◽  
Sexual Minorities ◽  
Prolonged Exposure ◽  
Rejection Sensitivity ◽  
Internalized Homophobia ◽  
Poor Mental Health ◽  
Stress Reactions ◽  
Population Attitudes

Abstract Background Increasing evidence suggests that structural stigma (e.g., discriminatory laws, policies, and population attitudes) can give rise to minority stress reactions (i.e., rejection sensitivity, internalized homophobia, and identity concealment) to compromise sexual minorities' mental health. Yet, many sexual minorities encounter divergent structural-stigma contexts over the life course, with potentially important implications for their experience of minority stress reactions and mental health. We take advantage of sexual minority male migrants' lifecourse-varying exposures to structural stigma contexts to examine this possibility. Methods A sample of 247 sexual minority men who had migrated from 71 countries to the low-structural-stigma context of Sweden completed a survey regarding migration experiences, minority stress reactions, and mental health. This survey was linked to objective indices of structural stigma present in these men's countries of origin, diverse in terms of structural stigma. Results Country-of-origin structural stigma was significantly associated with poor mental health and this association was mediated by rejection sensitivity and internalized homophobia, but only among those who arrived to Sweden at an older age and more recently. Conclusions Prolonged exposure to high levels of structural stigma can give rise to stressful cognitive, affective, and behavioral patterns to jeopardize sexual minority men's mental health; yet, these consequences of structural stigma may wane with increased duration of exposure to more supportive structural contexts.

Interpersonal Violence and Substance Use Among Female Sexual Minorities

2019 ◽  
Author(s):  
Cort M. Dorn-Medeiros ◽  
Cass Dykeman ◽  
Timothy Bergquist
Keyword(s):  
New York ◽  
Tobacco Use ◽  
Interpersonal Violence ◽  
Sexual Minorities ◽  
Sample Population ◽  
Life Outcomes ◽  
City Community ◽  
Increased Risk ◽  
Significant Difference ◽  
Community Health Survey

This archived data study used results from the New York City Community Health Survey to explore the relationship between interpersonal violence among female sexual minorities (FSM) and their levels of alcohol and tobacco use. A total of 92 FSM were included in the sample population. There was a significant difference in the mean number of alcoholic drinks consumed between FSM who reported past experience of interpersonal violence and those who did not. No difference was found in levels of tobacco use between FSM who reported interpersonal violence and those who did not. Results of the present study support current research indicating FSM may be at increased risk for elevated alcohol use and respective negative life outcomes related to the experience of interpersonal violence.

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