Comparison of Treatment Outcomes Between Lesbian, Gay, Bisexual and Heterosexual Individuals Receiving a Primary Care Psychological Intervention

Background: Lesbian, gay and bisexual individuals experience more anxiety and depression than heterosexual people. Little is known about their comparative treatment response to psychological interventions. Aims: To compare sociodemographic/clinical characteristics and treatment outcomes across sexual orientation groups, for adults receiving primary care psychological interventions from Improving Access to Psychological Therapies (IAPT) services in London, adjusting for possible confounders. Method: Data from 188 lesbian women, 222 bisexual women, 6637 heterosexual women, 645 gay men, 75 bisexual men and 3024 heterosexual men were analysed from pre-treatment and last treatment sessions. Males and females were analysed separately. Results: Before treatment, lesbian and bisexual women were more likely to report clinical levels of impairment (Work and Social Adjustment Scale) than heterosexual women; there were no significant differences in depression (PHQ-9) or anxiety (GAD-7). Bisexual men were more likely to meet depression caseness than gay men but less likely to meet anxiety caseness than gay or heterosexual men. Compared with heterosexual women, lesbian and bisexual individuals showed smaller reductions in depression and impairment, controlling for age, ethnicity, employment, baseline symptoms, number of sessions and intervention type. Bisexual women experienced significantly smaller reductions in anxiety than heterosexual women and were less likely to show recovery or reliable recovery. There were no significant differences in treatment outcomes between gay, bisexual and heterosexual men. Conclusions: Reasons for poorer outcomes in lesbian and bisexual women require investigation, for example lifetime trauma or stigma/discrimination regarding gender or sexual orientation in everyday life or within therapy services.

Download Full-text

Military service experiences and reasons for service separation among lesbian, gay, and bisexual individuals in a large military cohort

BMC Public Health ◽

10.1186/s12889-021-12420-1 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Felicia R. Carey ◽

Isabel G. Jacobson ◽

Keren Lehavot ◽

Cynthia A. LeardMann ◽

Claire A. Kolaja ◽

...

Keyword(s):

Sexual Orientation ◽

Military Service ◽

Gay And Bisexual Men ◽

Service Members ◽

Heterosexual Men ◽

Bisexual Men ◽

Bisexual Women ◽

Heterosexual Women ◽

And Bisexual ◽

The Military

Abstract Background The well-being of lesbian, gay, and bisexual (LGB) individuals is a topic of increasing concern within the military where significant institutional barriers, targeted aggression, and differential organizational policies such as “Don’t Ask Don’t Tell” have historically contributed to experiences of exclusion and discrimination. However, limited research has examined specific military and post-separation experiences among LGB service members and veterans. The goal of this study was to examine differences in military and service separation experiences by sexual orientation among a large representative sample of United States service members and veterans. Methods Survey data from the 2016 Millennium Cohort Study follow-up questionnaire were used to assess sexual orientation and multiple outcomes of interest: military experiences (morale, feelings about the military, missed workdays) and service separation experiences (reasons for separation, post-separation employment). The associations between sexual orientation (LGB versus heterosexual) and each of these outcomes were evaluated in a series of adjusted logistic regression models, stratified by sex when interactions were observed. Results Of the 99,599 participants, 3.4% identified as LGB. In adjusted models, LGB service members had significantly higher odds than heterosexual service members of feeling: unimpressed by the quality of unit leadership, unsupported by the military, and negative about the military overall. Bisexual women were more likely than heterosexual women to feel less unit camaraderie; both gay and bisexual men felt less camaraderie than heterosexual men. LGB veterans were more likely than heterosexual peers of the same sex to separate from service due to unplanned administrative reasons. Compared to heterosexual women, lesbian and bisexual women were more likely to separate from service due to dissatisfaction with promotions/pay and disability/medical reasons, while bisexual women specifically separated due to dissatisfaction with leadership and incompatibility with the military. Gay and bisexual men also reported separating due to incompatibility with the military, but only bisexual men were more likely to report separating due to disability/medical reasons compared to heterosexual men. Conclusions Less positive military- and separation-specific experiences disproportionately affected LGB service members in this study. Promoting inclusion and increasing support for LGB service members may improve satisfaction with military service and retention.

Download Full-text

Inequities in tobacco advertising exposure among young adult sexual, racial and ethnic minorities: examining intersectionality of sexual orientation with race and ethnicity

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055313 ◽

2019 ◽

Vol 30 (1) ◽

pp. 84-93

Author(s):

Andy S L Tan ◽

Elaine P Hanby ◽

Ashley Sanders-Jackson ◽

Stella Lee ◽

Kasisomayajula Viswanath ◽

...

Keyword(s):

Young Adults ◽

Sexual Orientation ◽

Black Women ◽

Race And Ethnicity ◽

Health Study ◽

Heterosexual Men ◽

Bisexual Men ◽

Heterosexual Women ◽

And Bisexual ◽

The Impact

ObjectiveThis study examined sexual orientation differences in encoded exposure to tobacco product ads and intersections with race and ethnicity.MethodsWe analysed data from young adults (18–24) from the US Population Assessment of Tobacco and Health Study in 2013 and 2014 (N=9110). First, we compared encoded exposure to cigarette, electronic cigarette (e-cigarette), cigar and smokeless tobacco ads between sexual minorities (lesbian/gay, bisexual and something else) versus heterosexual young adults. We then analysed encoded ad exposure across sexual orientation, racial and ethnic subgroups. Analyses controlled for demographic and tobacco use variables.ResultsBisexual women had significantly higher prevalence of encoded exposure to cigarette and cigar ads compared with heterosexual women, and significantly higher prevalence of encoded e-cigarette ad exposure compared with both heterosexual and lesbian/gay women. There were no significant differences in encoded ad exposure between lesbian versus heterosexual women and between gay or bisexual men versus heterosexual men. Compared with heterosexual white counterparts, increased encoded ad exposures were reported by heterosexual black women (cigarette and cigar ads), black heterosexual men (cigar ads) and bisexual black women (cigarette and cigar ads). Compared with heterosexual non- Hispanic counterparts, increased encoded ad exposures were reported by bisexual Hispanic women (cigarette, e-cigarette and cigar ads) and heterosexual Hispanic men (cigarettes and cigar ads).ConclusionSexual minority women of colour and black heterosexual women and men have increased encoded exposure to certain forms of tobacco ads. Further research is needed to address the impact of tobacco ads among multiple minority individuals based on sex, sexual orientation, race and ethnicity.

Download Full-text

Oversampling as a methodological strategy for the study of self-reported health among lesbian, gay and bisexual populations

Scandinavian Journal of Public Health ◽

10.1177/1403494817717407 ◽

2017 ◽

Vol 45 (6) ◽

pp. 637-646 ◽

Cited By ~ 5

Author(s):

Norman Anderssen ◽

Kirsti Malterud

Keyword(s):

Sexual Orientation ◽

Population Based ◽

Group Differences ◽

Bisexual Men ◽

Lesbian Women ◽

Bisexual Women ◽

Heterosexual Women ◽

Reported Health ◽

And Bisexual ◽

And Gender

Aims: Epidemiological research on lesbian, gay and bisexual populations raises concerns regarding self-selection and group sizes. The aim of this research was to present strategies used to overcome these challenges in a national population-based web survey of self-reported sexual orientation and living conditions—exemplified with a case of daily tobacco smoking. Methods: The sample was extracted from pre-established national web panels. Utilizing an oversampling strategy, we established a sample including 315 gay men, 217 bisexual men, 789 heterosexual men, 197 lesbian women, 405 bisexual women and 979 heterosexual women. We compared daily smoking, representing three levels of differentiation of sexual orientation for each gender. Results: The aggregation of all non-heterosexuals into one group yielded a higher odds ratio (OR) for non-heterosexuals being a daily smoker. The aggregation of lesbian and bisexual women indicated higher OR between this group and heterosexual women. The full differentiation yielded no differences between groups except for bisexual compared with heterosexual women. Conclusions: The analyses demonstrated the advantage of differentiation of sexual orientation and gender, in this case bisexual women were the main source of group differences. We recommend an oversampling procedure, making it possible to avoid self-recruitment and to increase the transferability of findings.

Download Full-text

Abstract P079: Examining Associations Of Sexual Identity And Cardiovascular Disease Risk In A Nationally Representative Sample: The Mediating Role Of Sleep Duration

Circulation ◽

10.1161/circ.143.suppl_1.p079 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Billy A Caceres ◽

Danny Vo ◽

Yashika Sharma ◽

Ipek Ensari ◽

Kasey Jackman ◽

...

Keyword(s):

Sexual Identity ◽

Gay Men ◽

Sleep Duration ◽

Sexual Minority ◽

Heterosexual Men ◽

Bisexual Women ◽

Cvd Risk ◽

Heterosexual Women ◽

Nationally Representative ◽

And Bisexual

Introduction: There is growing evidence that sexual minority (e.g., gay/lesbian and bisexual) adults have higher cardiovascular disease (CVD) risk and report shorter sleep duration than heterosexual adults. Previous research suggests that sleep duration is inversely associated with CVD risk in adults. To date, no study has examined the associations of sleep duration and objectively measured CVD risk in sexual minority adults. Hypothesis: We investigated the hypothesis that sexual minority adults have higher systolic and diastolic blood pressure (BP) and waist-to-height ratio (WHtr) than heterosexual adults and that sleep duration mediates these associations. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (2005-2016) were used. Sexual identity and sleep duration were assessed based on self-report. We used the average of systolic and diastolic BP across two readings to assess BP. We calculated the ratio between waist and height (in cm). We used sex-stratified linear regression models to compare CVD risk factors between sexual minority (i.e., gay/lesbian and bisexual) and heterosexual adults. Next, we used path analysis to determine whether the associations of sexual identity with systolic and diastolic BP and WHtr were mediated by sleep duration. Models were adjusted for demographic characteristics and tobacco use. Results: The sample included 17,858 adults. Participants had a mean age of 38.0 (SD = 12.1), 48.4% were female, and 65.6% were Non-Hispanic White. Gay men reported higher sleep duration ( B 0.27 [0.07]) relative to heterosexual men. However, WHtr and diastolic BP did not differ between gay and heterosexual men. No differences in sleep duration or diastolic BP were found between sexual minority and heterosexual women. Bisexual women had a higher systolic BP ( B 1.64 [0.70]) and WHtr ( B 0.02 [0.01]) than heterosexual women, but these associations were not mediated by sleep duration. Compared to heterosexual men, sleep duration partially mediated the associations of sexual identity with diastolic BP ( B - 0.12 [0.05]) and WHtr ( B - 0.01 [0.01]) in gay men. Conclusion: This is the first study to assess the associations of sexual identity, sleep duration, and an objectively measured marker of CVD risk in a nationally representative sample of US adults. We found that bisexual women had higher systolic BP and WHtr than heterosexual women and that higher sleep duration was associated with lower diastolic BP and WHtr in gay men. Findings can inform future studies investigating the interplay between sexual identity, sleep duration, and CVD risk in adults.

Download Full-text

Sexual orientation and health behaviors among college students in Italy

Genus ◽

10.1186/s41118-021-00136-4 ◽

2021 ◽

Vol 77 (1) ◽

Author(s):

Maria Sironi ◽

Julie Fricke

Keyword(s):

College Students ◽

Sexual Orientation ◽

Health Behaviors ◽

Heterosexual Men ◽

Homosexual Men ◽

Bisexual Men ◽

Bisexual Women ◽

Emotional Life ◽

Data Set ◽

Heterosexual Women

AbstractStudies regarding sexual orientation and health behaviors have largely neglected the Italian context. This research utilizes the second wave of the ‘Sexual and Emotional Life of Youths’ (SELFY) data set to compare the health behaviors of sexual minority (SM) and heterosexual college students in Italy. Results showed that bisexual women were more likely than heterosexual women to smoke both 1–7 and 8+ cigarettes per day, get drunk sometimes and often/very often, and use marijuana and/or ecstasy sometimes and often/very often. Homosexual women were more likely than heterosexual women to smoke 1–7 cigarettes per day, get drunk often/very often, and use marijuana and/or ecstasy often/very often. Homosexual men were more likely than heterosexual men to smoke 8+ cigarettes per day, but less likely to get drunk often/very often. Bisexual men were less likely than heterosexual men to participate in physical activity sometimes, often, and very often. Finally, bisexual men were less likely to exercise often than homosexual men. This work highlights that SM college students in Italy, particularly women, are more likely to engage in specific risky health behaviors compared to their heterosexual counterparts. More attention needs to be given to SMs in Italy to inform the Italian national health care system and to ensure that the appropriate care can be provided when required.

Download Full-text

Sexual orientation and wage discrimination: evidence from Australia

International Journal of Manpower ◽

10.1108/ijm-08-2018-0279 ◽

2019 ◽

Vol 41 (6) ◽

pp. 629-648

Author(s):

Alison Preston ◽

Elisa Birch ◽

Andrew R. Timming

Keyword(s):

Sexual Orientation ◽

Gay Men ◽

Sexual Minorities ◽

Wage Distribution ◽

Heterosexual Men ◽

Bisexual Women ◽

Wage Gaps ◽

Content Type ◽

The Public ◽

Highly Skilled

Purpose The purpose of this paper is to document the wage effects associated with sexual orientation and to examine whether the wage gap has improved following recent institutional changes which favour sexual minorities. Design/methodology/approach Ordinary least squares and quantile regressions are estimated using Australian data for 2010–2012 and 2015–2017, with the analysis disaggregated by sector of employment. Blinder–Oaxaca decompositions are used to quantify unexplained wage gaps. Findings Relative to heterosexual men, in 2015–2017 gay men in the public and private sectors had wages which were equivalent to heterosexual men at all points in the wage distribution. In the private sector: highly skilled lesbians experienced a wage penalty of 13 per cent; low-skilled bisexual women faced a penalty of 11 per cent, as did bisexual men at the median (8 per cent penalty). In the public sector low-skilled lesbians and low-skilled bisexual women significant experienced wage premiums. Between 2010–2012 and 2015–2017 the pay position of highly skilled gay men has significantly improved with the convergence driven by favourable wage (rather than composition) effects. Practical implications The results provide important benchmarks against which the treatment of sexual minorities may be monitored. Originality/value The analysis of the sexual minority wage gaps by sector and position on the wage distribution and insight into the effect of institutions on the wages of sexual minorities.

Download Full-text

Review: Prevalence and Co-Occurrence of Addictions Among Sexual Minority Subgroups

Annals of LGBTQ Public and Population Health ◽

10.1891/lgbtq-2020-0007 ◽

2020 ◽

Vol 1 (3) ◽

pp. 210-248

Author(s):

Ryan Ruppert ◽

Steve Sussman ◽

Shanna K. Kattari

Keyword(s):

Illicit Drugs ◽

Current Data ◽

Behavioral Addictions ◽

Addictive Behaviors ◽

Bisexual Men ◽

Lesbian Women ◽

Bisexual Women ◽

Heterosexual Women ◽

Internet Sex ◽

And Bisexual

The purpose of this study is to present current data on the prevalence and co-occurrence of 12 substance and behavioral addictions among adult cisgender sexual minorities (SM). We utilized MEDLINE, PsycINFO, and Google Scholar databases to systematically review the literature on alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, Internet, sex, love, exercise, work, and shopping within the SM community. Peer reviewed empirical articles in English from 2000 to 2019 were included. When possible, we compared prevalence and co-occurrence statistics between four SM subgroups (stratified into lesbian women, bisexual women, gay men, and bisexual men), and used heterosexual women and men as reference groups. Studies were scant within each area of addiction with the most studies focusing on addictions acknowledged within the DSM-V (alcohol, nicotine, cannabis, illicit drugs, gambling). Significantly fewer studies addressed the prevalence and co-occurrence of behavioral addictions across SM subgroups. Most studies assessing addiction among SM populations either categorize SMs into a single group or only stratify by gender. However, even with limited research, the findings from this review suggest that significant differences in addictive behaviors exist when comparing one SM subgroup to another. There is a strong need for more research that quantifies these disparities through prevalence and co-occurrence statistics.

Download Full-text

Prevalence of STD and HIV infections among attenders of the Erasmus MC STD clinic, Rotterdam, The Netherlands, during the years 1996 to 2000

International Journal of STD & AIDS ◽

10.1258/095646203321156890 ◽

2003 ◽

Vol 14 (2) ◽

pp. 119-124 ◽

Cited By ~ 8

Author(s):

E M van der Snoek ◽

H M Götz ◽

P G H Mulder ◽

R P Verkooyen ◽

W I van der Meijden

Keyword(s):

Hiv Infection ◽

Risk Behaviour ◽

Hiv Infections ◽

Contact Tracing ◽

Heterosexual Men ◽

Intravenous Drug Use ◽

Bisexual Men ◽

Heterosexual Women ◽

And Bisexual ◽

Chlamydial Infections

The purpose of the study was to investigate possible changes in the prevalence of STD and HIV collected at a Dutch STD clinic in the period 1996 to 2000. Age, gender, ethnic background, sexual preference, intravenous drug use and STD or HIV infection in persons attending an STD outpatient clinic were analysed and compared. The prevalence of HIV infection among the clinic visitors remained stable. The prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections increased significantly among heterosexual men and heterosexual women. Among homo- and bisexual men a significant increase was seen in chlamydial infections only. Because of the increasing prevalence of gonococcal and chlamydial infections among STD clinic visitors in Rotterdam, more attention should be paid to coordinated preventive activities, such as health education and contact tracing. Further subgroup analyses should be done in order to get more information on risk behaviour in the different groups.

Download Full-text

The Nexus of Sexual Orientation and Gender in the Determination of Earnings

ILR Review ◽

10.1177/001979390305600405 ◽

2003 ◽

Vol 56 (4) ◽

pp. 622-642 ◽

Cited By ~ 91

Author(s):

John M. Blandford

Keyword(s):

Sexual Orientation ◽

Marital Status ◽

Wage Differentials ◽

General Social Survey ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Bisexual Women ◽

Unobserved Effects ◽

And Bisexual ◽

And Gender

This analysis of 1989–96 General Social Survey data reveals how sexual orientation and gender jointly influence earnings outcomes. Gay and bisexual men experienced a 30–32% income disadvantage relative to heterosexual peers, while lesbian and bisexual women enjoyed a wage premium of 17–23%. The disparate earnings effects of sexual orientation across genders suggest that workplace discrimination may be only one factor accounting for measured wage differentials associated with sexual orientation. These findings qualify pioneering work on the subject that indicated that wage differentials were attributable largely to employer bias. A further analysis that distinguishes the separate effects of gender, marital status, and sexual orientation suggests that differentials long attributed to marital status may in part reflect previously unobserved effects of sexual orientation.

Download Full-text

Pay equity after the Equality Act 2010: does sexual orientation still matter?

Work Employment and Society ◽

10.1177/0950017016664678 ◽

2016 ◽

Vol 31 (3) ◽

pp. 483-500 ◽

Cited By ~ 7

Author(s):

Alex Bryson

Keyword(s):

Sexual Orientation ◽

Wage Differential ◽

Wage Gap ◽

Heterosexual Men ◽

Bisexual Men ◽

Equal Opportunities ◽

Pay Equity ◽

Ceteris Paribus ◽

Heterosexual Women ◽

Employee Data

Analyses of linked employer–employee data for Britain indicate bisexual men earn 20 per cent less per hour than heterosexual men, ceteris paribus. There is no wage differential between gay and heterosexual men. Among women there is no wage gap between bisexuals and heterosexuals. However, lesbians are paid nearly 30 per cent less than heterosexual women, unless they are employed in a workplace with an equal opportunities policy which explicitly refers to sexual orientation, whereupon there is no wage gap. Workplace sorting by sexual orientation does not affect the size of the sexual orientation wage gaps.

Download Full-text