Disparities in Subjective Cognitive Impairment by Sexual Orientation and Gender in a National Population Based Study of U.S. Adults, 2013–2018

2021 ◽  
pp. 089826432110464
Author(s):  
Karen I. Fredriksen-Goldsen ◽  
Hailey Jung ◽  
Hyun-Jun Kim ◽  
Ryan Petros ◽  
Charles Emlet
Keyword(s):  
Cognitive Impairment ◽  
Sexual Orientation ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Population Based ◽  
Population Based Study ◽  
Subjective Cognitive Impairment ◽  
Targeted Interventions ◽  
National Population ◽  
And Gender

Objectives: This is the first national population-based study to examine cognitive impairment disparities among sexual minority mid-life and older adults. Methods: Using the National Health Interview Survey (2013–2018), we compared weighted prevalence of subjective cognitive impairment by sexual orientation and gender, among those aged 45 plus, applying logistic regressions adjusting for age, income, education, race/ethnicity, and survey years. Results: Sexual minorities (24.5%) were more likely to have subjective cognitive impairment than heterosexuals (19.1%). Sexual minority women had higher odds of greater severity, frequency, and extent of subjective cognitive impairment. Sexual minorities were also more likely to report activity limitations resulting from cognitive impairment and were no more likely to attribute limitations to dementia or senility. Discussion: Cognitive health disparities are of particular concern in this historically and socially marginalized population. The investigation of explanatory factors is needed, and targeted interventions and policies are warranted to address cognitive challenges faced by sexual minorities.

scholarly journals Proving it: experiences of sexual minorities in the Canadian refugee determination system

2021 ◽  
Author(s):  
Casey Anderson
Keyword(s):  
Sexual Orientation ◽  
Gender Identity ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Decision Makers ◽  
Gender Identities ◽  
Theoretical Concepts ◽  
Canadian Immigration ◽  
Determination System ◽  
And Gender

This paper explores refugee claimant’s experiences negotiating the Canadian Immigration and Refugee Board (IRB). Focusing on claims based on sexual orientation and gender identity, this paper investigates how claimants are made to ‘prove’ their sexual orientation and gender identity. The IRB and its decision makers require that claimants prove their identity as a refugee as well as a member of a sexual minority. Through an analysis of the existing literature and by integrating queer and feminist theoretical concepts on gender, sex, performativity and representation, it is apparent that the Canadian IRB functions as a heteronormative system in which the understanding of sexual orientation and gender identities are essentialized.

scholarly journals Proving it: experiences of sexual minorities in the Canadian refugee determination system

2021 ◽  
Author(s):  
Casey Anderson
Keyword(s):  
Sexual Orientation ◽  
Gender Identity ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Decision Makers ◽  
Gender Identities ◽  
Theoretical Concepts ◽  
Canadian Immigration ◽  
Determination System ◽  
And Gender

This paper explores refugee claimant’s experiences negotiating the Canadian Immigration and Refugee Board (IRB). Focusing on claims based on sexual orientation and gender identity, this paper investigates how claimants are made to ‘prove’ their sexual orientation and gender identity. The IRB and its decision makers require that claimants prove their identity as a refugee as well as a member of a sexual minority. Through an analysis of the existing literature and by integrating queer and feminist theoretical concepts on gender, sex, performativity and representation, it is apparent that the Canadian IRB functions as a heteronormative system in which the understanding of sexual orientation and gender identities are essentialized.

scholarly journals Workshop: Predictors and developmental timing of mental health problems among sexual minority individuals

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Mental Health ◽  
Sexual Orientation ◽  
Social Anxiety ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Mental Health Problems ◽  
Population Based ◽  
Health Problems ◽  
Poor Mental Health ◽  
Social Stressors

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.

scholarly journals Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter?

2020 ◽  
Author(s):  
Ning Hsieh ◽  
Hui Liu ◽  
Wen-Hua Lai
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Sexual Orientation ◽  
Health Behaviors ◽  
Sexual Minority ◽  
Social Life ◽  
Sexual Minorities ◽  
Social Connections ◽  
Future Research

Abstract Background and Objectives Little research has examined cognitive health disparities between sexual minority and heterosexual populations. Further, most extant studies rely on subjective measures of cognitive functioning and non-probability samples. This study uses a performance-based cognitive screening tool and a nationally representative sample of older Americans to examine the disparity in cognitive impairment by sexual orientation and the potential mechanisms producing this disparity. Research Design and Methods Using data from the 2015–2016 National Social Life, Health, and Aging Project (N = 3,567), we analyzed respondents’ scores on the survey-adapted Montreal Cognitive Assessment. We estimated ordinal logit regressions to examine the relationship between sexual orientation and cognitive impairment and used the Karlson–Holm–Breen method to assess how mental and physical conditions, health behaviors, and social connections mediate this relationship. Results The prevalence of cognitive impairment is significantly higher among sexual minority older adults than among heterosexual older adults when sociodemographic factors are adjusted for. Depressive symptoms explain some of this prevalence gap. Although anxiety symptoms, physical comorbidity, health behaviors, and social connections may contribute to cognitive impairment, they do not explain the cognitive disparity by sexual orientation. Discussion and Implications The findings indicate that depressive symptoms are an important link between minority sexual orientation and cognitive impairment and highlight the importance of studying other potential mechanisms that we could not explore in this study. Future research should further investigate how minority stress processes may unfold to accelerate cognitive decline among sexual minorities over the life course.

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