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

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.

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

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465817000583 ◽

2017 ◽

Vol 46 (3) ◽

pp. 332-349 ◽

Cited By ~ 5

Author(s):

Katharine A. Rimes ◽

Matthew Broadbent ◽

Rachel Holden ◽

Qazi Rahman ◽

David Hambrook ◽

...

Keyword(s):

Primary Care ◽

Sexual Orientation ◽

Treatment Outcomes ◽

Gay Men ◽

Heterosexual Men ◽

Psychological Interventions ◽

Bisexual Men ◽

Bisexual Women ◽

Heterosexual Women ◽

And Bisexual

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.

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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.

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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.

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Gender Nonconformity and Minority Stress Among Lesbian, Gay, and Bisexual Individuals: A Meta-Analytic Review

Perspectives on Psychological Science ◽

10.1177/1745691620968766 ◽

2021 ◽

pp. 174569162096876

Author(s):

Brian C. Thoma ◽

Kristen L. Eckstrand ◽

Gerald T. Montano ◽

Taylor L. Rezeppa ◽

Michael P. Marshal

Keyword(s):

Sexual Orientation ◽

Minority Stress ◽

Gay And Bisexual Men ◽

Gender Nonconformity ◽

Future Research ◽

Bisexual Men ◽

Bisexual Women ◽

Sexual Orientation Identity ◽

Analytic Review ◽

And Bisexual

Lesbian, gay, and bisexual (LGB) individuals are less healthy than heterosexual individuals, and minority stress endured by LGB individuals contributes to these health disparities. However, within-groups differences in minority stress experiences among LGB individuals remain underexplored. Individuals are more likely to be categorized as LGB if they exhibit gender nonconformity, so gender nonconformity could influence concealability of sexual orientation among LGB individuals, carrying important implications for the visibility of their stigmatized sexual orientation identity and for how they experience and cope with minority stress. Through a meta-analytic review, we examined how gender nonconformity was associated with minority stress experiences among LGB individuals. Thirty-seven eligible studies were identified and included in analyses. Results indicate gender nonconformity is associated with experiencing more prejudice events, less concealment of sexual orientation, lower internalized homonegativity, and higher expectations of rejection related to sexual orientation among LGB individuals. Gender nonconformity is more strongly associated with experiencing prejudice events among gay and bisexual men than among lesbian and bisexual women. Gender nonconformity is systematically associated with minority stress experiences among LGB individuals, and future research must measure and examine gender nonconformity when investigating the role of minority stress in degraded health outcomes among LGB populations.

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Sexual Fantasies across Gender and Sexual Orientation in Young Adults: A Multiple Correspondence Analysis

Sexes ◽

10.3390/sexes2040041 ◽

2021 ◽

Vol 2 (4) ◽

pp. 523-533

Author(s):

Mattia Nese ◽

Greta Riboli ◽

Gianni Brighetti ◽

Raffaele Visciano ◽

Daniel Giunti ◽

...

Keyword(s):

Young Adults ◽

Sexual Orientation ◽

Correspondence Analysis ◽

Multiple Correspondence Analysis ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Bisexual Women ◽

Sexual Fantasies ◽

Online Questionnaire ◽

And Bisexual

Differences in the content of sexual fantasies across gender have been widely documented, while less attention was given to the role of sexual orientation. Previous studies focused on differences in the prevalence of broad themes consisting of sets of contents. The current study aimed to increase the knowledge about sexual fantasies in heterosexual, homosexual, and bisexual men and women. A descriptive approach that allows visualizing the patterns of fantasies reported by different groups using Multiple Correspondence Analysis (MCA) is presented. A sample of 3136 of young adults, 1754 women (Mage = 22.50, SD = 1.72, range 18–25) and 1382 men (Mage = 22.50, SD = 1.70, range 18–25), completed an online questionnaire assessing the presence of 29 different sexual fantasies. The prevalence of each fantasy among each group is shown. Also, relationships between fantasies and the distribution of groups along the two principal dimensions highlighted by MCA are represented. Heterosexuals women reported fewer fantasies and showed opposite patterns of response compared to heterosexual men. There was a substantial overlapping in the fantasies reported by gay and bisexual men, while responses of lesbian and bisexual women were more differentiated. These results indicate that the content of sexual fantasies varies according to both gender and sexual orientation.

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The association of sexual orientation with prostate, breast, and cervical cancer screening and diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.129 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 129-129

Author(s):

Michael Joseph Herriges ◽

Ruben Pinkhasov ◽

Keren Lehavot ◽

Oleg Shapiro ◽

Joseph M Jacob ◽

...

Keyword(s):

Cervical Cancer ◽

Sexual Orientation ◽

Cancer Screening ◽

Gay And Bisexual Men ◽

Heterosexual Men ◽

Bisexual Men ◽

Men And Women ◽

Breast And Cervical Cancer ◽

And Bisexual ◽

Screening And Diagnosis

129 Background: Data on heterogeneity in cancer screening and diagnosis rates among lesbians/gays and bisexuals is lacking. Recent studies showed that lesbians/gays and bisexuals have decreased healthcare utilization compared to heterosexual counterparts and continue to experience discrimination in healthcare. Few studies have examined how sexual orientation impacts cancer screening and prevalence. We, therefore, investigated the association between sexual orientation and prevalent sex-specific cancer including prostate, breast, and cervical cancer. Methods: This was a cross-sectional survey-based US study, including men and women aged 18+ from the Health Information National Trends Survey (HINTS) database between 2017-2019. The primary endpoint was individual-reported prostate, breast, and cervical cancer screening and prevalence rates among heterosexual and LGB men and women. Multivariable logistic regression analyses assessed association of various covariates with undergoing screening and diagnosis of these cancers. Results: Overall, 4,441 and 6,333 heterosexual men and women, respectively, were compared to 225 and 213 lesbian/gay and bisexual men and women, respectively. Lesbians/gays and bisexuals were younger and less likely to be screened for prostate, breast, and cervical cancer than heterosexuals. A higher proportion of heterosexual women than lesbian and bisexual women were screened for cervical cancer with pap smears (95.36% vs. 90.48% and 86.11%, p = < 0.001) and breast cancer with mammograms (80.74% vs. 63.81% and 45.37%, p = < 0.001). Similarly, a higher proportion of heterosexual men than gay and bisexual men were screened for prostate cancer with PSA blood tests (41.27% vs. 30.53% and 27.58%, p = < 0.001). Conclusions: Lesbians/gays and bisexuals in the US may be less likely to undergo screening of sex-specific prevalent malignancies, including prostate, breast, and cervical cancer. Healthcare professionals should be encouraged to improve cancer screening among lesbians/gays and bisexuals.

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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.

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Sexual orientation and life satisfaction

Journal of Sociology ◽

10.1177/14407833211017672 ◽

2021 ◽

pp. 144078332110176

Author(s):

David Bartram

Keyword(s):

Life Satisfaction ◽

Sexual Orientation ◽

Quantitative Research ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Bisexual Women ◽

Control Variables ◽

And Bisexual ◽

The Uk ◽

Correct Understanding

Existing quantitative research on sexual orientation and life satisfaction uses models with control variables that do not have a clear rationale. With a correct understanding of what control variables do, no controls are necessary to estimate the consequences of sexual orientation on life satisfaction. An analysis constructed from this perspective reveals gay and bisexual men in the UK and Australia are less satisfied with their lives (relative to heterosexual men). Bisexual women in both countries are less satisfied as well. Lesbians in Australia are less satisfied (relative to straight women) – but lesbians in the UK do not have lower satisfaction. These conclusions hold also in an analysis that considers the possibility that some non-heterosexual people might be unwilling to disclose their sexual orientation on surveys.

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A Scoping Review of Intimate Partner Violence as It Relates to the Experiences of Gay and Bisexual Men

Trauma Violence & Abuse ◽

10.1177/1524838020970898 ◽

2020 ◽

pp. 152483802097089

Author(s):

Aisling Callan ◽

Melissa Corbally ◽

Rosaleen McElvaney

Keyword(s):

Intimate Partner Violence ◽

Sexual Orientation ◽

Sexual Minority ◽

Partner Violence ◽

Gay And Bisexual Men ◽

Intimate Partner ◽

Bisexual Men ◽

Heterosexual Couples ◽

Heterosexual Women ◽

And Bisexual

Intimate partner violence (IPV) is a global health issue that encroaches beyond parameters of age, gender, sexual orientation and is the subject of extensive scholarly inquiry. Research on IPV in heterosexual couples, in particular on heterosexual women, has been prolific. However, there is a dearth of literature to document the distinct experiences of gay and bisexual men, despite the evidence of prevalence of IPV as reported equal or higher to heterosexual women. Studies have found that one in four gay men and four in 10 bisexual men have experienced IPV in their lifetime. This scoping review examines studies between 1931 and 2019 that had a predominant focus on violence among gay and bisexual men. Four electronic databases were searched in 2019. Arksey and O’Malley’s framework was utilized to extract 28 studies using a range of research designs that represented 13,224 sexual minority male participants. Across studies, gay and bisexual men were observed to experience IPV similarly to heterosexual couples involving psychological, physical, and sexual violence. However, as a marginalized and sexual minority group, they experience distinctive features of violence including sexual orientation outing, unprotected sexual intercourse, homophobia, internalized homophobia, and difficulties accessing minority men–focused services. Minority stress theory is posited as a useful lens in understanding the above features. In keeping with previous scholarship, a paucity of knowledge on gay and bisexual men’s experience of IPV was observed, and additional research is recommended.

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Population rates of HIV, gonorrhoea and syphilis diagnoses by sexual orientation in New Zealand

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-055186 ◽

2021 ◽

pp. sextrans-2021-055186

Author(s):

Peter J W Saxton ◽

Susan M McAllister ◽

Callum E Thirkell ◽

Adrian H Ludlam ◽

Jerram P Bateman ◽

...

Keyword(s):

Sexual Orientation ◽

New Zealand ◽

Sexual Identity ◽

Disease Incidence ◽

Gay And Bisexual Men ◽

Surveillance Systems ◽

Bisexual Men ◽

Bisexual Women ◽

And Bisexual ◽

Rate Ratios

IntroductionGlobally, gay and bisexual men (GBM) are over-represented in HIV, syphilis and gonorrhoea cases. However, surveillance systems rarely provide meaningful measures of inequity, such as population-specific rates, due to a lack of sexual orientation denominators. HIV, gonorrhoea and syphilis are legally notifiable diseases in New Zealand (NZ); we calculate rates by sexual orientation for the first time.MethodsWe analysed 2019 national surveillance data on HIV, syphilis and gonorrhoea notifications disaggregated by sexual orientation. Unique health records identified duplicate notifications and reinfections. Missing data were imputed from known cases. We used the NZ Health Survey 2014/2015 to estimate population sizes by sexual orientation, measured in two ways (current sexual identity, sexual contact in the previous 12 months with men, women or both). We calculated notification rates per 100 000 for each sexual orientation subgroup and rate ratios.ResultsIn 2019, GBM accounted for 76.3%, 65.7% and 39.4% of HIV, syphilis and gonorrhoea notifications, respectively. Population rates per 100 000 for HIV were 158.3 (gay/bisexual men) and 0.5 (heterosexuals); for syphilis, population rates per 100 000 were 1231.1 (gay/bisexual men), 5.0 (lesbian/bisexual women) and 7.6 (heterosexuals); for gonorrhoea (imputed), population rates per 100 000 were 6843.2 (gay/bisexual men), 225.1 (lesbian/bisexual women) and 120.9 (heterosexuals). The rate ratios for GBM compared with heterosexuals were: 348.3 (HIV); 162.7 (syphilis); and 56.6 (gonorrhoea). Inequities remained in sensitivity analysis (substituting sexual identity with sexual behaviour in the previous 12 months).ConclusionGBM in NZ experience profound inequities in HIV, syphilis and gonorrhoea. Rate ratios by sexual orientation provide useful ‘at-a-glance’ measures of inequity in disease incidence.

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