Chained Multimediator Model of Sexual Orientation Disclosure, Sexual Minority Stigma, Sexual Minority Identity, Social Support, and Resilience among YMSMs

Introduction: This study aimed to investigate sexual orientation disclosure and mental health among young men who have sex with men (YMSMs). To this end, we constructed a chained multimediator model of sexual minority stigma, sexual minority identity, social support, and resilience, with the moderator of sexual orientation disclosure. Methods: We conducted a cross-sectional survey of 345 YMSMs in Nanning, China. Univariate analysis was used to evaluate factors associated with sexual orientation disclosure. Sexual minority stigma was used to predict identity, with social support as the step 1 mediator and resilience as the step 2 mediator. Sexual minority identity was analyzed using a chained moderated mediation model; sexual orientation disclosure was included as a moderator in all models to control its confounding effect. Results: The average age of YMSMs was 20.0 ± 1.3 years. Univariate analysis indicated that YMSMs who disclosed sexual orientation may have experienced less stigma (15.49 ± 3.02 vs 16.21 ± 2.74), obtained more social support (65.98 ± 11.18 vs 63.19 ± 11.13), had strong psychological resilience (37.40 ± 8.57 vs 35.39 ± 7.73), and had a more positive self-identity (104.12 ± 21.10 vs 95.35 ± 16.67); differences between subgroups were statistically significant (p < 0.05). Sexual minority stigma, perceived stigma, and enacted stigma were significantly associated with social support and resilience. The association between sexual minority stigma and sexual minority identity was significantly mediated by social support (indirect effect [95% CI] = −3.307 [−4.782, −1.907]). Resilience significantly mediated the same association for identity (−2.544 [−4.052, −1.114]). The chained relationship from sexual minority stigma to social support, resilience, and identity was also significant, with an indirect effect of −0.404 [−0.621, −0.249]. Conclusion: Among YMSMs in China, sexual minority stigma affects sexual minority identity through social support and resilience. Given the psychological effects of stigma, social support and resilience must be considered to better promote positive self-identity and mental health among YMSMs.

The positive experiences associated with coming out at work

PurposeMuch research has focused on the negative aspects of disclosing sexual orientation and/or gender identity in the workplace but less has explicitly examined the positive aspects. This lack of research is problematic as this can oversimplify the work lives of lesbian, gay, bisexual, transgender or queer (LGBTQ) people. The current study examines positive intrapersonal, interpersonal and work opportunity experiences associated with coming out in the workplace as LGBTQ.Design/methodology/approachThe current study surveyed 135 working adults who identified as LGBTQ and used a mixed qualitative and quantitative design to examine the relationship between disclosure and various positive workplace experiences.FindingsResults suggest that sexual orientation disclosure at work was related to participants perceiving multiple positive interpersonal as well as work opportunity experiences. Furthermore, results suggest gender identity disclosure was similar to, but not the same as, sexual orientation disclosure in terms of perception of positive experiences.Originality/valuePrevious research on disclosure at work has taken a somewhat narrow and typically quantitative approach. The current study provides more nuance to the phenomenon by broadly examining multiple positive experiences associated with disclosure and studying them qualitatively in order to best understand participants' experiences in their own voices.

Predictors of Disclosing Sexual Orientation to Parents, Classmates, and School Adults among Latinx Sexual Minority High School and College Youth

The current study examined predictors associated with the degree of sexual orientation disclosure across social contexts (parents, classmates, and school adults) and educational context (high school and college) among Latinx sexual minority youth (SMY; N = 238). Results revealed that perceptions of more supportive social attitudes to sexual minority communities were associated with higher levels of sexual orientation disclosure across social contexts, including parents, classmates, and school adults. Compared to monosexual Latinx SMY, plurisexual Latinx SMY reported lower levels of sexual orientation disclosure to parents and school adults but not to classmates. Sexual orientation identity centrality was only associated with sexual orientation disclosure to parents but not to classmates or school adults. Degree of romantic attraction to the same gender was not associated with sexual orientation disclosure. Findings provide preliminary support for critical nuances in sexual orientation disclosure across social and educational contexts among Latinx SMY.

Health care access, health care utilisation and sexual orientation disclosure among Black sexual minority men in the Deep South

Background Black gay, bisexual, and other sexual minority men (BSMM) account for 39.1% of new HIV infections among men who have sex with men and 78.9% of newly diagnosed cases among Black men. Health care access, health care utilisation and disclosing sexuality to providers are important factors in HIV prevention and treatment. This study explored the associations among sexual orientation disclosure, health care access and health care utilisation among BSMM in the Deep South. Methods:Secondary analysis of existing data of a population-based study in Jackson, Mississippi, and Atlanta, Georgia, was conducted among 386 BSMM. Poisson regression models were used to estimate prevalence ratios (PR) between sexual orientation disclosure to healthcare providers, health care access and health care utilisation. Results:The mean (±s.d.) age of participants was 30.5 ± 11.2 years; 35.3% were previously diagnosed with HIV and 3.7% were newly diagnosed with HIV. Two-thirds (67.2%) self-identified as homosexual or gay; 70.6% reported being very open about their sexual orientation with their healthcare providers. After adjustment, BSMM who were not open about their sexual orientation had a lower prevalence of visiting a healthcare provider in the previous 12 months than those who were very open with their healthcare provider (PR 0.42; 95% confidence interval 0.18–0.97). Conclusion:Clinics, hospitals and other healthcare settings should promote affirming environments that support sexuality disclosure for BSMM.

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

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.