Modeling the impact of social discrimination on the physical and mental health of Portuguese gay,lesbian and bisexual people

Background: Despite growing acceptance of same-sex sexuality in Portugal, identity development of lesbian, gay and bisexual (LGB) individuals is still restricted by negative societal attitudes, which maintain the experience of stigmatization and discrimination. The purpose of this study is to document the frequency of discriminatory events experienced by sexual minorities and their association with indicators of physical and mental health in Portugal. Methods: A total of 610 LGB participants completed an online survey (mean age?=?34.48, SD?=?11.54). Most participants were single and self-identified as gay (73.8%). The survey included five categories of survey items: demographic information, social support, physical health, mental health, and discrimination experiences. Results: Physical and mental health results revealed that bisexual people were more likely to report higher levels of psychological distress than gay men. Overall, between one-fifth and one-fourth of the participants in this sample frequently felt the need to hide their sexual orientation to prevent discrimination experiences across the different settings. Regarding actual discrimination experiences, close to 20% reported having suffered from verbal abuse, followed by close to 10% who suffered from written threats, harassment, and physical threats. A hierarchical multiple regression analysis was performed to assess the effects of anticipated and actual discrimination on mental health. Possible confounding variables were added in the first block – age, sexual orientation, being in a relationship, body mass index, and HIV status. Anticipated and actual discrimination experiences were added in the second block. The first block of the analysis explained 6% of the overall variance, while the second block – discrimination experiences – explained an additional 17%. Conclusion: Portuguese culture and stigma/discrimination create discriminatory experiences which impact LGB people's health. Unless policies are changed to allow for the acceptance of LGB people, they will continue to experience violence and discrimination as a result of homophobia.     

Sexual Harassment in Casinos: Effects on Employee Attitudes and Behaviors

This study focuses on sexual harassment and job satisfaction, organizational commitment, and employee turnover among casino employees. It is the first study investigating sexual harassment in the gaming industry. Based on sex-role spillover theory it was expected that sexual harassment has less of an impact on casino employees than on employees in other industries. Six Reno, Nevada casinos participated in the study and 330 responses were generated from casino employees. The study results show that sexual harassment of and by casino employees is perceived to occur at about the same rate as in other industries. Sexually harassed employees were compared to employees who indicated that they had not been sexually harassed. Sexually harassed employees were less satisfied with their jobs and less committed to the organization. However, they were not more likely to quit their jobs. Sexually harassed employees tended to be younger, Caucasian, and in dealer positions. Hence, in addition to the well-publicized cost of sexual harassment lawsuits, the study shows that sexual harassment in casinos may well be the source of hidden costs important to human resources managers. A result of major interest was that employees who had been harassed held management responsible for not ensuring a work environment that is free of sexual harassment. Implications for casino management are discussed.     

‘Something to Deal With’: Customer Sexual Harassment and Women's Retail Service Work in Canada

While sexual harassment in the workplace has been extensively researched over the past two decades, the majority of studies have focused on employer–employee or co-worker relationships. In contrast, the issue of ‘customer sexual harassment’ (i.e. the sexual harassment of employees by customers) has been less explicitly explored. This paper examines customer sexual harassment in the Canadian context, drawing on a study of 63 female retail service workers and 20 security workers. It focuses on the nature, prevalence, and consequences of this form of harassment for women who work in various jobs in retail sales (e.g. flower shops, book shops). Findings from the study suggest that customer sexual harassment is a significant problem. Not only have a majority of women been sexually harassed by customers in their current job, but they appear to be highly constrained in dealing with such behaviour. To the extent that the work environment privileges the customer, through its emphasis on customer satisfaction, women are reluctant to confront harassers and may engage in behaviours (e.g. avoiding male customers, being less friendly) which potentially impact their performance on the job. The paper examines the dilemmas facing female workers and the policy issues raised.     

Social and Health Service Use and Treatment Outcomes for Sexual Minorities in a National Sample of Substance Abuse Treatment Programs

This study examines substance use severity, levels of social and health service utilization, and the impact of service utilization on treatment outcomes for sexual minorities versus non-minorities. The sample included 3,094 clients from the National Treatment Improvement Evaluation Study (NTIES). Substance use severity among sexual minorities and non-sexual minorities was similar at treatment entry and at 12 months post-discharge. Differences in social and health service utilization were significant for substance abuse counseling and health services. Significant interactions between sexuality and access services and sexuality and mental health services were also found. Practice and research implications are discussed.     

Pathways to Mental Health Services for Children and Youth in the Child Welfare System: A Focus on Social Workers’ Referral

Case abstraction was used to collect data from court reports to examine characteristics that predict referral to mental health services by court and child welfare social workers and whether referral to mental health services was a significant determinant of service utilization. Home placement and multiple types of abuse were significant predictors of a referral to mental health services by the court social worker and age and reported sexual abuse were significant in the utilization of services. Practice and policy implications are discussed.     

Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child

Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers’ mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers’ health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.     

Sexual Coercion,Verbal Aggression,and Condom Use Consistency Among College Students

Abstract

Objective: The relationship between condom use and 2 less visible categories of intimate partner violence (IPV), sexual coercion and verbal aggression, was examined among college students. Methods: In March 2007 a random cross-sectional sample of undergraduates from the southeast region of the United States was taken to collect information about sexual coercion and verbal aggression, in addition to condom use consistency. Alcohol use was also assessed. Results: Of the 142 participants, 31.7% reported being victims of sexual coercion, and 78% reported having verbally aggressive partners. Participants who reported experiencing sexual coercion in their relationship were significantly less likely to consistently use condoms. Additionally, alcohol use before or during episodes of verbal aggression was negatively associated with condom use. Alcohol use was also significantly associated with heightened incidents of coercion and aggression. Conclusions: Results indicate that among college students, the presence of sexual coercion adversely affects condom use, as does alcohol use.     

Understanding types,locations, & perpetrators of peer-to-peer sexual harassment in U.S. middle schools: A focus on sex,racial, and grade differences

This study employed a mixed-method design to examine sexual harassment victimization among American middle school youth (grades 5–8). Students completed a self-report measure of sexual harassment victimization and indicated where sexual harassment occurs in their school. They responded to open-ended questions about the most upsetting incident they experienced and identified characteristics of perpetrators (N = 858). Verbal victimization (e.g., unwanted sexual commentary and homophobic name-calling) was more frequent than physical victimization and sexual assault. The types of sexual harassment experienced and the perpetrators varied by sex, race, and grade level. Sexual harassment occurred most frequently in hallways, followed by classrooms, gym locker rooms, gym class, lunch room, and outside of the school. The most upsetting unwanted incidents included (1) verbal - homophobic language; (2) verbal - sexual commentary and sexual rumor spreading; (3) physical – being touched; (4) pulling down pants; (5) being sexually assaulted; and (6) dismissiveness of victimization. Girls reported other boys as perpetrators; whereas, boys reported their perpetrators as other boys and close friends. For African-American students, perpetrators were identified as older and romantic partners. For White students, perpetrators were reported as same-age peers and friends. Understanding and recognizing what constitutes sexual harassment and where it most commonly occurs among early adolescence is critical to preventing sexual harassment into late adolescence.     

College women’s sexual and reproductive health screening behaviors and the role of mother–daughter communication

Abstract

Objective: The study investigated the role of mother–daughter communication and race in college women’s decisions to pursue sexual health screening services. Participants: Participants were 301 college women who primarily identified as White and Asian American (M_age = 19?years). Methods: Participants completed an online survey that assessed mother–daughter communication about sex and responded to items pertaining to pursuing sexual health screening services. Results: Maternal communication predicted daughters’ screening behaviors and sexual anxiety mediated the negative association between conservative communication from mothers and screening behaviors. Asian American college women were less likely than White college women to report that they received frequent and open communication about sex from their mothers and reported higher levels of sexual anxiety. Conclusions: Mothers should be aware of the implications their communication patterns may have on their daughters’ sexual and reproductive health, and college women’s sexual anxiety should be addressed in order to increase utilization of screening services.     

Physical health characteristics of student service members and veterans by sexual orientation

Abstract

Objective: Little is known about the health status of the diverse population of student service members and veterans (SSM/V) enrolling in higher education in great numbers. The objective of this study was to explore the differences in physical health characteristics by sexual orientation among a national sample of SSM/V. Methods: Using secondary data, a series of maximum likelihood (ML) logistic regression models were estimated to explore physical health characteristics by sexual orientation in a sample of SSM/V. Results: SSM/V that identify as lesbian or gay reported higher rates of treatment and diagnosis for some physical health matters (respiratory illness and HIV) when compared with their heterosexual counterparts. Conclusions: Our findings support the need for campus health officials and policymakers to develop services to address the physical health needs of this population that differ from their peers.     

Sexual harassment: relation to other forms of discrimination and to health among women and men

During the last years, harassment experiences have more often than earlier been included in the framework of work stress, thereby being seen more as a result of how the work organisation function rather than being a result of poor characteristics among individuals. The aim of the present study was to examine the relation between sexual harassment, gender discrimination, bullying, conflicts and informal decision structures. The study took place at a large university in the northern part of Sweden, and data was collected by a questionnaire. Lack of equality and conflicts were significantly related to sexual harassment among women, but none of the studied factors to sexual harassment among men. Common among both women and men were that gender discrimination, bullying, conflicts, being negatively affected by informal decision structures, that women are given preferential treatment and lack of information were related to poor health. To summarise, the results in the present study support earlier studies in their conclusions that work organisation is closely related to the occurrence of harassment. This is especially important to point out when planning for interventions against for example sexual harassment, which very often focuses on the harassed individual, rather than the organisation.     

Female harassment after ending a relationship: A preliminary study

While dramatic instances of male aggression directed toward women, such as rape and wife battering, have been frequently studied, a more subtle form of male aggression—female harassment—has been investigated less often. In the present study, 50 women who had terminated relationships with males and then were harassed were interviewed. In general, the harassment lasted for about a year, and episodes which occurred on a daily basis consisted of calls, letters, visits to home or work, being followed, verbal threats, and physical aggression. For the most part, these aggressive actions were perceived as both threatening and disturbing. Findings indicated that assertive female strategies were not more effective in reducing harassment than more sex-role stereotyped passive and nonassertive responses to male aggression. In the second phase of this study a sample of college undergraduates was interviewed on the topic of harassment. Fifty-six percent of the women indicated that they had been harassed by men.My thanks to Lyn De Amicis and LaVome Robinson for their instructive and helpful comments.     

Risk Factors of Sexual Harassment by Peers: A Longitudinal Investigation of African American and European American Adolescents

The present research explores risk factors for, and longitudinal associations of, sexual harassment by peers during adolescence. Eight‐hundred and seventy‐two African American and European American adolescents (65.4% African American, 51.1% females) were assessed during the summer after the eighth grade (mean age=14.2 years) and then again in the 11th grade (mean age=17.1 years). At the first assessment, adolescents were asked about their experiences with sexual harassment, their psychological reactions to sexual harassment, and also about their peer relationships, perceived pubertal timing, problem behavior, and mental health. At the second assessment, adolescents reported on their problem behavior and mental health. In general, youth who associated with peers who were involved in problem behavior were at risk for victimization. Among females, those who perceived themselves to be experiencing early pubertal development were also at risk. Additionally, for some adolescents, sexual harassment predicted later adjustment difficulties.     

Men's Reproductive and Sexual Health

Abstract

A broad definition of men's reproductive and sexual health (MRSH) includes medical (pathophysiological) matters such as sexually transmitted infections (STIs), developmental anomalies, malignancy, trauma, and infertility. It also includes psychosocial concerns: sexuality, contraception, disease prophylaxis, developmental and lifecycle issues, tobacco and drug use, sexual identity and orientation, and partnership issues. College men, of whom a large majority are sexually active, have a range of MRSH needs, including some that are particular to their age and social environment. To reach men effectively requires approaches that are somewhat different from those used with women. Clinicians in college health services are in an excellent position to help young men recognize the importance of reproductive health and sexual responsibility. College health services therefore should offer men screening; clinical diagnosis and treatment for MRSH conditions; and information, education, and counseling services, in a manner designed to meet their unique needs.     

The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services

Adolescents residing in foster care are at higher risk for acquiring sexually transmitted infections (STIs) and human immune deficiency virus (HIV) compared to their non-foster care peers. A literature review was conducted to determine whether youth residing in foster care face different barriers to sexual health care compared to their peers in the general population and, if so, what those barriers are. The review revealed barriers common to adolescents in general as well as additional barriers specific to the ecosystem of adolescents in foster care. Systemic issues that decreased access to sexual health services included child welfare policies that were either missing or implemented without fidelity; complicated financial factors; barriers to service utilization; lack of collaboration between child welfare and medical professionals; and limited information provided to foster youth on their sexual health and development. Consent and confidentiality issues that foster youth face in seeking sensitive health services also need to be resolved. More research is needed on how to facilitate development of coherent policies and effective practices that promote sexual health care access for adolescents in foster care.     

Social‐developmental factors affecting lesbian and gay youth: a review of cross‐national research findings

Lesbian and gay youth face a great many challenges as they grow up. In this article, research focusing upon the social‐developmental factors that affect the positive development of a lesbian or gay identity are reviewed, comparing and contrasting data from the United States (US) and United Kingdom (UK). Consideration is also given to the efficacy of behaviours utilised by young lesbians and gay men to avoid harassment and discrimination. It is suggested that lesbian and gay youth represent a particularly vulnerable group of young people who engage in a number of health risk behaviours that are associated not only with sexual orientation, but also fears for personal safety. Finally the authors discuss whether or not strategies to conceal sexual orientation hold benefits for lesbian and gay youth in terms of their physical safety and mental health. Copyright © 2003 John Wiley & Sons, Ltd.     

‘But It's Your Job To Be Friendly’: Employees Coping With and Contesting Sexual Harassment from Customers in the Service Sector

This article analyses how employees in the service sector respond to sexual harassment from customers and attempts to explain why this is so. There are only a small number of previous studies examining the issue of customer‐perpetrated sexual harassment. Those that have been conducted have detailed the nature and prevalence of sexual harassment from customers, but this research lags behind employee experience and some emerging policy responses to this issue. The extant literature, whilst growing, remains largely limited to documenting the phenomenon. In this article, we attempt to create a deeper analysis of customer‐perpetrated harassment by conducting a new review of the literature to develop propositions about how employees respond to it and the factors that influence their responses. These propositions are analysed in relation to a qualitative pilot study with 15 interviewees who had experienced sexual harassment from customers to understand how they reacted and why. The article shows how the social norms and precarious working conditions of the service sector constrain employees from seeking formal redress, leading to the enactment of informal coping strategies and temporary contestations of the situation. This research is important for building our understanding of the influence of workplace context for framing employee responses to customer sexual harassment.     

Sexual Inactivity Among Transfeminine Persons: A Canadian Respondent-Driven Sampling Survey

Sexual health research with transfeminine persons (individuals assigned male at birth who identify as female or feminine) has focused on HIV infection and sexual function following medical treatments. Yet, approximately half of transfeminine persons in Ontario, Canada, reported no partnered sex in the previous year. Therefore, we identified sociodemographic, social, and psychosocial factors associated with past-year sexual inactivity among transfeminine Ontarians. A multi-mode respondent-driven sampling survey of transgender people was conducted in 2009–2010 (N = 433), including 173 transfeminine individuals who had ever been sexually active. Frequencies and regression models were weighted using RDS II methods; prevalence ratios were estimated from logistic regression models using average marginal predictions. Of sexually experienced transfeminine persons, 43% (95% CI [31, 55]) reported no past-year sex partners. Sexual inactivity was independently associated with older age, childhood sexual abuse, and residing outside of the province’s largest city. Transfeminine persons who had genital surgery for gender affirmation were less likely to be abstinent, as compared to those who were living in their felt gender without surgery. Transphobic harassment and higher levels of trans-related sexual body image worries were also associated with sexual inactivity, as was reduced sexual satisfaction. Implications for research and clinical practice are discussed.     

The Importance of Social Cues for Discretionary Health Services Utilization: The Case of Infertility

Infertility is a discretionary health condition; although it carries with it important life course implications, treatment is rarely necessary for health reasons. Sociological theories of medical help‐seeking emphasize demographic factors, perceived need, and enabling conditions in health services utilization, but we find that social cues are also strongly associated with health services utilization for infertility. Adjusted for conventional predictors of medical help‐seeking, several social cue indicators have significant associations with utilization, including having friends and family with children, perceiving infertility stigma, and having a partner and/or family member who encourages treatment. Perceived need accounts for the largest portion of the variation in utilization. Enabling conditions explain less of the variance than social cues. Social cues should be especially important for discretionary health services utilization. Studies of service utilization for discretionary health conditions should explicitly incorporate a range of measures of social cues into their models.     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.