Health Status and Risk Behaviors of Sexual Minorities Among Chinese Adolescents: A School-Based Survey

This study aimed to examine the association between sexual orientation and health disparities among a stratified random sample of 3776 secondary students in Hong Kong. The prevalence of homosexuality and bisexuality were 1.5% and 2.6% in boys and 1.8% and 3.7% in girls, respectively. A total of 10.7% of boys and 8.8% of girls were unsure of their sexual orientation. Homosexual and bisexual boys reported poorer physical and mental health than their heterosexual peers. Homosexual and bisexual boys were more likely to engage in smoking, frequent drinking, and vaginal sex and be subjected to sexually transmitted disease and sexual victimization. However, lesbian and bisexual girls were less likely to engage in risky health behaviors except for smoking and being subjected to sexual victimization. There is a gender-specific problem that may warrant prevention and intervention programs to address the unique health issues facing homosexual and bisexual adolescents in Hong Kong.     

Sexual orientation: a multi-variable dynamic process

Theory and research concerning sexual orientation has been restricted in its scope and influence by the lack of clear and widely accepted definitions of terms like heterosexual, bisexual, and homosexual. In an attempt to better demarcate and understand the complexities of human sexual attitudes, emotions, and behavior, the Klein Sexual Orientation Grid (KSOG) was developed and administered. The KSOG is composed of seven variables that are dimensions of sexual orientation, each of which is rated by the subject as applying to the present, past, or ideal. Analysis of the data from subjects who filled out the KSOG in Forum Magazine indicated that the instrument was a reliable and valid research tool which took into consideration the multi-variable and dynamic aspects of sexual orientation.     

Children of the closet: a measurement of the anxiety and self-esteem of children raised by a non-disclosed homosexual or bisexual parent

This research examined whether a parent's non-disclosure of his or her homosexual or bisexual orientation within the family unit negatively affects self-esteem and anxiety in children, as measured in adulthood. Thirty-six subjects indicated that they had not known of their parent's sexual orientation until an average age of sixteen for the children of lesbian or bisexual mothers, and twenty-two for the children of gay or bisexual fathers. This group's scores on the Rosenberg Self-Esteem Scale, the Marlowe Crowne Social Desirabilty Scale and the State-Trait Anxiety Scale were compared to scores obtained by sixty-three participants who did not have a homosexual/bisexual parent. The number of years a secretive environment surrounded the child was measured, as were participants' attitudes about the secret sexual identity. Although the study did not find that adults previously raised with a closeted parent had significantly higher levels of anxiety or lower levels of self-esteem, results indicated that those who had been raised as children with non-disclosed lesbian mothers showed a significantly higher level of self-esteem than participants with heterosexual parents. Implications of the findings for the targeted population are discussed.     

Bisexual women in marriages

A clinical sample of women who were currently or previously married were surveyed regarding demographics, homosexual experiences before marriage, problems in marriage, and sexual orientation. The average age of the 45 participants was 35.9. Before marriage, 21 (47%) were somewhat aware of their homosexual feelings but were much less likely to have thought of or identified themselves as homosexuals. Sexual difficulties were very common in these marriages (89%), the most cited sexual difficulty being a lack of sexual desire for their spouse (62%). Based upon Kinsey-type ratings, the sample could be described as almost exclusively heterosexual in behavior and fantasies before marriage. Some changes could be seen during marriage toward more of a homosexual orientation. The dramatic change, however, occurred following marriage, when the women reported even more of a homosexual orientation, tending toward the homosexual end of the Kinsey continuum. At the time of the study, a majority of the sample was, in fact, relating almost exclusively to other women. This study found that, compared to homosexual men who have been married, these women are more likely to marry at an earlier age, unlikely to be aware of their homosexual feelings prior to marriage, and more likely to terminate their marriage earlier because of conflicts arising as a result of their bisexual orientation and sexual dissatisfaction.     

Sexual violence at first intercourse against women in Moshi, northern Tanzania: prevalence, risk factors, and consequences

To explore the relationship between sexual violence at first intercourse and later sexually transmitted infections (STIs) in Moshi, Tanzania, we analysed data from a representative household survey that comprised face-to-face interviews with 1,835 women and tests for six STIs on biological samples from 1,235 of these women. Overall, 10.9 per cent report forced first intercourse and 15.3 per cent report unwanted first intercourse. Unadjusted analysis shows a relationship between forced first intercourse and STIs (OR: 1.72, 95 per cent CI: 1.19-2.51). Life-course variables mediate this relationship. Significant predictors of having an STI include older age, more sexual partners, and a partner who has children with other women. Coerced first intercourse appears to be associated with changes in the life course of women and with a heightened risk of contracting an STI.     

Identity conflict or adaptive flexibility? Bisexuality reconsidered

A definition of bisexuality is offered, followed by a discussion of two opposing models of bisexual functioning: the "conflict model," which views bisexuality as problematic, stemming from identity conflict and confusion that marks a transitional stage to a homosexual orientation; and the "flexibility model," which views bisexuality as the coexistence of heteroeroticism and homoeroticism, as the successful integration of homosexual and heterosexual identities into a dual sexual orientation. The Kinsey data are reviewed in an effort to determine the incidence of bisexuality in the U.S. population. Finally, specific clinical and empirical studies investigating bisexual subjects are reviewed in light of the two models.     

Same-sex domestic partnerships and lower-risk behaviors for STDs, including HIV infection

To determine the association between domestic partnership status and risk behaviors for sexually transmitted diseases, including HIV infection, we analyzed data from a population-based interviewer-administered telephone survey of 2,881 gay men in San Francisco, Los Angeles, New York and Chicago conducted in November 1996 to February 1998. Men in domestic partnerships had a statistically significantly lower prevalence of multiple partnerships, "one-night stands," and unprotected anal intercourse with a non-primary partner than either men with steady partners not identified as domestic partners or men without a steady partner. These findings were independent of age. Men in domestic partnerships had decreased risk behaviors for sexually transmitted diseases, including HIV infection, suggesting but not proving, that conferring legal status to same-sex unions might decrease sexual risk behavior.     

Sexual fulfillment of heterosexual, bisexual, and homosexual women

Seventy females were interviewed in depth regarding their sexual responses and sexual fulfillment. They were categorized as heterosexual, bisexual, or homosexual according to self-definition. The quantity and quality of female sexual response, the source of the response, and the interactional patterns of sexuality were analyzed, and shown to differ, for different sexual orientations. The fallacy of emphasizing heterosexuality, and the fallacy of utilizing a heterosexual-homosexual dichotomy, in studies of female sexuality are indicated. It is suggested that knowledge about all sexual orientations can lead to more fulfilling sexuality in general, regardless of the individual's particular orientation.     

Hazardous journey in intimacy: HIV transmission risk behaviors of young men who are victims of past sexual abuses and who have sexual relations with men

The aim of this research was to explore the behavioral patterns and dynamics that may increase vulnerability towards HIV transmission among young men who have been sexually molested as children and who have sexual relations with men. In recent years, researchers have found that a larger number of gay or bisexual men have been sexually abused as children than other men. In this study, we wanted to explore the possible links between sexual victimization of young men and risky sexual behaviors related to HIV transmission among these men.     

Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men

ABSTRACT

The correlation between current alcohol use and sexual risk behaviors among men who have sex with men (MSM) is well documented, but little is known about age of drinking onset and current risks among this population. Data from a 2008 Internet survey of 8,452 MSM in the United States were used to assess factors associated with age of onset of alcohol use. In a multivariable model, drinking onset before age 15 was significantly associated with a higher number of lifetime male anal sex partners and being behaviorally bisexual in the past 12 months. Men who reported depressive symptoms in the past two weeks or who screened positive for alcohol abuse in the past 60 days were more likely to have early age of drinking onset. Findings suggest the need for targeting younger adolescents for alcohol screening, particularly sexual minority youth, to prevent risk behaviors in adulthood.     

Marriages of bisexual men

This study examined the marriages of 26 couples in which the husband was bisexual. The subjects were a non-clinical sample married for at least two years and intending to continue their marriages. The sample was, overall, highly educated and earned concomitantly high incomes. Subjects were administered the Klein Sexual Orientation Grid and a research questionnaire to determine successful or problematic aspects of their marriages. Subjects were, for the most part, satisfied with the quality of their marriages, sexually active within the marriages, and open about the husband's homosexual behavior. A high-level of sexual activity within the marriage, open and direct communication, a valued friendship, previous counseling or psychotherapy, cognitive flexibility, and financial independence contributed to the success of these marriages. The husbands reported a great deal of ambiguity about their homosexual behavior, and the couples reported intense conflict dealing with their open marriage styles.     

The Effects of Three Types of Sexual Orientation Victimization on HIV Sexual Risk Behavior Among Black South African Men Who Have Sex With Men (MSM)

ABSTRACT

The goal of this study is to examine the relations between histories of three types of sexual orientation victimization (childhood, personal, and institutional) and HIV sexual risk behavior among Black South African men who have sex with men (MSM). Secondarily, this study examines whether marijuana use and problem drinking mediate the relations. Participants were 125 Black MSM recruited from neighborhoods in Eastern Cape Province, South Africa. Questionnaires administered through audio computerized self-interviewing assessed sexual orientation victimizations, problem drinking and marijuana use, and unprotected anal sex with casual partners. Data were analyzed using multiple regression and multiple mediation modeling.

Personal and institutional sexual victimizations were associated with condomless anal sex. Childhood sexual orientation victimization was positively associated with problem drinking. Neither problem drinking nor marijuana use mediated the relations between sexual orientation victimizations and having condomless anal sex with casual partners.     

Chasing Sexual Orientation: A Comparison of Commonly Used Single-Indicator Measures of Sexual Orientation

This research investigated the utility of single-indicator measures of sexual orientation in examining group differences. Adolescents and young adults reported their sexual orientations, preferences, and partners. Results indicate that, (a) depending on the measure of sexual orientation, 10% to 22% cannot be categorized into a sexual orientation group using a single-indicator measure; (b) self-identified sexual orientation is often incongruent with preference and behavior; (c) incongruity differs by gender and self-identified sexual orientation; and (d) detected differences in gay/lesbian, bisexual, and straight individuals vary by measure of sexual orientation. These results indicate that classification of sexual orientation by single-indicator measures can lead to inconsistent conclusions across studies.     

Identity Development and Exploration Among Sexual Minority Adolescents: Examination of a Multidimensional Model

Based on a multidimensional model of sexual identity development, the current study examined self-labeling, romantic, and sexual experiences among middle and late adolescent sexual minorities. Eighty-two youths between the ages of 14 and 21 were recruited from gay, lesbian, bisexual, and transgender (GLBT) community centers and associated Internet groups. Differences between males and females and between middle and late adolescents were first examined. Males reported markedly different patterns of self-labeling and romantic experiences, relative to females, but few age differences emerged. Additionally, patterns of association between self-labeling and sexual or romantic experiences provided support for the multidimensional model of identity development and exploration. Finally, significant associations emerged between relationship experiences and relational competency, such that adolescents who described themselves as isolated from intimate interpersonal relationships reported less relational esteem and more relational depression than those who reported predominantly engaging in same-sex romantic relationships. In addition, alternative styles of engaging in interpersonal relationships (e.g., same-sex intimate friendships, heterosexual dating) also were also associated with increased relational competency.     

Sexual identity distress, social support, and the health of gay, lesbian, and bisexual youth

Sex researchers and mental health clinicians have long recognized that the stigma surrounding homosexuality plays an important role in shaping the social psychological adjustment of gay, lesbian, and bisexual (g/l/b) people. In recent years, researchers have suggested that sexual identity- related distress may influence the physical health status of g/l/b people, primarily because of the ways these self-related feelings and beliefs impact patterns of health-related behavior. This study examines the influence of sexual identity distress and social support on g/l/b youth's drug and alcohol use, psychological distress, and risky sexual behavior. The data come from a services research demonstration program conducted at the Indiana Youth Group, Inc., a g/l/b youth development agency based in Indianapolis, Indiana. Results indicate that sexual identity distress is strongly associated with psychological distress, less frequent use of alcohol, and using fewer types of illegal drugs. Being out to more people in one's support network, however, attenuates the severity of youth's sexual identity-related distress. Youth who report more support ties to g/l/b people indicate engaging in more frequent risky sexual behavior. The implications of these findings for theories of g/l/b youth's sexual identity development are discussed.     

AIDS, sexuality, and sexual control

The AIDS epidemic is discussed in terms of its effect on general sexual attitudes and behavior of homosexual and bisexual men, then, in particular, on the issue of control over one's sexual behavior. Problems encountered in the formulation of the concept of sexual control are discussed along with relevant theoretical constructs. A group treatment program for homosexual and bisexual men with problems of sexual control is described, along with findings and discussions regarding the effect of such treatment on sexual behavior.     

Barriers to Optimal Care between Physicians and Lesbian,Gay, Bisexual,Transgender, and Questioning Adolescent Patients

The objective of this article was to identify barriers to optimal care between physicians and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) adolescents. To this end, 464 anonymous, self-administered surveys were distributed in 2003 to residents and attending physicians in pediatrics, internal medicine, obstetrics-gynecology, psychiatry, emergency medicine, and family practice at Upstate Medical University. The survey included questions pertaining to practice, knowledge, and attitude pertaining to lesbian, gay, transgender, or questioning (LGBTQ) adolescents. One hundred eight four surveys were returned. The majority of physicians would not regularly discuss sexual orientation, sexual attraction, or gender identity while taking a sexual history from a sexually active adolescent. As well, the majority of physicians would not ask patients about sexual orientation if an adolescent presented with depression, suicidal thoughts, or had attempted suicide. If an adolescent stated that he or she was not sexually active, 41% of physicians reported that they would not ask additional sexual health-related questions. Only 57% agreed to an association between being a LGBTQ adolescent and suicide. The majority of physicians did not believe that they had all the skills they needed to address issues of sexual orientation with adolescents, and that sexual orientation should be addressed more often with these patients and in the course of training. This study concludes that barriers in providing optimal care for LGBTQ adolescents can be found with regard to practice, knowledge, and attitude regardless of medical field and other demographics collected. Opportunities exist to enhance care for LGBTQ adolescents.     

Frequency of Sexual Activity With Most Recent Male Partner Among Young,Internet-Using Men Who Have Sex With Men in the United States

Sex frequency, defined here as the number of oral or anal sex acts with the most recent partner in the past year, is a potential driver of risk for sexually transmitted infections. However, few data on sex frequency have been reported for men who have sex with men (MSM). Data from an Internet survey of MSM were used to describe sex frequency with most recent main and casual male partners and to estimate factors associated with higher sex frequency. Among 5,193 MSM, higher sex frequency was associated with younger age, shorter relationship duration, and reporting a main (vs. casual) partner; and lower sex frequency with male partners was associated with heterosexual or bisexual (vs. homosexual) identity or Black race (vs. non-Hispanic White). Secondary analyses of estimates of sex frequency from 2 publicly available nationally representative datasets comprised of primarily heterosexual survey respondents (the 2008 General Social Survey and the 1992 National Health and Social Life Survey) were performed. Sex frequency among MSM respondents was similar to that reported by heterosexuals.     

Perceived Sexual Orientation of Men and Women with Eating Disorders and Obesity

ABSTRACT

The present study explores the perceived sexual orientation of hypothetical men and women with various eating disorders and obesity. Undergraduates were randomly provided with one vignette describing a male or female with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder, or obesity and were asked about the target’s likely sexual orientation. Significant differences emerged between male and female targets with AN and BN on the forced-choice question, with a greater percentage of participants indicating that the male targets were probably non-heterosexual. On continuous items, participants rated the female targets as significantly more likely to be heterosexual and significantly less likely to be homosexual than male targets. The general public may be more likely to perceive men with eating disorders as gay or bisexual relative to females with eating disorders. Perceived sexual orientation might be an important factor to consider when exploring the potentially unique perspectives of men with eating disorders.     

Crooked men and straightened women: images of homosexuality across race in two women's magazines, 1986-1995

Images of traditional sexuality, across race, prevail in mass media, especially in women's magazines. While omitting less traditional sexual practices for the most part, New Woman and Essence magazines construct the image of a bisexual male who threatens the heterosexual woman and the legitimate heterosexual couple. These women's magazines also redefine homosexual activity, suggesting women who experience homosexual inclinations are really engaging in normal heterosexual behavior.