Health Needs and Experiences of a LGBT Population in Georgia and South Carolina

ABSTRACT

The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.     

Gender Minority Stress: A Critical Review

ABSTRACT

Past studies that compare cisgender to transgender (or trans) and gender diverse people have found a higher prevalence of mental health problems among the latter groups. This article uses Testa’s gender minority stress framework, which is an expansion of minority stress theory, to assess minority stressors that are specific to the experiences of trans and gender diverse people. The concept of cisnormativity, an ideology that positions cisgender identities as a norm, is used in relation to the gender minority stress framework to describe the marginalizing nature of social environments for trans and gender diverse people. This article provides a critical review that integrates and expands on past theoretical perspectives on gender minority stressors and protective factors. Specifically, this article demonstrates the relevance of cultural and ethnic backgrounds to complement the application of intersectionality in research on health disparities experienced by trans and gender diverse people.     

Debating LGBT Workplace Protections in the Bible Belt: Social Identities in Legislative and Media Discourse

ABSTRACT

This article reports a case study of the legislative and media discourse surrounding the addition of sexual orientation and gender identity language to the employment nondiscrimination ordinance of a city in the heart of the Bible Belt. The purpose of the study is to uncover how different identities were constructed and contested at city council meetings and in the news media on the way to passing legal protection for LGBT city employees in a region that is often characterized by anti-gay prejudice. This debate over the nondiscrimination ordinance centered on the question of whether LGBT identities are equivalent to identity categories based on race, gender, or religious belief, and it was shaped by various intergroup communication dynamics, specifically between members of the LGBT minority and the straight majority, between LGBT and Christian identities, and between “true” and “false” Christian identities.     

Minority Stress,Parenting Styles,and Mental Health in Brazilian Homosexual Men

ABSTRACT

Homosexual men are constantly exposed to prejudice and violence in Brazil. The aim of this study was to investigate the relationship between minority stress, parenting styles, and indicators of mental health problems in a sample of homosexual men. Method: quantitative, cross-sectional, correlational, and retrospective design. Participants were 101 Brazilian men who selfidentified as homosexuals, aged between 18 and 55 years. Results: concealing sexual identity was a predictor of depression and stress. Parental responsiveness was associated with a lower incidence of enacted stigma and depression. Conclusions: the mental health of homosexual men can be negatively affected by the need to conceal their sexual orientation. Parental responsiveness is a protective factor in terms of experiencing enacted stigma and depression. The results found in the study may be useful for counselors and social workers who are working with LGBT people and their families.     

A National Survey on Depression,Internalized Homophobia,College Religiosity,and Climate of Acceptance on College Campuses for Sexual Minority Adults

ABSTRACT

Sexual minority persons have an increased risk for negative mental health outcomes in adulthood. This seems to largely be due to experiences of stigma in social settings. This study sought to understand the relationship between attending a religiously conservative college, internalized homophobia (a measure of sexual stigma), and depressive symptoms for sexual minority adults. Sexual minority adult participants (n = 384) from across the U.S. were recruited and completed a Web-based, anonymous survey. A mediation model predicting depression through college religious conservatism, college acceptance of sexual minority identities, and internalized homophobia was tested using path analysis. Results revealed an indirect effect of increased religious conservatism of a college predicted higher depression through lower college acceptance and higher internalized homophobia. Implications for the mental health of sexual minority adults and future research are examined.     

Health Care Issues Among Lesbian,Gay, Bisexual,Transgender and Intersex (LGBTI) Populations in the United States: Introduction

ABSTRACT

This supplemental issue of the Journal of Homosexuality presents research that explores a variety of health care issues encountered by lesbian, gay, bisexual, transgender and intersex (LGBTI) population groups in the United States over the 10-year period from 1993 to 2002.

Topics include access to health care, utilization of care, training of medical and mental health providers, and the appropriate preparation of clinical offices and waiting areas. Authors used a variety of community-based public health research methods, including participant and provider surveys and retrospective chart reviews of patients, to develop this body of research, providing a recent-historical perspective on the complex health care and health-related needs of sexual and gender minorities. Particularly for transgender and intersex populations, the state of research describing their health care needs is in its infancy, and much remains to be done to design effective medical and mental health programs and interventions.     

Queering Poetics: The Impact of Poetry on LGBT+ Identity in Singaporean Adolescents

ABSTRACT

This qualitative study explores identity formation in LGBT+ Singaporean adolescents, and how reading, writing, and listening to poetry shapes Singaporean adolescents’ social identities as queer people. Analyzing in-depth interviews with nine LGBT+ Singaporean adolescents, four themes were found: (1) LGBT+ Singaporean adolescents interested in poetry believe that reading, writing, and/or listening to poetry has been an integral part of constructing their queer identities; (2) the poems that have impacted LGBT+ Singaporean adolescents’ queer identities the most have been informed by queer sociocultural values; (3) poetry provides validation to LGBT+ Singaporean adolescents that their identities are real and that others before them have experienced the same challenges they are going through; and (4) poetry serves as a third space for LGBT+ Singaporean adolescents to safely construct their growing queer identities. Implications for teachers, counselors, and adult supporters of queer Singaporean adolescents are discussed, and recommendations for future research are provided.     

LGBT Family Lawyers and Same-Sex Marriage Recognition: How Legal Change Shapes Professional Identity and Practice

ABSTRACT

Lawyers who practice family law for LGBT clients are key players in the tenuous and evolving legal environment surrounding same-sex marriage recognition. Building on prior research on factors shaping the professional identities of lawyers generally, and activist lawyers specifically, I examine how practice within a rapidly changing, patchwork legal environment shapes professional identity for this group of lawyers. I draw on interviews with 21 LGBT family lawyers to analyze how the unique features of LGBT family law shape their professional identities and practice, as well as their predictions about the development of the practice in a post-Obergefell world. Findings reveal that the professional identities and practice of LGBT family lawyers are shaped by uncertainty, characteristics of activist lawyering, community membership, and community service. Individual motivations and institutional forces work to generate a professional identity that is resilient and dynamic, characterized by skepticism and distrust coupled with flexibility and creativity. These features are likely to play a role in the evolution of the LGBT family lawyer professional identity post-marriage equality.     

Persecution Experiences and Mental Health of LGBT Asylum Seekers

Asylum seekers are a unique population, particularly those who have endured persecution for their sexual orientation or gender identity. Little data exist about the specific experiences and needs of asylum seekers persecuted due to lesbian, gay, bisexual, or transgender (LGBT) identity. Quantitative data were gathered regarding demographics, persecution histories, and mental health of 61 clients from a torture survivors program in New York City who reported persecution due to LGBT identity. Thirty-five clients persecuted due to their LGBT identity were matched by country of origin and sex with clients persecuted for other reasons to explore how persecution and symptoms may differ for LGBT clients. LGBT asylum seekers have a higher incidence of sexual violence, persecution occurring during childhood, persecution by family members, and suicidal ideation. Understanding the type of persecution experiences and how these influence mental health outcomes is an essential step toward designing and delivering effective treatments.     

Violence as Mediating Variable in Mental Health Disparities Associated to Sexual Orientation Among Mexican Youths

ABSTRACT

In this study, we explored the role of sex as an effect-modifying variable in the association between sexual orientation and mental health in Mexican youth. In addition, we tested if violent experiences in the family and the school and attitudes toward homosexuality could act as mediating variables in such association. Data from three representative surveys performed in 2007, 2009, and 2013 among Mexican high school students were analyzed. Two dimensions of sexual orientation were evaluated: romantic partnership and sexual behavior. The outcomes were negative and positive mood, suicidal ideation and intent, self-concept, and self-esteem. There were differences by gender because in males, there were more disparities in mental health associated with sexual orientation (suicidal ideation and attempt, negative and positive mood, negative self-concept, and family-related self-esteem) than in females (suicidal ideation and negative mood). Experiences of school violence were mediators in the relationship between sexual orientation and most health outcomes in males.     

Staying in the Hood: Black Lesbian and Transgender Women and Identity Management in North Philadelphia

ABSTRACT

The concept Don’t Ask, Don’t Tell regarding Black LGBT sexuality in Black communities has been an acceptable form of identity management for Black LGBT people. In other words, Black LGBT people are accepted as long as they are not vocal about their sexuality. However, this is changing with the issue of gay marriage, which is creating a space where Black LGBT people are more open about their gender identity and sexuality in heterosexual Black spaces. This new form of openness allows Black LGBT people to “stay in” their communities, as opposed to coming out. In this article I examine how Black LGBT women in North Philadelphia stay in their communities: being politically active regarding LGBT issues, disengaging from LGBT issues, passing, and educating straight Black people about issues affecting the Black LGBT community. I conclude with implications of staying in and intersectionality among Black heterosexual and LGBT women fighting for social change.     

“Coming Out” of Prison: An Exploratory Study of LGBT Elders in the Criminal Justice System

ABSTRACT

This two-phase qualitative study explores the experiences of 10 formerly incarcerated LGBT elders’ experiences prior to, during, and after release from prison. A core theme of self and the social mirror emerged from the data that represented LGBT elders ongoing coming-out process of unearthing their “true selves” despite managing multiple stigmatized identities or social locations, such as being LGBT, elderly, HIV positive, formerly incarcerated, and a racial/ethnic minority. These findings further our awareness of an overlooked population of LGBT who are older and involved in the criminal justice system. Recommendations that incorporate suggestions from formerly incarcerated LGBT elders for services and policy reform are presented.     

Examining Sexual Orientation Disparities in Unmet Medical Needs Among Men and Women

Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen’s model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women.     

Lesbian,Gay, and Bisexual Individuals’ Perceptions of American Religious Traditions

ABSTRACT

The cumulative alienation sexual minorities experience from American mainline religious groups may leave them feeling disillusioned and even hostile toward the religious organizations that have historically rejected them. However, research to date has not explored sexual minorities’ perceptions of religious traditions in the United States. The current study examines the variations between lesbian, gay, and bisexual adults’ (LGB) perceptions of whether religious traditions are friendly/neutral or unfriendly toward the LGBT (lesbian, gay, bisexual, and transgender) population. Using data from the Pew Research Center 2013 Survey of LGBT Adults, the author conducts separate binary logistic regression analyses examining whether four religious traditions—evangelical Protestantism, the Catholic Church, the Jewish religion, and mainline Protestantism—are generally perceived as friendly/neutral or unfriendly toward LGBT people. The findings from this study offer rare insight on sexual minorities’ perceptions of major religious traditions and illustrates that sexual minorities have a complex relationship with religion.     

Sources of Discrimination and Their Associations With Health in Sexual Minority Adults

ABSTRACT

Health disparities exist between sexual minorities and heterosexuals. These health disparities may be due to stressful social situations and environments that are created by discrimination. The current study recruited 277 sexual minorities to complete an online survey to examine the effects of discrimination on health. Discrimination from family and friends, compared to non-family and friends, was found to be more strongly associated with poorer health. This effect was partially statistically mediated by perceived stress reactivity. Findings from this study highlight the importance of distinguishing between different sources of discrimination when examining the effect of discrimination on health in sexual minority adults.     

Mental Health Concerns of Gay and Bisexual Men Seeking Mental Health Services

ABSTRACT

Little data exist about the mental health needs of gay and bisexual men. This is due to limitations of existing studies such as small and nonrepresentative samples, failure to assess sexual orientation, and concerns about stigmatization, possibly causing sexual minority individuals to be reluctant to disclose their sexual orientation to researchers. Fenway Community Health is a large urban health center that serves the LGBT community. The large number of gay and bisexual men who present for mental health treatment allows for a unique opportunity to gain insight into mental health, prevention, and intervention needs for this group. The current study is a review of the mental health information from all of the gay and bisexual men who reported that they were HIV-negative during their mental health intake over a six-month period at Fenway Community Health (January to June 2000; N = 92). The most frequent presenting problems were depression, anxiety, and relationship issues. Additionally, presenting problems included current or past abuse, substance abuse, finance and employment, recent loss, and family issues. The most frequent diagnoses were depression, anxiety disorders, and adjustment disorders. These findings support the notion that presenting problems and mental health concerns among gay and bisexual men are similar to those frequently reported by individuals in other mental health facilities, however, specific psychosocial stressors are unique to this population.     

The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings

ABSTRACT

The present article maps out understandings about embodied distress among gender-nonconforming youth. Feminist bioethics and queer-inflected clinical perspectives are used to inform thinking about ethical, nonpathologizing health care in the case of gender-related distress. Specific attention is directed at self-harming among gender variant and trans youth. This is contextualized in relation to the role that self-harm plays for some LGBT youth, where it may be seen as a rite of passage or as reasonable and inevitable way of coping. The particular complexities of self-harm among trans youth seeking clinical intervention are examined. Queer bioethics is proposed as potentially facilitating productive uncertainty with regard to the diverse imagined futures of gender variant and trans youth.     

Balancing acts: drag queens, gender and faith

While engaged in research on the same-sex marriage debate in mainline denominations, I interviewed 23 LGBT Christians, four of whom were drag queens. While it is not possible to generalize from such a small sample, the drag queens in this study insist on maintaining their identity as Christians despite the hegemonic discourse that renders faith and LGBT identities mutually exclusive. They developed innovative approaches to reconciling their gender and sexual identities with their spirituality. Their innovations are potentially liberating not just for them personally, but for LGBT people generally because they challenge Christianity's rigid dichotomies of gender and sexuality.     

Transgender Identities,Pressures, and Social Policy: A Study Carried Out in Spain

ABSTRACT

This article draws on a qualitative research project concerning the relationship between trans people’s mental health and wellbeing, pressures, social policy, and heteronormative gender norms in Spain. Drawing on interviews carried out with trans people from all regions and generations, we use an ecological framework to illustrate how a socially entrenched heteronormativity pressures trans people to comply with gender norms that impact negatively their mental health and wellbeing. The article argues that the legal changes in Spain are not enough in themselves to bring about social change, but, rather, Spanish social policy makers also need to challenge gender categorization and work toward transforming public discourses on gender issues if trans people are to gain full social recognition and equal social rights.