'Struggling to be the Alpha': Sources of Tension & Intimate Partner Violence in Same-Sex Relationships Between Men

In countries such as the USA, gay and bisexual men experience high rates of intimate partner violence. However, little is known about the factors that contribute to this form of violence. 

In this study, we examine gay and bisexual men's perceptions of sources of tension in same-sex male relationships and how these may contribute to intimate partner violence. We conducted seven focus-group discussions with 64 gay and bisexual men in Atlanta, GA. Focus groups examined men's reactions to the short-form revised Conflicts Tactics Scale to determine if each item was considered to be intimate partner violence if it were to occur among gay and bisexual men. Analysts completed a thematic analysis, using elements of grounded theory. 

The sources of tension that men identified included: gender role conflict, dyadic inequalities (e.g. differences in income, age, education), differences in 'outness' about sexual identity, substance use, jealousy and external homophobic violence. 

Results suggest that intimate partner violence interventions for gay and bisexual men should address behavioural factors, while also focusing on structural interventions. Interventions that aim to reduce homophobic stigma and redefine male gender roles may help to address some of the tension that contributes to intimate partner violence in same-sex male relationships.

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By:  Goldenberg T1,2, Stephenson R1,2, Freeland R2, Finneran C3, Hadley C4.

• 1a Department of Health Behavior and Biological Sciences , School of Nursing, University of Michigan , Ann Arbor , MI , USA.
• 2b Center for Sexuality and Health Disparities , University of Michigan , Michigan , USA.
• 3c Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA.
• 4d Department of Anthropology , Emory College of Arts and Sciences , Atlanta , GA , USA. 
• Cult Health Sex. 2016 Mar 11:1-15.

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Sexual Behaviors and Partner Characteristics by Sexual Identity among Adolescent Girls

PURPOSE:

Data suggest that lesbian and bisexual adolescents engage in risky sexual behaviors at higher rates than heterosexual girls. Whether these findings also apply to girls of other sexual identities is less well understood. Potential differences in risky sexual behaviors reported by lesbian versus bisexual adolescents are also underreported in the literature.

METHODS:

Data were collected online in 2010-2011 among 2,823 girls, aged 13-18 years, in the United States. Multinomial logistic regression was used to quantify comparisons of sexual behaviors between (1) lesbian; (2) bisexual; and (3) questioning, unsure, or other (QUO) identity; and (0) heterosexual girls. Logistic regression compared lesbian and bisexual adolescents.

RESULTS:

• Lesbian and bisexual adolescents reported significantly more lifetime and past-year sexual partners than heterosexual girls. 
• Bisexual girls were also more likely to report penile-anal and penile-vaginal sex, 
• whereas lesbians were more likely to report earlier sexual debut for almost all types of sex, as compared to heterosexual girls. 
• Lesbians also were more likely to report infrequent condom use and less likely to have conversations with partners about the use of barriers (e.g., dental dams) before first sex. 
• Relative to lesbians, bisexual girls reported older age at first sex for almost all sexual behaviors and higher lifetime prevalence of recent male partners, penile-vaginal, and penile-anal sex. 
• Few differences were noted between QUO and heterosexual girls.

CONCLUSIONS:

Sexual minority adolescents are not identical in terms of sexual risk. Providers need to be sensitive to these differences and their implications for health and counseling of patients.

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By:  Ybarra ML1, Rosario M2, Saewyc E3, Goodenow C4.

• 1Center for Innovative Public Health Research, San Clemente, California. Electronic address: Michele@InnovativePublicHealth.org.
• 2Department of Psychology, The City University of New York-City College and Graduate Center, New York, New York.
• 3School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
• 4Independent Consultant, Northborough, Massachusetts. 
• J Adolesc Health. 2016 Mar;58(3):310-6. doi: 10.1016/j.jadohealth.2015.11.001.

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Association of Alcohol Misuse with Sexual Identity and Sexual Behavior in Women Veterans

BACKGROUND:

Sexual minority women report greater alcohol misuse than heterosexual women in the general population, with more pronounced differences found among younger age groups. It is unknown whether these differences exist among women veterans.

OBJECTIVE:

We evaluated differences in alcohol misuse across two dimensions of sexual orientation (identity and behavior) among women veterans, and examined whether these differences were modified by age.

METHODS:

Women veterans were recruited via the internet to participate in an online survey. Participants provided information on their self-reported sexual identity and behavior and responded to the validated 3-item Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Regression models were used to compare the prevalence of alcohol misuse (AUDIT-C ≥ 3) and severity (AUDIT-C scores) across sexual identity and behavior and to test effect modification by age.

RESULTS:

Among the 702 participants (36% lesbian/bisexual), prevalence and severity of alcohol misuse varied by both sexual identity and behavior, but there were significant interactions with age. Prevalence and severity of alcohol misuse were higher among relatively younger self-identified lesbians compared to heterosexual women. Similarly, both prevalence and severity of alcohol misuse were generally higher among younger women who had any sex with women compared to those who had sex only with men. Conclusions/Importance: In this online study of women veterans, younger sexual minority women were more likely to screen positive for alcohol misuse, and they had more severe alcohol misuse, than their heterosexual counterparts. Prevention and treatment efforts focused specifically on sexual minority women veterans may be needed.

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By:  Lehavot K1,2,3,4, Williams EC1,4, Millard SP2, Bradley KA1,4,5, Simpson TL2,3,6.

• 1a VA Health Services Research & Development, Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound , Seattle , Washington , USA.
• 2b Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System , Seattle , Washington , USA.
• 3c Department of Psychiatry and Behavioral Sciences, University of Washington , Seattle , Washington , USA.
• 4d Department of Health Services, University of Washington , Seattle , Washington , USA.
• 5e Group Health Research Institute , Seattle , Washington , USA.
• 6f Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System , Seattle , Washington , USA. 
• Subst Use Misuse. 2016 Jan 22:1-14.

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Mental Health and Sexual Identity in a Sample of Male Sex Workers in the Czech Republic

Background

Previous qualitative research has examined male sex workers in the Czech Republic, but this mapping study is the first to investigate male sex work in a quantitative research design and focus on the mental health of these sex workers. This study also examines male sex workers’ mental health problems in relation to their sexual identity or orientation.

Material/Methods

A sample of Czech male sex workers (N=40) were examined on a range of sexual and psychological variables using a quantitative survey administered face-to-face. The study employed locally validated versions of Beck’s Depression Inventory and Zung’s Self-Report Anxiety Scale.

Results

The results indicate that for homosexuals, working as a male sex worker is not related to any serious mental health problems. However, those identifying as heterosexual and bisexual more frequently reported symptoms of depression and bisexuals showed significantly more anxiety.

Conclusions

These findings suggest sexual identity is an important issue to consider when addressing the mental health needs of this population.

Below:  Male sex workers scores on Zung’s Self Report Anxiety Scale, with scores of 45 or greater indicating clinically significant levels of anxiety

Full article at:   http://goo.gl/ShuOWv

By:   Michael Bar-JohnsonA,B,C,D,E,F,G and Petr WeissA,B,C,D,E,F

First Medical Faculty, Charles University, Prague, Czech Republic

Corresponding Author: Michael Bar-Johnson, e-mail: zc.pynu@nosnhojm

  

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Exploring Lesbian, Gay, Bisexual & Queer (LGBQ) People’s Experiences with Disclosure of Sexual Identity to Primary Care Physicians

Background

It has been demonstrated that health disparities between lesbian, gay, bisexual and queer (LGBQ) populations and the general population can be improved by disclosure of sexual identity to a health care provider (HCP). However, heteronormative assumptions (that is, assumptions based on a heterosexual identity and experience) may negatively affect communication between patients and HCPs more than has been recognized. The aim of this study was to understand LGBQ patients’ perceptions of their experiences related to disclosure of sexual identity to their primary care provider (PCP).

Methods

One-on-one semi-structured telephone interviews were conducted, audio-recorded, and transcribed. Participants were self-identified LGBQ adults with experiences of health care by PCPs within the previous five years recruited in Toronto, Canada. A qualitative descriptive analysis was performed using iterative coding and comparing and grouping data into themes.

Results

Findings revealed that disclosure of sexual identity to PCPs was related to three main themes: 1) disclosure of sexual identity by LGBQ patients to a PCP was seen to be as challenging as coming out to others; 2) a solid therapeutic relationship can mitigate the difficulty in disclosure of sexual identity; and, 3) purposeful recognition by PCPs of their personal heteronormative value system is key to establishing a strong therapeutic relationship.

Conclusion

Improving physicians’ recognition of their own heteronormative value system and addressing structural heterosexual hegemony will help to make health care settings more inclusive. This will allow LGBQ patients to feel better understood, willing to disclose, subsequently improving their care and health outcomes.

Full article at:   http://goo.gl/s3JWfn

By:   Marcus Law, Anila Mathai, Paula Veinot, Fiona Webster, and Maria Mylopoulos

Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 3157, Toronto, ON M5S 1A8 Canada

Department of Family & Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, ON M5G 1V7 Canada

The Wilson Centre, 200 Elizabeth Street, 1ES-565, Toronto, ON M5G 2C4 Canada

Marcus Law, Phone: +416-978-4543, Email: ac.otnorotu@wal.sucram.

 

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Sexual Identity & Prevalence of Alcohol & Other Drug Use among Australians in the General Population

Abstract

Background

International research assessing differences in the prevalence of alcohol and other drug (AOD) use among Lesbian Gay Bisexual and Transgender (LGBT) and heterosexual populations shows elevated prevalence rates of substance use among LGBT people. To date no research has been published investigating these differences at a population level among both men and women in Australia.

Methods

The 2013 National Drug Strategy Household Survey, a multistage stratified population sample collecting data on AOD use in the Australian population over 14 years of age, was analysed for differences between Gay and Bisexual (GB) men and Lesbian/Gay and Bisexual (LGB) women and their heterosexual counterparts in: 1) the prevalence of lifetime and past year tobacco and AOD use; 2) age of initiation of tobacco and AOD use; and 3) frequency of alcohol and cannabis use, and history of AOD treatment.

Results

There were elevated rates of past year cannabis (22.4%), ecstasy (11.8%) and methamphetamine (9.7%) use among GB men compared to heterosexual men (12.4%, 2.9% and 2.5%). LGB women also reported elevated rates of past year use (tobacco - 23.7%; cannabis -29.0%) compared to heterosexual women (10.5% and 11.2%). LGB women initiated tobacco (15.2 years) and alcohol (15.5 years) at an earlier age than heterosexual women (16.6 and 17.7 years), and were significantly more likely to report daily alcohol consumption, and weekly or more frequent cannabis use.

Conclusions

These findings are indicative of the need for more responsive and targeted AOD harm reduction and treatment services for LGBT communities in Australia. Of concern is the elevated risk among LGB women for earlier initiation of substance use, and the development of problematic consumption patterns. Further research, investigating the risk and protective factors for AOD use among LGB women is warranted.

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By:  Amanda Roxburgh, Toby Lea, John De Wit, Louisa Degenhardt

Affiliations

National Drug and Alcohol Research Centre (NDARC), University of New South Wales, SYDNEY, NSW, 2052, AUSTRALIA

 

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Perceived Racial, Sexual Identity, and Homeless Status-Related Discrimination among Black Adolescents and Young Adults Experiencing Homelessness: Relations with Depressive Symptoms and Suicidality

There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. 

The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. 

Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. 

Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. 

We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. 

Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. 

The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. 

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By: Gattis MN, Larson A.

  

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Essentialist Beliefs, Sexual Identity Uncertainty, Internalized Homonegativity & Psychological Wellbeing in Gay Men

The present study examined essentialist beliefs about sexual orientation and their implications for sexual identity uncertainty, internalized homonegativity and psychological wellbeing in a sample of gay men. 

A combination of targeted sampling and snowball strategies were used to recruit 639 gay identifying men for a cross-sectional online survey. Participants completed a questionnaire assessing sexual orientation beliefs, sexual identity uncertainty, internalized homonegativity, and psychological wellbeing outcomes. Structural equation modeling was used to test whether essentialist beliefs were associated with psychological wellbeing indirectly via their effect on sexual identity uncertainty and internalized homonegativity. 

A unique pattern of direct and indirect effects was observed in which facets of essentialism predicted sexual identity uncertainty, internalized homonegativity and psychological wellbeing. Of note, viewing sexual orientation as immutable/biologically based and as existing in discrete categories, were associated with less sexual identity uncertainty. On the other hand, these beliefs had divergent relationships with internalized homonegativity, with immutability/biological beliefs associated with lower, and discreteness beliefs associated with greater internalized homonegativity. 

Of interest, although sexual identity uncertainty was associated with poorer psychological wellbeing via its contribution to internalized homophobia, there was no direct relationship between identity uncertainty and psychological wellbeing. 

Findings indicate that essentializing sexual orientation has mixed implications for sexual identity uncertainty and internalized homonegativity and wellbeing in gay men. Those undertaking educational and clinical interventions with gay men should be aware of the benefits and of caveats of essentialist theories of homosexuality for this population.

Via: http://goo.gl/5clQ94 Purchase full article at: http://goo.gl/j1atTV

By: Morandini JS1, Blaszczynski A1, Ross MW2, Costa DS1, Dar-Nimrod I1.

• 1School of Psychology, The University of Sydney.
• 2Department of Family Medicine and Community Health, The University of Minnesota Medical School.

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Generational Changes in the Meanings of Sex, Sexual Identity and Stigma among Latino Young and Adult Men

In this paper we examine the sexual identities of Latino men who have sex with men and women, in which an analysis was made of 150 sexual histories of Latino men aged 18–60. This study asks how is the bisexual identity and experience of stigma different for Latino men along the generational spectrum, and how do these differences relate to kinship support and gender ideology? 

In the process of analysis, two main clusters of characteristics were identified to reflect this population: young men aged 18–25, whose open bisexual identity correlated positively with kinship/peer support and flexible gender and sexual roles; and men aged 26–60, who refused or were reluctant to identify as bisexual despite the fact that they were sexually active with both men and women. 

This group as a whole had less kinship and peer support, were more likely to identify with traditional gender roles and were less sexually versatile. 

Finally, a third group reflected Latino men across the generational divide who were less concerned with same-sex stigma, but who nevertheless felt the bisexual label to be confining, illegitimate, or otherwise negative.

Participant input:

He was fine. He was like, “I don’t care.” We still love each other. We have a good time regardless. (P041/11)

That means that like if I’m in a relationship with a masculine guy like Juan, I would have to be at the bottom. But if I was in a – with a feminine boy like the kid I was just with, Armando, I would be considered masculine. And I don’t have a problem being the top because he likes bottom. Most boys who I find are my bottom, and more masculine guys are tops (K002/43)

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By: Nicolette Severson,1 Miguel Muñoz-Laboy,1 Jonathan Garcia,2 Ashley Perry,2 Patrick Wilson,2 and Richard Parker2

²

²

1College of Health Professions and Social Work, Temple University, Philadelphia, USA
2Columbia University Mailman School of Public Health, Sociomedical Sciences, New York City, USA

1College of Health Professions and Social Work, Temple University, Philadelphia, USA

1College of Health Professions and Social Work, Temple University, Philadelphia, USA