Sissies, Mama's Boys, and Tomboys: Is Children's Gender Nonconformity More Acceptable When Nonconforming Traits Are Positive?

The evaluation of gender nonconformity in children was examined in two studies. In Study 1, 48 young adults evaluated the positivity of culturally popular labels for gender nonconformity, including "tomboy," "sissy," and two new labels generated in a pilot study, "mama's boy" and "brat." The "mama's boy" was described as a boy who has positive feminine traits (gentle and well-mannered) as opposed to the "sissy" who was described as having negative feminine traits (crying and easily frightened). 

In Study 2, 161 young adults read descriptions of gender-typical and nonconforming children, evaluating them in several domains. The label "mama's boy" was considered negative in Study 1 but an unlabeled positive nonconforming boy was rated as likable and competent in Study 2. However, participants worried about nonconforming boys, saying they would encourage them to behave differently and describing such children with derogatory sexual orientation slurs. "Tomboy" was generally considered a positive label in Study 1. 

In Study 2, gender nonconforming girls were considered neither likable nor dislikeable, and neither competent nor incompetent, reflecting ambivalence about girls' nonconformity. It may be that we use gender nonconformity labels as indicators of sexual orientation, even in young children. Therefore, even when an individual displays objectively positive traits, the stigma associated with homosexuality taints judgments about their nonconforming behavior.

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By:  Coyle EF1, Fulcher M2, Trübutschek D3,4,5.

• 1Department of Psychology, Beloit College, 700 College Street, Beloit, WI, 53511, USA. emilyfcoyle@gmail.com.
• 2Department of Psychology, Washington and Lee University, Lexington, VA, USA.
• 3Cognitive Neuroimaging Unit, CEA DSV/I2BM, INSERM, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France.
• 4Ecole des Neurosciences de Paris Ile-de-France, Paris, France.
• 5Université Pierre et Marie Curie, Paris, France.
• Arch Sex Behav. 2016 Mar 7. 

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Face-ism and Objectification in Mainstream and LGBT Magazines

In visual media, men are often shown with more facial prominence than women, a manifestation of sexism that has been labeled face-ism. 

The present research extended the study of facial prominence and gender representation in media to include magazines aimed at lesbian, gay, bisexual, and transgender (LGBT) audiences for the first time, and also examined whether overall gender differences in facial prominence can still be found in mainstream magazines. Face-ism emerged in Newsweek, but not in Time, The Advocate, or Out. Although there were no overall differences in facial prominence between mainstream and LGBT magazines, there were differences in the facial prominence of men and women among the four magazines included in the present study. 

These results suggest that face-ism is still a problem, but that it may be restricted to certain magazines. Furthermore, future research may benefit from considering individual magazine titles rather than broader categories of magazines, given that the present study found few similarities between different magazines in the same media category—indeed, Out and Time were more similar to each other than they were to the other magazine in their respective categories.

Below:  Face-ism Indices of Men and Women in Two Mainstream and Two LGBT Magazines

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

By:  Nathan N. Cheek 

Department of Psychology, Swarthmore College, Swarthmore, PA, United States of America

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The Relationship Between Sexual Activity and Depressive Symptoms in Lesbian, Gay, and Bisexual Youth: Effects of Gender and Family Support

There is considerable debate over whether adolescent sexual activity is maladaptive and associated with worse mental health outcomes versus a positive developmental milestone that is associated with better mental health outcomes. Although these perspectives are often pitted against one another, the current study employed a more integrative perspective: adolescent sexual activity may be maladaptive in certain contexts, but healthy in other contexts. 

We investigated whether family support and gender moderated the relation between sexual activity and mental health outcomes in a diverse sample of 519 lesbian, gay, and bisexual (LGB) youth. Specifically, we examined whether youth who engaged in more sexual activity would have fewer depressive symptoms in the context of a more supportive family environment, but more depressive symptoms in the context of a less supportive family environment and whether this effect was stronger for sexual minority girls. Consistent with the sexual health perspective, we found that among girls with more family support, those who engaged in more frequent same-sex sexual contact had lower levels of depressive symptoms. 

Unexpectedly, we found that among boys with more family support, those who engaged in more frequent same-sex sexual contact had higher levels of depressive symptoms. In contrast, girls and boys with less family support showed no relation between sexual activity and depressive symptoms. 

Overall, results suggest that context is critical when determining whether same-sex sexual contact among LGB youth should be considered maladaptive or beneficial.

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By:  Dickenson JA1, Huebner DM2.

• 1Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA. janna.dickenson@psych.utah.edu.
• 2Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA. 

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Scrutinizing Immutability: Research on Sexual Orientation and U.S. Legal Advocacy for Sexual Minorities

We review scientific research and legal authorities to argue that the immutability of sexual orientation should no longer be invoked as a foundation for the rights of individuals with same-sex attractions and relationships (i.e., sexual minorities). 

On the basis of scientific research as well as U.S. legal rulings regarding lesbian, gay, and bisexual (LGB) rights, we make three claims: 

• First, arguments based on the immutability of sexual orientation are unscientific, given what we now know from longitudinal, population-based studies of naturally occurring changes in the same-sex attractions of some individuals over time. 
• Second, arguments based on the immutability of sexual orientation are unnecessary, in light of U.S. legal decisions in which courts have used grounds other than immutability to protect the rights of sexual minorities. 
• Third, arguments about the immutability of sexual orientation are unjust, because they imply that same-sex attractions are inferior to other-sex attractions, and because they privilege sexual minorities who experience their sexuality as fixed over those who experience their sexuality as fluid. 

We conclude that the legal rights of individuals with same-sex attractions and relationships should not be framed as if they depend on a certain pattern of scientific findings regarding sexual orientation.

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By:  Diamond LM1, J Rosky C2.

• 1 Department of Psychology , University of Utah.
• 2 S. J. Quinney College of Law , University of Utah. 
• J Sex Res. 2016 Mar 17:1-29. 

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Place Matters: Contextualizing the Roles of Religion & Race for Understanding Americans' Attitudes About Homosexuality

As laws and policies related to homosexuality have evolved, Americans' attitudes have also changed. Race and religion have been established as important indicators of feelings about homosexuality. However, researchers have given almost no attention to how county characteristics shape Americans' attitudes. 

Using Hierarchical Linear Modeling techniques, we examine how personal characteristics and the religious and racial context of a county shape feelings about homosexuality drawing on data from the American National Election Survey and information about where respondents reside. 

We find that African Americans initially appear less tolerant than other racial groups, until we account for the geographical distribution of attitudes across the nation. 

Additionally, once we consider religious involvement, strength of belief, and religious affiliation African Americans appear to have warmer feelings about homosexuality than whites. Drawing on the moral communities' hypothesis, we also find that the strength of religiosity amongst county residents heightens the influence of personal religious beliefs on disapproving attitudes. 

There is also a direct effect of the proportion conservative Protestant, whereby people of all faiths have cooler attitudes towards homosexual individuals when they reside in a county with a higher proportion of conservative Protestants. 

Finally, we do not find any evidence for an African American cultural influence on attitudes.

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By:  Adamczyk A1, Boyd KA2, Hayes BE3.

• 1John Jay College of Criminal Justice and the Graduate Center, City University of New York, USA. Electronic address: AAdamczyk@jjay.cuny.edu.
• 2Department of Sociology, Philosophy, and Anthropology, The University of Exeter, UK.
• 3Department of Criminal Justice and Criminology, Sam Houston State University, USA. 
• Soc Sci Res. 2016 May;57:1-16. doi: 10.1016/j.ssresearch.2016.02.001. Epub 2016 Feb 8.

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Trajectories of Dating Violence: Differences by Sexual Minority Status & Gender

The purpose of this study was to examine how sexual minority status (as assessed using both identity and behavior) was associated with trajectories of dating violence. 

University students from a large Southwestern university completed questions on their sexual minority identity, the gender of their sexual partners, and about experiences of dating violence for six consecutive semesters (N = 1942). Latent growth curve modeling indicated that generally, trajectories of dating violence were stable across study participation. 

Sexual minority identity was associated with higher initial levels of dating violence at baseline, but also with greater decreases in dating violence across time. These differences were mediated by number of sexual partners. Having same and other-sex sexual partners was associated with higher levels of dating violence at baseline, and persisted in being associated with higher levels over time. 

No significant gender difference was observed regarding trajectories of dating violence.

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By:  Martin-Storey A1, Fromme K2.

• 1Département de Psychoéducation, Université de Sherbrooke, Pavillon A7, 2500 Boul. De L'Université, Sherbrooke, Quebec J1K 2R1, Canada. Electronic address: alexa.martin@gmail.com.
• 2Department of Psychology, University of Texas at Austin, 108 E Dean Keeton Stop A8000, Austin, TX 87812-1043, USA. 
• J Adolesc. 2016 Mar 16;49:28-37. doi: 10.1016/j.adolescence.2016.02.008.

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The National LGBT Cancer Action Plan: A White Paper of the 2014 National Summit on Cancer in the LGBT Communities

Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. 

Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. 

In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. 

Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. 

This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers...

Recommendations

1. Add SOGI questions to all national health surveys and promote SOGI data collection in diverse healthcare settings so as to better understand psychosocial, behavioral, and medical risk factors that can increase LGBT persons' cancer risk and to examine health outcomes and disparities in each LGBT community.
2. Organize stakeholders and promote education within the NIH and its institutes, centers, and offices, and in particular the NCI, about the health and cancer needs of LGBT communities to arm with facts and sensitize decision-makers who help set scientific and funding priorities.
3. Overcome the gap in financial support of research to develop and test cancer prevention and control interventions targeted and tailored to LGBT communities by issuing research funding opportunities specific to the population.
4. Increase the amount of federal funding dedicated to LGBT cancer research. Furthermore, assure that career development and training grants for under-represented populations in the workforce include those identifying as LGBT and with potential for conducting high-quality cancer research with LGBT communities.ⁱ
5. Address the absence of SEER cancer registry data on SOGI. SEER should consider partnering with cancer researchers to pilot test such an effort, perhaps within a region or state, to identify and overcome barriers to standard collection of SOGI data.
6. Recognize intersectionality within the LGBT communities when conducting cancer research by assessing and examining the impact of SOGI, race, ethnicity, class, disability/ability, and other sociodemographic factors on cancer outcomes across the cancer care continuum.

Recommendations

1. Increase research to document elevated cancer risks and cancer screening disparities in LGBT communities.
2. Develop psychosocial and educational support groups specifically for LGBT survivors and caregivers, and when this is not feasible, assure the cultural competence of professional support service providers to better meet the needs of LGBT communities.
3. Improve care coordination for LGBT patients, survivors, and caregivers through the integration of LGBT community resources. These resources include culturally competent oncologists, primary care and specialty physicians, mental health providers, and other professional providers.
4. Educate healthcare providers about the unique cooccurring conditions that LGBT cancer patients may present in their care settings.
5. Ensure that palliative and end-of-life care addresses the specific legal and psychosocial needs of LGBT communities.
6. Support efforts to increase insurance coverage for LGBT communities, with a focus on the transition and cancer care needs of transgender communities.

Recommendations

1. Develop accreditation agency standards for the provision of culturally competent care to LGBT people and to assure professional training in LGBT cultural competence and health for providers of primary care, cancer screening and treatment, and cancer survivorship healthcare both during their academic training and for those already working in the field. This can be best accomplished by working with LGBT-focused organizations and other content experts in these areas.
2. Educate LGBT communities about their increased cancer risks and the importance of appropriate cancer screening and early detection through outreach by cancer experts through tailored lectures, print materials, internet content, mass media messaging, and other means that will effectively engage the community.
3. Increase representation of LGBT persons in leadership positions and throughout the workforce. The workforce pipeline draws from many streams, but for there to be greater LGBT representation at all levels of the cancer healthcare continuum and in health policy and research, efforts are needed to welcome, include, and develop the potential of LGBT persons within the under-represented populations in the workforce. This will entail collecting SOGI data to track the effectiveness of such efforts, as well as targeting for recruitment of LGBT-identified persons in academic and training programs and assuring that they will experience LGBT-affirmative environments and mentoring opportunities in their new settings.
4. Initiate a comprehensive effort to identify and modify healthcare organization policies that are not inclusive or pose barriers to patient-centered cancer care for LGBT persons. These policies may range from how to manage the comfort and confidentiality of transgender patients presenting for cancer screening based on gender-specific anatomy to providing culturally sensitive psychosocial support for LGBT cancer survivors. Systemic changes promoting equity in LGBT cancer care are more likely to be implemented when an independent prestigious organization advocates such changes and more so when mandated by an accrediting or certifying organization. Furthermore, by instituting collaborations with LGBT advocacy and professional groups, healthcare organizations can establish a lifeline when addressing internal LGBT-related policies, procedures, and patient concerns.

Full article at:   http://goo.gl/2Gl9sl

By:  Jack E. Burkhalter, PhD,1,* Liz Margolies, LCSW,2,* Hrafn Oli Sigurdsson, PhD, NP, PMHNP-BC,3 Jonathan Walland, LLB,4 Asa Radix, MD, MPH,5 David Rice, RN, PhD,6 Francisco O. Buchting, PhD,7 Nelson F. Sanchez, MD,8 Michael G. Bare, MPH,9 Ulrike Boehmer, PhD,10 Sean Cahill, PhD,11 Tomas L. Griebling, MD, MPH,12 Diane Bruessow, PA-C, DFAAPA,13 and Shail Maingi, MD14

¹Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.

²National LGBT Cancer Network, New York, New York.

³Nursing Professional Development, Memorial Sloan Kettering Cancer Center, New York, New York.

⁴The Office of General Counsel, Memorial Sloan Kettering Cancer Center, New York, New York.

⁵Callen-Lorde Community Health Center, New York, New York.

⁶City of Hope, Duarte, California.

⁷Buchting Consulting, Oakland, California; Horizons Foundation, San Francisco, California.

⁸Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

⁹Grassroots Change, Oakland, California.

¹⁰Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.

¹¹The Fenway Institute, Boston, Massachusetts.

¹²Department of Urology, School of Medicine, University of Kansas, Kansas City, Kansas.

¹³Healthy Transitions, LLC, Stirling, New Jersey.

¹⁴St. Peter's Health Partners Cancer Care, Troy, New York.

Corresponding author.

^*Cofirst authors.

Address correspondence to:, Jack E. Burkhalter, PhD, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY 10022,

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Barriers to Health Care among Adults Identifying as Sexual Minorities: A US National Study

OBJECTIVES:

To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 years experience barriers to health care.

METHODS:

We used 2013 National Health Interview Survey data on 521 gay or lesbian (291 men, 230 women), 215 bisexual (66 men, 149 women), and 25 149 straight (11 525 men, 13 624 women) adults. Five barrier-to-care outcomes were assessed (delayed or did not receive care because of cost, did not receive specific services because of cost, delayed care for noncost reasons, trouble finding a provider, and no usual source of care).

RESULTS:

Relative to straight adults, 

• gay or lesbian and bisexual adults had higher odds of delaying or not receiving care because of cost. 
• Bisexual adults had higher odds of delaying care for noncost reasons, 
• and gay men had higher odds than straight men of reporting trouble finding a provider. 

By contrast, gay or lesbian women had lower odds of delaying care for noncost reasons than straight women. 

• Bisexual women had higher odds than gay or lesbian women of reporting 3 of the 5 barriers investigated.

CONCLUSIONS:

Members of sexual minority groups, especially bisexual women, are more likely to encounter barriers to care than their straight counterparts

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By:  Dahlhamer JM1, Galinsky AM1, Joestl SS1, Ward BW1.

1The authors are with the National Center for Health Statistics, Hyattsville, MD

Am J Public Health. 2016 Mar 17:e1-e7.

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Transmission Dynamics of HIV-1 Subtype B in the Basque Country, Spain

This work was aimed to study the HIV-1 subtype B epidemics in the Basque Country, Spain. 1727 HIV-1 subtype B sequences comprising protease and reverse transcriptase (PR/RT) coding regions, sampled between 2001 and 2008, were analyzed. 

156 transmission clusters were detected by means of phylogenetic analyses. Most of them comprised less than 4 individuals and, in total, they included 441 patients. 

• Six clusters comprised 10 or more patients and were further analyzed in order to study their origin and diversification. 
• Four clusters included men who had unprotected homosexual sex (MSM), 
• one group was formed by intravenous drug users (IDUs), 
• and another included both IDUs and people infected through unprotected heterosexual sex (HTs). 

Most of these clusters originated from the mid-1980s to the mid-1990s. Only one cluster, formed by MSM, originated after 2000. The time between infections was significantly lower in MSM groups than in those containing IDUs (P-value <0.0001). Nucleoside RT and non-nucleoside RT inhibitor (NRTI and NNRTI)-resistance mutations to antiretroviral treatment were found in these six clusters except the most recent MSM group, but only the IDU clusters presented protease inhibitor (PI)-resistance mutations. 

The most prevalent mutations for each inhibitor class were PI L90M, NRTI T215D/Y/F, and NNRTI K103N, which were also among the most prevalent resistant variants in the whole dataset. 

In conclusion, while most infections occur as isolated introductions into the population, the number of infections found to be epidemiologically related within the Basque Country is significant. Public health control measures should be reinforced to prevent the further expansion of transmission clusters and resistant mutations occurring within them.

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By:  Patiño-Galindo JA1, Thomson MM2, Pérez-Álvarez L2, Delgado E2, Cuevas MT2, Fernández-García A3, Nájera R2, Iribarren JA4, Cilla G4, López-Soria L5,Lezaun MJ6, Cisterna R7, González-Candelas F8; Group of HIV-1 Antiretroviral Resistance Studies in the Basque Country.

• 1Joint Research Unit "Infection and Public Health" FISABIO-Universitat de Valencia, Spain; CIBER in Epidemiology and Public Health, Madrid, Spain.
• 2Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
• 3CIBER in Epidemiology and Public Health, Madrid, Spain; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
• 4Hospital Universitario Donostia, San Sebastián, Spain.
• 5Hospital Universitario Cruces, Bilbao, Spain.
• 6Hospital Universitario Araba, Vitoria, Spain.
• 7Hospital Universitario Basurto, Bilbao, Spain.
• 8Joint Research Unit "Infection and Public Health" FISABIO-Universitat de Valencia, Spain; CIBER in Epidemiology and Public Health, Madrid, Spain. Electronic address: fernando.gonzalez@uv.es. 
• Infect Genet Evol. 2016 Feb 24. pii: S1567-1348(16)30059-4. doi: 10.1016/j.meegid.2016.02.028. 

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Conducting Clinical Trials in Outbreak Settings: Points to Consider

In the summer of 1981, the U.S. Centers for Disease Control and Prevention reported cases of a rare respiratory infection, Pneumocystis pneumonia and an unusual cancer, Kaposi’s sarcoma, in young, previously healthy homosexual men in Los Angeles, New York, and San Francisco. The underlying reason for these infections, immune compromise due to infection of immune competent cells by the human immunodeficiency virus (HIV), would not be understood for three more years with the discovery of HIV, and the global impact of the virus would take many more years to elucidate. Still, even in the earliest days of the HIV/AIDS pandemic, the near-inevitable mortality associated with the disease was clear. Affected individuals and their caregivers were desperate to find effective treatments, and many tried unproven interventions that would sometimes cause more harm than good. Biomedical researchers experienced intense pressure to offer access to experimental therapies in the face of near certain death.

Most investigators felt that interventions for HIV/AIDS should be tested according to sound scientific principles, using the “gold standard” of double-blinded, randomized, placebo-controlled trials to determine the safety and efficacy of candidate therapies. Prioritization for testing of drugs was based on a careful analysis of available preclinical data. This approach yielded a solid basis for the testing and ultimate proof of efficacy of the first approved antiretroviral drug, zidovudine (AZT), and other agents to treat HIV and its complications in the early years of the HIV/AIDS pandemic. However, some stakeholders felt that strict adherence to scientific practices was unnecessary and insisted upon immediate access to any therapy with a remote chance of making a difference. Eventually, through extensive dialogue and engagement of scientists, regulatory agencies and the affected communities, a compromise was reached whereby first priority was given to rigorous evaluation of the most promising treatments with immediate expanded access to those treatments upon demonstration of efficacy. The HIV/AIDS experience provides a paradigm for conducting clinical trials in other emerging epidemics, such as the Ebola outbreak of 2014-2015 in West Africa...

Core Ethical and Scientific Principles for Trial Conduct in Outbreak Settings*

Ethical conduct to avoid exploitation – including respect for volunteers, local community engagement and carefully informed consent

Partnership with affected country investigators and officials – including identification of interested local investigators, bolstering of trial infrastructure as needed and shared best practices regarding regulatory oversight

Scientific validity – including plausibility of benefit from candidate countermeasures and sound trial design

Independent review and scientific oversight – careful oversight by an independent and skilled Data and Safety Monitoring Board

Transparency – prompt sharing of data with practitioners and affected communities

*Adapted in part from Reference 1

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

By:  H. Clifford Lane, MD, Hilary D. Marston, MD, MPH, and Anthony S. Fauci, MD

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD

Corresponding author: H. Clifford Lane, Email: vog.hin.diain@enalc, Mailing address: MSC 1460, 10 Center Drive, Bethesda, MD 20892

  

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