Challenges faced by marginalized communities such as transgenders in Pakistan

Challenges faced by marginalized communities such as transgenders in Pakistan. Read more at: http://ow.ly/M0yD30mlMyV   

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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Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study

PURPOSE:

There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status.

METHODS:

Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case-control design to determine if medical and/or mental health disparities exist in the TG veteran population.

RESULTS:

In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups.

CONCLUSION:

This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems.

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By:  Brown GR1,2, Jones KT3.

• 1 Psychiatry Service, Mountain Home Veterans Affairs Medical Center , Johnson City, Tennessee.
• 2 Department of Psychiatry and Behavioral Sciences, Quillen College of Medicine, East Tennessee State University , Johnson City, Tennessee.
• 3 Office of Health Equity , Veterans Health Administration, Washington, District of Columbia.
• LGBT Health. 2016 Apr;3(2):122-31. doi: 10.1089/lgbt.2015.0058. Epub 2015 Dec 16. 

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Sexual Orientation & Symptoms of Common Mental Disorder or Low Wellbeing: Combined Meta-Analysis of 12 UK Population Health Surveys

BACKGROUND:

Previous studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults. Our aims were to determine an estimate of the association between sexual orientation identity and poor mental health and wellbeing among adults from 12 population surveys in the UK, and to consider whether effects differed for specific subgroups of the population.

METHODS:

Individual data were pooled from the British Cohort Study 2012, Health Survey for England 2011, 2012 and 2013, Scottish Health Survey 2008 to 2013, Longitudinal Study of Young People in England 2009/10 and Understanding Society 2011/12. Individual participant meta-analysis was used to pool estimates from each study, allowing for between-study variation.

RESULTS:

Of 94,818 participants, 1.1 % identified as lesbian/gay, 0.9 % as bisexual, 0.8 % as 'other' and 97.2 % as heterosexual. Adjusting for a range of covariates, adults who identified as lesbian/gay had higher prevalence of common mental disorder when compared to heterosexuals, but the association was different in different age groups: apparent for those under 35 (OR = 1.78, 95 % CI 1.40, 2.26), weaker at age 35-54.9 (OR = 1.42, 95 % CI 1.10, 1.84), but strongest at age 55+ (OR = 2.06, 95 % CI 1.29, 3.31). These effects were stronger for bisexual adults, similar for those identifying as 'other', and similar for 'low wellbeing'.

CONCLUSIONS:

In the UK, LGB adults have higher prevalence of poor mental health and low wellbeing when compared to heterosexuals, particularly younger and older LGB adults. Sexual orientation identity should be measured routinely in all health studies and in administrative data in the UK in order to influence national and local policy development and service delivery. These results reiterate the need for local government, NHS providers and public health policy makers to consider how to address inequalities in mental health among these minority groups.

• Adults identifying as lesbian, gay, bisexual or ‘other’ are at increased risk of poor mental health and low wellbeing compared to those identifying as heterosexual.
• The association varies across the life course, with the lowest relative risks seen in midlife and the highest among older adults
• Our study used cross-sectional data suitable for estimating prevalence, but future studies should consider longitudinal patterns (such as onset and persistence of new mental health problems) and clarify mechanisms

Full article at:  http://goo.gl/c6MrVB

By:  Semlyen J1, King M2, Varney J3, Hagger-Johnson G4.

• 1Department of Psychology, London Metropolitan University, London, UK.
• 2Division of Psychiatry, UCL, London, UK.
• 3Public Health England, London, UK.
• 4Administrative Data Research Centre for England (ADRC-E), Farr Institute, UCL, London, NW1 2DA, UK. G.Hagger-Johnson@ucl.ac.uk.
• BMC Psychiatry. 2016 Mar 24;16(1):67. doi: 10.1186/s12888-016-0767-z. 

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Bisexuality, Poverty & Mental Health: A Mixed Methods Analysis

Highlights

• Poverty is associated with poor mental health among bisexual people.
• Poverty is also associated with experiences of discrimination among bisexuals.
• Multiple pathways may link bisexuality, poverty, and mental health.
• Lack of affordable culturally competent services may sustain the disparities.

Bisexuality is consistently associated with poor mental health outcomes. In population-based data, this is partially explained by income differences between bisexual people and lesbian, gay, and/or heterosexual individuals. However, the interrelationships between bisexuality, poverty, and mental health are poorly understood. 

In this paper, we examine the relationships between these variables using a mixed methods study of 302 adult bisexuals from Ontario, Canada. Participants were recruited using respondent-driven sampling to complete an internet-based survey including measures of psychological distress and minority stress. A subset of participants completed a semi-structured qualitative interview to contextualize their mental health experiences. 

Using information regarding household income, number of individuals supported by the income and geographic location, participants were categorized as living below or above the Canadian Low Income Cut Off (LICO). Accounting for the networked nature of the sample, participants living below the LICO had significantly higher mean scores for depression and posttraumatic stress disorder symptoms and reported significantly more perceived discrimination compared to individuals living above the LICO. 

Grounded theory analysis of the qualitative interviews suggested four pathways through which bisexuality and poverty may intersect to impact mental health: through early life experiences linked to bisexuality or poverty that impacted future financial stability; through effects of bisexual identity on employment and earning potential; through the impact of class and sexual orientation discrimination on access to communities of support; and through lack of access to mental health services that could provide culturally competent care. 

These mixed methods data help us understand the income disparities associated with bisexual identity in population-based data, and suggest points of intervention to address their impact on bisexual mental health.

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By:  Ross LE1, O'Gorman L2, MacLeod MA3, Bauer GR3, MacKay J4, Robinson M4.

• 1Dalla Lana School of Public Health, University of Toronto, 155 College St. Room 560, Toronto, Ontario, M5T 3M7, Canada; Social & Epidemiological Research Department, Centre for Addiction & Mental Health, 33 Russell St. Room T406, Toronto, Ontario, M5S 1R8, Canada. Electronic address: l.ross@utoronto.ca.
• 2School of Rural and Northern Health, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, P3E 2C6, Canada.
• 3Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, Kresge Building Room K201, London, Ontario, N6A 5C1, Canada.
• 4Social & Epidemiological Research Department, Centre for Addiction & Mental Health, 33 Russell St. Room T406, Toronto, Ontario, M5S 1R8, Canada. 
• Soc Sci Med. 2016 Mar 10;156:64-72. doi: 10.1016/j.socscimed.2016.03.009

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The Association between AIDS-Related Stigma & Aggression Toward Gay Men & Lesbians

This study examined whether self-identified race and prior contact with a gay man or lesbian moderate the association between AIDS-related stigma and aggression toward gay men and lesbians when controlling for sexual prejudice. 

A regional, community-recruited sample of 194 heterosexual men (50% Black, 50% White) completed measures of AIDS-related stigma, sexual prejudice, and prior contact with gay men and lesbians. 

Regression analyses showed that AIDS-related stigma was positively associated with aggression toward gay men and lesbians among White men who reported no prior contact, but not among White men who endorsed prior contact and Black men regardless of prior contact. 

Findings suggest that intergroup contact may be a key component to reducing the effects of AIDS-related stigma towards stigmatized groups. Implications for aggression theory and intervention are discussed.

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By:  Vincent W1, Peterson JL2, Parrott DJ2.

• 1Center for AIDS Prevention Studies, Division of Prevention Science, School of Medicine, University of California, San Francisco, California.
• 2Department of Psychology, Georgia State University, Atlanta, Georgia. 

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Mental Health among Men Who Have Sex with Men in Cambodia: Implications for Integration of Mental Health Services within HIV Programs

BACKGROUND:

Poor mental health contributes to poor HIV prevention, treatment and care outcomes. This paper documents factors associated with psychological distress among men who have sex with men (MSM) in Cambodia and discusses potential ways in which routine mental health management could be integrated into HIV services.

METHODS:

A cross-sectional study was conducted in 2014 among 394 MSM randomly selected from two provinces using a two-stage cluster sampling method. A structured questionnaire was used to assess psychological distress, sexual behaviors, substance use, adverse childhood experiences and family dysfunction. Multivariate logistic regression analysis was performed to explore factors associated with levels of psychological distress.

RESULTS:

In total, 10.7 % of the respondents reported having suicidal thoughts and 6.6 % reported having attempted to commit suicide in the past three months, while 38.8 % had a higher level of psychological distress, which indicates poor mental health. Higher levels of psychological distress were independently associated with older age, alcohol use, illicit drug use, poor self-reported quality of life, and reduced condom use at last sex. MSM with higher levels of psychological distress were significantly more likely to report that a family member said hurtful things to them, a parent or guardian had been physically abused, and a family member had been mentally ill when they were growing up.

CONCLUSIONS:

In order to mitigate psychological distress among MSM in Cambodia, integration of mental health interventions within HIV programmes should be strengthened. To achieve optimal impact, these interventions should also address alcohol and other substance use, and low condom use among distressed MSM. In addition, training of clinical and non-clinical HIV service providers to screen for mental health symptoms, and subsequent provision of peer-based outreach and social support for MSM identified with psychological distress is required.

Comparisons of sexual behaviors and HIV/STI testing among MSM with a lower and higher level of psychological distress

Sexual behaviors in the past 3 months	Total	Total GHQ-12 score
	(n = 394)	≤3 (n = 241)	>3 (n = 153)	p-value*
Mean number of sex partners	3.9 ± 5.4	3.8 ± 5.7	4.0 ± 5.0	0.68
Used a condom in the last sex	313 (82.8)	202 (87.4)	211 (75.5)	0.003
Had sex with girlfriends	118 (29.9)	79 (32.7)	39 (15.4)	0.03
Mean number of girlfriends you had sex with	1.7 ± 1.1	1.7 ± 1.0	1.9 ± 1.2	0.26
Used a condom in last sex with girlfriends	97 (82.2)	68 (86.1)	29 (74.4)	0.12
Had sex with boyfriends	206 (86.9)	126 (85.7)	80 (88.9)	0.48
Mean number of boyfriends you had sex with	2.4 ± 3.8	2.3 ± 3.5	2.6 ± 4.3	0.53
Used a condom in last sex with boyfriends	192 (92.8)	117 (92.9)	75 (92.6)	0.94
Had anal sex with boyfriends	196 (94.2)	116 (91.3)	80 (98.8)	0.03
Used condom in last anal sex with boyfriend	187 (92.1)	114 (94.2)	73 (89.0)	0.18
Sold sex to men	67 (17.0)	42 (17.4)	25 916.3)	0.78
Used condom when selling sex last time	63 (94.0)	40 (95.2)	23 (92.0)	0.59
Tested for HIV in the past 6 months	252 (64.0)	160 (66.4)	92 (60.1)	0.21
Been diagnosed with an STI	28 (7.1)	16 (6.6)	12 (7.9)	0.63

GHQ general health questionnaire, MSM men who have sex with men, STI sexually transmitted infection

Values are number (%) for categorical variables and mean ± SD for continuous variables

*Chi-square test or Fisher’s exact test was used as appropriate for categorical variables and Student’s t-test was used for continuous variables

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

By:  Yi S1, Tuot S1, Chhoun P2, Pal K2, Choub SC2, Mburu G3,4.

• 1Research Department, KHANA, Phnom Penh, Cambodia.
• 2Programs Department, KHANA, Phnom Penh, Cambodia.
• 3Program Impact Unit, International HIV/AIDS Alliance, Brighton, UK. gmburu@aidsalliance.org.
• 4Department of Health Research, Lancaster University, Lancaster, UK. gmburu@aidsalliance.org. 

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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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