A Pilot Study of Metacognitive Training in U.S. Republican Leaners: Reducing Polarization Toward LGBTIQ+ Persons.

Negative attitudes and stigmatization toward sexual minorities is a cause of minority stress of non-heterosexual persons on an individual level and has a negative impact on democratic coexistence in postmodern, plural society on a societal level. Derived from clinical research, we developed a short metacognitive training (MCT) intended to induce doubt toward inaccurate beliefs about LGBTIQ+ persons. We expected this MCT to reduce homonegativity, threat perceptions of LGBTIQ+ persons, and to foster extended outgroup tolerance compared to an education and a no-treatment control condition. We tested this hypothesis in U.S. Republican leaners who represent a social group that is likely to hold homonegative attitudes. We randomly assigned 490 U.S. Republican leaners to an MCT condition comprising 16 questions and respective answers (n = 166) vs. an education control condition (n = 164) vs. a no-treatment control condition (n = 160). We found that Republican leaners after receiving MCT (1) had a significant reduction of homonegativity (ds ≥ 0.28), (2) significantly perceived LGBTIQ+ persons as less threatening (ds ≥ 0.30), and (3) were significantly more tolerant of various outgroups such as LGBTIQ+ persons, feminists, liberals, and climate activists (ds ≥ 0.23) relative to both control conditions. The small effects of this short intervention and the possibility of systematically applying MCT in social discourse to reduce homonegativity with its potential significance for LGBTIQ+ individuals' mental health are discussed. Furthermore, we highlight this pilot study's significance toward intervention possibilities regarding political division and polarization in postmodern, democratic societies.

Heterosexual, Lesbian, and Gay Adults' Reactions to Same-Gender versus Other-Gender Flirtation: Findings from a German Study.

Using a vignette methodology, this study examined reactions to same-gender versus other-gender flirtation in a sample of 445 German young adults: 320 participants with a heterosexual orientation and 125 participants with a lesbian or gay (LG) orientation. Even in LG-friendly societies as Germany, receiving advances from someone of the same gender might still evoke heterosexuals' homonegativity. Another factor that might influence heterosexuals' reactions to same-gender flirtation is the fear of being misidentified as LG (social contagion concerns). Contrary to hypothesis, results provided little evidence to classify heterosexual participants' reactions to same-gender flirters as homonegative. Firstly, heterosexual participants showed the same degree of negative affect and avoidance behavior in the same-gender flirtation condition as LG participants did in the other-gender flirtation condition. Only positive affect scores were somewhat lower for heterosexual participants in the same-gender flirtation condition compared to LG participants in the other-gender flirtation condition. Secondly, when anti-LG attitudes and social contagion concerns were considered together, only social contagion concerns contributed to explaining variance in heterosexual participants' response to same-gender flirters. Specifically, the impact of social contagion concerns on heterosexual participants' avoidance of same-gender flirters was mediated by (lacking) positive affect, but not negative affect.

Individual-Level Psychosocial Resiliencies as Mediators of the Relationship Between Internalized Homophobia and Depressive Symptoms Among Middle-Aged and Older Men Living With and Without HIV.

Among sexual minority men (SMM), internalized homophobia (IH) has been consistently associated with increased depression symptoms. However, some SMM experiencing IH demonstrate resilience to buffer against depression symptoms. In this analysis, we used the Stress Process Model (SPM) as a conceptual framework to explore individual-level psychosocial resilience (ILPR) factors serving as a buffer of the IH-depression relationship. To utilize the SPM to explore whether four ILPR factors, including volunteerism, optimism, religiosity/spirituality, and global resiliency measure mediate the relationship between IH and depression symptoms among middle-aged and older SMM living with and without HIV. We used exploratory and confirmatory factor analysis to construct measurement models for the four ILPR factors. We examined whether the four ILPR factors mediated the IH-depression relationship. IH was significantly and positively associated with depression symptoms. There was a partial mediation of the IH-depression association by the four ILPR. Specifically, we found statistically significant indirect effects of optimism and the global resilience measure and supporting buffering effects of the IH-depression association. Although, the indirect effects religiosity/spirituality on the IH-depression relationship was significant, it did not support a buffering of effect. The indirect effects of volunteerism were not statistically significant. Our findings highlight the potential role of ILPR factors in the development of resilience against the negative effects of IH. Implications of these results for future research and practice are discussed.

Professional Help-Seeking in Men Experiencing Sexual Problems - The Role of Sexual Identity and Minority Stress.

BACKGROUND: Only a minority of men experiencing sexual problems will seek professional help and the proportion of gay or bisexual men can be even lower. AIM: To investigate if sexual identity and minority stress are related to professional help-seeking in Polish gay and bisexual men. METHODS: Sexual identity was measured with the standard question: "Do you consider yourself to be heterosexual, gay, or bisexual?" Men who provided a complete set of answers to the study tools and replied "yes" to the question: "Have you ever had a problem with sexual functioning that lasted at least several months?" were included (Ntotal =644, Nstraight = 203, Ngay = 324, Nbi = 117). A simple question on help-seeking was: "Did you seek professional assistance then?" Other data were gathered with the use of a self-constructed questionnaire. Minority stress processes, that is, internalized homophobia, expectations of rejection, and identity concealment, were measured with the subscales of the Sexual Minority Stress Scale. Bivariate analyses and multivariate logistic regressions were performed to test the statistical significance of sexual identity and minority stress processes as predictors of professional help-seeking. OUTCOMES: Contacting a specialist when experiencing a sexual problem. RESULTS: A total of 84.5% of all men did not seek professional help. Gay identity (OR = 0.58, P = .045), as opposed to bisexual identity, was significantly related to reduced odds of consulting a specialist. Age (OR = 1.03, P = .005), number of doctor's visits per year (OR = 1.51, P < .001), and a psychiatric diagnosis (OR = 1.65, P = .043) were positively related to help-seeking behaviors. Identity concealment significantly decreased the likelihood of consulting a specialist (OR = 0.94, P = .017). CLINICAL TRANSLATION: Specialists need to be aware that gay identity and identity concealment may prevent a proportion of men from seeking their help and thus should be publicly explicit about their inclusive and nonpathologizing approach to sexual diversity. STRENGTHS AND LIMITATIONS: The major strengths of the study include the use of a relatively large sample size and data from the little recognized Polish context characterized by a predominantly hostile anti-LGBT social climate, and exploration of a neglected topic of substantial significance at the public and individual levels. The major limitations are the use of nonprobability sampling, cross-sectional self-report design, and a single question to capture the presence of sexual problems with no measurement of associated distress. CONCLUSION: Gay men are at risk of avoiding help-seeking when experiencing sexual problems because of identity concealment. Grabski B., Kasparek K., Koziara K., et al. Professional Help-Seeking in Men Experiencing Sexual Problems - The Role of Sexual Identity and Minority Stress. J Sex Med 2022;19:1090-1097.

Childhood Gender Nonconformity and Recalled Perceived Parental and Peer Acceptance Thereof, Internalized Homophobia, and Psychological Well-Being Outcomes in Heterosexual and Gay Men from Poland.

The link between gender nonconformity and psychopathology may be due in part to negative childhood experiences resulting from other people's reactions to gender nonconformity. The aim of this study was to test whether recalled perceived levels of parental and peer acceptance of childhood gender nonconforming behaviors and play mediate the relationship of childhood gender nonconformity with depression and social anxiety in adulthood. We also tested whether this relationship was moderated by sexual orientation and, among gay men, whether internalized homophobia was an additional mediator. All variables were measured in a large sample of male participants using self-report (n = 449 gay men, age: M = 27.8 years, SD = 6.69; and n = 296 heterosexual men, age: M = 27.4 years, SD = 6.57) in Poland. Gay men reported more childhood gender nonconformity than heterosexual men. The relationship between gender nonconformity and depressive symptoms as well as social anxiety symptoms was significant in both gay and heterosexual men. Among gay men, this relationship was partially mediated by peer but not parental acceptance of the measured aspects of gender nonconformity and internalized homophobia. Among heterosexual men, recalled perceived parental acceptance of gender nonconformity partially mediated the relationship between gender nonconformity and depressive and social anxiety symptoms. Our findings were partially in line with those found in Western European and North American samples. Although the two groups differed in their recalled perceived gender nonconformity, they did not differ in their depression or social anxiety scores. Nevertheless, childhood gender nonconformity may be an indirect risk associated with mental health symptoms, irrespective of sexual orientation. Its higher prevalence among nonheterosexual individuals makes it a particular risk for this group.

Experiential Avoidance and Emotion Dysregulation as Mediators in the LGBTQ Minority Stress Model.

Gender and sexual minorities are at increased risk for psychological disorders compared to the general population. The minority stress model has been proposed to explain these elevated rates of psychological distress. Per this model, minority stress factors (e.g., prejudice, discrimination, rejection, internalized homophobia/ transphobia) combine to create a unique stress which negatively impacts the mental health of gender and sexual minority individuals. With support for the general minority stress model established, attention has turned to investigating possible mediators in this model. In other words, how does minority stress cause psychological distress and negative mental health outcomes? The aim of the present study was to investigate experiential avoidance and emotion dysregulation as potential mediators in the relationship between minority stress factors and psychological distress. Final parallel mediation models supported that experiential avoidance and emotion dysregulation were significant mediators in the relationship between minority stress variables and psychological distress. These final models support that minority stress experiences, experiential avoidance, and emotion dysregulation are all factors that contribute to psychological distress in gender and sexual minority individuals. The implications of these findings are discussed.

Internalized Homophobia and Suicide Ideation Among Sexual Minority Adults: The Serial Mediation of Core Self-Evaluations and Depression.

Internalized homophobia (IH) is the endorsement of negative attitudes and stereotypes about sexual minority individuals among those who are LGBQ + . However, although IH is associated with suicide ideation, the underlying mechanisms of this association are relatively understudied. To address this limitation, this research investigates Core Self-Evaluation (CSE; one's fundamental evaluations about themselves, their own abilities, and their own control) and depression as underlying mechanisms associating IH with suicide ideation. CSE comprises four traits: self-esteem, locus of control, emotional stability, and generalized self-efficacy. An online survey was completed by 404 sexual minority adults (Meanage = 27.42 years, %Female = 51.50, %Male = 30.40, %Trans Female = 3.2, %Trans Male = 5.4). Participants were recruited via Prolific, an online crowdsourcing platform. Four serial mediation analyses examined the direct and indirect effects of IH on suicide ideation via each CSE trait and depression symptoms. Results showed support for the CSE-depression mediated pathway. Self-esteem, emotional stability, and general self-efficacy (but not locus of control) mediated the relationship between IH and suicide ideation via depression symptoms. Across three serial mediations, greater IH was associated with lower (1) self-esteem, (2) emotional stability, and (3) self-efficacy; lower self-esteem, emotional stability, and self-efficacy were associated with greater reported depression symptoms, which were then associated with greater suicide ideation. This research has implications for understanding the underlying mechanisms that associate IH with poor mental health among sexual minority adults. Studying the social and psychological mechanisms can help develop therapeutic interventions that target suicide ideation and promote positive self-evaluations among sexual minority individuals.

Looking into the LGB affirmative therapies over the last fifty years - a mixed method review synthesis.

In the past few decades, affirmative therapies for sexual minorities have burgeoned. These are appropriate therapies but often there is a lack of adequate research. We set out to study the research evidence available. For this mixed-methods review, we identified 15 studies looking into the experiences of lesbian, gay and bisexual people in psychological therapies. These included nine qualitative, five quantitative and one mixed method studies. Minority stress hypothesis may explain some of the major difficulties LGB individuals face. Studies showed computer based therapies may reduce or even eliminate unhelpful responses on part of the therapist. Challenges related to confidentiality and privacy in this context remain. Therapists may focus on minority stress but other stressors and not just discrimination may contribute to various mental health problems and their clinical presence. And finally, divergent findings found internalized homophobia may best explain discrimination-based minority stress and that therapist self-disclosure of own sexuality produced better results than the therapists who did not self-disclose. These findings are discussed and future directions for research are identified.

Intercategorical and Intracategorical Experiences of Discrimination and HIV Prevalence Among Transgender Women in San Francisco, CA: A Quantitative Intersectionality Analysis.

Objectives. To examine differences in HIV prevalence and experiences of discrimination within the trans women community in California's San Francisco Bay Area.Methods. Intersectional positions were constructed on the basis of race/ethnicity (non-Hispanic White, non-Hispanic Black, Latina) and gender identity (female identifying, transgender identifying). We used baseline data from the Trans*National study (2016-2017) to construct regression models that estimated racial/ethnic differences in the attribution of discrimination experienced and, along with surrogate measures for intersectionality, estimated risk among those who were dually marginalized (racial/ethnic minority and transgender identifying). Margins plots were used to visually compare absolute risk across all intersectional positions.Results. Black and Latina trans women were more likely to be HIV positive than non-Hispanic White trans women. In several of the study domains, we estimated a lower risk of reporting discrimination among dually marginalized trans women than among White female-identifying trans women.Conclusions. Quantitative intersectionality methods highlight the diversity of experiences within the trans women community and reveal potential measurement challenges. Despite facing multiple forms of systemic marginalization, racial/ethnic minority trans women report less discrimination than White trans women. Subjective reporting of discrimination likely undercounts risks among racial/ethnic minorities.

Disgust sensitivity mediates the link between homophobia and sexual orientation obsessive-compulsive symptoms.

Previous research has shown that intrusive thoughts in obsessive-compulsive disorder (OCD) often focus on emotionally significant aspects of individuals' lives (e.g., values and beliefs). The current study sought to expand our understanding of OC symptoms related to sexual orientation (SO-OC symptoms) by investigating the roles of homophobia (i.e., negative attitudes, affect, and behaviors toward individuals with a same-gender orientation) and disgust propensity and sensitivity. A total of 592 self-identified heterosexual college students were recruited to complete measures of homophobia, disgust propensity and sensitivity, and SO-OC symptoms. Results of separate parallel mediation analyses indicated that the relationships between homophobic affect/attitudes and avoidance/aggression on one hand, and SO-OC symptoms on the other, were partially mediated specifically by disgust sensitivity, after controlling for gender. Theoretical and clinical implications are discussed, including how homophobia can be conceptualized as a disgust response in the treatment of SO-OC symptoms, as well as how other constructs of potential interest (sexual and moral disgust, religiosity, conservative sexual ideology) can be examined in future research.

Country level homophobia and protective sexual health behaviours among HIV negative or untested men who have sex with men in 45 countries.

Despite new, effective biomedical technologies to prevent the transmission of HIV, social and structural factors still impact the opportunity for gay, bisexual and other men who have sex with men (GBMSM) to access safe sexual health services. Within this paper we describe findings of a pilot analysis that seeks to identify relationships between country level homophobia, individual-level sexualised drug use and key sexual health protective behaviours in a sample of HIV negative men from 45 countries recruited via a large online survey. Responses to questions relating to HIV and STI testing history, use of pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) and engagement in sexualised drug use were treated as dependent variables within generalised linear mixed-effects model with logit link analysis, with country level homophobia (drawn from a recently published international index) operating as the dependent variable. In total, data from 9,356 respondents were included for analysis. Overall, uptake of behaviours known to be protective of sexual health overall was significantly lower in countries with high levels of homophobia. This paper is unique in linking a robust measure of country-level homophobia to engagement in health protective behaviours on a large-scale, multi-country level basis.

Psychometric Properties of the Spanish Version of the Homophobic Content Agent Target Scale Among Adolescent Students.

This study examined the psychometric properties and factor structure of the Spanish version of the Homophobic Content Agent Target (HCAT) scale in a sample of 1848 high school students. Participants completed an online survey including measures of homophobic bullying, depression, and anxiety. The factor structure showed adequate fit indices in Spanish adolescents similar to the original scale. An exploratory factor analysis showed a simple factor solution of two related factors strongly correlated describing the extent to which students use homophobic language (agent) and the extent to which students are called homophobic epithets (target) due to sexual orientation. The Spanish HCAT scale showed high Cronbach's alpha coefficient at the subscale score levels, as well as good convergent validity. This study contributes a Spanish-language validated measure of homophobic victimization to be used among adolescents. Implications for understanding homophobic bullying in adolescents are discussed.

Changes in Sexual and Gender Identity and Their Associations with Internalized Homophobia Among Black Men Who Have Sex with Men in the HPTN 061 BROTHERS Cohort.

Sexual and gender identity have frequently been assessed in public health research as static states. However, a substantial and growing body of evidence indicates that both identities may have greater potential for change over time than once supposed. Despite this evidence, research into adult identity change remains relatively limited. Using longitudinal data from 1553 Black men who have sex with men (BMSM) aged 18-68 years and recruited from study locations in six major cities across the country, we examined changes in sexual and gender identities over a period of 12 months. The results showed that sexual and gender identity did indeed change among adult BMSM. Additionally, we explored internalized homophobia (IH) as a potential driver of identity change and found that IH significantly impacts the degree and direction of change, with individuals who reported higher baseline IH more likely to demonstrate a shift toward a heterosexual/straight identity at 6 and 12 months. The results are discussed in light of what is known and unknown regarding identity change, and potential avenues for future research are explored.

Experiences of sexual and gender minorities in an urban enclave of Haiti: despised, beaten, stoned, stabbed, shot and raped.

Studies of sexual and gender minorities in Haiti and globally typically involve HIV research and programming with men who have sex with men. We conducted focus groups with individuals in Haiti's Cité Soleil slum whose assigned gender at birth matched neither their gender identity nor contextual heteronormative constructions of gender roles, i.e. transwomen and transmen. The Yogyakarta Principles provided the study framework. Focus group participants offered emic perspectives on overall well-being, identities, biopsychosocial strengths and HIV-protective and risk factors. We found that gender expression that conflicts with contextual norms evoked recurring, humiliating and intentionally injurious sexual assaults against participants, heightening their HIV risk; participants endured beatings, shootings, stabbings, stonings and socio-political violence. Lack of confidentiality and stigma hinder participants' access to scarce HIV resources. Indistinct boundaries between sexuality, gender identity and gender expression merged with traditional gender-based roles to perpetuate sexual violence towards transwomen by cisgender heterosexual men and by transmen towards cisgender heterosexual women. Despite resignation to omnipresent violence, participants showed resilience regarding gender identity. Needed are integrated socio-behavioural and health programmes to challenge existing gender inequities while providing training on human rights and HIV risk reduction for Haitian sexual and gender minorities.

Gay-Straight Alliances, Inclusive Policy, and School Climate: LGBTQ Youths' Experiences of Social Support and Bullying.

Gay-Straight Alliances (GSA) and school policies focused on support for lesbian, gay, bisexual, transgender, and queer/questioning youth may reduce bias-based bullying and enhance social supports in schools. Using multivariate regression, we tested the relationship between youth reports of the presence of GSAs and LGBTQ-focused policies, independently and mutually, with experiences bullying and perceived support (n = 1,061). Youth reported higher classmate support in the presence of GSAs and higher teacher support in the presence of LGBTQ-focused policies; the presence of both GSAs and LGBTQ-focused policies was associated with less bullying and higher perceived classmate and teacher support. The findings indicate that GSAs and LGBTQ-focused policies are distinctly and mutually important for fostering safer and more supportive school climates for youth.

Heroes against homophobia: does elevation uniquely block homophobia by inhibiting disgust?

Homophobia has decreased in past decades, but gut-level disgust towards gay men lingers. It has been suggested that disgust can be reduced by inducing its proposed opposite emotion, elevation. Research suggests elevation might reduce homophobia, but only general elevation (not elevation evoked by gay people) and general attitudes (rather than disgust) have been studied. Nor has elevation's effect on homophobia been differentiated from effects of related emotions, such as admiration or surprise. We pretested a series of news stories featuring either a gay man or a man of unspecified sexuality that were intended to distinctly elicit elevation, admiration, or surprise. We pre-registered the prediction that an elevation-inducing story would reduce negative attitudes by reducing disgust. In Study 1 (N = 593), participants who read elevation-inducing stories did not express more positive attitudes or less disgust towards gay men than those who read stories inducing admiration or surprise. The admiration stories elicited similar or lower levels of disgust than the elevation stories. Study 2 (N = 588), replicated the findings of Study 1 with improved stimuli and measures. Both studies suggest that elevation may not uniquely reduce homophobia, as elevation and admiration have similar effects on this prejudice.

Assessment of Couple Relationships Standards in Same-Sex Attracted Adults.

Relationship standards are beliefs about what makes a good romantic relationship. To date, no research on relationship standards in same-sex relationships has been conducted. This paper describes development of the Rainbow Couples Relationship Standards Scale (Rainbow CRSS). In common with measures of relationship standards developed with heterosexuals, the Rainbow CRSS assesses the importance people attach to Couple Bond standards (expression of love, caring, intimacy), Family Responsibility standards (extended family relations, maintenance of face and harmony), Religion, and Relationship Effort standards. The Rainbow CRSS also assesses three standards hypothesized to be of particular importance to same-sex couples: Relationship Outness (public disclosure of the relationship), Sexual Openness (acceptance of open sexual relationship), and Dyadic Coping with Homophobic discrimination. Participants were 414 same-sex attracted men and women who completed the Rainbow CRSS online, plus some validation scales. The Rainbow CRSS showed a coherent two-level factor structure that was similar to that in heterosexual couples for the Couple Bond and Family Responsibility Scales. Same-sex attracted people's standards were similar for men and women, and for singles versus those in a relationship. Same-sex attracted people's standards were very similar in endorsement of Couple Bond, Family Responsibility, Religion, and Relationship Effort standards to those of heterosexuals. The Relationship Outness and Dyadic Coping with Homophobia scales assessed potentially important standards that reflect some distinctive challenges for same-sex couple relationships.

La terapia familiar generalmente se ha conceptualizado como un proceso conversacional por medio del cual los terapeutas y los pacientes generan nuevos significados. Basándose en un estudio de tres años de prácticas conversacionales observables en procesos satisfactorios de terapia familiar de familias chilenas con un niño/adolescente que tiene comportamientos disruptivos, buscamos ejemplos clínicos de patrones interpersonales transformadores (PIT). Estos patrones son un aspecto clave del "IPscope" o instrumento de evaluación de los patrones interpersonales (Tomm, St. George, Wulff, & Strong, 2014), un marco que usamos para analizar los procesos de creación de significado en la terapia familiar. Los patrones interpersonales transformadores constituyen un enfoque innovador para analizar los procesos terapéuticos mediante el reconocimiento de prácticas conversacionales fáciles de seguir empíricamente que participan en la generación de "significados nuevos". Los patrones interpersonales transformadores intervienen en la presentación y la articulación discursiva ("convencer de crear") de las manersa preferidas de los pacientes de relacionarse y vivir (p. ej.: preferencias relacionales o PR). Analizamos datos conversacionales de sesiones/tratamientos satisfactorios de terapia familiar y presentamos un modelo emergente de cinco categorías de prácticas conversacionales que constituyen patrones interpersonales transformadores, por ejemplo: PIT preparatorios, PIT identificadores, PIT localizadores, PIT transformadores y PIT consolidadores. Los hemos llamado "realizadores" porque estas prácticas conversacionales ayudan a las familias a convencerlas de crear (o a "hacer realidad") preferencias relacionales particulares. También ofrecemos descriptores fáciles de usar de las subcategorías de los realizadores (p. ej.: PIT de medición) que pueden ayudar a los profesionales a reconocer, aprender y llevar a cabo estas invitaciones conversacionales. Se debaten las consecuencias teóricas y las futuras líneas de investigación.