Racialized Migrant Transgender Women Engaged in Sex Work: Double Binds and Identifications with the Community.

Racialized migrant transgender women engaged in sex work represent an understudied population. They face unique challenges resulting from their multiple marginalized identities, such as racialized transmisogyny. Since marginalized communities play a vital role in mitigating systemic stigma, it is essential to expand the literature on the community of this population. The present study used the frameworks of gender minority stress and intersectionality, along with a decolonial and transfeminist approach. Twenty participants aged between 28 and 66 years old (M = 43.15; SD = 10.49) took part in a semi-structured interview. Thematic analysis identified two main areas with ten corresponding themes. "The double bind of community" described the complex dynamics experienced by transgender refugees within their community, including (1) sex work between emancipation and exploitation, (2) non-prescribed treatments for gender affirmation, (3) negative experiences with the community, (4) positive impact of trans organizations, and (5) practical and economic support and exploitation. "The identification with the community" highlighted how participants positively or negatively identified with the community, containing: (6) awareness of one's privileges and oppressions, (7) internalized cisgenderism and assimilation, (8) gender euphoria; (9) sexual objectification, and (10) trans-generativity. The study evidenced the complex dynamics within marginalized communities. Trauma, stigma, and survival struggles can lead to violence and exploitation within the community. However, the community also has the potential to promote positive feelings and generativity. These findings have practical implications for social workers, healthcare practitioners, and researchers, emphasizing the need for appropriate and culturally competent care, including resources for coping with stress, fostering resilience, and facilitating post-traumatic growth.

Feeling safe and content: Relationship to internalized sexual stigma, self-awareness, and identity uncertainty in Italian lesbian and bisexual women.

Research has linked feelings of safety and contentment to lower adverse mental health outcomes (e.g., stress, anxiety, depression) in the general population. The current study aimed at exploring the relationship between safe/content positive affect and minority stress (e.g., internalized sexual stigma) in lesbian and bisexual women, considering the effect of potential mediators such as identity self-awareness and identity uncertainty. An online survey was administered to 400 Italian women (220 lesbian and 180 bisexual women), aged 18-40 years (M = 25.98, SD = 6.07). The results showed that lesbian women reported lower internalized sexual stigma and identity uncertainty and higher safe/content positive affect and identity self-awareness, relative to bisexual women. Higher internalized sexual stigma predicted lower safe/content positive affect, regardless of sexual orientation. Furthermore, identity self-awareness and identity uncertainty significantly mediated the relationship between internalized sexual stigma and safe/content feelings, thus confirming the protective role of sexual identity variables on lesbian and bisexual women's positive affectivity. Finally, univariate analyses suggested that lesbian women were more resilient than bisexual women in the face of minority stressors. The results contribute to the understanding of the differences between lesbian and bisexual women in their perception of salient identity categories. In addition, the findings highlight the relevance of protective factors (e.g., identity certainty, lesbian and bisexual positive identity) in ameliorating the adverse effects of minority stress and promoting positive affect and social adjustment in lesbian and bisexual women. Research and clinical implications and directions are discussed.

Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use.

BACKGROUND: Most studies on chemsex focus on the health risks associated with the practice, whereas less attention has been paid to the perception of sexual gratification in men who have sex with men (MSM) who use these substances. AIM: The purpose of this study was to explore the effects of chemsex substances on sexual response, motivations to engage in chemsex and the relationship with sober sex. METHODS: Thirty-one Italian cisgender MSM involved in sexualized drug use were interviewed and transcripts were thematically analyzed. OUTCOMES: An ad hoc grid exploring sociodemographic data, chemsex sexual experience, motives, and relationships with sober sex was used during telephone-based interviews. RESULTS: Participants showed significant individual differences in how chems may affect their sexual experience. The most reported effects were an increase in sexual desire and subjective arousal, access to higher disinhibition, possible erection and ejaculation difficulties, significant extension of the sexual experience duration, and an intensified perception of intimacy and pleasure. All the positive outcomes of substances on sex creates a great curiosity around chemsex, which is among the primary motives to engage in chemsex for the first time. Over time, other motives may emerge, also connected to substance abuse and craving. Some men reported to be motivated by their partners and friends and to use chemsex to cope with depressive mood/anxiety symptoms, stress and sexual problems. Many differences were reported between chemsex and sober sex. Chemsex seems to embody the idea of transgressive and exciting sex, while sober sex is outlined as a more intimate encounter, that can be significantly affected by performance anxiety. CLINICAL TRANSLATION: These results offer some new perspectives that may add interesting information to the literature and be fundamental for future prevention and harm-reduction projects. STRENGTHS & LIMITATIONS: Although this study is based on a small group of Italian MSM and the interviews were not audio-recorded, transcripts were consistent with scientific literature that considers it important to pay attention to the positive links between sex and substance use. CONCLUSION: The promotion of safer sexual behavior should contemplate an in-depth discussion and recognition of both pleasurable and distressing aspects of chemsex sexual experience, its motivations over time and perceived differences with sober sex. Nimbi FM, Rosati F, Esposito RM, et al. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021;18:1955-1969.

Aging well in an aging society: physical health in older lesbian, gay, and bisexual adults.

Introduction: Older sexual minority people meet a double stigma in our society related to their sexual identity and chronological age. The present study explores how experiences of discrimination and prejudice, coming out, and personal resiliency influence physical health of older lesbian, gay, and bisexual (LGB) adults. Methods: Respondents were recruited through online advertisements and an online-based survey. The sample included 82 Italian cisgender LGB adults over 65 years: young older adults (65-70 years; 78%) and old-old adults (over 71 years; 22%). Regarding sexual orientation, the sample was composed of sexual minority women (n = 30; 37%) and sexual minority men (n = 52; 63%). Results: ANOVAs' findings showed that sexual minority women described lower levels of physical health compared to sexual minority men. At the same time, old-old adults reported higher experiences of discrimination and prejudice compared to young older adults. Moreover, findings from hierarchical multiple regression analysis described that coming out, higher levels of personal resiliency, and fewer experiences of discrimination were predictors of physical health, regardless of age and sexual minority categories. Conclusion: These findings seem to align with previous studies that underline the relevance of investigating aging well in sexual minority people. Knowledge and awareness of LGBTQ+ issues are necessary for recognizing the unique needs and resources of older LGB people for promoting a healthy aging process.

Non-Binary Clients' Experiences of Psychotherapy: Uncomfortable and Affirmative Approaches.

Non-binary people may face specific challenges in psychological settings. Psychotherapists often display a lack of preparation for non-binary gender identities, resulting in overt or subtle forms of prejudice that compromise the therapeutic alliance. The present study aimed to provide data on non-binary clients' positive and negative experiences within therapeutic relationships. Twenty-five interviews were conducted with non-binary people in the age range of 19-35. Using codebook thematic analysis, the researchers identified three main themes: (1) the self of the psychotherapist, consisting of the impact of the therapist's personal (i.e., sexual identity) and professional (i.e., competence) characteristics on the therapeutic experience; (2) the practice of the psychotherapist, emerging as affirmative (validation and microaffirmations) or negative (gender identity change efforts, manifest aggressions, and microaggressions) approaches toward non-binary identities; (3) the therapeutic relationship, referring to the alliance, rupture, and reparation based on the therapists' openness toward non-binary identities. To provide a safer setting for non-binary clients, psychotherapists should incorporate issues related to gender minority identities in their training, acknowledge clinical errors when they occur and adopt an active predisposition to learn through the client's experience, giving value to their unique contribution.

Experiences of Life and Intersectionality of Transgender Refugees Living in Italy: A Qualitative Approach.

Transgender refugees are at risk of experiencing increased minority stress due to experiences of trauma in their country of origin, and the intersection of multiple marginalized identities in their host country. Adopting a transfeminist and decolonial approach, the present study aimed at exploring transgender refugees' experiences of life and migration. A semi-structured interview protocol was developed, grounded in the perspectives of minority stress and intersectionality. Participants were five transgender refugees (four women and one non-binary) from different cultural/geographic contexts, professing different religions. Using thematic analysis, the researchers identified three themes: pre- and post-migration minority stress and transphobia; religion as a protective factor for gender affirmation; and individuation and the synthesis of social identities. Participants reported traumatic experiences and the inability to openly live out their gender identity in their country of origin as the main push factors to migration. They also reported feelings of isolation and experiences of victimization during interactions with the Italian asylum services, due to a lack of adequate training, racial prejudice, and transphobia. Participants demonstrated positive individuation, linked to gender affirmation treatments and religious protective factors. The interview protocol may be used by social operators to support the claims of transgender asylum seekers, and to clinically assess transgender people with an immigrant background.