I was born this way: New research confirms that a mix of prenatal factors and genetic differences could explain human sexual orientation: New research confirms that a mix of prenatal factors and genetic differences could explain human sexual orientation.

Homosexuality has been a constant throughout human evolution and civilization, and yet, science has been slow to look at the causes of sexual preferences.

The City Clinic Cohort Study: Hepatitis B, HTLV-III/LAV, and CDC AIDS Project 24.

Anticipating the availability of a safe vaccine, scientists at the Center for Disease Control (CDC) planned for a multicenter study of the prevalence, incidence, and efficacy of an experimental vaccine for hepatitis B in 1977, conducted the study among homosexual male volunteers in five collaborating sexually transmitted infection (STI) clinics in the United States from April 1978 through 1980, and concluded that the candidate vaccine was highly efficacious in preventing infections with the hepatitis B virus. Then something completely unexpected and portentous happened. Some successfully vaccinated as well as other homosexual and bisexual men began to show signs and symptoms of a rare cancer, Kaposi's sarcoma, and opportunistic infections typically associated with severe immunodeficiency. As early as October 1983, members of the Hepatitis B study cohort in San Francisco were invited to return to the city STI clinic for further examinations, testing, and confidential interviews about their sexual and other practices. CDC AIDS Project 24 was designed to help describe the natural history of AIDS, define risk factors, and predict future trends. It produced some of the earliest and most convincing scientific evidence about the seriousness and extent of the AIDS epidemic among homosexual and bisexual men in the United States. How the City Clinic Cohort Study came about and evolved is the focus of this commentary.

RESUMEN: Anticipando la disponibilidad de una vacuna segura, los científicos del Centro para el Control de Enfermedades (CDC) planearon un estudio multicéntrico sobre la prevalencia, incidencia y eficacia de una vacuna experimental contra la hepatitis B en 1977; realizaron el estudio entre voluntarios varones homosexuales en cinco colaboraron con clínicas de infecciones de transmisión sexual (ITS) en los Estados Unidos desde abril de 1978 hasta 1980, y concluyeron que la vacuna candidata era muy eficaz para prevenir infecciones por el virus de la hepatitis B. Entonces sucedió algo completamente inesperado y portentoso. Algunos hombres vacunados con éxito, así como otros hombres homosexuales y bisexuales, comenzaron a mostrar signos y síntomas de un cáncer poco común, el sarcoma de Kaposi, e infecciones oportunistas típicamente asociadas con una inmunodeficiencia grave. Ya en octubre de 1983, se invitó a los miembros de la cohorte del estudio de la hepatitis B en San Francisco a regresar a la clínica de ITS de la ciudad para realizar más exámenes, pruebas y entrevistas confidenciales sobre sus prácticas sexuales y de otro tipo. El Proyecto 24 del CDC sobre SIDA fue diseñado para ayudar a describir la historia natural del SIDA, definir factores de riesgo y predecir tendencias futuras. Produjo algunas de las primeras y más convincentes pruebas científicas sobre la gravedad y el alcance de la epidemia de SIDA entre los hombres homosexuales y bisexuales en los Estados Unidos. El tema central de este comentario es cómo surgió y evolucionó el estudio de cohorte de City Clinic.

What Do Different People Look for in a Partner? Effects of Sex, Sexual Orientation, and Mating Strategies on Partner Preferences.

Partner preferences are an important differential in relationship formation and evolutionary fitness, and vary according to individual, ecological, and social factors. In this study, we evaluated the variation in preference for intelligence, kindness, physical attractiveness, health, and socioeconomic level among individuals of different sexes and sexual orientations in a Brazilian sample. We analyzed the preference scores of 778 heterosexual, bisexual, and homosexual men and women in three budgeted mate design tasks (low vs. medium vs. high budget) and their association with sociosexuality, attachment styles, homogamy, and willingness to engage in short- and long-term relationships. Results indicated a global trait preference order, with intelligence ranking first, followed by kindness, physical attractiveness, health, and lastly by socioeconomic status. Typical sex differences were observed mostly within the heterosexual group, and specific combinations of sex and sexual orientation were linked to variation in preference for physical attractiveness, kindness, and socioeconomic status. We also found unique associations of the other variables with partner preferences and with willingness to engage in short- or long-term relationships. By exploring the partner preferences of non-heterosexual individuals from a Latin American country, an underrepresented group in evolutionary psychology research, our results help understand the universal and specific factors that guide partner preferences and human sexual behavior.

Sexual Attraction and Non-Suicidal Self-Harm: The Role of Stressors and Psychological Mediators.

Non-suicidal self-harm (NSSH) is a serious concern for the well-being of youth. Stressors relate to greater NSSH risk, such as being non-heterosexual in a heteronormative society. Other stressors may include traumatic experiences. These relationships may be mediated by psychological factors (depressed mood, anxiety, anger, and self-esteem) as well as contextual factors (support from parents and peers). The purpose of this study was to examine NSHH ideation and behavior among Icelandic youth, as well as relationships with stressors and mediators. Students in Icelandic high schools (N = 8921, 50.8% female) completed an in-class survey in the year 2016. Results showed an elevated risk of NSSH ideation and behavior among bisexual and homosexual youth. Mediation analyses showed that, for girls, being bisexual related to greater NSSH ideation and behavior, and these relationships were mediated by depressed mood, anger, and self-esteem, as well as by support from parents and peers. For boys, however, both homosexual and bisexual attraction related to greater risk for NSSH ideation and behavior, which was mediated by depressed mood, anger, and self-esteem. These results suggest that NSSH risk factors vary by gender and, therefore, they may benefit from different interventions to stop and prevent this behavior. This is the first study of its kind in Iceland, where sexual minority stress may need further study within the Nordic context.

Divergence in Chinese Sexual Attitudes: An Age-Period-Cohort Analysis.

A crucial component of comprehending societal change is understanding how sexual attitudes have evolved over time. The substantial and typical changes in China have created an ideal quasi-experimental design and a wealth of empirical data for tracking the evolution of sexual attitudes. However, existing research has failed to adequately analyze the temporal trends in Chinese sexual attitudes. This study employed an age-period-cohort framework to investigate changes in public sexual attitudes, including premarital sex, extramarital sex, and homosexuality. And it further delved into these attitudes in light of two unique aspects of Chinese society: urban-rural divide and political status. It explored the contributing elements and potential processes of changing public sexual attitudes in China using data from seven waves of national social survey conducted from 2010 to 2021. The findings indicated that public sexual attitudes became more conservative with age; the period effect exhibited a fluctuating upward trend, indicating a general increase in acceptance of the three sexual attitudes; notable differences in sexual attitudes among cohorts were identified. The divergence in sexual attitudes was significantly influenced by urban-rural divide and political status.

Iatrogenic necropolitics: forced anal examinations and state-sanctioned homophobia.

In 2016, Human Rights Watch, an international human rights organisation, published a report on the use of forced anal examinations to identify and prosecute putative 'homosexuals'. The report provided detailed descriptions and first-person accounts of these examinations in several countries in the Middle East and Africa. Drawing on theories of iatrogenesis and queer necropolitics, this paper uses these accounts and other reports of forced anal examinations to explore the role of medical providers in the 'diagnosis' and prosecution of homosexuality. The goal of these medical examinations is explicitly punitive rather than therapeutic, making them quintessential examples of iatrogenic clinical encounters which harm rather than heal. We argue that these examinations naturalise socioculturally derived beliefs about bodies and gender that construct homosexuality as 'readable' on the body through close medical inspection. These acts of inspection and 'diagnosis' reveal broader hegemonic state narratives of heteronormative gender and sexuality, both within countries as well as internationally as different state actors circulate and share these narratives. This article highlights the entanglement of medical and state actors, as well as contextualises the practice of forced anal examination within its colonial roots. Our analysis offers the potential for advocacy and holding medical professions and states accountable.

Wakefield's Harm-Based Critique of the Biostatistical Theory.

Jerome Wakefield criticizes my biostatistical analysis of the pathological-as statistically subnormal biological part-functional ability relative to species, sex, and age-for its lack of a harm clause. He first charges me with ignoring two general distinctions: biological versus medical pathology, and disease of a part versus disease of a whole organism. He then offers 10 counterexamples that, he says, are harmless dysfunctions but not medical disorders. Wakefield ends by arguing that we need a harm clause to explain American psychiatry's 1973 decision to declassify homosexuality. I reply, first, that his two distinctions are philosophic fantasies alien to medical usage, invented only to save his own harmful-dysfunction analysis (HDA) from a host of obvious counterexamples. In any case, they do not coincide with the harmless/harmful distinction. In reality, medicine admits countless chronic diseases that are, contrary to Wakefield, subclinical for most of their course, as well as many kinds of typically harmless skin pathology. As for his 10 counterexamples, no medical source he cites describes them as he does. I argue that none of his examples contradicts the biostatistical analysis: all either are not part-dysfunctions (situs inversus, incompetent sperm, normal-flora infection) or are indeed classified as medical disorders (donated kidney, Typhoid Mary's carrier status, latent tuberculosis or HIV, cherry angiomas). And if Wakefield's HDA fits psychiatry, the fact that it does not fit medicine casts doubt on psychiatry's status as a medical specialty.

Is football coming out? Anti-gay attitudes, social desirability, and pluralistic ignorance in amateur and professional football.

Past work consistently points to improved attitudes towards gay athletes and growing support for homosexuality, yet reports of a homophobic climate in amateur and professional football persist. Here, we explore two potential explanations for the prevalence of homophobia in football despite low levels of anti-gay attitudes: social desirability and pluralistic ignorance. We conduct an online survey among a football-affine and socio-demographically diverse sample in the UK. We find that anti-gay attitudes are rare. Importantly, estimates from a list experiment do not differ from the prevalence measured by direct questions, providing no evidence of social desirability. By contrast, second-order beliefs about anti-gay attitudes substantially and consistently exceed attitudes, pointing towards pluralistic ignorance as the most likely explanation. We conclude by emphasizing the need for transparent communication to reduce pluralistic ignorance and correct misperceptions among players, officials and supporters.

Changing attitudes toward homosexuality in South Korea, 1996-2018.

Women are often considered more liberal than men on controversial social issues, but gender gaps in sociopolitical attitudes across different age groups have not been fully explored. This study challenges the taken-for-granted gender differences in public attitudes toward homosexuality by examining both between-gender gaps and within-gender changes across the life course. Using data from five waves of the World Values Survey in South Korea, we explore gender and age differences in Korean adults' attitudes toward homosexuality from 1996 to 2018. Consistent with previous research, people become more conservative as they get older, and in general, women are more accepting of homosexuality than men, accounting for sociodemographic covariates. However, this gender difference is conditioned by people's life stages. Only among young adults (aged 18-29) were female respondents more accepting of homosexuality than their male counterparts. For people aged 30 and older, there are no significant gender differences in attitudes, and for both women and men, homosexuality is mostly unacceptable during their mid (aged 50-59) and late adulthood (aged 60+). Further mediation investigation has shown gendered mechanisms behind age differences in homosexuality acceptability. For both women and men, traditional family/gender attitudes provide significant explanations about age differences in homosexuality, while for women, not for men, family status, especially the number of children, makes older women more conservative in homosexuality issues. We suggest that heteropatriarchal social structures may lead to a resistance to attitudinal changes in non-traditional family forms, such as homosexuality.

Deep Learning in the Identification of Electroencephalogram Sources Associated with Sexual Orientation.

INTRODUCTION: It is unclear if sexual orientation is a biological trait that has neurofunctional footprints. With deep learning, the power to classify biological datasets without an a priori selection of features has increased by magnitudes. The aim of this study was to correctly classify resting-state electroencephalogram (EEG) data from males with different sexual orientation using deep learning and to explore techniques to identify the learned distinguishing features. METHODS: Three cohorts (homosexual men, heterosexual men, and a mixed sex cohort), one pretrained network on sex classification, and one newly trained network for sexual orientation classification were used to classify sex. Further, Grad-CAM methodology and source localization were used to identify the spatiotemporal patterns that were used for differentiation by the networks. RESULTS: Using a pretrained network for classification of males and females, no differences existed between classification of homosexual and heterosexual males. The newly trained network was able, however, to correctly classify the cohorts with a total accuracy of 83%. The retrograde activation using Grad-CAM technology yielded distinctive functional EEG patterns in the Brodmann area 40 and 1 when combined with Fourier analysis and a source localization. DISCUSSION: This study shows that electrophysiological trait markers of male sexual orientation can be identified using deep learning. These patterns are different from the differentiating signatures of males and females in a resting-state EEG.

The care status and factors affecting antiretroviral therapy timing for people living with HIV: a retrospective cohort study in Shandong Province, China.

This study described the care status of People Living with HIV (PLWH) including antiretroviral therapy (ART) and viral suppression from 2018 to 2020. We recognized that immediate ART was associated with improved viral suppression. Therefore, we also aimed to explore the factors affecting the early initiation of ART. We initiated a retrospective cohort study to evaluate the care status of people living with HIV in Shandong Province. From 2018 to 2020, patients infected by homosexual transmission in particular had a higher ART rate (78.82%, 79.69%, and 87.72%, respectively). Of PLWH who received ART, 79.57%, 77.63%, and 67.71% achieved viral suppression, respectively. However, COVID-19 may affect the rate of ART and viral suppression, which we need to explore in our research. From 2018 to 2020, the proportion of immediate antiretroviral therapy within 30 days of diagnosis increased from 48.12% to 65.42%. Multivariate logistic regression demonstrated that patients with junior college degree or above (OR, 1.39 [95%CI, 1.12-1.73]) and key population or medical institutions (OR, 3.62 [95%CI, 2.18-6.16]; OR, 3.88 [95%CI, 2.33-6.59]) were substantially likely to receive ART immediately, while patients outside the province (OR, 0.60 [95%CI, 0.50-0.73]) were less likely to receive ART immediately.

Homopositivity Across Europe: Predictors, Pathways, and Moderators.

Although homopositivity, the attitudinal acceptance of homosexuality, has generally increased across Western societies, there remains considerable homonegativity across certain regions of the world as well as certain demographic and socioeconomic groups. Although previous cross-national research has successfully identified the key factors affecting homopositive attitudes, the literature neglects both potentially key mediation pathways and moderating interactions between those factors that may unlock more nuanced understanding of these variations in homopositive attitudes across individuals and places. In response, the present study innovatively applied a multivariate structural equation modelling approach to the latest Wave 9 (2018 data) of the large-scale cross-national European Social Survey data in order to shed new light on these currently neglected predictors, pathways, and moderating influences on homopositive attitudes. It used a three-item latent variable to measure the homopositive attitudes outcomes construct. Its explanatory variables were focused across three key sets of factors identified in theoretical and empirical literature (socioeconomics, religiosity, and values) alongside various wider controls. Our analyses made several innovative methodological and empirical contributions to existing debate. Key innovative findings include the original identification of important indirect effects of religious beliefs on homopositive attitudes via religious practices, important indirect effects of education on homopositive attitudes via household income, and the role of national welfare regimes to homopositive attitudes (and with its effects interestingly not moderated by household income).

Impact of Internal Migration on Sexual Attitudes in China: The Moderating Role of Internet Use.

Using nationally representative data from China, this paper investigated the impact of internal migration on sexual attitudes and whether this relationship is moderated by Internet use. We provide evidence that internal migration had a significantly positive impact on attitudes toward the acceptance of premarital sex, extramarital sex, and homosexuality. We also found that the positive nexus between internal migration and sexual attitudes was moderated by Internet use. The results further indicated that internal migration influenced sexual attitudes through extrication from traditional gender role values, the deterioration of subjective well-being, and the improvement of economic status.

Homosexual Courtship in Young Wild Capuchin Monkeys: A Case Study.

In primates, many species exhibit same-sex sexual behaviors (SSB), defined as "genital contact or genital manipulation between same-sex individuals." Several sociosexual functions have been proposed, including proceptivity enhancement, receptivity reduction, dominance assertion, practice for heterosexual copulation, tension regulation, reconciliation, and alliance formation. Capuchin monkeys are known for their rich and flexible sexual behavioral repertoire and elaborated courtships. At present, the few reports of SSB in capuchin monkeys (genera Sapajus and Cebus) focused on mounting. Here, we describe the case observed in a population of wild yellow-breasted capuchin monkeys (Sapajus xanthosternos) in which two young males, aged 5-6 years and 19 months, performed a 15-min uninterrupted sequence of courtship behaviors and mounting. Comparing with a previously established ethogram of 20 behaviors typical for heterosexual behavior of tufted capuchins, we show that these males performed 16 of them. Thus, SSBs are already present in the repertoire of young individuals and the practice may serve to create or strengthen bonds. Although same-sex mounting and genital inspection are common in capuchins' play and other social interactions, the almost entire array of courtship behaviors has never been observed in youngsters. Additionally, this example supports the notion that primate (homo)sexual behavior is not limited to genitalia and copulation, since the observed courtship included diverse behaviors different from genital contact. Thus, we propose a broader definition of sexual behavior.

British mental healthcare responses to adult homosexuality and gender non-conforming children at the turn of the twenty-first century.

The roots of the recent controversy about how mental health professionals should respond to gender non-conforming children are traced. To make historical sense, this paper distinguishes between epistemological (discursive) and ontological (non-discursive) aspects and describes their features, since 1970. This helps to clarify some of the confusions at the centre of the still heated debate about sexuality and gender identity today. In the concluding discussion, the philosophical resource of critical realism is used to interpret the historical narrative provided. It cautions against the anachronistic tendency to amalgamate the short-lived, and now defunct, experiment of aversion therapy for homosexuality with more recent defences of exploratory psychotherapy. The latter have challenged a different form of experimentation: the bio-medicalisation of gender non-conforming children.

Science, Scripture, and Sexuality: The US United Methodist Church at Crossroads.

During the past 50 years, medical and behavioral scientists have made great progress in understanding the variables which influence the development of sexual orientation, identity, and consequent behavior. In most instances, homosexuality is influenced by hormonal, genetic, and immunologic variables during fetal development, and the effects cannot usually be altered without consequence. The recent struggle within The United Methodist Church in the USA reflects the difficulty that society in general has with accepting homosexuality as part of the spectrum of sexuality. Hopefully, understanding the factors influencing sexual orientation will aid in reducing prejudice and eventually bring an end to the pain endured by the LGBTQ community, and the conflict within The United Methodist Church, a prototype of the struggle.

Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations.

This article provides an overview of the current literature on seven cancer sites that may disproportionately affect lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. For each cancer site, the authors present and discuss the descriptive statistics, primary prevention, secondary prevention and preclinical disease, tertiary prevention and late-stage disease, and clinical implications. Finally, an overview of psychosocial factors related to cancer survivorship is offered as well as strategies for improving access to care.

Characteristics of heterosexually-acquired compared to homosexually-acquired HIV and implications for clinical practice: results from the Australian HIV Observational Database.

Heterosexuals living with HIV report feeling additional HIV stigma compared to homosexual men, which may affect clinical outcomes. Yet, beyond routinely collected surveillance data, little is known about the characteristics of individuals who acquire HIV heterosexually and clinical outcomes by mode of sexual acquisition have not been directly compared. Using data from the Australian HIV Observational Database, we compared clinical characteristics of those with heterosexually-acquired (Het-HIV) to homosexually-acquired HIV (Hom-HIV) to investigate any differences and their implications for clinical management. 513 Het-HIV and 1467 Hom-HIV patients were included and contributed 3,127 and 9,457 person-years of follow-up, respectively. Compared with Hom-HIV, Het-HIV were more often born outside Australia (62.5% vs 39.9%, p<0.001), less likely to have Hepatitis C (4.8% vs 7.8%, p=0.029) and had lower median CD4 counts at diagnosis (292 vs 450 cells/µL, p<0.001) and cART initiation (270 vs 340 cells/µL, p<0.001). Despite these lower CD4 counts, there were no significant differences between groups for time to the major clinical endpoints of cART initiation, viral suppression, virological failure or all-cause mortality. Het-HIV had a lower risk of loss-to-follow-up than Hom-HIV (aHR 0.78; 95% CI 0.64-0.95). Further studies examining factors associated with, and interventions to inform retention in care are required.