Internalized homophobia and depression in homosexual and bisexual men and women: LGBT+ health survey, 2020. / Homofobia internalizada e depressão em mulheres e homens homossexuais e bissexuais: Inquérito de saúde LGBT+, 2020.

This study aimed to analyze the association between internalized homophobia and its domains and depression in homosexual and bisexual individuals and to quantify its results in depression. This is a cross-sectional online and anonymous study based on the LGBT+ health study conducted in Brazil from August to November, 2020, summing 926 respondents. Depression was self-reported. Internalized Homophobia was measured by the Brazilian Internalized Homophobia Scale for Gays and Lesbians, using 80% percentile to classify elevated total and by domain scores. Statistical analysis was based on Poisson Regression models with robust variance. Depression prevalence was 23.7%. The results revealed that internalized homophobia was positively associated with depression only among homosexuals (Prevalence Ratio (RP) = 1.80; 95% confidence interval (95%CI) 1.12-2.90). We found no statistical association for stigma and oppression domains. Population attributable fraction of depression was 2.3% (95%CI 0.1-4.5) in relation to internalized homophobia. Our findings highlight the need of controlling internalized homophobia to decrease the prevalence of depression among homosexuals.

Objetivou-se analisar a associação entre homofobia internalizada e seus domínios e a depressão em indivíduos homossexuais e bissexuais e quantificar o resultado da sua diminuição na depressão. Trata-se de um estudo transversal baseado em dados do inquérito de saúde LGBT+, realizado no Brasil entre agosto e novembro de 2020, de forma on-line e anônima, totalizado 926 participantes. A depressão foi avaliada por autorrelato. A homofobia internalizada foi medida pela Escala de Homofobia Internalizada para Gays e Lésbicas Brasileiros, adotando-se como escores elevados total e por domínio os percentis de 80%. A análise estatística baseou-se na regressão de Poisson com variância robusta. A prevalência de depressão foi de 23,7%. Os resultados mostraram que a homofobia internalizada associou-se positivamente à depressão apenas entre os homossexuais (Razão de Prevalência (RP) = 1,80; intervalo de confiança de 95% (IC95%) 1,12-2,90). Não houve associação com os domínios isolados de estigma e opressão. A fração atribuível populacional de depressão foi de 2,3% (IC95% 0,1-4,5) em relação à homofobia internalizada. Esses achados destacam a importância do combate à homofobia que é internalizada para a diminuição da depressão em indivíduos homossexuais.

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.

Sexist, Racist, and Homophobic Violence against Paramedics in a Single Canadian Site.

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between 1 February 2021 and 28 February 2022, two paramedic supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high inter-rater agreement across the dimensions (k = 0.73-0.83), and after resolving discrepant cases, we found that one in four violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience over the course of their work and its potential for psychological harm.

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.

When disability and homoparenting meet: the adoption of children with disability by same sex couples. / Quando a deficiência e a homoparentalidade se encontram: a adoção de crianças com deficiência por casais homoafetivos.

The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of children with disabilities, through the lenses of human and social sciences in public health. The reports were interpreted in light of studies on same-sex adoption and the adoption of children with disabilities. Feminist approaches related to care and disability were also included in the interpretative perspective, operating as expressive webs of grammars of ableism. It was found that media approaches endorse the right to family formation and the adoption of children with disabilities by homoparental families, but with little critical depth on the category of disability and without highlighting support for the adoption of all adoptee profiles. Moreover, the intersections between homophobia and ableism increase discriminatory and oppressive logics, with the union of social groups considered to be "undesirable" representing a strategy of governmentality that reveals the complexity of grammars of ableism, applied to the sexual and reproductive rights of LGBTQIA+ adopters and to the fundamental rights of children and adolescents with disabilities who are available for adoption.

O ensaio teórico parte de seis reportagens sobre casais homoafetivos e pessoas gays e lésbicas para interseccionar homoparentalidade e adoção de crianças com deficiência, pelas lentes das ciências humanas e sociais em saúde coletiva. As reportagens foram interpretadas à luz dos estudos sobre adoção homoparental e adoção de crianças com deficiência. Abordagens feministas sobre cuidado e deficiência também compuseram o olhar interpretativo, operando como teias expressivas das gramáticas do capacitismo. Verificou-se que as abordagens midiáticas endossam o direito à constituição familiar e à adoção de crianças com deficiência por famílias homoparentais, sem aprofundar criticamente a categoria deficiência e sem destacar apoio à adoção de todos os perfis de adotandos. E que as intersecções entre homofobia e capacitismo incrementam lógicas discriminatórias e de opressão, sendo a união de grupos considerados "indesejáveis" uma estratégia de governamentalidade que revela a complexidade das gramáticas do capacitismo aplicadas aos direitos sexuais e reprodutivos de adotantes LGBTQIA+ e aos direitos fundamentais de crianças e adolescentes com deficiência disponíveis para adoção.

Being out in high school: Positive implications for well-being in three U.S. cohorts of sexual minority adults.

For lesbian, gay, bisexual, or queer (i.e., sexual minority [SM]) youth, coming out is an important developmental milestone and is typically associated with positive well-being. However, coming out in high school may entail a higher risk of school-based victimization. Due to the greater risk of homophobic bullying, the implications of being out in adolescence and well-being later in adulthood remain unclear. Using data from a national probability survey (Generations Study) of three distinct age cohorts of SM adults (N = 1,474) in the United States, this study (a) examined how being out at school in adolescence affects general well-being in adulthood and (b) SM-specific well-being in adulthood, and (c) examined if these associations differ by cohort. Results from multivariate regression analyses demonstrated that being out in adolescence was not significantly associated with general well-being, but was significantly associated with SM-specific well-being: higher rates of identity centrality and community connectedness, and lower rates of internalized homophobia. There were no cohort differences in the associations between outness in high school, general well-being, and SM well-being. The findings from this national probability sample of SM adults provide novel insight into implications of being out across the life course, including the positive implications of being out at school in adolescence for SM-specific well-being in adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining Factors Associated with Cannabis Use Among Sexual and Gender Minority and Cisgender Heterosexual Emerging Adults in California.

Purpose: We explored correlates of cannabis risk and examined differences between sexual and gender minority (SGM) and cisgender heterosexual emerging adults (ages 18-29) in California. Methods: We recruited 1491 participants aged 18-29 years for a cross-sectional online survey. Ordinal logistic regressions assessed associations between minority stress (discrimination and internalized homophobia [IH]), social support (perceived social support and lesbian, gay, bisexual, transgender, and queer+ [LGBTQ+] community connectedness), and cannabis risk scores (low, medium, and high risk of developing problems related to their cannabis use). We also explored differences in cannabis risk scores by sexual orientation and gender identity (SOGI). Results: Higher everyday discrimination scores were associated with increased odds of self-scoring in a higher cannabis risk range (adjusted odds ratio = 1.53, 95% confidence interval [CI] = 1.31-1.79). We found no significant associations for IH, LGBTQ+ community connectedness, or social support on cannabis risk scores. There were also no statistically significant differences by SOGI groups; however, SOGI did moderate the relationship between IH and cannabis risk score such that the slope for IH was 0.43 units higher for cisgender sexual minority women compared to cisgender sexual minority men (95% CI = 0.05-0.81). Conclusion: Our findings suggest that experiences of everyday discrimination are important contributors to developing cannabis-related problems and IH may have more pronounced effects for sexual minority women compared to sexual minority men. More research is needed to better understand risk and protective factors of cannabis risk to inform the development of culturally tailored interventions for SGM emerging adults.

School Memories about Homophobic Bullying: A Study Based on Cultural-Historical Psychology.

The expression of homophobic violence in schools reveals the urgency of an analytical approach to debate the impact of this phenomenon on students' mental health. This article seeks to debate and better comprehend school memories from young gays, lesbians, and bisexuals, as well as to discuss how homophobic bullying affected their school trajectories. This study is based on cultural-historical psychology in intersection with gender and sexuality studies. In-depth online interviews were conducted with three young subjects who identified themselves as non-heterosexual. The interviews were recorded, transcribed, and analyzed through the analytical discourse tool defined as Nuclei of Meanings. The results were organized in two topics of discussion: (a) the problems associated with non-heterosexual identity in schools; (b) the search for other ways of experiencing sexual identity in school. Throughout the article, reflections were held about the challenges participants had to deal with in order to regularly attend school and be educated, as well as the obstacles they faced in building their own ways of recognizing their sexual identity. The unique ways in which these young subjects took a stand in the face of homophobic situations show new methods to create educational interventions in order to include sexual diversity and openness to different possibilities of being and acting.

An Experiment Using a Sexual Strategies Explanation to Alleviate Internalized Homophobia Among Men Who Have Sex With Men in China.

Some men who have sex with men (MSM) having more casual sex and sexual partners is interpreted to be a sign of mental disorder and used to justify negative attitudes toward them by some. MSM may internalize this attitude causing internalized homophobia (IH). According to the sexual strategies theory, MSM having more casual sex is the result of differences between men's and women's sexual strategies and is unrelated to sexual orientation. We investigated whether this explanation would reduce IH and improve mental health in MSM. We recruited 255 Chinese MSM online using Wenjuanxing, Douban, Weibo, Tieba, and Blued and divided them using simple randomization into an experimental group (n = 77; sexual strategies explanation provided), an active control group (n = 99; minority stress explanation provided), and a control group (n = 79; no intervention) with pretest (N = 255); a 1 week post-test (n = 195); and a 1 month follow-up test (n = 170) of outcome measures. IH, mental distress (MD), sort-term mating orientation, and risky sexual behaviors were measured online. The data were analyzed by SPSS 28. IH was associated with MD while being married was associated with IH and sexual contact with women with both more IH and MD as were not being masculine and self-identifying as straight. The sexual strategies explanation reduced IH related to pathologizing sexual behaviors and high-risk sexual behaviors while the minority stress explanation reduced MD. Providing a sexual strategies explanation may be used to de-stigmatize casual sex among MSM.

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.

African American Gatekeepers or the Black Church?: Using Modified Grounded Theory to Explore the Debate on Black Homophobia.

In a comparison of attitudes concerning same-sex relationships and inclusive policies for lesbian, gay, bisexual, transgender, and intersex (LGBTI) persons, African Americans are more likely to possess stronger opposition than Whites. The default agent in explaining disapproving attitudes is the Black Church. However, observations from 2017 expert interviews, part of a study on causes of Black homophobia, revealed that varying experts do not affirm the Black Church as the primary actor in sustaining these attitudes. Based on this observation, this study theorizes that attitudes considered homophobic are primarily sustained by actors distinct and separate from the Black Church. This study employs a modified grounded theory to explore themes toward the creation of an expert-driven narrative that disapproval of same-sex relationships and opposition to LGBTI policies are attitudes sustained by Black gatekeepers, as they see same-sex relationships and policy as oppositional to the Black identity and Black sociopolitical progress.

Scale of Sexual Prejudice Against Bisexuals: evidence of validity / Escala de Preconceito Sexual Contra Bissexuais: evidências de validade / Escala de Prejuicio Sexual Contra Bisexuales: evidencia de validez

Sexual prejudice against bisexuals is widespread in society. However, little research has been done on this phenomenon because it is difficult to measure. The aim of the current study was to validate a short version of the Biphobia Scale for the Brazilian context (EPSB-br). In the first study, the EPSB-br showed unifactorial structure and convergent validity with scales measuring beliefs and stereotypes about bisexuality. Study 2 showed the EPSB-br's convergent-discriminant validity with scales measuring religiosity, right-wing authoritarianism, social dominance orientation, and sleepiness. Finally, Study 3 demonstrated the criterion-related validity of the EPSB-br through an experimental manipulation in which participants watched a video of a pretend teacher and assigned a salary to it. Taken together, these results showed evidence of validity and reliability of the EPSB-br, which introduced a measure of prejudice against bisexual people in Brazil. (AU)

O preconceito sexual contra bissexuais é fortemente presente na sociedade. Entretanto, este fenômeno ainda é pouco estudado, dada a dificuldade em sua mensuração. O presente trabalho teve o objetivo de validar uma versão reduzida da Biphobia Scale para o contexto brasileiro. No primeiro estudo, a Escala de Preconceito Sexual contra Bissexuais (EPSB-br) apresentou uma estrutura unifatorial e uma validade convergente com escalas que mensuram crenças e estereótipos sobre a bissexualidade. O Estudo 2 evidenciou a validade concorrente-discriminante da EPSB-br com a religiosidade, escalas de autoritarismo de direita, orientação à dominância social e sonolência. Por fim, o Estudo 3 demonstrou a validade de critério da EPSB-br a partir de uma manipulação experimental, na qual os participantes assistiram a um vídeo sobre um professor e atribuíram-lhe um salário. A síntese dos resultados mostrou evidências de validade e confiabilidade da EPSB-br, introduzindo uma medida de preconceito contra pessoas bissexuais no Brasil. (AU)

Lo Prejuicio Sexual contra Bisexuales está muy presente en la sociedad. Sin embargo, es un fenómeno poco estudiado, dada la dificultad de medirlo. Este trabajo buscó validar una versión reducida de la Biphobia Scale para el contexto brasileño. En el primer estudio, la EPSB-br presentó una estructura unifactorial y validez convergente con escalas que miden creencias y estereotipos sobre la bisexualidad. El estudio 2 evidenció la validez concurrente-discriminante de la EPSB-br con escalas de religiosidad, autoritarismo de derecha, orientación al dominio social y somnolencia. Finalmente, el Estudio 3 demostró la validez de criterio de la EPSB-br a través de una manipulación experimental, donde los participantes vieron un video sobre un maestro y le asignaron un salario. La síntesis de los resultados mostró evidencia de validez y confiabilidad de la EPSB-br, introduciendo una medida de prejuicio contra las personas bisexuales en Brasil. (AU)

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.

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.

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.

Moral Disengagement Mechanisms and Personality Dimensions Implicit to Homophobia.

Recent advances in sexual equality and diversity have not been able to mitigate the serious problem of discrimination suffered by sexual minorities. The most serious cases involve violence and physical or psychological aggression towards sexual orientations that differ from the heterosexual norm. This research analyses the dimensions of the personality and the moral disengagement mechanisms related to homophobia and the predictive value they have for hostile attitudes towards sexual diversity. The sample was made up of 849 university students between 18 and 24 years of age. The instruments used were the Modern Homophobia Scale (MHS), the Mechanisms of Moral Disengagement Scale (MMDS), and the reduced version of the Neo Personality Inventory-Reduced Version (NEO-FFI). The results show the involvement of moral disengagement in homophobia. It highlights evidence of subtle intimidatory behaviour patterns of rejection towards homosexuality. Furthermore, the low levels in the dimensions of a friendly personality and openness to experiences can be seen to predict homophobic behaviour. Thus, young people fall back on diverse mechanisms of moral disengagement to justify harmful attitudes towards the LGTBI collective. The results of the research are particularly relevant and useful for setting up programmes aimed at preventing and mitigating this serious problem of sexual discrimination.

Internalized Homophobia, Body Dissatisfaction, Psychological Distress, and Nonsuicidal Self-Injury Among Young Sexual Minority Men in China.

Purpose: Sexual minority men (SMM) have been shown to be at high risk of nonsuicidal self-injury (NSSI). Internalized homophobia, body dissatisfaction, and psychological distress have been found to be related to NSSI among SMM, but few studies have focused on the mechanisms underlying these associations. Thus, the current study was conducted to examine the association between internalized homophobia and NSSI, and whether body dissatisfaction and psychological distress mediate this relationship among young SMM in China. Methods: In total, 264 young SMM (mean age, 22.00 ± 2.86 years) in Henan Province, China, participated in the study. A set of questionnaires were used to assess participants' internalized homophobia, body fat dissatisfaction, muscularity dissatisfaction, psychological distress, and NSSI. Correlation and mediation analyses were used to examine the data. Results: Internalized homophobia correlated positively with NSSI (r = 0.24, p < 0.001) among young SMM in China. This relationship was partly mediated by body fat dissatisfaction, muscularity dissatisfaction, and psychological distress. Conclusion: The study findings suggest that internalized homophobia is a risk factor for NSSI among young SMM in China, and that body fat and muscle dissatisfaction and psychological distress underlie the association between internalized homophobia and NSSI. In developing interventions targeting NSSI among SMM, the findings of the current study should be considered to improve intervention outcomes.

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.