Saving Lives: Suicide Prevention in LGBTQ Youth.

Suicide in young people is a challenge, but suicide rates in lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) youth are alarming. The current article explores the influence of several social determinates of health, specifically mental health care access and quality and education, on suicide among LGBTQ youth. Providers must recognize the mental health challenges and disparities in LGBTQ youth and address them to improve mental health and decrease suicide rates. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 6-8.].

Lesbian and bisexual couples experiencing dual motherhood: (dis)encounters in the provision of healthcare. / Casais de mulheres lésbicas e bissexuais que vivenciam a dupla maternidade: (des)encontros na produção do cuidado em saúde.

The bond with healthcare services is a crucial dimension in facilitating the maternal journey of lesbian and bisexual women couples. This study aimed to analyze the culturally constructed meanings regarding the bond with healthcare services and professionals by lesbian and bisexual women who experienced dual motherhood. It is a qualitative investigation grounded in interpretative anthropology. The research corpus was built based on in-depth interviews with 10 lesbian and bisexual women, aged 30 to 39 years. The results indicate that access to parenthood, until its realization, involved a journey permeated by satisfactions and sufferings triggered by failed attempts and gestational losses. Challenges experienced in healthcare provision were also reported due to prejudices, lack of empathy, and unpreparedness of professionals in dealing with prenatal care for lesbian and bisexual women couples. Manifestations of discrimination were more pronounced concerning non-gestational mothers. The findings offer insights into implementing policies that prioritize humanization and planning programs and healthcare services based on culturally sensitive care for lesbian and bisexual women couples as they transition into dual motherhood.

O vínculo com os serviços de saúde é uma dimensão crucial para viabilizar o projeto materno de casais de mulheres lésbicas e bissexuais. Este estudo teve como objetivo analisar os significados culturalmente construídos sobre o vínculo com os serviços e profissionais de saúde por mulheres lésbicas e bissexuais que vivenciaram a dupla maternidade. Investigação qualitativa fundamentada na antropologia interpretativa. O corpus de pesquisa foi construído com base em entrevista em profundidade com 10 mulheres de 30 a 39 anos. Os resultados mostram que o acesso à parentalidade implicou um itinerário permeado por satisfações e sofrimentos devido a tentativas frustradas e perdas gestacionais. Também foram relatados percalços vivenciados na produção do cuidado em saúde devido a preconceitos, falta de empatia e despreparo de profissionais para lidarem com acompanhamento de pré-natal aos casais de mulheres lésbicas/bissexuais. As manifestações de discriminação foram mais contundentes em relação às mães não gestantes. Os resultados oferecem subsídios para implementação de políticas de humanização e planejamento de programas e serviços de saúde baseados em cuidados culturalmente sensíveis à diversidade para casais de mulheres lésbicas/bissexuais que vivenciam a transição para a maternidade.

Factors associated with help-seeking regarding sexual orientation concerns among Japanese gay and bisexual men: results from a cross-sectional survey.

OBJECTIVE: This study investigates Japanese gay and bisexual men's experiences of seeking help for emotional support from others regarding their sexual orientation concerns. It examines the relationship between their help-seeking and presence of gay and bisexual peers, duration between questioning their sexual orientation and accepting it, and experience of coming out to family members by multiple logistic regression analysis. RESULTS: We conducted a cross-sectional survey using a self-reported paper questionnaire. There were 360 valid responses. Eighty-two respondents (22.8%) had experience of help-seeking for emotional support, and this was associated with age, occupation, presence of gay/bisexual friends, and experience of coming out to family members about their sexual orientation. Respondents sought the most help from their male friends (70.0%), followed by female friends (25.0%), mothers (17.5%), and the Internet (16.3%). Even after controlling for age and occupation, experience of help-seeking for emotional support was higher among participants who had gay/bisexual friends when they were aware of their sexual orientation, took < 1 year from questioning to realizing their sexual orientation, and had come out to their family about their sexual orientation.

Medical Issues Affecting Older Gay and Bisexual Men.

Older gay and bisexual men constitute diverse, sizable, and potentially vulnerable populations. They have and continue to face discrimination and stigma in multiple settings, including health care. Older gay and bisexual men report worse health, higher rates of alcohol and tobacco use, and higher HIV rates compared with their heterosexual counterparts. They have unique needs and experiences in multiple realms of health care including mental health, sexual health, and cancer screenings. Geriatric medicine physicians and providers can educate themselves on these unique needs and risks and take steps to provide inclusive, affirming care.

Subtypes of Alcohol Expectancies Are Differentially Associated With Alcohol Use for Bisexual and Heterosexual Women.

Background: Bisexual women, compared to heterosexual women, report greater amounts of alcohol use and heavy drinking. Alcohol expectancies (i.e., beliefs about alcohol outcomes) are a strong predictor of alcohol use, but few studies have examined the importance of alcohol expectancies in relation to alcohol use among bisexual women specifically or in comparison to heterosexual women. Objectives: The current study examined 262 heterosexual and 225 bisexual women using an online survey about alcohol use, sexual risk-taking, and alcohol expectancy subtypes (sexuality, tension reduction, and aggression). Results: Compared to heterosexual women, bisexual women reported greater sexuality and tension reduction expectancies after accounting for their level of drinking, but groups did not differ on aggression expectancies. Moreover, sexual identity status moderated the associations between sexuality and tension reduction expectancies and alcohol use, respectively. Specifically, our study findings suggested that sexuality and tension reduction alcohol expectancies were more strongly tied to alcohol use among bisexual women than heterosexual women. Conclusions: Taken together, in our study, bisexual women held stronger sexuality and tension reduction expectancies, as compared to heterosexual women. Interventions targeting alcohol expectancies may be considered when tailoring intervention content for this population.

Let's Connect: Impact Evaluation of an Intervention to Reduce Mental Health Disparities Among People Who are LGBTQ+ .

Lesbian, gay, bisexual, transgender, queer, or similarly identified (LGBTQ+) people experience substantial mental health disparities compared to heterosexuals. The "Let's Connect" intervention was designed to improve mental health outcomes for LGBTQ+ people. This impact evaluation aimed to assess effectiveness of this intervention during its pilot phase, using a single arm pilot trial. Respondents completed baseline surveys at intervention start, a post survey on the last day of the intervention (at 6 weeks), then a follow-up survey 6 weeks after the intervention ended (at 12 weeks). Pre-post differences in outcomes were analyzed using paired t-tests, chi-square tests, and generalized estimating equations to evaluate impact on mental health outcomes at 6 and 12 weeks, and identify characteristics associated with loss to follow-up. The average value of all three outcome measures decreased substantially between the baseline and post surveys; all of these differences were highly statistically significant, and further decreased between the end of the intervention at 6 weeks and the 12 week follow-up survey. Let's Connect participants did experience substantial improvements in mental health outcomes, on average, between the start and end of this intervention. Further study of this intervention using a randomized design and control group is warranted.

Emotional Distress Disparities Across Multiple Intersecting Social Positions: The Role of Bias-Based Bullying.

OBJECTIVES: To apply an intersectional lens to disparities in emotional distress among youth, including multiple social positions and experiences with bias-based bullying. METHODS: Data are from the 2019 Minnesota Student Survey (n = 80 456). Social positions (race and ethnicity, sexual orientation, gender) and 2 forms of bias-based bullying (racist, homophobic or transphobic) were entered into decision tree models for depression, anxiety, self-injury, suicidal ideation, and suicide attempts. Groups with the highest prevalence are described. Rates of emotional distress among youth with matching social positions but no bias-based bullying are described for comparison. RESULTS: LGBQ identities (90%) and transgender, gender diverse, and questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently; racial and ethnic identities rarely emerged. Bias-based bullying characterized 82% of the highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20% to 60% lower (average 38.8%). CONCLUSIONS: Findings highlight bias-based bullying as an important point for the intervention and mitigation of mental health disparities, particularly among lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning adolescents. Results point to the importance of addressing bias-based bullying in schools and supporting lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning students at the systemic level as a way of preventing emotional distress.

Understanding Motivations for Dating App Use Among Gay and Bisexual Men: Validation, Latent Profile Analysis, and Differences in Health Outcomes.

While there has been a proliferation in gay dating app (GDA) use in China, research into their potential effects on health outcomes, particularly mental health outcomes, among gay and bisexual men is lacking. The motivations for GDA use are diverse, and understanding users' motivation profiles may provide a necessary starting point for exploring the heterogeneous effects of GDA use on health outcomes. A cross-sectional survey of the motivations for GDA use and other health outcome variables (i.e., condom use frequency, self-stigma, and subjective emptiness) was conducted among 366 Chinese gay and bisexual men. The results of exploration structure equation modeling indicate that the GDA Use Motivation Scale, with a four-factor first-order model, had strong psychometric properties. Then, latent profile analysis (LPA) based on the mean scores of four aspects of motivation was performed. The results of the LPA revealed the existence of four profiles: "Weak motivations" (30.9%), "Differentiated motivations" (17.8%), "Moderate motivations" (30.3%), and "Strong motivations" (21.0%). Differences in health outcomes among the motivation profiles were found by using the Bolck-Croon-Hagenaars approach. Overall, most participants (60.1%) tended to use condoms consistently, regardless of how strong their GDA use motivation was; however, stronger GDA use motivations were associated with higher levels of self-stigma and subjective emptiness. We call for more research to focus on the real needs behind and motivations for GDA use so that all such app users' voices can be heard, as well as to raise awareness about the potential health risks associated with GDA use among Chinese gay and bisexual men.

Social and Structural Drivers of Health and Transition to Adult Care.

CONTEXT: Youth with chronic health conditions experience challenges during their transition to adult care. Those with marginalized identities likely experience further disparities in care as they navigate structural barriers throughout transition. OBJECTIVES: This scoping review aims to identify the social and structural drivers of health (SSDOH) associated with outcomes for youth transitioning to adult care, particularly those who experience structural marginalization, including Black, Indigenous, and 2-spirit, lesbian, gay, bisexual, transgender, queer or questioning, and others youth. DATA SOURCES: Medline, Embase, CINAHL, and PsycINFO were searched from earliest available date to May 2022. STUDY SELECTION: Two reviewers screened titles and abstracts, followed by full-text. Disagreements were resolved by a third reviewer. Primary research studying the association between SSDOH and transition outcomes were included. DATA EXTRACTION: SSDOH were subcategorized as social drivers, structural drivers, and demographic characteristics. Transition outcomes were classified into themes. Associations between SSDOH and outcomes were assessed according to their statistical significance and were categorized into significant (P < .05), nonsignificant (P > .05), and unclear significance. RESULTS: 101 studies were included, identifying 12 social drivers (childhood environment, income, education, employment, health literacy, insurance, geographic location, language, immigration, food security, psychosocial stressors, and stigma) and 5 demographic characteristics (race and ethnicity, gender, illness type, illness severity, and comorbidity). No structural drivers were studied. Gender was significantly associated with communication, quality of life, transfer satisfaction, transfer completion, and transfer timing, and race and ethnicity with appointment keeping and transfer completion. LIMITATIONS: Studies were heterogeneous and a meta-analysis was not possible. CONCLUSIONS: Gender and race and ethnicity are associated with inequities in transition outcomes. Understanding these associations is crucial in informing transition interventions and mitigating health inequities.

Differences in Minority Stress Experiences, Mental Health, and Relationship Quality Outcomes Among Bisexual, Pansexual, and Queer Women.

The majority of sexual minority women in the United States today identify as bi+. Recent research suggests that "non-traditional" bi+ labels such as pansexual and queer are being adopted more frequently than ever before, making it increasingly important to evaluate whether these women have unique needs. In the current study, we explored differences in minority stress experiences, mental health, and relationship quality outcomes by sexual identity label among women who identify with the most common bi+ labels: bisexual, pansexual, and queer. Participants were 285 bi+ cisgender women in romantic relationships. They completed online measures of minority stress (antibisexual experiences, identity concealment, disconnection from the sexual and gender minority (SGM) community, and internalized stigma), mental health (depression and anxiety), and relationship quality (satisfaction and commitment). Overall, participants reported similar experiences of minority stress and few differences in their mental health outcomes. However, there were differences in antibisexual experiences by sexual identity label, such that pansexual women reported more frequent antibisexual experiences than bisexual and queer women. There were also differences in relationship quality by sexual identity label, such that bisexual women reported higher satisfaction than pansexual women and higher commitment than both pansexual and queer women. Findings suggest that pansexual and queer women may be facing their own unique challenges, even compared to bisexual women. Clinical prevention and intervention efforts can be tailored for these women to include strategies to cope with more frequent exposure to antibisexual experiences, as well as relationship education and skill-building to promote healthy romantic relationships.

Alcohol Use, Discrimination, and Psychological Partner Abuse Among LGBQ+ College Students: Results From a Daily Diary Study.

Alcohol use correlates with psychological partner abuse (PA) perpetration among lesbian, gay, bisexual, queer, and other nonheterosexual (LGBQ+) young adults. However, less is known about the proximal association between alcohol use and psychological PA within this population, which would provide valuable information for intervention development. Informed by minority stress and alcohol-related PA theories, we evaluated whether (a) psychological PA perpetration odds increased as the number of drinks consumed prior to psychological PA on a given day increased, (b) psychological PA perpetration odds were greater following heavy episodic drinking (HED) relative to non-HED, and (c) experiencing LGBQ+-specific discrimination (i.e., heterosexist harassment, incivility, and hostility) strengthened the association between daily alcohol use (number of drinks, HED) and subsequent psychological PA perpetration. LGBQ+ college students (N = 41; 75.6% women, 22.0% men, and 2.4% transgender/non-binary) completed a baseline survey of past-year discrimination before completing daily reports of their alcohol use and psychological PA for 60 consecutive days. Multilevel modeling revealed that drinking more than one usually does on a given day is positively associated with subsequent psychological PA odds (OR = 1.31, p < .001). Psychological PA was more likely following HED relative to non-HED (OR = 3.23, p < .001). Unexpectedly, experiencing discrimination was negatively associated with psychological PA odds across models (OR = .26 p = .01). No alcohol × discrimination interactions emerged. Results support alcohol use as a proximal risk factor for psychological PA among LGBQ+ college students and underscore the need for more nuanced examination of discrimination and other contextual variables in alcohol-related PA.

Identity Processes and Psychological Wellbeing Upon Recall of a Significant "Coming Out" Experience in Lesbian, Gay and Bisexual People.

This study focuses on the relations between minority stressors, protective factors and psychological wellbeing among lesbian, gay and bisexual (LGB) people. Experimental data based on a sample of 156 showed that participants asked to recall a negative coming out experience to somebody significant reported more identity threat and distress and less positive affect compared to those recalling a neutral coming out experience. In the negative recall condition, the effects of the stressors of discrimination and rejection on the variance of distress through the mediation of identity threat were statistically significant but not in the neutral recall condition and the two conditions statistically significantly differed in regards to the relationship between discrimination and distress. Identity resilience-continuity was associated with less identity threat and distress in the negative recall condition only, while social support was negatively associated and LGB stigma sensitivity was positively associated with distress in both conditions. Degree of outness (operating as a coping strategy) was associated with increased positive affect in both the neutral and negative recall conditions. When recalling a negative coming out experience, LGB people may be more susceptible to distress associated with minority stressors but also capitalize on available coping strategies.

Correlates of Attitudes Toward Bisexuality: A Systematic Review and Meta-Analysis.

This paper presents a systematic review of factors that correlate with attitudes toward bisexuals, and a meta-analysis to estimate the effect size of these relationships. A search strategy was designed to identify studies that had a measure of attitudes toward bisexuals and assessed the relationship between these attitudes and at least one attitude-relevant correlate. The strategy was then applied to PsycINFO, PsycEXTRA, Proquest Psychology Collection, EBSCO Psychology and Behavioral Sciences Collection and SociINDEX databases, and calls for unpublished data were circulated through relevant professional bodies. Effect size data were extracted from the articles, and meta-analyses were conducted on each of the applicable correlates. The meta-analyses revealed that age, contact (quality and quantity), income, political orientation, religion, sexual orientation, education, ethnicity, gender, and population density were related to negative attitudes toward bisexual individuals (Fisher's Zs = 0.108, -0.418, -0.209, 0.221, 0.231, 0.346, & 0.831, and Hedges' g's = 0.365, 0.344, 0.278, & 0.193, respectively). In addition, a sub-group moderation analysis revealed these effect sizes for participant gender differed as a function of target gender (i.e., bisexual men vs. bisexual women).

Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults: A Structural Competency Approach.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults experience significant health disparities. Examining these disparities has become an international research priority, but gaps remain. In this review article, we summarize major contributions of and ongoing gaps in health disparities research among LGBTQ+ older adults, while focusing on four major content areas: (a) social determinants of health disparities, (b) mental, cognitive, and physical health disparities, (c) reproductive and sexual health disparities, and (d) seeking LGBTQ+-affirming and age-friendly care. Using a structural competency approach, we develop a four-part agenda for this research area that enhances our understanding of how macro-level systems, institutions, and structures drive health disparities among aging LGBTQ+ communities. We also outline future research on structural competency in LGBTQ+ older adult health, while providing recommendations for researchers and clinicians. These recommendations illuminate potential best practices for bettering the health and quality of life of LGBTQ+ older populations.

Associations between Sexual Minority Identities, Heterosexism, Identity Concealment, and Depression in Lesbian, Gay, and Bisexual Emerging Adults: Adjusting for the Effects of General Stressors.

OBJECTIVES: Lesbian, gay, and bisexual (LGB) individuals experience stressors distinctively tied to their sexual identities, such as externalized and internalized heterosexism and identity concealment, which are correlated with increased psychological distress, including depression. The present study examined the variance in depression scores resulting from heterosexism, LGB identity concealment, and minority sexual identities, after adjusting for race/ethnicity and interpersonal violence victimization experiences. METHODS: Participants were 277 LGB emerging adults 18 to 29 years old (mean 25.39, standard deviation 2.77; 46 lesbian women, 71 gay men) recruited from an online platform. RESULTS: Nearly 41% reported moderate to severe depression symptoms. A two-step hierarchical regression model examining the effect of sexual minority stressors, heterosexism, LGB identity concealment, and minority sexual identity on depression after controlling for childhood maltreatment and face-to-face intimate partner violence types was significant. Bisexual women (vs gay men), those with greater exposure to heterosexism, and those with a greater degree of identity concealment experienced significantly higher scores on depression. In addition, being a person of color (including identifying as Hispanic), exposure to childhood maltreatment, and experiencing psychological intimate partner violence significantly predicted increases in depression scores. CONCLUSIONS: Findings emphasize the importance of assessing minority stressors and taking them into account when providing clinical interventions to LGB individuals.

Conformity to Masculinity Norms and Mental Health Outcomes Among Gay, Bisexual, Trans, Two-Spirit, and Queer Men and Non-Binary Individuals.

Homophobia and biphobia negatively impact the mental health of gay, bisexual, trans, Two-Spirit, and queer men and non-binary individuals (GBT2Q) and sexual and gender minority men, but little is known about the impact of gender-related oppression. The current study examines the impact of pressure to conform to masculine norms in Canada-based GBT2Q individuals. Specifically, the associations between (a) gender expression and pressure to be masculine and (b) pressure to be masculine and depression, anxiety, and self-rated mental health were investigated. Drawing from an online national cross-sectional survey of 8,977 GBT2Q individuals and sexual and gender minority men living in Canada aged 15 years or older, 56.4% (n = 5,067) of respondents reported experiencing pressure to conform to masculine norms. Respondents were more likely to report masculine pressure if they were younger than 30 years, described their gender expression as fluid, identified their sexuality as queer, were an ethnoracial minority, and were trans. Pressure to be masculine was associated with increased odds of depression, anxiety, and reporting poor or fair mental health. The current study provides evidence of the detrimental impact of pressure to conform to masculine norms on the mental health of gay, bisexual, trans, Two-Spirit, and queer men and non-binary peoples.

Trichotillomania in sexual minority individuals.

BACKGROUND: Trichotillomania is a common psychiatric disorder, but little is known about whether or how it differs in people with minority sexual identities. We sought to understand whether lesbian, gay, bisexual, and other individuals differ from heterosexual individuals in terms of hair pulling and associated characteristics. METHODS: A total of 207 participants age 18 to 64 with trichotillomania undertook clinical evaluations. Those who identified as sexual minorities were compared to those who identified as heterosexuals on clinical measures, comorbidities, impulsivity, and stress responses. RESULTS: Overall, 33 participants (15.9%) identified as sexual minorities. These individuals showed significantly higher levels of attentional impulsivity and higher rates of co-occurring obsessive-compulsive disorder compared to heterosexual participants. The groups did not differ in terms of trichotillomania severity or dysfunction due to trichotillomania or in terms of stress response CONCLUSIONS: The rate of sexual minorities in this study (15.9%) is higher than recent US Census Bureau data for sexual minorities in the US population (11.7%). People with trichotillomania from sexual minority groups may present with unique clinical symptoms. Treatments may need to be tailored for this population.

Comparing asexual with heterosexual, bisexual, and gay/lesbian individuals in common mental health problems: A multivariate meta-analysis.

We aimed to test whether asexual individuals were at increased risk of higher levels of depressive symptoms, self-harm attempts, and suicide attempts compared with heterosexual, bisexual, or gay/lesbian individuals using multivariate meta-analysis. Seventeen, five, and eight samples were included for depressive symptoms, self-harm attempts, and suicide attempts, respectively, reaching a total sample size of 125,675, 30,116, and 73,366, respectively. Asexual individuals reported higher levels of depressive symptoms than heterosexual individuals (Hedges' g = -0.44, 95%CI = [-0.61, -0.26]) but did not differ from heterosexual individuals in the risk of self-harm (odds ratio = 1.11, 95%CI = [0.88, 1.39]) and suicide attempts (odds ratio = 0.76, 95%CI = [0.56, 1.04]). Asexual individuals were at lower risk of self-harm and suicide attempts than bisexual and gay/lesbian individuals but did not differ from bisexual and gay/lesbian individuals in the levels of depressive symptoms. The greatest risk of higher levels of depressive symptoms was found in bisexual and asexual, followed by gay/lesbian individuals; the greatest risk of self-harm and suicide attempts was found in bisexual, followed by gay/lesbian individuals, and the lowest risk was found in asexual individuals. The magnitude of the disparities in the risk of poorer mental health among heterosexual, bisexual, gay/lesbian, and asexual individuals depended on the type of mental health outcomes.

Strong community belonging moderates poor mental health in lesbian, gay, and bisexual individuals living in Canada: an intersectional analysis of a national population-based survey.

OBJECTIVES: Lesbian, gay, and bisexual (LGB) individuals report worse mental health than heterosexuals; however, this disparity may vary across intersecting social locations and be moderated by community belonging. METHODS: We investigated these relationships using the Canadian Community Health Survey 2015-2016. Log-binomial regression models were used to estimate associations between self-rated mental health and social locations (sexual orientation, gender, race, immigration, education, income), community belonging, and interactions between explanatory variables. RESULTS: Poor mental health was 1.79 (95%CI: 1.37-2.33) times higher in lesbian/gay individuals and 3.3 (95%CI: 2.89-3.76) times higher in bisexuals when compared to heterosexuals. LGB participants across all social locations reported poorer mental health as compared with heterosexuals, with bisexuals consistently displaying worse mental health. Strong community belonging modifies this relationship, reducing disparities across all sexual orientations and social locations. CONCLUSION: The intersections of differing social locations and community belonging should be considered when addressing LGB Canadians' mental health needs.

RéSUMé: OBJECTIFS: Les lesbiennes, les hommes gais et les personnes bisexuelles (LGB) déclarent une moins bonne santé mentale que les personnes hétérosexuelles, mais cette disparité peut varier selon l'emplacement social, et elle peut être modérée par l'appartenance communautaire. MéTHODE: Nous avons examiné ces relations à l'aide de l'Enquête sur la santé dans les collectivités canadiennes de 2015­2016. Nous avons utilisé des modèles de régression log-binomiaux pour estimer les associations entre la santé mentale autoévaluée et les emplacements sociaux (l'orientation sexuelle, le genre, la race, l'immigration, l'instruction, le revenu), l'appartenance communautaire et les interactions entre les variables explicatives. RéSULTATS: La mauvaise santé mentale était 1,79 fois (IC de 95% : 1,37­2,33) plus élevée chez les lesbiennes et les hommes gais et 3,3 fois (IC de 95% : 2,89­3,76) plus élevée chez les personnes bisexuelles que chez les personnes hétérosexuelles. Les participantes et les participants LGB de tous les emplacements sociaux ont déclaré une moins bonne santé mentale que les personnes hétérosexuelles, et les personnes bisexuelles ont systématiquement fait état d'une moins bonne santé mentale. Une forte appartenance communautaire modifie cette relation en réduisant les disparités pour toutes les orientations sexuelles et tous les emplacements sociaux. CONCLUSION: Les croisements entre les différents emplacements sociaux et l'appartenance communautaire devraient être pris en compte lorsqu'on aborde les besoins de santé mentale des Canadiennes et des Canadiens LGB.

Proposed mechanisms of hypertension and risk of adverse cardiovascular outcomes in LGBT communities.

Hypertension (HTN), a highly prevalent public issue affecting one in two adults in the United States, has recently been shown to differentially burden individuals belonging to marginalized communities, such as the lesbian, gay, bisexual, and transgender (LGBT) communities. The minority stress theory posits that a unique combination of marginalization-related psychosocial stressors and coping behaviors may underlie the increased burden of diseases like HTN in LGBT populations. Uncontrolled or poorly managed HTN often leads to the development of adverse cardiovascular outcomes, such as heart failure (HF). Despite our understanding of minority stress theory and demonstrated associations between LGBT identities and HTN, the mechanisms whereby psychosocial stress drives HTN in LGBT populations remain unclear. This mini-review discusses the physiological systems governing blood pressure and the epidemiology of HTN across different subgroups of LGBT people. In addition, we propose mechanisms demonstrated in the general population whereby psychological stress has been implicated in elevating blood pressure that may be occurring in LGBT populations. Finally, we discuss the limitations of current studies and methodological frameworks to make suggestions for study designs to better delineate the mechanisms of psychosocial stress-related HTN in LGBT communities.