The juxtaposition of invalidation and "inviting in": a qualitative study of bisexual identity in South Africa.

Understanding one's sexual orientation plays a significant role in contributing to one's sexual identity and developing a coherent sense of self. Misconceptions and prevailing prejudices make it difficult for bisexual individuals to navigate their sexual identities in many societies. Disclosure of one's identity is accompanied by certain risks depending on how the information is received. However, disclosing one's identity can also be positive, especially as it assists in fostering relationships. This article derives from a descriptive study involving 14 semi-structured interviews with young adults aged 18-24 who identified as bisexual. Data were subjected to a reflexive thematic analysis. Themes of invalidation, belongingness and reclaiming through 'inviting in' were identified. By processing the feelings of invalidation regarding their bisexual identities which were placed upon them by their respective cultural groups, and society in general, participants were able to develop a sense of agency and reclaim their power. Findings highlight the need for further research on bisexuality, particularly in South Africa, and the need to understand how bisexual identity development occurs in interaction with other sexual and gender identities.

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.

Palliative and end-of-life care needs, experiences, and preferences of LGBTQ+ individuals with serious illness: A systematic mixed-methods review.

BACKGROUND: Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals experience discrimination throughout the care continuum, including during serious illness and at end of life. High-quality palliative care requires that health professionals deliver individualized services that reflect the needs, experiences, and preferences of LGBTQ+ persons. AIM: To identify and appraise existing evidence related to the needs, experiences, and preferences for palliative and end of life care among LGBTQ+ individuals with serious illness. DESIGN: Data-based convergent synthesis design reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: PubMed, Embase, Cochrane CENTRAL, PsycINFO, CINAHL, and Scopus from January 1, 2010 to November 6, 2020. RESULTS: Of 4875 results captured, 69 articles underwent full-text review and 13 were retained for analysis. Most studies were from North America with trans individuals represented in 10 of 13 studies. Needs (n = 6) included increased social support, institutional safety, economic and legal supports, and advocacy to mitigate health barriers.Experiences (n = 12) were driven by fear and worry associated with discrimination/stigma,providers' hetero-/cisnormative assumptions, homophobia and transphobia, social isolation, and an undignified death. Preferences (n = 6) pertained to inclusion of chosen families in decision-making, disclosure of LGBTQ+ identity based on safety of the clinical environment, and a desire to maintain autonomy. CONCLUSIONS: The robustness of the science has improved regarding the needs, experiences, and preferences of trans individuals. Actionable, inclusive policies coupled with sustained and integrated cultural sensitivity training for health workers are mandatory. Interventional research is critical to enhance tailored palliative care for LGBTQ+ people and their chosen families.

Robust evidence for bisexual orientation among men.

The question whether some men have a bisexual orientation-that is, whether they are substantially sexually aroused and attracted to both sexes-has remained controversial among both scientists and laypersons. Skeptics believe that male sexual orientation can only be homosexual or heterosexual, and that bisexual identification reflects nonsexual concerns, such as a desire to deemphasize homosexuality. Although most bisexual-identified men report that they are attracted to both men and women, self-report data cannot refute these claims. Patterns of physiological (genital) arousal to male and female erotic stimuli can provide compelling evidence for male sexual orientation. (In contrast, most women provide similar physiological responses to male and female stimuli.) We investigated whether men who self-report bisexual feelings tend to produce bisexual arousal patterns. Prior studies of this issue have been small, used potentially invalid statistical tests, and produced inconsistent findings. We combined nearly all previously published data (from eight previous studies in the United States, United Kingdom, and Canada), yielding a sample of 474 to 588 men (depending on analysis). All participants were cisgender males. Highly robust results showed that bisexual-identified men's genital and subjective arousal patterns were more bisexual than were those who identified as exclusively heterosexual or homosexual. These findings support the view that male sexual orientation contains a range, from heterosexuality, to bisexuality, to homosexuality.

Social media use among bisexuals and pansexuals: connection, harassment and mental health.

Analysing survey data from 1,304 LGBTQ + young people in Australia collected in 2016, this paper considers key distinctions between the experiences of bisexual and pansexual participants, and lesbian and gay participants in relation to social media use and aspects of connection, harassment and mental health. Presenting quantitative data, illustrated by qualitative extracts, we found broad similarities in motivations for using social media and how participants connected to peers and communities. There were some statistically significant differences, however, in respondents' motivations for using social media and who they connected with on these platforms. Importantly, bisexual and pansexual participants reported more negative experiences of harassment and exclusion across all major social media platforms when compared to their lesbian and gay peers. Bisexual and pansexual respondents also reported poorer mental health experiences. These findings speak to the different impacts of discrimination and oppression that young people experience in everyday life. There is a need for focused attention on bisexual and pansexual young people in academic, policy and youth-work domains. Young people will benefit from more substantial school-based education on LGBTQ + identities - beyond the experiences of gay and lesbian people - to 'usualise' varieties of difference in gender and sexual identity.

Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States.

BACKGROUND: Sexual minority (lesbian, bisexual, mostly heterosexual) young women face many sexual and reproductive health disparities, but there is scant information on their experiences of chronic pelvic pain, including an absence of information on prevalence, treatment, and outcomes. AIM: The purpose of this study was to describe the characteristics of chronic pelvic pain experiences of young women by sexual orientation identity and gender of sexual partners. METHODS: The analytical sample consisted of a nationwide sample of 6,150 U.S. young women (mean age = 23 years) from the Growing Up Today Study who completed cross-sectional questionnaires from 1996 to 2007. OUTCOMES: Age-adjusted regression analyses were used to examine groups categorized by sexual orientation identity (completely heterosexual [ref.], mostly heterosexual, bisexual, lesbian) and gender of sexual partner (only men [ref.], no partners, both men, and women). We examined differences in lifetime and past-year chronic pelvic pain symptoms, diagnosis, treatment, and quality of life outcomes. Sensitivity analyses also examined the role of pelvic/gynecologic exam history and hormonal contraceptive use as potential effect modifiers. RESULTS: Around half of all women reported ever experiencing chronic pelvic pain, among whom nearly 90% had past-year chronic pelvic pain. Compared to completely heterosexual women, there was greater risk of lifetime chronic pelvic pain among mostly heterosexual (risk ratio [RR] = 1.30, 95% confidence interval [CI]: 1.22-1.38), bisexual (RR = 1.30, 95% CI: 1.10-1.52), and lesbian (RR = 1.23, 95% CI: 1.00-1.52) young women. Additionally, compared to young women with only past male sexual partners, young women who had both men and women as past sexual partners were more likely to report chronic pelvic pain interfered with their social activities (b = 0.63, 95% CI: 0.25-1.02), work/school (b = 0.55, 95% CI: 0.17-0.93), and sex (b = 0.53, 95% CI: 0.05-1.00). CLINICAL IMPLICATIONS: Healthcare providers, medical education, and field-wide standards of care should be attentive to the way sexual orientation-based healthcare disparities can manifest into differential prognosis and quality of life outcomes for women with chronic pelvic pain (particularly bisexual women). STRENGTHS & LIMITATIONS: Our study is the first to examine a variety of chronic pelvic pain outcomes in a nationwide U.S. sample across different outcomes (ie, past-year and lifetime). Though limited by sample homogeneity in terms of age, race, ethnicity, and gender, findings from this article provide foundational insights about chronic pelvic pain experiences of sexual minority young women. CONCLUSION: Our key finding is that sexual minority women were commonly affected by chronic pelvic pain, and bisexual women face pain-related quality of life disparities. Tabaac AR, Chwa C, Sutter ME, et al. Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. J Sex Med 2022;19:1012-1023.

Disordered eating in sexual minority post-9/11 United States veterans.

OBJECTIVE: It is well documented that sexual minority individuals are more likely to report disordered eating (DE) than those identifying as heterosexual. Although DE is prevalent in veterans, investigation of potential disparities in DE among sexual minority veterans is limited. This study examined rates of DE in post-9/11 United States (U.S.) veterans identifying as sexual minorities and explored their association with discrimination because of marginalized identities. METHODS: A national sample of recently separated post-9/11 U.S. veterans were recruited. Women (N = 805; heterosexual [n = 656]; lesbian [n = 51]; bisexual [n = 98]) and men (N = 558; heterosexual [n = 540]; gay [n = 11]; bisexual [n = 7]) completed a survey assessing eating behaviors, mental health, and military experiences. Weighted correlational and regression analyses were conducted. Analyses in men were exploratory. RESULTS: DE was prevalent across gender and sexual orientation identity groups. Women identifying as bisexual and men identifying as gay reported higher rates of DE and consequent impairment compared to veterans who identified as heterosexual. There were no differences in DE between heterosexual and lesbian female veterans, but lesbian women reported lower DE-related impairment. Experiencing any discrimination in the military was positively related to DE. DISCUSSION: This study found evidence of disparities in DE among sexual minority U.S. military veterans. While the factors contributing to these differences, such as the role of discrimination, are not completely understood, DE is a health concern for sexual minority veterans and requires continued investigation. PUBLIC SIGNIFICANCE: Sexual minority individuals experience disparities in disordered eating; yet, this has not been explored in military veterans. This study found that disordered eating is a significant health concerns for veteran women and men, especially among those identifying as sexual minorities. More research is needed to explore why these disparities exist, such as the role of minority stress, in order to address the unique healthcare needs of these veterans.

The Direct Reproductive Cost of Same-Sex Attraction: Evidence from Two Nationally Representative U.S. Samples.

Same-sex attraction is associated with a direct reproductive cost, i.e., a reduced number of biological children. The current study aimed to assess this cost for different forms of sexual attraction (i.e., only attracted to opposite sex, mostly attracted to opposite sex, equally attracted to both sexes, mostly attracted to same-sex, only attracted to same-sex), using two large nationally representative datasets (N = 15,208) from the USA. The results indicated that same-sex attraction was associated with substantial loss in direct reproductive output. More specifically, significant differences between the different types of same-sex attraction were found: Exclusive and mostly homosexual orientation identities were associated with the highest direct reproductive cost, while mostly attracted to opposite sex orientation and bisexuality identities were associated with lower direct reproductive costs. In addition, bisexual women did not differ significantly from exclusively heterosexual women in terms of their reproductive output. The implications of these findings for the evolutionary origins of same-sex attraction are further discussed.

Historical and generational forces in the Iridescent Life Course of bisexual women, men, and gender diverse older adults.

Purpose: Little is known about the life course of bisexual older adults. This study examines life events and experiences of bisexuals by generation: Pride Generation, born 1950-1964; Silenced Generation, born 1935-1949; and Invisible Generation, born 1934 or earlier, as well as by gender among women, men, and gender diverse older adults. Methods: Aging with Pride: National Health, Aging, and Sexuality/Gender Study is the first national longitudinal study of LGBTQ older adults in the US. We utilize the Iridescent Life Course to examine the life events and life course experiences of bisexual older adults (N = 216) using 2014 survey data. The Iridescent Life Course frames this study for comparing generational and gender differences in five key areas: identity development; work; kin and social relationships; bias-related experiences; and physical and mental health. Findings: The Invisible Generation, the oldest generation, compared to the two younger generations, reports significant risks related to social relationships, the lowest levels of openly disclosing, and fewer bias-related experiences. They also demonstrate important signs of resilience and better mental health. Bisexual men and gender diverse older adults report higher rates of bias-related experiences and fewer social resources than bisexual women. Conclusion: Based on the Iridescent Life Course, we document important differences in the heterogeneity and intersectionality in bisexual lives, particularly for those in late life and those gender diverse. It is essential to document the distinct nature of bisexuals' life course, as it provides both historical and contemporary insights into aging and the reframing of future research.

Self-assessment of health status among lesbian, gay, and bisexual cancer survivors in the United States.

BACKGROUND: Research is lacking for understanding the health disparities in cancer survivorship in the lesbian, gay, and bisexual (LGB) population in the United States. Self-reported health status is used as a predictor of health disparities. METHODS: This secondary data analysis study used 2018 Behavioral Risk Factor Surveillance System data to analyze cancer survivorship characteristics by sexual orientation and sex through the use of logistic regressions. RESULTS: Overall, 17,656,329 US cancer survivors were included in this study after weighting, with percentage estimates of 1.52% for gays/lesbians and 1.41% for bisexuals. LGB participants were younger and more ethnically diverse. Significantly, bisexuals had current smoking (32.3% vs 13.6%) and binge drinking rates (17.1% vs 9.1%) twice those of heterosexuals; 16.6% of bisexuals versus 4.1% of heterosexuals reported no health insurance coverage (P < .0001). After adjustments for socioeconomic, health-related behavioral risk, and health care access factors, bisexual females reported poorer general health (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.31-1.36) as well as mental health (OR, 2.43; 95% CI, 2.39-2.46) than their heterosexual peers (P < .0001). Bisexual males were 5.14 times more likely to be told that they had depressive disorders than their heterosexual counterparts (95% CI, 5.05-5.23), whereas bisexual females were 3.23 times more likely for the same outcome (95% CI, 3.18-3.28). All LGB groups reported significantly more inadequate sleep than their heterosexual counterparts (especially lesbians: OR, 2.14; 95% CI, 2.10-2.18). CONCLUSIONS: This study indicates that LGB cancer survivors have worse survivorship than their heterosexual peers with heterogeneity in subgroups. Future studies should use larger sample sizes, further investigate disparities, and promote survivorship in LGB populations. LAY SUMMARY: It has been observed that lesbian, gay, and bisexual (LGB) cancer survivors may face challenges in cancer survivorship that are not as prevalent in the heterosexual community. This cross-sectional study has found that LGB cancer survivors, especially bisexuals, have overall poorer physical and mental health, are more likely to be told that they have depressive disorders, and have worse sleep quality in comparison with their heterosexual counterparts. These results also differ by sex, and this can provide rationales for future studies and guide interventions to relocate resources to better promote equality.

Bisexual Men Living with HIV: Wellbeing, Connectedness and the Impact of Stigma.

Social research with people living with HIV (PLHIV) rarely distinguishes between gay men and bisexual men. However, bisexual men may have unique experiences of HIV-related stigma and distinct support needs. In this paper, findings are presented from a cross-sectional survey of Australian PLHIV, which included the Berger (HIV) stigma scale. A total of 872 PLHIV completed the survey, of which 48 (6.0%) were bisexual men. Bisexual men reported higher levels of internalised HIV-related stigma, greater negative self-image and poorer emotional wellbeing than gay men. Bisexual men also reported less social support, less connection with lesbian, gay, bisexual, transgender and queer (LGBTQ) communities, and less connection with other PLHIV. Analysis of data from an open-text question revealed feelings of social isolation and fear of rejection was associated with participant's HIV diagnosis. Study findings suggest that existing social supports for PLHIV may not adequately address the unique support needs of bisexual men.

Born this Way-or Not? The Relationship Between Essentialism and Sexual Minorities' LGBTQ+ Identification and Belonging.

Bisexual people experience lower levels of belonging in the LGBTQ+ community than gay and lesbian people. We investigated one of the factors that may reduce bisexual individuals' feelings of belonging in and identification with the LGBTQ+ community: Sexual orientation essentialism. Across two online studies with participants recruited through Prolific, we tested whether bisexual people endorsed sexual orientation essentialism less than lesbian and gay individuals and, in turn, feel lower levels of identification and belonging with the LGBTQ+ community. Essentialism separated into three dimensions in Study 1 (N = 375): Entitativity, naturalness, and discreteness. Relative to lesbian and gay individuals, bisexual individuals viewed sexual orientation as less natural, in turn reporting lower levels of belonging and identification. They also viewed sexual orientation groups as less discrete, which instead translated to higher levels of belonging and identification. Sexual orientation groups did not differ in their endorsement of entitativity beliefs. In Study 2 (N = 390), we focused on naturalness and replicated findings from Study 1. In addition, lower naturalness beliefs were associated with the belief that one's own views were different from those held by the LGBTQ+ community, which also contributed to lower levels of belonging and identification. Together, these studies contribute to understanding the role of essentialism in intragroup processes and paint a nuanced picture of essentialism in different sexual minority groups.

Stories Told Together: Male Narratives of Non-Monogamous Bi+ and Heterosexual Men.

The stories we tell about our identities and sexual orientations shape how we perform gendered scripts and negotiate relationships with significant others. Previous literature inquired the styles and outcomes of consensual non-monogamous (CNM) relationships, but more research is need on how CNM men resist or abide to hegemonic models of masculinity. To understand how constructions of masculinity and conceptualizations of sexual orientation are embedded in CNMs, the study analysed the stories of non-monogamous Bi+ and heterosexual men. Following a critical narrative approach, the study inquired the diverse conceptualizations of masculinity, sexual orientation and relationship practices in the narratives of 20 non-monogamous Bi+ and heterosexual identified men. The semi-structured in-depth narrative interviews (105 min on average) were analyzed via Nvivo 12 and explored their stories of desire and the sense-making process of being sexually oriented to one or more genders and to one or more partner/s. Engaging in non-monogamy was signified as a relevant insight from their personal stories and/or from adopting new concepts of desire beyond the "love as a zero-sum game." The latter theme was also shared by many heterosexual participants that, when negotiating a non-monogamous agreement, signified their attractions to more than one person as part of their personal identity. Finally, the paper discusses how non-monogamous spaces can offer a positive and safe space for bisexuals/Bi+ people to explore and reaffirm their identities, constantly challenged by biphobia, invisibility, and erasure. Experiences and stories of Italian cisgender Bi+ and heterosexual men cannot be generalized to the whole spectrum of masculinities within CNM spaces, and the study lacks how other gendered and sexual subjectivities construct masculinity. Diverse stories and construction of sexuality and gender can lead to similar relationship preferences and understanding how we signify them can greatly improve our understanding of intimacies.

Birth Cohort Trends in Health Disparities by Sexual Orientation.

Lesbian, gay, and bisexual-identified (LGB) people experience worse mental and physical health than their straight-identified counterparts. Given remarkable social and legal changes regarding LGB status in recent decades, we theorize that this profound health disadvantage may be changing across cohorts. Using data from the 2013-2018 National Health and Interview Surveys, we analyze five mental and physical health outcomes-psychological distress, depression, anxiety, self-rated physical health, and activity limitation-across three birth cohorts colloquially known as (1) Millennials, (2) Generation Xers, and (3) Baby Boomers and pre-Boomers. We find no evidence of reduced health disparities by sexual orientation across cohorts. Instead, relative to straight-identified respondents, the health disadvantages of gay, lesbian, and-most strikingly-bisexual-identified people have increased across cohorts. Findings highlight the importance of identifying the causes of increased health disparities as well as designing and implementing moredirect public policies and programs to eliminate health disparities among more recent LGB cohorts.

Orienting Toward Possibility: Girls and Bisexuality at School.

While many more high school girls identify as bisexual than as lesbian, queer, or other marginalized sexual identities, girls who identify as bisexual remain peripheral to sexuality research and to many sexual health education programs. Nevertheless, research suggests that bisexuality is a distinct claim and experience for girls, marked by highly gendered discourses of sexuality and queerness. Based on the Beyond Bullying Project, a multimedia storytelling project that invited students, teachers, and community members in three U.S. high schools to enter a private booth and share stories of LGBTQ (lesbian, gay, bisexual, transgender and queer or questioning) sexuality and gender, this article explores the work the identity "bisexual" and the category "bisexuality" accomplish for girls when claimed for themselves or another or put into circulation at school. We consider the range of meanings and identifications mobilized by bisexuality and, drawing on insights of critical narrative intervention, explore how sexual health and sexuality educators might receive girls' narratives of bisexuality as capacious and contradictory-as claims to identity, as uncertain gestures toward desire, and as assertions of possibility and resistance. We show that in the assertion of bisexuality, girls align themselves with the surprise of desire and position themselves to resist the disciplining expectations of heteronormative schooling. Critical narrative intervention, with its focus on using stories to challenge the status quo, allows educators and researchers to recognize in girls' stories of bisexuality, the potential of new approaches to sexual health education and social belonging.

Bisexuality and Health Care.

Using data from the fourth wave of the National Study of Adolescent Health, this paper offers a preliminary investigation of factors implicated in the physical and mental health of bisexual individuals. The roles of sleep, socioeconomic status, feelings of disrespect, and reported lack of health insurance are considered. Further, this study examines depression as a psychological stress response and systemic inflammation as a physiological stress response. Systemic inflammation in this population was estimated using the biomarker C-reactive protein (CRP). Reported acute illness in the past month and blood pressure serve as measures of physical health outcomes. Analyses revealed a pattern of elevated CRP (>3mg/L) among participants who reported no health insurance coverage. For participants who reported no health insurance coverage and identified as mostly homosexual, bisexual, or mostly heterosexual, feelings of disrespect were associated both with their sleep outcomes as well as their total household income. Moreover, linear regression showed that CRP significantly predicted blood pressure values. These analyses serve to bring health disparities and specific considerations for individuals attracted to more than one gender further into scientific conversation. Suggestions for further study of bisexual minority stress and bisexual health are offered.

Internalized Binegativity, LGBQ+ Community Involvement, and Definitions of Bisexuality.

Bisexual people can internalize stigma from both heterosexual and gay/lesbian communities, which often occurs in the form of monosexism, the belief that people should only be attracted to one gender. Although community involvement is protective for lesbian, gay, bisexual, and queer+ (LGBQ+) people, bisexual people may benefit more from bisexual-specific communities than LGBQ+ communities because of monosexism. Further, how bisexual people define their identity may be related to internalized binegativity, especially given the historical invisibility of bisexuality in mainstream media and recent debates about the definition of bisexuality within LGBQ+ communities. We examined LGBQ+ and bisexual-specific community involvement, definitions of bisexuality, and internalized binegativity among an online sample of 816 bisexual adults. Multivariate regression analyses showed that those with spectrum definitions, which acknowledged the nuanced understanding of sex, gender, and sexuality, reported lower internalized binegativity than those with binary definitions, which described sexuality as consistent with mainstream norms. Involvement in LGBQ+ communities, but not bisexual communities, was associated with lower internalized binegativity. There was no interaction between the type of definition and type of community involvement. Our results suggest that broad community involvement may be protective for internalized binegativity, but findings should be considered in light of a lack of well-funded, local bisexual communities. The current study adds to a growing literature on sexual minority stressors among bisexual people, a population that continues to be understudied.

[Supporting access to fatherhood]. / Accompagner l'accès à la paternité.

The social prescription of fatherhood for the modern father, with its array of new rights and the absence of ritual, often overlooks the profound identity crisis that accompanies fatherhood. Access to fatherhood for men is based on the early stages of child sexuality and psychological bisexuality, which are at the origin of a vulnerability that can be at psychopathological risk. The necessary reconciliation with parental imagos and narcissistic rearrangements may require specialised support, beyond the support role currently reserved for it in the context of motherhood.

Sexual Anal Pain in Gay and Bisexual Men: In Search of Explanatory Factors.

BACKGROUND: Sexual anal pain-or anodyspareunia-in gay and bisexual men is a scientifically and clinically neglected topic. More understanding of its origins and correlates is needed. AIM: To search for correlates of painful anal intercourse with the inclusion of minority stress processes. METHODS: The analysis is based on data collected in an Internet study on the sexuality of Polish gay, bisexual, and straight men. Multiple ordinal regression analysis was used to search for the correlates of painful receptive anal intercourse in a group of 1,443 nonheterosexual men who declared practicing this type of intercourse within the last 12 months. The investigated correlates included demographics, sexual patterns and experiences, experiencing minority stress, sexual problems, and mental and physical health. To assess the level of minority stress, we used the Sexual Minority Stress Scale based on Ilan Meyer's Minority Stress Model, with its subscales relating to internalized homophobia, expectation of rejection, concealment, and sexual minority negative events. Sexual problems were measured with single-item questions adapted from the National Health and Social Life Survey. Data on the remaining correlates were obtained using a survey that we developed. MAIN OUTCOME MEASURES: The intensity of pain during receptive anal sexual intercourse as rated on a 5-point Likert scale was a dependent variable. RESULTS: Age (odds ratio [OR]: 0.97; P < .001), performance anxiety (OR: 1.94; P < .001), and internalized homophobia (OR: 1.04; P < .001) were the only statistically significant predictors of the intensity of pain during receptive anal sexual intercourse. CLINICAL IMPLICATIONS: Clinicians addressing sexual anal pain should consider performance anxiety, internalized homophobia, and younger age as possible operating factors. STRENGTHS & LIMITATIONS: The major strengths of the study include the provision of additional data on this neglected topic derived from a large sample of participants from the little recognized Central European cultural context and the major limitations are the nonrepresentative sampling, retrospective data collection, cross-sectional design, Internet methodology, and lack of information on the clinical relevance of experienced pain, that is, distress or help-seeking, as well as its recurrent or persistent character. CONCLUSION: Painful sexual anal activity requires further investigation. Grabski B, Kasparek K. Sexual Anal Pain in Gay and Bisexual Men: In Search of Explanatory Factors. J Sex Med 2020;17:716-730.

Bisexual Men's Experiences with Discrimination, Internalized Binegativity, and Identity Affirmation: Differences by Partner Gender.

Bisexual individuals experience unique forms of discrimination related to their sexual orientation (e.g., anti-bisexual prejudice), which occurs from both heterosexual and gay/lesbian individuals. Bisexual individuals may experience stigma differently depending on the gender of their relationship or sexual partners, because they may be perceived as heterosexual if they have a partner of a different gender and as gay/lesbian if they have a partner of the same gender. The present longitudinal study investigated within-persons differences in anti-bisexual experiences, internalized binegativity, and bisexual identity affirmation based on the gender of participants' serious relationship partners and gender of sex partners in a sample of 180 young bisexual men. Results indicated that young bisexual men experienced more interpersonal hostility from both heterosexual and gay/lesbian individuals when their serious relationship partner was female. No significant differences were found in other types of anti-bisexual prejudice, internalized binegativity, or bisexual identity affirmation by serious partner gender. For sexual partner gender, men who had only male sex partners experienced more sexual orientation instability attitudes from heterosexual and lesbian/gay individuals; men with only female sex partners experienced more sexual irresponsibility attitudes from heterosexuals, but not from lesbian/gay individuals; and, like those with female serious relationship partners, men with only female sex partners had more frequent experiences of interpersonal hostility from heterosexual and lesbian/gay individuals. Results indicate that bisexual men experience unique forms of prejudice based on the gender of their relationship and sexual partners. Implications for the mental health of bisexual men are discussed.