Background: Sexual minority women (SMW; e.g., lesbian, bisexual women) are at substantially higher risk for hazardous drinking (HD) than their heterosexual, cisgender counterparts. There is considerable evidence that minority stressors at the individual (e.g., internalized stigma) and interpersonal (e.g., discrimination) levels are associated with HD among SMW, but minority stressors at the structural level (e.g., structural stigma) are understudied. Further, there is a wide gap in the literature on the relationships between multilevel minority stressors and HD. Additionally, there is evidence that these associations may differ by race/ethnicity and sexual identity, but relatively little is known about these differences, particularly in a multilevel context. Methods: This dissertation includes three studies that were guided by an adaptation of the minority stress model and the social ecological model. In the first study we conducted a systematic review of quantitative research studies that examined associations between structural stigma and alcohol-related outcomes among sexual and gender minority (SGM) adults in the United States. In the second study we used data from a diverse sample of SMW enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study to determine whether structural stigma at Wave 4 (2017-2019) was prospectively associated with HD at Wave 5 (2019-2022), and whether this association was attenuated when accounting for individual- (i.e., internalized stigma, stigma consciousness) and interpersonal- (i.e., discrimination, sexual identity concealment) level minority stressors. In the third study we used data from Waves 4 and 5 of the CHLEW study to examine whether associations between multilevel minority stressors (i.e., internalized stigma, stigma consciousness, discrimination, sexual identity concealment, structural stigma) and HD varied by race/ethnicity and sexual identity. Results: The systematic review included 11 studies. There was moderate to strong support for a positive association between structural stigma and poor alcohol-related outcomes among SGM people, with differences by gender, sexual identity, race, and ethnicity. All studies used cross-sectional designs, and nearly half utilized non-probability samples. Transgender and nonbinary people, SGM people of color, and sexual identity subgroups beyond gay, lesbian, and heterosexual were underrepresented. Multilevel stigma and resiliency factors were understudied. In the second study, structural stigma was positively associated with HD alone, and when combined with interpersonal-level minority stressors. With the addition of individual-level minority stressors, the association between structural stigma and HD was attenuated, with partial attenuation (i.e., structural stigma was still significant) in the model combining all three levels, and full attenuation (i.e., structural stigma was no longer significant) in the model with only structural stigma and individual-level stressors. Discrimination was negatively associated with HD in the fully combined model and was not associated with HD in any other models. In the third study, we found that associations between structural stigma and HD did not vary by race/ethnicity or sexual identity. However, the associations between individual-level minority stressors (i.e., internalized stigma, stigma consciousness) and interpersonal-level minority stressors (i.e., sexual identity concealment) with HD varied somewhat by race/ethnicity and sexual identity. Conclusions: Findings from this dissertation highlight the importance of structural stigma in SMW’s HD and underscore the importance of both structural-level and multilevel minority stressors in designing interventions to effectively address HD drinking disparities and inequities among SMW. Future research is needed using intersectional approaches with probability samples, longitudinal designs, expanded measures of structural stigma, and samples that reflect the diversity of SGM people.

The purpose of this research was to explore social hardships of non-gay identifying, [behaviorally] bisexual, and “other” marginal LGBTQ+ men who are sexually intimate with men in a heteronormative and [toxic] masculine world. Relatedly, hegemonic masculinity dominates the patriarch through regulating behavioral norms that often stigmatize and discriminate opposing traits, ideologies, or groups, such as LGBTQ+. This has been known to affect and mediate health outcomes and “outness.” Therefore, this study explored how minority stressors impact self-concept, mental health, well-being, and motivations to disclose and/or conceal. Data collection involved survey and interview formats (mixed-methods cross-sectional design) that assessed internalized homophobia, conformity to masculine norms, subjective masculinity stress, disclosure, and concealment in relation to lifestyle and social context. While all variables had expected linear associations, not all were causal. Those who conformed to masculine norms significantly experienced internalized stigma/homophobia. Hence, it can be hypothesized that participants who conformed sought to conceal stigma under pressure of heteronormative culture and the patriarch. However, subjective masculinity stress was nonsignificant, exemplifying hegemonic influence as more defining to their self-concept than their own. Further, minority stress constructs (masculine norms, internalized stigma/homophobia, and subjective masculinity stress), when age, regional location, and faith were controlled, significantly predicted less disclosure and more concealment in social contexts. This reinforces the power of modern patriarchy/masculine norms/minority stress and its adverse effects on mental health, well-being, and outness in marginalized populations of LGBTQ+. Relatedly, qualitative data validated these quantitative findings but generally over the lifecycle of “coming out” as opposed to respondents’ current growth and development in outness, mental health, and well-being. However, to further affirm such quantitative findings, both survey and interview data did report distress regarding modern day masculinity and its ill standards that place unrealistic expectations on men, which continue to create disparities among and between many communities and humanity.

This dissertation aims to fill important gaps in the weight discrimination literature by applying a non-pathologizing, intersectional approach and by focusing on previously understudied groups (i.e., sexual and gender minority (SGM) people, racial and ethnic minoritized people, and early adolescents). Chapter 1 is an introduction to weight discrimination, including its origins in anti-fatness, its intersections with other systems of oppression, and the necessity to de-pathologize fatness to confront anti-fat oppression. Chapter 2 describes a scoping review of weight stigma/discrimination and its relationship with mental and emotional health among SGM people across the lifespan. Across 23 included studies, findings include consistent relationships between weight stigma and worse mental and emotional health and a scarcity of research focused on gender minority people, racial and ethnic minoritized people, early adolescents, and important outcomes such as self-injurious thoughts and behaviors (SITBs). Aiming to address these gaps, Chapters 3 and 4 both describe cross-sectional analyses of data from a large national sample of 10- to 14-year-old adolescents from the Adolescent Brain Cognitive Development Study. Chapter 3 reports analyses of prevalence of weight discrimination among early adolescents with minoritized sexual, gender, racial, and ethnic identities and those who are gender nonconforming, as well as those at the intersections of these identities. Minoritized adolescents, including intersectionally minoritized adolescents, were significantly more likely to report weight discrimination compared to their peers. Chapter 4 reports analyses of weight discrimination in association with SITBs, and includes testing of sexual identity, gender identity, gender nonconformity, race/ethnicity, sex assigned at birth, and social support as potential moderators. It also includes analysis of intersectional discrimination (based on weight plus sexual identity and/or race/ethnicity) in association with SITBs. Findings indicate that weight discrimination is associated with higher odds of SITBs; none of the proposed moderators had a significant effect. Intersectional discrimination was associated with heightened odds of SITBs. Finally, Chapter 5 presents a synthesis of results and discusses overall strengths, limitations, and implications. This includes implications for future research to fill identified gaps, policy changes to confront anti-fatness and protect adolescents from weight discrimination, and clinical interventions to make healthcare safe and affirming for fat and intersectionally minoritized adolescents.

Purpose - This thesis investigates how London art museums work to deconstruct heteronormative filters. The aim is to study how museums relate to LGBTQ content, and the influence of internal power structures. I have chosen to focus on the Victoria & Albert Museum, the Wallace Collection, and the British Museum.  Method - To answer my questions, I interview eight individuals who work with LGBTQ content in museums. I am also doing some activity-based observations during several LGBT History month events. Analysis - The qualitative data collected through interviews and observations will be analyzed and presented in case studies. I apply an intersectional perspective, and a critical theoretical method, encompassing queer theory. Findings - The findings show that museums are slowly incorporating more LGBTQ content and perspectives. This may be due to changing social norms as well as a conscious effort to address various target audiences to diversify visitor demographics. The current focus is on visibility. Ideally, this will encourage updating terminol- ogy in databases and galleries, staff training, policies explicitly supporting LGBTQ content and LGBTQ staff, increased online presence, publications, and community co-creation, to name some aspects. Museums still think of LGBTQ interpretation as optional. People often work with these efforts in their spare time. Increasingly, the legacy of these events is being evaluated, as well as how museum terminology can become more inclusive. There are no coordinated efforts shared by the museums, but they often look to each other for inspiration.  Originality/value - Previous research on LGBTQ museum projects has not evaluated their legacy. There hasn't been any particular focus on LGBTQ perspectives in art museums. I am taking into account aspects of gender and queer theory, discussing the act of labelling as a means to exercise power through language. Paper type - Two years master's thesis in Archive, Library and Museum studies. / Syfte - Syftet med denna uppsats är att undersöka och jämföra de insatser som tre konstmuseum i London, Stor- britannien, gör för att dekonstruera heteronormativa filter. Målet är att observera hur olika museum jobbar med HBTQ som tema och innehåll. Jag studerar vem det är som initierar normkritiska projekt på museerna, samt de maktstrukturer som projekten anpassar sig efter. Metod - Jag intervjuar åtta individer som på olika sätt jobbar med HBTQ på museum. Därtill företar jag mig ett antal aktivitetsbaserade observationer. Analys - De kvalitativa data som insamlats genom intervjuer och observationer analyseras utifrån ett intersek- tionellt perspektiv. Teori och metod inspireras även av kritisk kulturteori samt queerteori. Resultat - Resultaten visar bland annat att samhälleliga förändringar och besökarfokus öppnar upp för HBTQ- teman på museer. Synlighet ligger för närvarande i fokus. Detta kan utvecklas till arbete med t.ex. normkritisk personalutbildning, uppdaterade museipolicydokument som inkluderar HBTQ-fokus och skyddar HBTQ- personal, mer inklusiva etiketter och databaser, samt medskapande i dialog med olika sociokulturella grupper.  Värde - Tidigare forskning fokuserar på teoretiska utgångspunkter, och har sällan utvärderat existerande HBTQ- museumprojekt. Konstmuseum och HBTQ har inte heller specifikt utvärderats utifrån ett normkri- tiskt/intersektionellt perspektiv som involverar kritisk teori och queerteoretiska aspekter. Typ av uppsats - Tvåårig masteruppsats inom Arkiv-, biblioteks-, samt musei- och kulturarvsvetenskap.

SANTRAUKA Seksualinės mažumos – asmenų grupė, kurių lytinė orientacija, lytinė tapatybė, ar seksualinės charakteristikos skiriasi nuo daugumos gyventojų. Kadangi šis terminas yra labai platus, magistriniame darbe didžiausias dėmesys bus koncentruotas į LGBT bendruomenės narius. Juos sudaro lesbietės, gėjai, biseksualai ir transeksualai. Dėl visuomenėje susiformavusių stereotipų, šie asmenys dažnai susiduria su teisinės ir socialinės atskirties problema. Todėl seksualinių mažumų teisių ir laisvių užtikrinimas yra viena iš labiausiai diskutuojamų temų Lietuvoje ir pasaulyje. Magistro baigiamojo darbo tikslas – atliekant Lietuvos, Norvegijos, Nyderlandų ir Didžiosios Britanijos Konstitucinių žmogaus teisių ir įstatyminių nuostatų analizę, palyginti Lietuvos ir pasirinktų šalių užtikrinamas seksualinių mažumų teises ir laisves. Atsižvelgiant į atliktą lyginamąją analizę, pateikti išvadas, kurios atkleistų seksualinių mažumų teisių užtikrinimo padėtį Lietuvoje. Darbą sudaro įvadas, du skyriai ir išvados. Pirmoji darbo dalis skirta seksualinių mažumų sąvokos ir homoseksualios lytinės orientacijos sampratos atskleidimui, taip pat analizuojamos Lietuvos Respublikos Konstitucijoje įtvirtintos žmogaus teisės ir šalyje galiojantys įstatymai, kurie suteikia seksualinėms mažumoms teisę į apsaugą, lygiateisiškumą, saviraišką ir privatumą, aiškinamasi realus šių teisių įgyvendinimas. Antrame skyriuje analizuojama seksualinių mažumų teisinis reguliavimas Norvegijoje, Nyderlanduose ir... [toliau žr. visą tekstą] / SUMMARY The objective of this Master‘s Thesis is to analyze and compare Lithuania, Norway, Netherlands and The Great Britain Constitutional human rights and legal provisions wich ensure the rights and freedoms of sexual minorities. With regard to the comparative analysis of the present findings, disclosed the sexual minority rights in Lithuania. The Thesis consists of an introduction followed by two chapters and conclusions. The first chapter deals with the conceptions of sexual minorities and homosexual orientation. Also analyzed the Lithuanian Constitutional human rights and legal provisions wich provide the right to protection, equality, freedom of expression and privacy of sexual minorities. The second section consist legal acts analysis wich regulate sexual minorities rights in Norway, Netherlands and Great Britain. Specifying Constitutional rights and statutory provisions which are providing legal rights to protection, equality, freedom of expression and privacy of sexual minorities. Analyze and compare Lithuania, Norway, Netherlands and Great Britain Constitutional human rights and legal provisions wich ensure the rights and freedoms of sexual minorities. Sexual minorities are groups of people whose sexual orientation, gender identity or sexual characteristics are different from the presumed majority of the population, which are male or female heterosexuals. The term referred primarily to lesbians and gays, bisexuals and transgender people. These four categories... [to full text]

According to public health research, bisexual men are at elevated risk for contracting STIs and HIV relative to other sexual minority groups (e.g., gay men, lesbian women) as well as heterosexual people; yet, no studies to date have examined contextual factors that may contribute to this sexual health trend. Using a minority stress theory framework, the present study tested the direct and indirect associations of anti-bisexual discrimination with risky sexual behaviors in a sample of 508 self-identified bisexual men (age range = 18 - 76), with internalized biphobia, bisexual identity concealment, and substance use mediating this relation. Bisexual identity centrality’s direct relations with internalized biphobia, bisexual identity concealment, and risky sexual behavior were also tested. A path analysis was used to analyze the data. Results indicated that anti-bisexual discrimination yielded significant direct positive associations with internalized biphobia, bisexual identity concealment, and risky sexual behavior. Internalized biphobia, but not bisexual identity concealment, yielded a significant direct association with substance use, which yielded a significant direct positive link with risky sexual behavior. Bisexual identity centrality yielded significant direct negative associations with both internalized biphobia and bisexual identity concealment, but it yielded a nonsignificant association with risky sexual behavior. Internalized biphobia also yielded a total indirect link with risky sexual behavior through the mediating role of substance use. Implications of these findings for clinical practice and future research with bisexual men are discussed.

The study used a pre-/post-test design within a secondary analysis of existing de identified data obtained from a major Northeastern hospital for use by permission, in order to evaluate the impact of a communication cultural competency training of hospital registration personnel focused on teaching the collection of gender identity and sexual orientation data (SOGI). The study’s convenience sample (N=240) was diverse, given 34.6% (N=83) identified as White/Caucasian, 28.3% (N=68) as Hispanic/Latino, 27.1% (N=65) as Black /African American, and 10.0% (N=24) as Asian. For gender identity, 74.6% (N=179) identified as female, and 15.8% (N=37) as male. Those who identified their sexual orientation as heterosexual comprised 79.6% (N=191) of the sample. The mean time in current role for the sample was 3.97 years (Min = 1-1 to 6 months, Max = 6-over 10 years, SD = 1.547). For example, 18.3% (N=44) indicated being in their current role for between 5-10 years. Some 74.2% (N=178) indicated that they know someone who is LGBTQ+. Of note, 16.7% (N=38) indicated that they had other training in the last three months. Cronbach’s Alphas ranged from .858-.978 for the 11 new study scales, as very good to excellent internal consistency. As main study findings, paired t-tests for all five global scale scores (knowledge, self-efficacy, skill/ability level, and personal preparation for collecting SOGI data—and engagement in recommended SOGI data collection behavior) demonstrated significant differences from pre- to post- training in this sample (p˂.000; Bonferroni Significance level, p<.007). This suggested that participation in the training was associated with statistically significant improvements from pre- to post-training for knowledge, self-efficacy, skill/ability level, personal, and engagement in recommended SOGI data collection behavior. Through backward stepwise regression, having higher post-training self-efficacy was significantly predicted by: higher pre-training personal skill/ability (B=.589, SEB=.468, p=.000); and, higher post-training overall evaluation (B=.244, SEB=.305, p=.000). The adjusted R-squared value for this model was 0.346, meaning that 34.6% of the variance for higher post-training self-efficacy for collecting for collecting patients’ sexual orientation and gender identity data was explained by this model. Findings suggest the need for further dissemination, implementation and evaluation of the new communication cultural competence training.

Rebellion and repudiation of the mainstream recur as motifs throughout Christopher Isherwood's novels and life, dating back to his early experience of the death of his father and continuing through to the end of his own life with his vituperative rant against the heterosexual majority. Threatened by the accepted, by the traditional, by the past, Isherwood and his characters escape to the margin, hoping to find there people who share alternative values and ways of living that might ultimately prove more meaningful and enlightened than those they leave behind in the mainstream. In so doing, they both discover that the margin is a complicated place that is more often menacing than redemptive. Consistently, Isherwood's fiction looks at margins and the impulse to flee from the mainstream in search of a marginal alternative. On the one hand, these alternative spaces are thought to be redemptive, thought to liberate and nourish. Isherwood reveals that they do neither. To explore this theme, the dissertation focuses on three novels, The Berlin Stories (The Last of Mr. Norris and Goodbye to Berlin), A Meeting by the River, and A Single Man, because ach of these novels corresponds to marginal journeys of Isherwood--namely, his sexual and creative exile in Berlin from 1929 to 1933, his embrace of Hindu philosophy, and his life as a homosexual. Each of these novels positions characters outside of the mainstream in order to subvert a redemptive message and depict the margin as a very dark and dangerous place. Chapter 1 focuses on the period from 1929 to 1933 when Isherwood lived in Berlin and on the collection entitled The Berlin Stories, which includes The Last of Mr. Norris and Goodbye to Berlin. That fiction tells of the variegated landscape that was Weimar Berlin. In that landscape, Isherwood discovers and examines others who, like himself, seek alternatives to the mainstream: the bohemian Sally Bowles, the Landaurer family, who as Jews fear the rising Nazi tide, and the politically ambiguous Mr. Norris. His portraits of these people and the world they inhabit expose not only the darkest corners of mainstream Berlin, but also the futility of attempts to flee from the mainstream to more satisfying alternatives. Chapters 2 and 3 are devoted to Vedanta, one of the six schools of Hindu thought that would become central to Isherwood's life from July of 1939 until he died in 1986 and that is at the heart of Isherwood's final novel, A Meeting by the River (1967). In that work the margin and the mainstream are juxtaposed throughout. Rhetorically, the novel is rich and clearly one of Isherwood's finest. One approach to the novel emphasizes the redemptive power of the margin. The monastic life and all that it entails spiritually free one from the burdens of the material world. A compatible approach to the novel emphasizes the power of self-discovery as a bonding agent between the brothers. I argue for an alternative reading of the novel, one that emphasizes Patrick's journey and the implicit peril of the moral relativism endorsed by Vedanta. Patrick is nothing more than a con artist. And finally, Chapter 4 examines Isherwood's finest novel, A Single Man, the story of George, who is left alone after the death of his lover, Jim. Isherwood's homosexuality asserts itself both covertly and overtly throughout the novels, though today many of the positions reveal themselves as nascent attempts to understand sexual identity in personal, social, and political terms. A Single Man is Isherwood's most sophisticated and probing look at what it means to be a homosexual. The militantly political is ever present. And yet, the novel is in many ways a contemplative piece, one of stunning beauty that grows out of the simple fact that George's lover of many years has died. In reflecting on the cottage where they lived, George reminisces early on that "they loved it because you could only get to it by the bridge across the creek; the surrounding trees and the steep bushy cliff behind shut it in like a house in a forest clearing. `As good as being on our own island,' George said." In essence, George and Jim cut themselves off from the world. They live unto each other and in a community of like-minded people. Together on the margin, they are content and fulfilled. And yet, when Jim dies, George is abandoned and adrift. He is deprived of mainstream consolation--public memorials, spousal recognition, and children--and deserted; he is a sobering portrait of isolation and despair.

This dissertation considers a neglected legacy of the long 1960s (1959-1975): the struggle to form lasting connections across seemingly irreparable social divides. Through a comparative analysis of North American novels by James Baldwin, Toni Morrison, Margaret Atwood, Linda Hogan, Tim O'Brien and Susan Choi, I identify a common story their works all share: the narrative of affiliation. These novels of affiliation, I argue, represent the creation of lateral bonds of attachment among individuals of different races, ethnicities, genders, sexualities and classes. As a transgressive and unruly form of interpersonal relationship, affiliation works to bridge divisions by joining together the contradictory feelings of erotic desire and friendship. Defining an overlooked sub-genre of the post-1960 North American novel of development, this project illuminates the heterogeneous bonds of solidarity that undoubtedly arose during the sixties, yet have been continually silenced by national discourses of identity and multiculturalism. In the wake of neo-liberalism, 1960s collective projects for social change, including the New Left, the civil rights movement, Black Nationalism, feminism, and the Asian American movement, among others, appear historically and ideologically separate, and even antagonistic. In stark contrast, this dissertation illuminates the common ethics of affiliation that aligned these disparate movements and was built from collaborative, immanent and provisional attempts at repairing suffering and disparity. Positioned not within, but alongside the fraught history of the sixties, this project offers a new portrait of the subterranean modes of experimental living that animated the era.

This dissertation examines the emergence of queer personhood among black publics and medical cultures in South Africa over the past century. Based on more than two years of fieldwork in South Africa, it contains both a historical and an ethnographic component. The historical research was comprised of archival research and 16 life history interviews exploring how black South Africans reference multiple cultural fields of sexual and gender identities to elaborate composite formations of sexual subjectivity and personhood. In the ethnographic component, I conducted participant-observation and 70 in-depth interviews among various groups, including a number of queer, non-governmental organizations and two global health, HIV-focused clinical sites. In these settings, I examined how social actors, in the context of community settings and global health and community development projects, address sexual and gender nonconformity. Existing scholarship on gender and sexuality in South Africa presumes the existence of only one cultural field of gender and sexual identities in this social field. In contrast, my dissertation argues that multiple cultural fields and sexual ideologies have emerged coevally here. One is a liberal field of sexual subjectivity consisting of globally diffuse concepts of sexual personhood that are historically rooted in a psychiatric style of reasoning, such as homosexual, heterosexual, etc.; the other fields are more localized and are based on ethnic cultural fields of sexual and gender identities. However, they have incorporated aspects of, a globally diffuse psychiatric and anatomical style of reasoning about sexuality. Whereas the `global' liberal sexual ideology dictates a strict alignment of sex and gender, and has done so for some time, the ethnic sexual ideologies I examine, until recently, have not. My work explores the interrelationship of these multiple cultural fields. It follows the enactment of composite sexual subjectivities that are produced when social actors call upon multiple cultural fields of meaning about gender and sexuality. The study demonstrates how race and class mediate the co-emergence of these multiple cultural fields, and how they are entwined with political and economic ideologies and global health knowledge systems. The introductory chapter maps the theoretical and empirical terrain as well as the main questions that are discussed and proposed through the rest of the monograph. The second chapter is a historical analysis of gendered and sexual personhood among black South Africans during the twentieth century. Chapter 3 maps how discourses about cultural authenticity are being used to both contest and constitute LGBTQ sexualities as African. As these cultures and sexual ideologies co-emerge, Chapter 4 examines how they have become entwined with particular political traditions and ideologies during the past century. Chapter 5 explores the ways that biomedicine and public health only reference the a liberal sexual ideology when producing knowledge about black queer bodies and populations in the context of global health HIV interventions. Specifically, I explore the enactment of the MSM and WSW epidemiologic risk categories within HIV science. In Chapter 6, the disjuncture between global health knowledge and everyday experiences of gender and sexuality are highlighted through an ethical case study of the implementation of the HIV intervention known as pre-exposure prophylaxis, or PrEP. The case study concretely demonstrates how the symbolic violence enacted by medical cultures, which only reference the liberal cultural field, conditions structural violence in the form of unjust distribution of health resources among queer groups. The analyses presented in this dissertation suggest new avenues for queer and feminist anthropological inquiry throughout the sub-Saharan African region. In particular, this scholarship contributes to a novel understanding of the political economy of global health and sexuality by exploring how knowledge production and circulation about sexuality within global health contributes to gendered health disparities.