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Researchers examining clinically-relevant trends for sexual minority women have found evidence of psychological distress and greater utilization of mental health services compared to heterosexually-identified women. However, the results of many research studies with this population have methodological limitations surrounding recruitment of participants, cross-sectional methods, and participant report of clinical services utilized. Few researchers have sought to analyze actual clinical presentation, service utilization, or clinical outcome of sexual minority women in a treatment-setting. This study is an in-depth clinical analysis of 215 sexual minority woman who sought services at a large Midwestern university counseling center over a period of two years and nine months. The analyses conducted allowed for the initial clinical presentation, service utilization, and clinical outcome of sexual minority women to be described and compared to comparative samples of service-seeking female college students. Sexual minority women were found to have a greater incidence of prior suicidality and prior counseling compared to heterosexual women at the same agency. Sexual minority women also reported greater symptoms of social anxiety, eating concerns, and family distress than heterosexual women at the same agency. Of seven examined predictors of service utilization, sexual minority identity label, age, and academic term of service initiation differentiated brief and extended service utilization from moderate service utilization. Prior use of counseling, psychological distress, racial-ethnic minority status, and time in the semester of initiation of services were not significant predictors of service utilization. Implications and limitations of these findings are presented, and future directions for research and intervention are discussed.

D.Litt. et Phil. / This study posits that although the South African government has shown an unprecedented commitment to acknowledging and upholding the human rights of bisexual men and women, negative attitudes exist towards bisexual men and women. A mixed method research study was conducted, consisting of three phases. In the first phase of the study (quantitative), a biographical questionnaire, the Attitudes Regarding Bisexuality Scale (ARBS-FM) (Mohr & Rochlen, 1999), and the Sexual orientation scale of Berkey, Perelman-Hall and Kurdek (1990) was utilised. A total of undergraduate 1 459 students were selected by convenience sampling. However, the reliability of the scales of the ARBS-FM in this student sample appeared to be significantly lower than desired. Therefore, the researcher organised an expert group (N = 11). This second section of the study served as expert advice from cultural interpreters that brought about adaptation of the measures (qualitative) and was complementary to the quantitative study. The researcher endeavoured to seek elaboration and clarification of the results from one method with the results of the other method. In the third phase of the study a revised ARBS (consisting of two scales measuring attitudes towards bisexual men and women separately), a biographical questionnaire, and the sexual orientation scale was administered. A total of 578 undergraduate students were selected by convenience sampling. The psychometric properties of the revised ARBS instruments were investigated by means of confirmatory factor analyses. Results indicated a two-factor structure (Tolerance and Stability) for both of the ARBS-F and ARBS-M. Tucker’s coefficients of congruence showed that attitudes towards bisexual men and women may be measured by an integrated scale. Differential item functioning (DIF) and differential test functioning (DTF) analyses suggested the removal of some items that favoured either the black or the white group. The revised ARBS-F and revised ARBS-M were used for testing the stated hypotheses. The results indicated that participants’ attitudes towards bisexual men and women vary on a range of factors such as gender, religiosity, contact, and the sexual orientation of the participants. Both heterosexual and homosexual students have more negative attitudes towards bisexual men and women than bisexual students. This double discrimination by heterosexuals and the gay and lesbian community is seldom recognised or acknowledged. Therefore, the current research findings elucidate that this oppression is real, and may have negative psychological effects on bisexual men and women. The results are discussed against the background of previous studies, and suggestions for future research are made. Key words: bisexual men, bisexual women, biphobia, homophobia, heterosexism, sexual orientation, university community, survey, attitudes, students.

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For approximately the last 20 years, researchers have studied the "environment" for students who are lesbian, gay, and bisexual. However, there has been little empirical research on the experiences of lesbian, bisexual, or gay students at historically Black colleges and universities. Most of the literature to date has focused on students at predominantly White institutions and students who are male. Further, HBCUs have long-been lauded for the unique educational experience they have created for African American students in general as evidenced by reports of greater satisfaction, faculty and social support, positive self-images, strong racial pride, and better psychosocial adjustment (Allen, Epps, & Haniff, 1991; Berger & Milem, 2000; Fleming, 1984; Fries-Britt & Turner, 2002; Terenzini, Bohr, Pascarella, & Nora, 1997). However, little research has been conducted on within-group differences among African American students at HBCUs to explore whether and how other social identities such as sexual orientation or socioeconomic class impact an African American student's experience of an HBCU. This is an exploratory study that examines the experiences of seven lesbian and bisexual female students at an historically Black college and inquires into the relationship between the culture of HBCUs and the students' perceptions of campus climate. Drawing from a focus group interview, a survey, institutional artifacts, and historical data, I explore three research questions. The questions are 1) what can be characterized as the culture at historically Black colleges and universities; 2) what is the lesbian and bisexual female student perception of the campus climate for lesbian and female bisexual students at HBCUs and; 3) how, if at all does the HBCU culture impact the campus climate? The culture was characterized by adherence to traditional gender norms of dress and behavior, affirming racial identity but not sexual identity, the dominance and prevalence of Christian values and beliefs, and a system of rewards and punishments for conforming or not conforming to gender norms. The climate was characterized by students feeling afraid; being harassed; feeling as though they are not wanted at the institution; restricting themselves from participating in activities; facing threats of expulsion; and having little to no social or institutional support.

Background: Research suggests sexual minority women have higher rates of substance use and mental health problems than straight women. Specifically, past studies have shown alcohol consumption and dependence rates are higher among sexual minority women, in addition to use of some drugs. Similarly, research shows mental health problems such as anxiety, depression and suicide rates are elevated among sexual minority women. These differences in mental health and substance use characteristics by sexual orientation may be explained by the negative health effects of social marginalization and the common use of drinking establishments for sexual minorities. Objective: The objective of this thesis is to compare substance use and mental health characteristics between lesbian/bisexual women and straight women, including: a) demographic variables; b) alcohol and drug consumption and dependence; c) the social context of substance use (i.e., use with others, motivations to use and locations of use); and, d) mental health characteristics. Methods: Data were obtained from a sample of residential treatment clients in treatment for primarily alcohol and/or cocaine problems. Respondents were asked to fill out self-administered questionnaires, which included details on demographics, substance use, mental health and the social context of use, as well as information on sexual orientation and gender identity. Bivariate and logistic regression analyses were performed to examine differences by sexual orientation. Results: Some sexual orientation differences were found regarding alcohol consumption and dependence during bivariate analysis. In logistic regression results, methamphetamine use was significantly (p<.01) elevated among bisexual women and tranquilizers use was elevated among lesbian and bisexual women when compared to straight women. Bivariate analysis revealed lesbian and bisexual women reported higher levels on motivations to use, but this difference was not significant in multivariate regression results. After regression adjustments, lesbian and bisexual women had higher levels of anxiety and higher rates of suicide attempts. Lastly, lesbian and bisexual women reported substance use with sex workers and sex clients more often than straight women, but no other differences in location and motivations to use were seen in the regression results. Conclusion: Among this sample of residential treatment clients, some mental health and substance use characteristic differences were found. These finding can assist in determining the best treatment practices for sexual minority women. / Graduate / 0347

The extremely high rates of intimate partner violence (IPV) experienced by Black women in community supervision programs (CSPs) who use drugs represents a major public health concern given the vast overrepresentation of Black women in the criminal legal system compared to non-Hispanic white women due to racialized drug laws and policies. National IPV surveillance data suggest that the rates of IPV in this population may be even higher among Black women who have sex with women and men (WSWM) in CSPs who use drugs. However, there remains a dearth of research that centers the experience of Black WSWM. Fear of experiencing police violence and experiences of racial and sexual discrimination pose additional challenges for Black WSMW in CSPs who use drugs to access both IPV and a broader range of services. No studies, to date, have examined typologies of IPV and its association to accessing IPV-related services among Black women with multiple intersecting minoritized identities including substance use, sexual behavior, and criminal-legal involvement. To address these gaps, this dissertation: 1) Identified typologies of IPV; 2) Examined how membership to latent classes is associated with use of core IPV services; and 3) Explored underlying mechanisms that may link IPV class, sexual behavior, and access to and utilization of IPV-related services. This dissertation study uses a sequential explanatory mixed methods approach with 1) secondary baseline survey data from Project EWORTH, a NIDA-funded HIV intervention study of 352 Black, drug-involved women mandated to CSPs and 2) primary qualitative follow-up data with participants from the same study to inform findings from the secondary data analysis. This dissertation found positive significant associations between having had both male and female sexual partners and more types and greater severity of IPV. Additionally, there was a significant, positive association between more types and greater severity of IPV and lifetime use of an order of protection. WSWM had a significantly higher odds of lifetime use of a DV shelter. Of interest, WSWM moderated the effect of people experiencing more severe violence accessing DV shelters. Qualitative interviews revealed unique forms of IPV such as feeling coerced to take a criminal charge for their partner and spiritual abuse, both of which are not captured with standard IPV measures or discussed broadly in IPV literature. Additionally, CSP staff served as an important link to services among these women. Overall, these results suggest that more inclusive IPV screening, referral to service, and actual services, as well as providing training for service providers that consider the effects of multiple, marginalized identities has on experience of IPV, and access to and use of services among Black women in the criminal legal system.

Most individuals spend more than half their lives as single due to divorce, widowhood, and remaining single (Simpson, 2016). Singlehood, in general, has meant not being in a heterosexual relationship. Historically, lesbian women have been considered single because their relationships were not legally recognized. Single women and lesbian women have had more choices to live outside heterosexual marriage, financially and with social acceptability, in the later portion of the 20th century and in the early 21st century than previously. Single sexual minority women of the baby boom came of age during this time and are beginning to plan for and enter into old age. This study used qualitative methods to study how single sexual minority women of the baby boom cohort defined family and planned for their later years. Women from the baby boom cohort who are currently single and identify as a sexual minority were connected to their family of origin and extended families in their youth, focused on romantic relationships during adulthood, and currently identify their family as biological and chosen family. The women had formal and informal plans for their future as they continue to age. Limitations, future directions, and implications are also discussed. / Ph. D. / Within the United States, most individuals spend more than half their lives as single. Singlehood, in general, has meant not being in a heterosexual relationship. Historically, lesbian women have been considered single because their relationships were not legally recognized. Single and sexual minority women are recently more able financially and with social acceptability, to live outside heterosexual marriage. Single sexual minority women of the baby boom came of age during this time and are beginning to plan for and enter into old age. This study used interviews to research how single sexual minority women of the baby boom cohort defined family and planned for their later years. Women from the baby boom cohort who are currently single and identify as a sexual minority were connected to their immediate family and extended families in their youth, focused on romantic relationships during adulthood, and currently identify their closest circle as biological and chosen family. The women had formal and informal plans for their future as they continue to age with a desire to remain independent for as long as possible. Discussions around sexuality in relation to singlehood also emerged during the interviews.

Though South Asians are one of the largest and fastest growing immigrant groups in the United States (Rico, 2023; U.S. Immigration and Customs Enforcement, 2020), their experiences are understudied and often only included within the larger umbrella of Asian and Asian American research (Sandil et al., 2015). Furthermore, there is a dearth of research on the experiences of Queer South Asians as well on the experiences of South Asian immigrants and those on non-immigrant visas in the United States. The present study attempts to address this gap by exploring the experiences of South Asian bisexual+ women living in the United States with regard to the impact of their experiences of discrimination and exclusion within LGBTQ+ and South Asian communities. Using Consensual Qualitative Research (CQR), the study analyzed data from 12 bisexual+ cisgender South Asian women living in the United States. The interview investigated their experiences of discrimination within South Asia as well as the LGBTQ+ community and the general public in the United States, examined their relationship with their identity and experiences of connectedness and exclusion within these communities, and explored their use of mental health services as well as their emotional responses and coping strategies to discriminatory experiences. The results revealed that experiences of discrimination, invalidation, and invisibilization affected participants’ wellbeing by contributing to increased distress, feelings of exclusion, and a lack of belonging within these communities. The implications of the results for policy, theory, and practice are presented, and include the promotion of multicultural competence and responsiveness in mental health practitioners and increased awareness to the experiences of an understudied population.

The background to this thesis is that we know very little about lesbian and bisexual women's sexual health in Sweden, particularly in relation to sexually transmitted infections (STI) and their transmissions. An internet-based questionnaire with self-selected participants targeted to the group WSW (Women who have Sex with Women) has been implemented. An international survey on the subject shows that the WSW has sexually transmitted infections. This is also in line with the results in this study. The most common sexually transmitted infection in the survey is chlamydia which 12.3 percent have had. This is a remarkably high figure in comparison with international studies. There are a number of barriers to WSW developing safer sex strategies. Many described a heteronormative response and very low level of knowledge in the health-care.Also WSW themselves have no or little knowledge on the subject. Prevention messages to the group, WSW is often about to use dental dams and very few in practice and in the case where it is used, it has only a very limited function. The majority of women in the study have had sexual contact with both men and women, this applies to both lesbian and bisexually women. In a theoretical analysis, it is possible to discern a conflict between the postmodern and the modern understanding of love and sexuality. This conflict does not exist only on an interpersonal / cultural level but also on a intrapsychic level of humans.