BACKGROUND: Although prior studies have established the association of asthma with smoking and obesity, literature on difference-in-differences analyses involving sexual identity is sparse. Therefore, this study aimed to examine the between and within sexual identity-group differences in asthma prevalence among individuals who smoke and are obese. METHODS: We aggregated the 2017-2019 National Survey on Drug Use and Health data on adults ( = 128,319) to perform weighted multivariable logistic regression analysis and marginal estimates and marginsplot to determine asthma prevalence by sexual identity and the status of smoking and obesity. RESULTS: About 66% of the study population reported having asthma. Among the individuals with asthma, 42% were obese, 10% were daily cigarette smokers, and 6% identified as bisexual persons. Lesbian/gay daily smokers (86%) or former smokers (75%) had a higher probability of having asthma than bisexual (daily smokers = 78% vs former smokers = 72%) and heterosexual (daily smokers = 68% vs former smokers = 65%) persons. Within each sexual identity subgroup, daily smokers (68-86%) had the highest probability of asthma. Obese bisexual (73%) or lesbian/gay (72%) persons had higher probabilities of having asthma than heterosexual persons (69%). Obese (73%) or overweight (72%) bisexual (compared to normal weight = 70% or underweight = 51%) and obese (69%) or overweight (65%) heterosexual (compared to normal weight = 62% or underweight = 57%) persons had the highest probabilities of having asthma within their groups, whereas overweight persons (overweight = 81% vs underweight = 79%, normal weight = 78%, and obese = 72%) had the highest probabilities within lesbian/gay persons. CONCLUSIONS: Smoking and obesity show heightened odds for asthma, with significant odds for sexual minorities in asthma diagnosis relative to heterosexuals. These findings provide formative information for future longitudinal and experimental studies to explore these mechanisms of asthma risks among sexual and gender minorities.

Research on forced migration has largely ignored asylum seekers from sexual and gender minorities. This exploratory study aimed to examine both positive and negative experiences of LGBT asylum seekers who had migrated to Sweden. Within the study, experiences prior to migration, during transit, and after arrival in Sweden were conceptualized as a process. Guided by the research question “How do LGBT asylum seekers describe positive and negative experiences of their asylum journeys?”, semi-structured interviews with eleven LGBT asylum seekers were conducted and analyzed using inductive thematic analysis. The analysis resulted in five themes; 1. Living Under Threat, 2. Into the Abyss, 3. Living in Suspension, 4. External Sources of Support and 5. Strength from Within. Considerable stressors were reported, spanning form pre- to post migration. LGBT asylum seekers are found to be an especially vulnerable group that demonstrates considerable internal resources.

In this thesis I am putting the sexual and gender minorities in South Korea and Japan under the limelight. I am discussing the topic of LGBT social acceptance, and the connection between the level of social acceptance and how the sexual and gender minorities have been perceived through history, and are currently being perceived within the law, culture and religion, politics, and Socio-economic areas in South Korea and Japan. In both countries there is still a visible lack of social acceptance towards LGBT persons, and the hypothesis of this paper is that all of the factors contributing to that outcome, except for religion, are evidently similar. The aim is to analyze and show the connection between these factors and how the sexual and gender minorities are viewed and treated, as well as to compare the outcome in respective country and discuss the similarities and differences.

Bakgrund: Sexuella- och könsminoriteter faller utanför hetero- och tvåkönsnormen som finns i samhället och utsätts för diskriminering på olika sätt överallt i världen. Personer inom gruppen sexuella- och könsminoriteter har rapporterat negativa erfarenheter av vårdmötet, till exempel i form av homofoba och transfoba attityder, vilket kan medföra att hbtq-personer undviker att söka vård. Sjuksköterskan kan vara med och förbättra detta då hen har ett ansvar att främja insatser som tar särskild hänsyn till utsatta gruppers hälsa och sociala behov.  Syfte: Syftet var att beskriva vilka faktorer som påverkar upplevelsen av bemötande från vårdpersonal enligt personer som ingår i gruppen sexuella- och könsminoriteter. Metod: Deskriptiv litteraturöversikt användes som metod och i resultatanalysen ingick 14 originalartiklar som undersökte sexuella- och könsminoriteters upplevelse av vårdmötet. Resultat: Det visade sig vara viktigt när vårdpersonal gav personcentrerad vård, respekterade patientens identitet och att de utvecklade en tillits- och förtroendefull relation. Det var även viktigt att vårdpersonal hade specifik kunskap inom området och använde ett könsneutralt språk i vårdmötet. Negativa faktorer var upplevelse av diskriminering och att vårdpersonal gjorde hetero- eller cisnormativa antaganden.  Slutsats: Vårdpersonal bör vara medveten om att normer och förutfattade meningar kan påverka vårdmötet utan att de tänker på det. För att undvika stereotypt bemötande bör vårdpersonal respektera patientens identitet och ha mer kunskap om behov som är unika för sexuella- och könsminoriteter. / Background: Sexual and gender minorities do not conform to heterosexual and gender-binary social norms and are subjected to different forms of discrimination all over the world. Members of these minorities have reported instances of negative experiences of healthcare encounters which can result in a hesitation to seek further care. Given their responsibility to promote healthcare interventions tailored to the needs of marginalised groups, nurses could play an important role in resolving this issue. Aim: The aim of the study was to describe which factors affect the experience of an encounter with a health professional according to people who identify as a sexual or gender minority.  Method: The study comprised a descriptive literature review of 14 empirical studies which explored the experience of sexual and gender minorities in relation to the healthcare encounter. Result: The following factors were revealed to be particularly influential in determining the healthcare experiences of sexual and gender minorities. Positive factors included: when health professionals delivered person-centered care, respected the patient’s sexual and gender identity, and when they could develop a trusting relationship with a healthcare professional. It was also important that health professionals were knowledgeable and used gender-neutral language. Negative factors included instances of discrimination and when health professionals made hetero- or cis-normative assumptions.  Conclusion: Health professionals need to be aware of the impact that norms and preconceptions can have on the healthcare encounter. To avoid stereotypical treatment, health professionals should respect the patient’s identity and have more knowledge about sexual and gender minority-specific needs.

The mind and body connection has been actively examined in neuroscience and developmental psychology backgrounds. Sociological theorists posit ways that individuals develop a sense of self through mind, body, and the social world. While research on the connection between the mind and body in disabled and aging populations is common, less is known of the everyday impact of these connections for other minority populations. The present study uses mixed-methods research to explore the relationship between mind and body and the impacts on internal and social life. The quantitative aspect of the study found significant relationships between physical and mental health for sexual and gender minorities (N = 788). The qualitative portion of the research consisted of interviews with sexual and/or gender minorities (N = 20). Interviews revealed central themes of ownership, oppression, and disconnection as a coping mechanism for external and internal body dissatisfaction.

Considerando-se a trajetória sociocultural e política da constituição da entidade familiar, assiste-se a um aumento da visibilidade dos arranjos familiares configurados por casais do mesmo sexo/gênero e seus/suas filhos(as). A aceitação social e possível regulamentação jurídica que assegure os direitos dos membros das famílias homoparentais são questões prementes na atualidade. Estudos realizados no cenário brasileiro têm evidenciado que essas famílias convivem, nos mais variados contextos relacionais, com o estranhamento e enfrentam barreiras decorrentes de preconceitos e discriminação. Em face da necessidade de compreender essa realidade a partir de estudos que contemplem e deem voz aos/às integrantes das famílias homoparentais, depreende-se a relevância de conhecer como os casais formados por gays e lésbicas e seus/suas filhos(as) constituem suas vivências familiares nos âmbitos privado e social. Este estudo teve por objetivo conhecer as vivências de quatro famílias homoparentais a partir das vozes de quatro casais constituídos por dois homens e duas mulheres, e seus/suas quatro filhos(as). Os instrumentos e técnicas utilizados com os casais foram: Formulário de Dados Sociodemográficos, Critério de Classificação Econômica Brasil, Entrevista Aberta, Genograma e Mapa de Rede; com os(as) filhos(as): Formulário de Dados Sociodemográficos, Entrevista Aberta e Mapa de Rede. A Entrevista Aberta, definida como a principal técnica de coleta, foi audiogravada, transcrita na íntegra e analisada de forma articulada com os dados extraídos dos demais instrumentos aplicados, a partir do referencial teórico-metodológico da Análise Fenomenológica Interpretativa (AFI). Os resultados apontaram que os casais compartilharam suas vivências relacionadas a ser lésbica/gay em uma sociedade marcada pela homofobia, contaram as histórias detalhadas de seus relacionamentos amorosos, destacaram a relação de companheirismo como base da vivência conjugal e refletiram sobre as vivências dos papéis de gênero no relacionamento conjugal, fazendo um contraponto entre o que é esperado socialmente e o que é realmente vivenciado em suas relações cotidianas. Encontrou-se uma pluralidade de vivências conjugais e parentais, assim como de modos de acesso à parentalidade, todavia a percepção de transformação pessoal com a transição para a maternidade/paternidade e o cuidado e a preocupação relativos à educação do(a) filho(a) perpassam todas as vivências familiares. A despeito das dificuldades enfrentadas no cotidiano, das experiências de preconceito social e familiar e dos percalços da aceitação por parte das famílias de origem, todos(as) os(as) participantes afirmaram viver bem em família. Compreende-se que as vivências do ser/viver família configuram percursos singulares no processo de construção da subjetividade de cada membro da família e, particularmente, para os(as) cônjuges representam um marco fundamental rumo à apropriação de quem cada um/uma é. O conhecimento gerado por esta pesquisa oferece subsídios que permitem aprofundar a compreensão do fenômeno investigado, e para o planejamento de estratégias que contribuam para fornecer cuidados às famílias homoparentais e que promovam condições para que elas possam ser reconhecidas e respeitadas na sociedade em que se inserem. A produção e divulgação de pesquisas nesta área podem fornecer elementos para novas reflexões que contribuam para transformar posturas preconceituosas e excludentes frente ao desenvolvimento e à pluralidade das organizações familiares existentes na contemporaneidade / In view of the sociocultural and political constitution of the family as an institution throughout the course of history, there is an increase in the visibility of the family arrangements made up of same-sex couples/gender and their children. Social acceptance and possible legal regulation that ensures the rights of members of same-sex/gender families are pressing issues today. Studies carried out in the Brazilian scenario have evidenced that these families coexist in the most varied relational contexts with strangeness and face barriers resulting from prejudice and discrimination. Given the need to understand this reality based on studies that contemplate and give voice to the members of same-sex/gender families, the relevance of knowing how couples formed by gays and lesbians and their children constitute their experiences in the private and social spheres. This study aimed to know the experiences of four same-sex/gender families from the voices of four couples consisting of two men and two women, and his/her four children. The instruments and techniques used with the couples were: The Sociodemographic Form, the Brazilian Economic Classification Criteria, the Open-ended Interview, the Genogram and the Network Map; with the children: The Sociodemographic Form, the Open-ended Interview and the Network Map. The Open Interview, defined as the main collection technique, was audio-recorded, transcribed verbatim and analysed in an articulated way with the data extracted from the other instruments applied, based on the theoretical and methodological framework of the Interpretative Phenomenological Analysis (IPA). The results showed that the couples shared their experiences related to being lesbian/gay in a society marked by homophobia, told the detailed stories of their love relationships, highlighted the relation of companionship as a basis for conjugal experience and reflected on the experiences of gender roles in the marital relationship, making a counterpoint between what is expected socially and what is actually experienced in their daily relationships. There was a plurality of conjugal and parental experiences, as well as ways of access to parenting, but the perception of personal transformation with the transition to motherhood/fatherhood and the care and concern regarding the education of the child permeate all family experiences. In spite of the difficulties faced in daily life, the experiences of social and family prejudice and the mishaps of acceptance by the families of origin, all the participants affirmed to live well with the family. It is understood that the experiences of being/living family constitute unique paths in the process of constructing the subjectivity of each member of the family and, in particular, for the spouses represent a fundamental landmark towards the appropriation of who each one is. The knowledge produced by this research provides support to deepen the understanding of the phenomenon investigated, offering subsidies for the planning of strategies that contribute to offer care to same-sex/gender families that promote conditions so that they can be recognized and respected in the society in where they are inserted. The production and dissemination of research in this area can provide elements for new reflections that contribute to transform prejudices and exclusionary postures in the face of the development and plurality of family organizations existing in the contemporary world

No description available.

BACKGROUND AND OBJECTIVES: Sexual minority individuals demonstrate disparate rates of substance use. Research suggests that bisexual women are vulnerable to substance use disorders when compared to other sexual minority groups. This study explored differences in prevalence of past-year alcohol use disorder (AUD) with and without concurrent past-year opioid and/or benzodiazepine misuse. METHODS: The present study utilized responses from the National Survey on Drug Use and Health (NSDUH) public dataset between the years 2015-2019 (N = 16,002) to examine the association between sexual orientation and concurrent misuse of opioids and/or benzodiazepines among individuals with past-year AUD, stratified by sex. RESULTS: Bisexual females demonstrated higher rates of concurrent opioid and benzodiazepine use compared to all other groups. Although there was no association between sexual orientation and concurrent substance use patterns among males, female respondents with past-year AUD endorsing past-year misuse of opioids and benzodiazepines, both alone and in combination, were more likely to be bisexual compared to heterosexual. Lesbians were less likely to endorse concurrent misuse of opioids and benzodiazepines compared to bisexual females. DISCUSSION AND CONCLUSIONS: In a national sample, bisexual females demonstrated higher odds of risky concurrent substance use patterns. Identifying sexual minority individuals who exhibit elevated risk of co-occurring alcohol, opioid, and/or benzodiazepine misuse is an important step to targeted prevention efforts and allocation of resources to combat rising overdose deaths. SCIENTIFIC SIGNIFICANCE: For the first time, this study explored risky concurrent alcohol, opioid, and benzodiazepine misuse patterns among individuals of different sexual orientations.

Bakgrund: Icke-heterosexuella ungdomar har ökad risk att drabbas av psykisk ohälsa. Forskning om icke-heterosexuella ungdomars psykiska hälsa i svensk kontext är dock begränsad. Syftet med denna studie var att undersöka sambandet mellan sexuell läggning och psykisk ohälsa respektive psykiskt välbefinnande bland ungdomar på Gotland.  Metod: Tvärsnittsstudiedesign med befolkningsenkäten Liv och Hälsa Ung i Region Gotland användes. Psykisk ohälsa mättes med Strenghts and Difficulties Questionnaire (SDQ). Psykiskt välbefinnande mättes med Mental Health Continuum Short Form (MHC-SF). Chi2-tester, t-tester och logistiska regressioner användes för att analysera data.  Resultat: Jämfört med heterosexuella ungdomar hade icke-heterosexuella ungdomar signifikant högre odds för både psykisk ohälsa och nedsatt psykiskt välbefinnande i ojusterade regressioner. Dessa samband var dock inte signifikanta i justerade regressioner. Däremot påvisades högre odds för psykisk ohälsa respektive nedsatt psykiskt välbefinnande bland tjejer, ungdomar med hög stressnivå, ungdomar som kände sig ensamma eller som inte hade någon att prata med. Risken för nedsatt psykiskt välbefinnande minskade även med bättre upplevd familjeekonomi och ökad social status i skolan.  Slutsats: De justerade resultaten påvisade inga signifikanta samband mellan sexuell läggning och psykisk ohälsa respektive psykiskt välbefinnande bland ungdomar på Gotland. Sexuell läggning kunde därmed inte direkt associeras med en ökad risk för psykisk ohälsa respektive nedsatt psykiskt välbefinnande. Signifikanta samband påvisades mellan stress, ensamhet och att inte ha någon att prata med och psykisk ohälsa samt nedsatt psykiskt välbefinnande. Inkluderingsinsatser och riktade stödjande insatser kan möjligen minska upplevelsen av stress, ensamhet och utanförskap. Studien visade också hög förekomst av nedsatt psykiskt välbefinnande i hela studiepopulationen. Breda åtgärder för att stärka ungdomars psykiska välbefinnande, såsom insatser i skolan, skulle kunna förbättra hälsan för många ungdomar, inklusive de med icke-heterosexuell läggning. / Background: Non-heterosexual adolescents are at higher risk of mental health problems than heterosexual adolescents. Research on the mental health among non-heterosexual adolescents in the Swedish context is limited. The purpose of this study was to investigate the relationship between sexual orientation and mental health problems and mental well-being in adolescents on Gotland.  Method: A cross-sectional design including the population survey Life and Health Youth in Region Gotland was utilized. The survey included the Strengths and Difficulties Questionnaire (SDQ) for assessing mental health problems, and the Mental Health Continuum Short Form (MHC-SF) for assessing mental well-being. Chi2 tests, t-tests and logistic regressions were used to analyze the data.  Results: In unadjusted regressions, non-heterosexual adolescents had significantly higher odds for both mental health problems and decreased mental well-being compared to heterosexual adolescents. These associations were no longer significant in adjusted regressions. Significantly higher odds for mental health problems and decreased mental well-being was demonstrated in girls, adolescents with high levels of stress, and adolescents who felt lonely or who had no one to talk to. The risk of decreased mental well-being was also reduced with better perceived family finances and increased social status at school.  Conclusion: Adjusted regressions showed no significant associations between sexual orientation and mental health problems or mental well-being among adolescents on Gotland. Therefore, sexual orientation could not be directly associated with an increased risk of mental health problems or decreased mental well-being. The results showed significant associations between stress, loneliness and not having anyone to talk to and mental health problems and decreased mental well-being. Inclusive interventions and targeted support efforts could possibly reduce the experience of stress, loneliness and exclusion. The study also showed a high prevalence of decreased mental well-being in the entire study population. Interventions to strengthen adolescents’ well-being, e.g. school-based interventions, could improve the health of adolescents, including those with a non-heterosexual orientation.

L'adolescence est une période importante dans le développement de soi en tant qu'être sexuel, qui contribue à façonner le bien-être sexuel ultérieur de l'adulte. La thèse visait à documenter les barrières aux expériences sexuelles positives à l’adolescence avec les données de la cohorte PRÉSAJ. La première étude, incluant 1036 adolescents en troisième secondaire, a examiné le vécu d’intimidation, le bien-être sexuel, et le rôle médiateur des difficultés de régulation émotionnelle en tenant compte du genre et de l’orientation sexuelle. Le vécu d’intimidation était négativement associé aux difficultés de désir/excitation sexuelle et positivement associé à la détresse sexuelle. Les difficultés de régulation émotionnelle ont agi comme médiateur entre l’intimidation et la fonction orgasmique, ainsi que la détresse sexuelle. La deuxième étude a examiné les différences en fonction du genre et de la configuration relationnelle quant à l'orgasme (durant la masturbation et avec partenaire) et les comportements sexuels (oraux et manuels) chez 2800 adolescents en cinquième secondaire. Les résultats ont montré que, par rapport aux garçons cisgenres, les filles cisgenres avaient moins de chances de rapporter un orgasme pendant la masturbation et avec un partenaire. De plus, les filles cisgenres recevaient davantage de stimulation manuelle, mais moins de stimulation orale. Ensuite, les individus trans et non-binaires (TNB) assignés au sexe masculin à la naissance (AMAN) recevaient davantage de stimulation manuelle, mais les individus TNB assignés au sexe féminin àla naissance (AFAN) recevaient moins de stimulation orale que les garçons cisgenres. Pour la configuration relationnelle, les filles cisgenres ayant des partenaires de genre différent et les filles cisgenres ayant des partenaires de genre multiple avaient moins de chances d'avoir déjà eu un orgasme pendant la masturbation, rapportaient plus de difficultés à expérimenter l'orgasme avec un partenaire et recevaient moins de stimulation orale comparativement garçons cisgenres ayant un partenaire de genre différent. Le groupe TNB AMAN avec des partenaires de même genre avait plus de chances d’avoir un orgasme en se masturbant et de recevoir davantage de stimulation orale comparativement au groupe TNB AFAN ayant des partenaires de genre multiple. En outre, le groupe TNB AFAN avec des partenaires de même genre a rapporté plus de difficultés d'orgasme avec partenaire et recevait moins de stimulation manuelle. La troisième étude visait à identifier les classes longitudinales de changements dans l'identité sexuelle, les décrire en termes de variables sociodémographiques, et tester les associations avec le bien-être sexuel ultérieur. Une analyse de classe latentes incluant 3027 adolescents de 14 à 17 ans a permis de dégager trois classes: Identité Hétérosexuelle Stable (Classe 1 : 84,4%), Identité Principalement de Minorité Sexuelle (Classe 2 : 10,2%), et Identité de Minorité Sexuelle Émergente ou en Questionnement Constant (Classe 3 : 5,4%). Par rapport à la Classe 1, être membre de la Classe 2 était associé à une satisfaction sexuelle plus faible et une détresse sexuelle plus élevée, alors qu’être membre de la classe 3 était associé à un désir/excitation sexuelle plus élevée. Les implications et contributions cliniques, théoriques et méthodologiques, ainsi que les limites de la thèse seront discutées. / Adolescence is an important period in the development of the sense of self as a sexual being, which contributes to shape subsequent adult sexual wellbeing. The general objective of this thesis was to document experiences of and barriers to positive sexuality experiences in adolescence. The aim of the first study was to examine the associations between bullying victimization and sexual wellbeing (sexual satisfaction, sexual desire/arousal, orgasm function and sexual distress) via the mediating role of emotion regulation difficulties, considering potential sexual/gender minority differences in 1036 sexually active high school students. Bullying victimization was directly and negatively associated with sexual desire/arousal difficulties and positively with sexual distress. Greater emotion regulation difficulties mediated the associations between greater bullying victimization and greater orgasmic difficulties, as well as greater bullying victimization and greater sexual distress. The second study examined differences in orgasm and sexual behaviours across gender and sexual orientation among 2800 middle adolescents. Results showed that, using cisgender boys as reference, cisgender girls had lower odds of experiencing orgasm during masturbation, more difficulties with orgasm during partnered sex, received more manual sex, and less oral sex. TNB individuals assigned male at birth (AMAB) received more manual stimulation, and TNB assigned female at birth (AFAB) received less oral sex. For dyad type, using cisgender boys with different-gender partners as reference, cisgender girls with different-gender partners and cisgender girls with multiple-gender partners had lower odds of having ever experienced orgasm during masturbation, reported more difficulties experiencing orgasm during partnered sex and received oral stimulation less often. Using TNB AFAB with multiple-gender partners as reference, TNB AMAB with same-gender partners had higher odds of experiencing orgasm while masturbating and receiving more oral stimulation. Also, TNB AFAB with same-gender partners reported more diffiuclties with orgasm in partnered contexts and received less manual stimulation. The third study aimed to identify and characterize longitudinal classes of sexual identity change across three time points and test the associations between class membership and later sexual wellbeing. A total of 3027 adolescents aged 14 to 17 years completed in-class questionnaires during three waves over three years. Three-step latent class analysis of sexual identity including sociodemographic covariates was followed by Wald tests to examine differences in sexual wellbeing across classes. Three classes emerged: Consistent Heterosexual (84.4%), Mostly Sexual Minority (10.2 %), and Consistent Questioning and Emerging Sexual Minority (5.4 %). Compared to Consistent Heterosexuals, other class members were more likely to be cisgender girls or trans/non-binary youth. Also, members of the Consistent Questioning and Emerging Sexual Minority classes had higher odds of coming from a metropolitan area. Compared to Consistent Heterosexuals, Mostly Sexual Minority members had lower sexual satisfaction as well as higher sexual distress, yet members of the Consistent Questioning and Emerging Sexual Minority class had significantly higher sexual desire/arousal. Results document the complex associations between identity and sexuality during adolescence. The clinical, theoretical and methodological implications and contributions, as well as the limitations of the thesis are discussed.