Introduction to the special section: Mental health of lesbians and gay men.

There has been little focus on the mental health of lesbians and gay men in the 2 decades since homosexuality was removed as a diagnostic category from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; American Psychiatric Association, 1980). This special section contains articles on research methodology on lesbian and gay mental health; the practice and ethics of sexual orientation conversion therapy; the mental health results of the National Lesbian Health Care Survey; ethnicity and sexual orientation; sexual orientation as a factor in research on eating disorders and body dissatisfaction; and verbal and physical abuse as stressors in the lives of lesbian and gay youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emerging issues in research on lesbians' and gay men's mental health: Does sexual orientation really matter?

Theoretical writings and research suggest that the onset, course, treatment, and prevention of mental disorders among lesbians and gay men differ in important ways from those of other individuals. Recent improvements in studies of sexual orientation and mental health morbidity have enabled researchers to find some elevated risk for stress-sensitive disorders that is generally attributed to the harmful effects of antihomosexual bias. Lesbians and gay men who seek mental health services must find culturally competent care within systems that may not fully address their concerns. The affirmative therapies offer a model for intervention, but their efficacy and effectiveness need to be empirically documented. Although methodological obstacles are substantial, failure to consider research questions in this domain overlooks the welfare of individuals who may represent a sizable minority of those accessing mental health services annually. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Minority stress and mental health among Dutch LGBs: Examination of differences between sex and sexual orientation.

Minority stress is often cited as an explanation for greater mental health problems among lesbian, gay, and bisexual (LGB) individuals than heterosexual individuals. However, studies focusing on sex or sexual orientation differences in level of minority stress and its impact on mental health are scarce, even more so outside the United States. Performing secondary analyses on the data of a Dutch population study on sexual health, the present study examines the robustness of the minority stress model by explaining mental health problems among men and women with mostly or only same-sex sexual attraction, and men and women who are equally attracted to same-sex and opposite-sex partners in the “gay-friendly” Netherlands (N = 389; 118 gay men, 40 bisexual men, 184 lesbian women, and 54 bisexual women). Results showed that minority stress is also related to mental health of Dutch LGBs. Participants with a higher level of internalized homonegativity and those who more often encountered negative reactions from other people on their same-sex sexual attraction reported more mental health problems. Such negative reactions from others, however, had a stronger link with mental health among lesbian/gay than among bisexual participants. Openness about one's sexual orientation was related to better mental health among sexual minority women, but not among their male counterparts. Suggestions for future research, implications for counseling, and other societal interventions are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Prevalence of mental disorders, psychological distress, and mental services use among lesbian, gay, and bisexual adults in the United States.

Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay-bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian-bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research on sexual orientation and human development: A commentary.

Over the last 25 yrs, dramatic advances have occurred in the understanding of the development of sexual orientation. Gay and lesbian interests and behavior appear to result from a complex interplay of genetic, prenatal, and environmental influences. Gender identity develops early, especially for males, and is difficult to change. Homosexuality is less likely to be characterized as pathological, although discrimination and hate crimes continue to affect many gay men and lesbians. The overall emotional well-being of gay men and lesbians, as well as children raised in gay and lesbian families, is as psychologically healthy as that of their heterosexual counterparts. Methodological difficulties in research remain with continued needs for more delineated definitions of sexual orientation and empirically derived databases of population statistics of gay men and lesbians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The practice and ethics of sexual orientation conversion therapy.

Sexual orientation conversion therapy was the treatment of choice when homosexuality was thought to be an illness. Despite the declassification of homosexuality as a mental illness, efforts to sexually reorient lesbians and gay men continue. The construct of sexual orientation is examined, as well as what constitutes its change. The literature in psychotherapeutic and religious conversion therapies is reviewed, showing no evidence indicating that such treatments are effective in their intended purpose. A need for empirical data on the potentially harmful effects of such treatments is established. Ethical considerations relative to the ongoing stigmatizing effects of conversion therapies are presented. The need to develop more complex models for conceptualizing sexual orientation is discussed, as well as the need to provide treatments to gay men and lesbians that are consonant with psychology's stance on homosexuality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of sexual orientation similarity and counselor experience level on gay men's and lesbians' perceptions of counselors.

Investigated the effects of sexual orientation similarity of counselor and client as well as counselor experience level on perceptions of counselors by gay men and lesbians. After receiving pre-session information in which the variables of counselor sexual orientation (gay male/lesbian or heterosexual) and experience level (experienced vs inexperienced) were manipulated, 40 gay male and 40 lesbian Ss in parallel experiments viewed different 15-min videotapes of same-sex counselor–client pairs and then completed the Counselor Rating Form (A. Barak and M. B. LaCrosse, 1975). Results indicated that the lesbian Ss rated the experienced therapists, both lesbian and heterosexual, as more expert; there were no other significant main or interaction effects. The results suggest that sexual orientation of the counselor may be a less salient concern of gay men and lesbians when the therapeutic issue is not sexual in nature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Lesbian and gay psychology: Theory, research, and clinical applications.

Reviews the book, Lesbian and gay psychology: Theory, research, and clinical applications by Beverly Greene and Gregory M. Herek (1994). This volume is a collection of theoretical, research, and clinical articles which share in common only their focus of a psychological approach to gay and lesbian issues. Particularly admirable is the handling of a variety of lesbian issues including sexual pride and shame, physical appearance, and feminist politics of sexual orientation. There are also good articles on stereotypes and attitudes toward lesbians and gay men. This volume moves the psychological study of lesbian and gay issues beyond being merely gay affirmative into looking at hard issues, and reconnecting gay studies with the larger body of psychological theory, research, and clinical practice. As a psychological potpourri of articles, it suggests what can be accomplished in lesbian and gay psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extension of the rejection sensitivity construct to the interpersonal functioning of gay men.

On the basis of recent evidence suggesting that gay men are particularly likely to fear interpersonal rejection, the authors set out to extend the rejection sensitivity construct to the mental health concerns of gay men. After establishing a reliable and valid measure of the gay-related rejection sensitivity construct, the authors use this to test the mediating effect of internalized homophobia on the relationship between parental rejection of one's sexual orientation and sensitivity to future gay-related rejection. The present data support this mediational model and also establish rejection sensitivity's unique contribution to unassertive interpersonal behavior in the context of internalized homophobia and parental rejection. The authors conclude that gay-related rejection sensitivity is a useful construct for clinicians working with gay men given the impact that past gay-related rejection can have on their gay clients' present cognitive-affective-behavioral functioning. The authors discuss the possibility of revising rejection-prone schemas in clinical work with gay men. Future research is necessary to further examine the internal processing and interpersonal functioning of gay men by using existing constructs (or modifications of them) that are likely to be particularly relevant to the unique concerns of this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional cerebral asymmetry and sexual orientation in men and women.

Functional cerebral asymmetry was assessed in 32 gay men and 32 heterosexual men and in 30 lesbians and 30 heterosexual women with a linguistic dichotic listening test. All groups showed the typical greater right-ear accuracy and, by inference, left-hemisphere representation for language functions. As shown repeatedly in previous studies (e.g., M. P. Bryden, 1982), among heterosexuals, consistent-right-handers showed greater perceptual asymmetry than did nonconsistent right-handers. In contrast, gay men and lesbians did not show an association between hand preference and magnitude of perceptual asymmetry. The results indicate different patterns of functional cerebral asymmetry in gay men and lesbians compared with heterosexual people and, specifically, less association between motoric and linguistic components of cerebral asymmetry. This suggestion of atypical patterns of functional asymmetries is consistent with previous results of an increased prevalence of left-hand preference among gay men and lesbians compared with the heterosexual population. The finding of an association between aspects of functional asymmetry, a neurological characteristic likely present from birth, and sexual orientation suggests that a neurobiological factor is involved in the origins of sexual orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual orientation and the second to fourth finger length ratio: A meta-analysis in men and women.

The ratio of the lengths of the second and fourth fingers (2D:4D) may serve as a marker for prenatal androgen signaling. Because people are typically unaware of their 2D:4D, its use allows possible effects of early sex hormone regimes and socialization to be disentangled. We conducted a meta-analysis on relationships between 2D:4D and sexual orientation in men and women in 18 independent samples of men and 16 independent samples of women. Collectively, these samples comprised 1,618 heterosexual men, 1,693 heterosexual women, 1,503 gay men, and 1,014 lesbians. In addition to identifying the normative heterosexual sex difference in 2D:4D for both hands, we found that heterosexual women had higher (more feminine) left- and right-hand 2D:4D than did lesbians, but we found no difference between heterosexual and gay men. Moderator analyses suggested that ethnicity explained some between-studies variation in men. These results add to a literature suggesting that early sex hormone signaling affects sexual orientation in women, and highlight the need for further research exploring the relationships among 2D:4D, sexual orientation, and ethnicity in men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring attitudes regarding bisexuality in lesbian, gay male, and heterosexual populations.

Five studies on the development and validation of the Attitudes Regarding Bisexuality Scale (ARBS) were conducted. Factor analysis of an initial pool of 80 items yielded 2 factors assessing the degree to which bisexuality is viewed as a tolerable, moral sexual orientation (Tolerance) and a legitimate, stable sexual orientation (Stability). Three forms of the ARBS were created: a form to assess attitudes about female and male bisexuality (i.e., ARBS-FM) and forms to assess attitudes about female bisexuality (i.e, ARBS-F) and male bisexuality (ARBS-M). These forms evidenced moderate-to-high internal consistency reliability in both lesbian and gay samples and heterosexual samples. In heterosexual women and men, subscale were most strongly related to attitudes toward lesbians and gay men; frequency of religious attendance; political ideology; and prior contact with lesbian, gay, and bisexual people. In lesbians and gay men, subscales correlated with prior experiences with bisexual people, desired contact with bisexual people, contact with homosexual people, and sexual orientation identity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Ruling in" and "ruling out": two approaches to the micro-rationing of health care

Seropositive gay and bisexual men who reveal their sexual orientation or HIV/AIDS status to their employer risk discriminatory reprisals. However, non-disclosure may limit potential social, emotional, and tangible support. Among our sample of 389 seropositive gay and bisexual men employed in the US, 52% were 'out' to their employer and 35% had disclosed their serostatus to him or her. Among gay men, employer awareness of their sexual orientation was related to their being European American (vs Latino or African American), being HIV-seropositive for more than 4 years, and having a gay or bisexual employer. Disclosure of HIV infection in the total sample was related to being European American, HIV-seropositive for more than 4 years, symptomatic (vs asymptomatic), 'out' at work, and having a gay or bisexual employer. Men who had informed their employers of their HIV status reported consequences that were substantially more positive than those anticipated by men who had not disclosed. Policy and research implications for improving the work environment for gay and bisexual men living with HIV are considered.     

The strategic approach to contraceptive introduction

Lesbian, gay, and bisexual educators have faced many barriers in their professions, including harassment, discrimination, and even nationwide antigay political campaigns. Recently, lesbian, gay, and bisexual educators, particularly on college campuses, have challenged such stigmatization by coming out. Because previous research has demonstrated that interpersonal contact with lesbians, gay men, and bisexuals is related to less heterosexist attitudes, the current study investigated the impact of a gay instructor's coming out on his students' attitudes toward lesbians and gay men. Data were collected from 156 undergraduate students enrolled in an Introductory Psychology course, 40 of whom were taught by a gay instructor. Herek's (1984, 1994b) Attitudes Toward Lesbians and Gay Men (ATLG) scale was used to measure students' relative levels of heterosexism and was administered to students at the beginning and end of the semester. Midway through the semester, the gay instructor disclosed his gay identity to his students as part of a lesson about sexual orientation. Results from the postcourse survey indicated that students in the gay instructor's course section exhibited improved attitudes. Conversely, students enrolled in the same course in sections taught by heterosexual instructors demonstrated no change in their attitudes. Implications of these findings are discussed, and it is argued that gay instructors' coming out may positively affect their students' attitudes toward lesbian, gay, and bisexual people. However, these efforts by individual instructors must only be a small part of more comprehensive institutional efforts by university communities to address homophobia and heterosexism in educational settings.     

Pioneers in Partnership: Lesbian and Gay Male Couples in Civil Unions Compared With Those Not in Civil Unions and Married Heterosexual Siblings.

This study compared 212 lesbians and 123 gay men who had civil unions in Vermont (during the first year legislation made this available) with 166 lesbians and 72 gay men in their friendship network who had not had civil unions, and also with 219 heterosexual married women and 193 heterosexual married men consisting of civil union couples' siblings and their spouses. Married heterosexual couples had been together longer and had more traditional division of labor and child care than did lesbians and gay men in both types of couples. Lesbians in civil unions were more open about their sexual orientation than those not in civil unions, and gay men in civil unions were closer to their family of origin than gay men not in civil unions. This is the first study on same-sex couples with civil unions, and the first to compare lesbians and gay men with their married siblings. At a time of legal changes for same-sex couples, these results indicate that legalized same-sex relationships are related to visibility of same-sex couples to their family and the general public. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Don't ask, don't tell: Deception required, disclosure denied.

This article explores some therapeutic benefits of voluntary disclosure of sexual orientation by gay, lesbian, and bisexual persons as well as some of the opportunities lost by requiring concealment. Though the article is not about the military, the military policy on gay men, lesbians, and bisexuals serves as a useful vehicle to explore these issues. The article outlines provisions of the old, new, and promised policies. After considering the opportunities lost by rejection of President Bill Clinton's original proposal, the article reviews the literature on self-disclosure, the benefits of self-disclosure, and the role self-disclosure plays in reducing prejudice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public policy and private prejudice: Psychology and law on gay rights.

Although the Supreme Court's decision in Bowers v. Hardwick was a great disappointment to advocates for lesbians and gay men, the law in regard to gay rights remains unsettled. Organized psychology has an important role to play in rebutting erroneous stereotypes of homosexuals that long influenced mental health professionals' views and that continue to affect public policy and private prejudice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and coping among gay men: Age and ethnic differences.

Previous studies suggest that perceived stigmatization of sexual minority status, ethnicity, and age are associated with negative mental health outcomes, and other studies suggest that coping styles may influence these outcomes. However, no studies have examined these relationships among gay men of varying ethnicities and age groups. Three hundred eighty-three Black and White, younger, middle-aged, and older adult gay men completed measures of perceived stigmatization, coping style, and mental health outcomes. Black older adult gay men reported significantly higher levels of perceived ageism than the older White group, significantly higher levels of perceived racism than the younger Black group, significantly higher levels of homonegativity than the younger Black and the White groups, and were more likely to use disengaged coping styles than White gay men. However, Black older adult gay men did not experience significantly higher levels of negative mental health outcomes. Results suggest that further research should examine how older Black gay men, who perceive higher levels of stigma while reporting greater use of less effective coping styles, do not appear to be experiencing more negative mental health outcomes as a result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults.

Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)