Sexual Victimization Among Sexual and Gender Minoritized Groups: Recent Research and Future Directions.

PURPOSE OF THE REVIEW: Sexual victimization is a significant public health concern. Compared to heterosexual and cisgender peers, sexual and gender minoritized (SGM) individuals are at elevated risk for sexual victimization. Prominent theories suggest that this risk is due in part to the stigma SGM individuals face when navigating heteronormative cultures. The goal of this article is to review the prevalence, risk factors, and consequences of sexual victimization in SGM individuals. RECENT FINDINGS: Studies continue to show that SGM individuals-bisexual and/or gender minoritized in particular-are at higher risk for sexual victimization. Little work has focused on risk factors, though recent research continues to highlight post-victimization disparities among SGM individuals. Emerging studies also point to theoretically informed factors that may influence victimization risk and recovery, including sexual and gender-related stigma. To inform prevention and intervention efforts, future research would benefit from streamlining assessment, methodology, and dissemination practices.

How deep is the cut? The influence of daily microaggressions on bisexual women's health.

Bisexual women experience disproportionately poorer health outcomes in comparison to lesbian and gay groups, and the general population, including inequities related to mental and physical health. Although bisexual-specific health inequities are increasingly well-documented, research examining putative causes of such inequities, as well as research that accounts for differences within bisexual populations - particularly among racial minorities- remains limited. To address these gaps, this paper reports findings from the Women's Daily Experiences Study (WoDES), a multi-method study that explored the relationship between microaggressions and health outcomes among racially/ethnically diverse cisgender, bisexual women in Chicago. Data from 28-day daily e-diaries (N = 2,104 observations; 99 participants, 57% women of color) were analyzed using multilevel modeling to (1) measure the frequency of microaggressions among bisexual women; (2) examine the influence of sexual orientation, racial, and gender microaggressions on mental and physical health; and (3) investigate how race influences relationships between microaggressions and health. Participants reported an average of 8.1 microaggressions in the previous 28 days, and at least one microaggression was reported for more than 42% of days (n = 802). Microaggressions of any type were associated with increased same-day negative affect and somatic complaints. Latina bisexual women experienced worse health outcomes in comparison to Black bisexual women. This study demonstrated the detrimental impact of microaggressions on the health of bisexual women and highlights the critical need for strategies on broader structural changes that could improve the health and well-being of bisexual women.

Prospective associations among relationship abuse, sexual harassment and bullying in a community sample of sexual minority and exclusively heterosexual youth.

INTRODUCTION: Sexual minority youth (SMY) are at significantly greater risk for experiencing adolescent relationship abuse (ARA) than exclusively heterosexual youth, yet little is known about the factors that elevate their risks for such abuse. Peer victimization (i.e., bullying, sexual harassment) has been associated with ARA among heterosexual youth. SMY experience higher rates of peer victimization than heterosexual youth, suggesting that it may be a risk factor for ARA among these youth. Using longitudinal data from a community sample of adolescents recruited from the northeastern US, we examined whether sexual identity was associated prospectively with ARA, and whether that relationship would be indirect, and mediated via bullying and sexual harassment at a 12-month follow-up. We expected to find higher rates of peer victimization and ARA among SMY than heterosexual youth, and we expected that sexual harassment and bullying would predict subsequent relationship abuse. METHODS: Adolescents (N = 800; 58% female; 81% European-American; 19% SMY) between 13 and 15 years (M = 14.45, SD = 0.85) completed a web survey at baseline, 6-months and 12-months. RESULTS: Consistent with prior studies, SMY reported higher rates of bullying, sexual harassment, and relationship abuse than heterosexual youth. SMY who reported sexual harassment at baseline were more likely to report relationship abuse over time. Contrary to our expectations, however, bully victimization did not predict subsequent relationship abuse. CONCLUSIONS: Sexual harassment can be particularly harmful for SMY because it targets gender and sexual identity at a formative developmental period and puts youth at risk for relationship abuse.

Concurrent Daily Alcohol and Tobacco Use among Sexual Minority and Heterosexual Women.

Background: Studies show that sexual minority women (SMW) report more hazardous alcohol use patterns and higher rates of tobacco use than exclusively heterosexual women. Despite the public health implications of drinking and smoking, especially when they co-occur, little is known about SMW's daily use patterns or the factors that may facilitate concurrent use. Objectives: The present study seeks to identify patterns of daily concurrent alcohol and tobacco use among SMW and heterosexual women, including socio-environmental drinking contexts of concurrent use. Methods: Data come from a community sample of lesbian, bisexual, and heterosexual women (N = 246) who completed up to 84 consecutive days of web-based reports about substance use. Results: Participants reported 4,012 drinking days (24%), 2,019 smoking days (12%), and 769 concurrent drinking and smoking days (5%). No differences were found between SMW and heterosexual women in the proportion of drinking days; however, SMW consumed more drinks on drinking days. SMW also reported a greater proportion of smoking days, more cigarettes smoked on smoking days, and a greater proportion of concurrent drinking and smoking days. Reciprocal daily relationships between alcohol and tobacco use were identified, and these relationships were strongest for bisexual women. Socio-environmental factors-including certain locations, situations, and companions-increased the likelihood of concurrent use for all women; however, few sexual identity differences were found in concurrent use contexts. Importance: Results expand our understanding about daily concurrent alcohol and tobacco use risk among SMW, and potentially inform treatment research to better address the unique experiences of this vulnerable group.

Maximizing respondent-driven sampling field procedures in the recruitment of sexual minorities for health research.

OBJECTIVES: Research to address the significant health burden experienced by sexual minority populations remains hampered by a lack of appropriate sampling methods to support evidence-based studies. Respondent-driven sampling offers one viable strategy to recruit these hidden populations. Because few studies systematically report their experiences using respondent-driven sampling to recruit sexual minorities, this article aligns with recent recommendations for the standardization of reporting and transparency in studies utilizing respondent-driven sampling. We (1) provide detailed descriptions about the successful execution of respondent-driven sampling in two community-based studies of sexual minority individuals, (2) outline procedures to enhance the effectiveness of respondent-driven sampling referral processes, (3) present mixed-methods results regarding the effectiveness of respondent-driven sampling in our studies, and (4) offer recommendations for other researchers when using respondent-driven sampling. METHODS: We successfully recruited 655 sexual minority men and women for two studies using respondent-driven sampling. RESULTS: Resulting metrics indicate the successful achievement of equilibrium in each study. In addition, exit interviews elucidated strategies to effectively target referrals who meet the study criteria and procedures to promote the study that will maximize referral chains and ensure attainment of equilibrium. CONCLUSION: Mixed-methods results suggest that respondent-driven sampling can be an effective means of recruiting a community-based sample of sexual minorities in smaller urban regions. Limitations are presented and suggestions are offered to researchers utilizing respondent-driven sampling in future studies.

Sexual assault risks among gay and bisexual men.

The goal of this study was to examine lifetime patterns of sexual assault and associated risks among a purposive sample of gay and bisexual men (N = 183; 18 to 35 years old, M = 24.3). Cross-sectional data were collected via written, self-administered questionnaires and face-to-face, event-based qualitative interviews. Alcohol severity scores indicated high rates of hazardous drinking (53.0%) and possible dependence (14.2%) among participants. One-half of men (50.8%) reported childhood sexual abuse (CSA), and 67.2% reported adult sexual assault (ASA). Average age at most recent ASA was 21 years. Most perpetrators (83.9%) of recent ASA incidents were male; 67.0% of participants reported consuming alcohol and/or drugs prior to the most recent incident. Regression findings indicated more severe CSA experiences and past alcohol-related problems predicted recent severe ASA. Although we found similarities between gay and bisexual men in lifetime sexual assault history, we found some distinct differences in ASA risk factors. Bisexual men reported higher alcohol severity scores, more female ASA perpetrators, higher internalized homophobia scores, and fewer male sexual partners than gay men. Findings suggest the need for interventions that reduce ASA risk among sexual minority men-and the potential benefits of focusing on alcohol consumption in risk reduction efforts.

Culturally (in)competent? Dismantling health care barriers for sexual minority women.

Lesbian and bisexual (LB) women exhibit elevated rates of a variety of behaviors (i.e., smoking, excessive caloric intake, physical inactivity, heavy alcohol consumption) that put them at risk for adverse health consequences. Furthermore, LB women experience numerous barriers to obtaining culturally competent health care. In this article we review risk behaviors and health care barriers and we discuss the role of stress as an important contributing factor in LB women's health outcomes. We suggest future research, health care delivery changes, and training improvements that will prepare social workers to effectively address the needs of their LB clients.

Mixed Drinks and Mixed Messages: Adolescent Girls' Perspectives on Alcohol and Sexuality.

Experimentation with alcohol and sexuality is a normative aspect of adolescent development. Yet both present distinct risks to adolescent females and are especially problematic when they intersect. Although youth are often cautioned about the dangers associated with having sex and using alcohol, popular entertainment media frequently depict the combination of alcohol and sexuality as carefree fun. It is unclear how adolescent females interpret these contradictory messages in their everyday lives. Focus group interviews were used to explore young women's understandings of the relation between alcohol and sexuality. Young women, ages 14-17 years (N = 97, 61% White), and their mothers were recruited through advertisements in local newspapers to participate in separate, simultaneous focus group interviews. Only data from the 15 daughters' groups are presented here. Qualitative analysis revealed that participants recognized the risks associated with combining alcohol and sex, yet they also perceived sexual advantages to drinking alcohol. Advantages included facilitating social and sexual interactions and excusing unsanctioned sexual behavior. Alcohol was also seen as increasing the likelihood of sexual regret and coercion through impaired judgment and self-advocacy abilities. Educational and prevention efforts need to consider adolescent developmental and social needs, as well as the influences of the larger cultural context in which youth function.

Sexual victimization and associated risks among lesbian and bisexual women.

This study examines relationships among childhood sexual abuse (CSA), risky alcohol use, and adult sexual victimization among bisexual and lesbian women. Half (51.2%) of women reported CSA and 71.2% reported adult sexual victimization. Perpetrators were generally male, and 56.4% of women's most recent adult sexual victimization incidents occurred after coming out. Regression results indicated that adult sexual victimization severity was associated with a bisexual identity, more severe CSA history, more lifetime sexual partners, and higher alcohol severity scores. Compared to lesbians, bisexual women reported more severe adult sexual victimization experiences, greater revictimization, riskier drinking patterns, and more lifetime male sexual partners.

Exploring shame, guilt, and risky substance use among sexual minority men and women.

This study examined the interrelations among shame-proneness, guilt-proneness, internalized heterosexism (IH), and problematic substance use among 389 gay, lesbian, and bisexual men and women. Problematic alcohol and drug use were positively related to shame-proneness and negatively related to guilt-proneness. Bisexuals reported riskier substance use behaviors, lower levels of guilt-proneness, and higher levels of IH than gay men and lesbians. Furthermore, study findings indicated that shame and IH are related. Additional investigations of these associations would supplement current understandings of sexual minority stress and advance the development of substance-related intervention and prevention efforts targeting sexual minorities.

Minding the noise: conducting health research among bisexual populations and beyond.

In this article, we draw upon our experiences conducting health-related studies with sexual minorities to suggest guidelines and best-practices for carrying out research among bisexual populations specifically. Too often bisexuality has been treated as "noise in the data," because it does not conform to monosexual notions of sexual orientation. We discuss methodological, theoretical and conceptual concerns as they pertain to conducting research among bisexual persons. We hope that the insights we offer will prompt greater attention to bisexual groups and their specific concerns, not only among health researchers, but among those from other fields and disciplines as well.

Sexual victimization and health-related indicators among sexual minority men.

This study reports rates of childhood and adult sexual victimization among a community sample of 634 gay and bisexual-identified men, and examines how men with differing sexual victimization histories compare on a number of health-related outcomes. Results indicate that men with histories of childhood and adult sexual victimization are more likely to report substance use, more lifetime STIs, higher sexual compulsivity scores, and greater gay-related stigma scores than men with no histories of sexual victimization. Few differences are found in comparisons of health outcomes based on age at first sexual victimization (childhood vs. adulthood). Furthermore, men with histories of sexual victimization report healthier coping skills than men with no histories of sexual victimization, but no significant group differences are found in social support or stress-related growth. Findings underscore the importance of assessing lifetime sexual victimization among sexual minority men during counseling, with special attention given to the enhancement of protective factors among those at risk for harmful behaviors and subsequent poor health outcomes.

An exploration of sexual minority stress across the lines of gender and sexual identity.

Despite growing evidence to suggest that gays, lesbians, and bisexuals experience a range of stressors and consequences related to their sexual minority status, no known studies to date have employed focus group discussion to explore and document their perceptions of sexual minority stress. In this exploratory study, we present focus group data on a range of sexual minority stressors as described by 43 gay men, lesbians, and bisexual men and women. We explore gender and sexual identity differences in the respondents' perceptions of heteronormativity, disclosure issues in different social settings, sources of support, and strategies for coping with stress. Respondents reported that women's same-sex relationships were eroticized and distorted to accommodate heterosexual male desire, while men were negatively depicted as sexually promiscuous and deviant. These differing stereotypes held important consequences for disclosure decisions and affected men's and women's social interactions with heterosexual men. Bisexual respondents reported unique strategies to cope with exclusion and isolation associated with misunderstandings about their sexual identities. Directions for future research on sexual minority stress are discussed.

WOMEN'S SOCIAL BEHAVIOR WHEN MEETING NEW MEN: THE INFLUENCE OF ALCOHOL AND CHILDHOOD SEXUAL ABUSE.

Heavy alcohol consumption (Testa & Parks, 1996) and childhood sexual abuse (CSA; Messman-Moore & Long, 2003) have been associated with adult sexual victimization. We examined the social behavior of 42 women under two alcohol conditions (high dose and low dose) in a bar laboratory. Women were videotaped interacting with a man they had just met. Women in the higher dose condition engaged in more open body position and talked, stood, and walked more than women in the lower dose condition. These behaviors are consistent with signs of intoxication or romantic interest. The women in the high-dose condition also frowned more than women in the low-dose condition. An increase in frowning could indicate less comfort or may be considered consistent with an increase in animation during the social interaction given the concomitant increase in other behaviors. Thus, the nonverbal behavior of women in the high-dose condition could be interpreted as mixed signals. CSA victims exhibited fewer head movements (e.g., nods), were less animated, and frowned more than non-CSA victims. These behaviors convey reticence or possibly even anxiety or discomfort during the social interaction. Thus, the nonverbal behavior of women with a history of CSA may convey an unease that could be viewed by a potential perpetrator as vulnerability. Our findings suggest that both acute alcohol consumption and history of CSA may influence nonverbal social behavior and may influence risk for sexual assault by sending mixed cues of romantic interest or signs of vulnerability to potential perpetrators.

Becoming lesbian mothers.

Lesbian mothering strategies are commonly theorized as instances of assimilationism or resistance. This essay critiques those approaches and presents a promising alternative using the conceptual framework of Gilles Deleuze and Felix Guattari. Their concepts of "becoming" and "rhizoming" are utilized as mechanisms for understanding the inconsistencies and contradictions that constitute the subjectivities of two lesbian co-mothers. The essay concludes with the political implications of these analyses.