Exploring patterns in mental health treatment and interests of single adults in the United States: a secondary data analysis.

Objective: The objective of this study is to examine mental health treatment utilization and interest among the large and growing demographic of single adults in the United States, who face unique societal stressors and pressures that may contribute to their heightened need for mental healthcare. Method: We analyzed data from 3,453 single adults, focusing on those with possible mental health treatment needs by excluding those with positive self-assessments. We assessed prevalence and sociodemographic correlates of mental health treatment, including psychotherapy and psychiatric medication use, and interest in attending psychotherapy among participants who had never attended. Results: 26% were in mental health treatment; 17% were attending psychotherapy, 16% were taking psychiatric medications, and 7% were doing both. Further, 64% had never attended psychotherapy, of which 35% expressed interest in future attendance. There were differences in current psychotherapy attendance and psychiatric medication use by gender and sexual orientation, with women and gay/lesbian individuals more likely to engage in both forms of mental health treatment. Additionally, interest in future psychotherapy among those who had never attended varied significantly by age, gender, and race. Younger individuals, women, and Black/African-American participants showed higher likelihoods of interest in psychotherapy. Conclusion: Our research highlights a critical gap in mental health treatment utilization among single adults who may be experiencing a need for those services. Despite a seemingly higher likelihood of engagement in mental health treatment compared to the general population, only a minority of single adults in our sample were utilizing mental health treatment. This underutilization and the observed demographic disparities in mental health treatment underscore the need for targeted outreach, personalized treatment plans, enhanced provider training, and policy advocacy to ensure equitable access to mental healthcare for single adults across sociodemographic backgrounds.

Beyond sex: A review of recent literature on asexuality.

Asexuality has gained increasing attention in academic research and literature over the last two decades. This review discusses findings from 28 relevant studies published in academic journals between January 2020 and July 2022. In this time, academic literature on asexuality has focused primarily on 1) development of asexual identity, 2) sex and romantic relationships for asexual individuals, 3) intersections between asexuality and other aspects of identity, and 4) the need for increased awareness and understanding of asexuality. Future research should expand the scope of asexuality research to include more intersectional perspectives and more experiences of those on the ace spectrum who do not identify as asexual (e.g. graysexual, demisexual).

Assessing Whether Medical Students Consistently Ask Patients About Sexual Orientation and Gender Identity as a Function of Year in Training.

Purpose: The Institute of Medicine has suggested that teaching health care providers to inquire about and document the sexual orientation and gender identity (SOGI) of their patients will provide more accurate epidemiological data and allow for more patient-centered care, thus improving sexual and gender minority health. The purpose of this study was to determine whether medical students are asking about SOGI and to identify reasons why students were opting not to ask. Methods: In July 2020, an online survey was made available to second-, third-, and fourth-year medical students at a Midwestern medical school. Respondents were asked whether they consistently inquired about the SOGI of their patients, and the reasons they do not ask. The number of students asking about SOGI and reasons for not asking were analyzed using chi-square analyses as a function of year in training. Results: Of 1089 eligible participants, 364 completed the survey (33.4%). The number of students asking about sexual orientation significantly decreased with every year of training (92.8%, 82.2%, and 52.7%). The number of students asking about gender identity significantly decreased after the second year of training (69.9%, 40.6%, and 26.4%). Reasons that significantly increased across training included believing SOGI is irrelevant to encounters, limiting inquiries to patients with sexual health complaints only, and negative influence from their attendings. Conclusion: As medical students progressed into the clinical years of their training, they were less likely to ask their patients about SOGI and more likely to cite negative influence from their attendings and question the relevance of obtaining SOGI.

They "Don't Know How to Deal with People Like Me": Assessing Health Care Experiences of Gender Minorities in Indiana.

Purpose: Within the LGBTQ+ community, the transgender and nonbinary (TGNB) population experience a disproportionate amount of discrimination when seeking health care. Such disparities may arise from lack of proper medical training and resources for providers or biases. In this study, we examine the health care experiences of TGNB individuals living in Southern Indiana. Methods: We analyzed responses from TGNB respondents to an LGBTQ+ health care needs assessment survey in Southern Indiana. Respondents were asked about demographic data, their self-assessed health status, quality of health care received, whether they have a provider with whom they feel comfortable sharing their gender identity with, and if they have to commute to see their provider. Finally, respondents were asked an open-ended question about their health care experiences while living in Southern Indiana. Responses were coded and several themes emerged and were analyzed. Results: Eighty-five TGNB individuals completed our survey. Less than half of respondents indicated that they had an LGBTQ+-welcoming provider (44.7%). Individuals with an LGBTQ+-welcoming provider were more likely to report their self-assessed health as excellent/good (p=0.02) and quality of health as excellent/very good (p=0.03) compared to individuals without an LGBTQ+-welcoming provider. Five themes emerged from the write-in responses (n=64): discrimination (34.4%), invalidation (32.8%), distrust (28.1%), logistic concerns (35.9%), and positive experiences (35.9%). Conclusion: The TGNB community living in Southern Indiana reports numerous barriers related to provider attitudes when obtaining health care. Additional training is needed to address provider biases and improve LGBTQ+ community health disparities.

"Sex" and the Ace Spectrum: Definitions of Sex, Behavioral Histories, and Future Interest for Individuals Who Identify as Asexual, Graysexual, or Demisexual.

This paper explores how people (n = 1,093) who identify as asexual or on the ace spectrum (i.e., graysexual, demisexual) define sex behaviorally using a list of 22 specific behaviors and assesses their lifetime behavioral histories and interest in future engagement in these activities. Lifetime behavioral history was also compared to each individual's personal definition of sex. Asexual, demisexual, and graysexual groups defined sex similarly. Although there were significant group differences in behavioral histories, almost all had engaged in behaviors included in their personal definition of sex. There was little interest in engaging in "sex" in the future (~4% asexual and graysexual groups, ~12% demisexuals, p < .004). Reasons for or against engaging in these behaviors in the future were explored qualitatively. The most common reasons were classified as "Emotional connection," "Partner interest," and "Disinterest-Disgust," with significant group differences noted. Disinterest-Disgust was the most frequently cited reason for the asexual group (43%). Emotional Connection was the most frequent reason for the graysexual (40%) and demisexual (69.3%) groups. Findings highlight the heterogeneity of the ace community with regard to history of and interest in sexual behaviors and the importance of distinguishing between wanting and being willing to engage in sexual behaviors across the ace spectrum.