Minority stress and romantic relationship functioning among young sexual minority women.

Growing research suggests that minority stress adversely affects relationship functioning among same-gender couples. However, studies have predominantly focused on concurrent, between-persons associations and neglected the relationships sexual minority people have with partners of other genders. We used multiwave longitudinal data from 200 young sexual minority women in relationships with cisgender men, cisgender women, and transgender or nonbinary individuals to assess between- and within-person associations between minority stress and relationship functioning and to test for differences in these associations by partner gender. Participants reported on minority stressors (couple marginalization; microaggressions; internalized heterosexism) and relationship functioning (quality; destructive conflict) from the same partnership at 3-7 assessments (M = 4.44), collected at 6-month intervals. Multilevel models assessing each minority stressor separately revealed between-person associations of each stressor with worse relationship quality and conflict; however, only couple marginalization showed within-person associations with relationship functioning. In multilevel models including all three minority stressors, couple marginalization showed unique within- and between-persons associations with worse relationship functioning; microaggressions were only uniquely associated with couple conflict at the between-persons level. Moderation analyses revealed a negative between-persons association of microaggressions with relationship quality only for participants with cisgender male partners, and a positive within-person association of microaggressions with relationship quality only for those with cisgender female partners. Several associations were weaker for participants with transgender or nonbinary compared to cisgender partners. Findings highlight the importance of couple-level minority stress and partner gender in understanding how sexual minority stress affects relationship functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Disclosure and Help-Seeking Experiences of Sexual and Gender Minority Victims of Intimate Partner Violence: A Mixed-Methods Study.

Sexual and gender minorities assigned female at birth (SGM-AFAB) experience high rates of intimate partner violence (IPV), with negative effects on health and well-being. Disclosure of and help-seeking for IPV can support the well-being of IPV survivors, yet are understudied among SGM-AFAB people. To better understand the IPV disclosure and help-seeking experiences in this population, we conducted semi-structured interviews with 41 SGM-AFAB young adults who experienced physical, sexual, or severe psychological IPV. Qualitative analyses explored to whom SGM-AFAB disclosed IPV, barriers to disclosure/help-seeking, the types of responses received, and perceived helpfulness of responses. Exploratory mixed methods analyses assessed frequency of code endorsement, demographic differences, and associations among codes. Three-quarters of participants disclosed IPV, though rates were lower for sexual and physical than psychological IPV and very few sought help from formal sources. The most common barriers to disclosure were not viewing the IPV as abuse and anticipation of negative responses, often due to stigma; other participants described inability to access formal help and concerns about SGM incompetence in those services. Most actual responses received were considered helpful, including emotional support, labeling the IPV as unhealthy, nonjudgmental listening, actions to stop the IPV, and practical support. Minimizing IPV or criticizing the victim was common unhelpful response; advice to end the relationship was considered helpful and unhelpful. Whereas 92% of friend responses were described as helpful, around half of family (56%) and therapist (62%) responses were helpful. Findings suggest that efforts to increase access to culturally affirmative services and educate SGM youth to recognize IPV in their relationships may help promote help-seeking and well-being among SGM-AFAB IPV survivors.

Demographic and Minority Stress Risk Factors for Obesity Among Sexual Minority Youth Assigned Female at Birth.

Purpose: Sexual minority youth (adolescents and young adults) assigned female at birth (SM-AFAB) are at disproportionate risk of developing obesity compared with heterosexual cisgender youth AFAB. Grounded in minority stress theory, this study aimed to identify potential risk factors for obesity among SM-AFAB youth to inform the development of prevention and intervention efforts for this high-risk population. Methods: Data were collected in 2017 from 367 SM-AFAB youth (ages 16-20 years). Multinominal logistic regression was used to assess cross-sectional associations of race/ethnicity, sexuality, gender identity, household income, and sexual minority (SM) stressors (internalized stigma, microaggressions, and victimization) with weight status (normal, overweight, and obese). Results: Roughly half (53.1%) of participants' body mass index were in the normal weight range, with 24.8% in the overweight range and 22.1% in the obese range. Rates of obesity in Black and Latinx participants were 3-4.5 times those of White participants. Bisexual, pansexual, and queer individuals were at greater risk for obesity than gay/lesbian participants; only bisexual participants were at higher risk for overweight. Participants with a household income <$20,000 and between $20,000 and $39,000 were at greater risk for obesity than participants with household income >$80,000. Microaggressions were positively associated with obesity. Conclusion: Findings highlight risk for obesity among SM-AFAB youth, particularly for those who identify as racial minority, as low income, as being attracted to more than one gender, and for those who experience high levels of anti-SM microaggressions. Targeted obesity prevention and treatment programs should consider the unique needs, challenges, and strengths of SM-AFAB youth.

Differences in Minority Stress Experiences, Mental Health, and Relationship Quality Outcomes Among Bisexual, Pansexual, and Queer Women.

The majority of sexual minority women in the United States today identify as bi+. Recent research suggests that "non-traditional" bi+ labels such as pansexual and queer are being adopted more frequently than ever before, making it increasingly important to evaluate whether these women have unique needs. In the current study, we explored differences in minority stress experiences, mental health, and relationship quality outcomes by sexual identity label among women who identify with the most common bi+ labels: bisexual, pansexual, and queer. Participants were 285 bi+ cisgender women in romantic relationships. They completed online measures of minority stress (antibisexual experiences, identity concealment, disconnection from the sexual and gender minority (SGM) community, and internalized stigma), mental health (depression and anxiety), and relationship quality (satisfaction and commitment). Overall, participants reported similar experiences of minority stress and few differences in their mental health outcomes. However, there were differences in antibisexual experiences by sexual identity label, such that pansexual women reported more frequent antibisexual experiences than bisexual and queer women. There were also differences in relationship quality by sexual identity label, such that bisexual women reported higher satisfaction than pansexual women and higher commitment than both pansexual and queer women. Findings suggest that pansexual and queer women may be facing their own unique challenges, even compared to bisexual women. Clinical prevention and intervention efforts can be tailored for these women to include strategies to cope with more frequent exposure to antibisexual experiences, as well as relationship education and skill-building to promote healthy romantic relationships.

Minority Stress and Intimate Partner Violence among Sexual and Gender Minorities assigned Female at Birth.

Objective: Sexual and gender minorities assigned female at birth (SGM-AFAB) experience high rates of intimate partner violence (IPV). Using multiwave longitudinal data, the present study tested the following associations of minority stress and IPV among SGM-AFAB: concurrent within-person (i.e., whether changes in minority stress co-occur with changes in IPV), prospective within-person (i.e., whether changes in minority stressors precede changes in IPV), and between-persons (i.e., whether individuals who experience more minority stress, on average, experience more IPV). Method: Data were from Waves 1-7 (spanning 3.5 years) of a longitudinal cohort study of 488 young SGM-AFAB. At each wave, participants reported on SGM victimization, sexual orientation microaggressions, internalized heterosexism, and five types of IPV for up to three partners in the past six months. Results: Controlling for other minority stress experiences, microaggressions showed concurrent within-person associations with two types of IPV victimization (psychological and coercive control) and three types of IPV perpetration (psychological, physical, and sexual), and between-persons associations with psychological IPV victimization and coercive control victimization and perpetration. Microaggressions also had a significant prospective within-persons association with SGM-specific IPV perpetration. SGM victimization showed no unique within-person associations with IPV but, between-persons, was associated with all types of IPV victimization (except coercive control), and psychological and sexual IPV perpetration. Internalized heterosexism was not associated with any IPV outcome. Conclusions: Minority stress, particularly distal stressors, appear to contribute to risk for IPV among SGM-AFAB. Clinicians working with SGM-AFAB individuals in relationships may benefit from screening for experiences of minority stress.

Relationship risk factors for intimate partner violence among sexual and gender minorities: A multilevel analysis.

Intimate partner violence (IPV) is alarmingly prevalent among sexual and gender minority youth assigned female at birth (SGM-AFAB), making it important to identify risk factors that can be targeted in prevention efforts for this population. Although several relationship-level risk factors for IPV have been identified in different-sex couples, research on SGM-AFAB is sparse and predominantly cross-sectional. The present study used seven waves of data from a longitudinal cohort study of SGM-AFAB youth (n = 463) to explore relationship factors (relationship quality, destructive conflict, and self- and partner-jealousy) as risk factors for perpetration and victimization of three types of IPV (physical, psychological, and coercive control). At each wave, participants reported on relationship factors and IPV for up to three romantic partners in the past 6 months. Multilevel models tested for associations between the relationship factors and IPV at three levels: between-persons, within-persons across time (wave), and within-persons across relationships. Relationship quality was associated with IPV mostly at the between-persons and within-persons (wave) levels. Couple conflict was associated with all IPV outcomes at all levels. Partner jealousy was more consistently associated with IPV victimization; participant jealousy was more consistently linked with IPV perpetration. These novel findings suggest that, within SGM individuals, IPV may be influenced by relationship quality, destructive conflict, and jealousy as they fluctuate within individuals from relationship to relationship and within individuals over time. As such, these relationship factors represent promising potential targets for interventions to reduce IPV among SGM-AFAB youth.

Violence and Related Health Outcomes in Sexual and Gender Minority Communities: Introduction to the Special Issue.

Violence affects every community but is particularly prevalent among sexual and gender minority (SGM) people. Although research on violence within SGM populations is increasing, knowledge gaps remain that limit development of evidence-based policy, prevention, and intervention efforts to reduce the violence disparities the SGM community faces. In 2021, the National Institutes of Health (NIH) hosted a multiphase scientific workshop to identify and prioritize key research needs to further our understanding of violence affecting SGM communities and its health outcomes. In this perspective, we summarize the research needs identified. NIH supports this special issue as an outcome of the scientific workshop.

The Sexual Orientation Microaggression Inventory Short Form (SOMI-SF): Validation in Three Samples of Racially/Ethnically Diverse Sexual Minority Youth.

Introduction: The Sexual Orientation Microaggression Inventory (SOMI) has been used to measure sexual orientation-based microaggression experiences. However, at 19 items, the SOMI may be difficult to fit into survey batteries where microaggressions are not the primary predictor or the time researchers have with each participant is very limited. Methods: We sought to identify an eight-item short form of the SOMI (SOMI-SF) in a sample of sexual minority (SM) youth (N = 879) and confirm the validity and reliability of the SOMI-SF by administering both versions to separate cohorts of male-assigned (N = 533) and female-assigned (N = 430) at birth SM youth. Data was collected from April 2018 to May 2020. Results: We found high reliability (α > 0.80) and validity (significant association with SM victimization, depression symptoms, anxiety symptoms, and internalized stigma) in all three samples for the SOMI-SF. Conclusions: For researchers looking to conserve time and limit burden, the SOMI-SF is a high quality option for measuring sexual orientation microaggressions. Policy Implications: The greater ease of administering the SOMI-SF means that sexual orientation microaggressions can be measured in a greater number of contexts. With a growing literature linking these experiences to poorer health outcomes for SM populations, measuring these experiences quickly and accurately can improve our understanding of the mechanisms creating those links and impact policy necessary to alleviate them.

Associations between Drinking Contexts, Minority Stress, and Problematic Alcohol Use among Sexual Minority Individuals Assigned Female at Birth.

Sexual minority individuals assigned female at birth (SM-AFAB) are at increased risk for problematic alcohol use compared to heterosexual women. Despite evidence that drinking locations and companions play an important role in problematic alcohol use among heterosexuals, few studies have examined these social contexts of alcohol use among SM-AFAB. To address this gap, the current study examined two aspects of social contexts in which SM-AFAB drink (locations and companions). We utilized two waves of data (six-months between waves) from an analytic sample of 392 SM-AFAB ages 17-33 from a larger longitudinal study. The goals were: (1) to identify classes of SM-AFAB based on the contexts in which they drank; (2) to examine the associations between drinking contexts, minority stressors, and problematic alcohol use; and (3) to examine changes in drinking contexts over time. Using latent class analysis, we identified four classes based on drinking locations and companions (private settings, social settings, social and private settings, multiple settings). These classes did not differ in minority stress. Drinking in multiple settings was associated with more problematic alcohol use within the same timepoint and these differences were maintained six months later. However, drinking in multiple settings did not predict subsequent changes in problematic alcohol use when problematic alcohol use at the prior wave was controlled for. Based on these findings, SM-AFAB who drink in multiple settings may be an important subpopulation for interventions to target. Interventions could focus on teaching SM-AFAB strategies to limit alcohol consumption and/or minimize alcohol-related consequences.

Biomedical and behavioral outcomes of 2GETHER: A randomized controlled trial of a telehealth HIV prevention program for young male couples.

OBJECTIVE: This study evaluated the efficacy of the 2GETHER relationship education and HIV prevention program for young male couples in reducing risk for HIV. METHOD: We conducted a comparative effectiveness randomized controlled trial of 2GETHER, a five-session hybrid group- and couple-based intervention delivered via videoconference, relative to a single-session HIV testing and risk reduction counseling protocol delivered to couples. We randomized 200 young male couples (N = 400) to 2GETHER or control from 2018 to 2020. Primary biomedical (i.e., rectal Chlamydia and Gonorrhea infection) and behavioral outcomes (i.e., condomless anal sex [CAS]) were measured at 12-months postintervention. Secondary outcomes were other HIV prevention and risk behaviors, relationship quality, and substance use. Multilevel regression was used to model intervention outcomes to account for clustering within couples. Postintervention change over time was modeled as a latent linear growth curve at the within-persons level. RESULTS: We observed significant intervention effects on primary biomedical and behavioral HIV risk outcomes. Participants in 2GETHER had significantly lower odds of rectal STIs at 12-months relative to control. We also observed significantly steeper declines in the number of CAS partners and acts from baseline to 12-month follow-up in 2GETHER relative to control. Few differences were observed for secondary relationship and HIV-related outcomes. CONCLUSIONS: 2GETHER is an efficacious intervention that has a significant impact on both biomedical and behavioral HIV prevention outcomes among male couples. Couple-based HIV prevention programs enhanced with evidence-based relationship education may effectively reduce the most proximal predictors of HIV infection. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recruiting and retaining sexual and gender minority couples in intervention research: Lessons learned from trials of tailored relationship education programs.

Relationship interventions, including healthy relationship education, couple therapy, and dyadic approaches to treating mental and physical health issues, hold promise for promoting relationship and individual health among sexual and gender minority (SGM) populations. Because SGM couples live within a context of societal stigma against their minority identities and relationships, they are likely to be best served by targeted, culturally sensitive relationship interventions that are affirming, free of hetero- and cis-normativity, and address the unique stigma-based challenges that they face. Therefore, a key goal for the field today is to conduct research evaluating and refining newly developed relationship interventions designed specifically for SGM couples. In this paper, we offer recommendations for effectively recruiting and retaining large, diverse samples of SGM couples for clinical trials of tailored relationship interventions, grounded in guidelines for psychological practice and conducting research with SGM populations. Throughout, we offer examples and lessons learned from our experiences conducting clinical trials of tailored SGM relationship education programs. We encourage the use of recruitment and retention strategies that involve members of the target SGM community from the outset, are informed by knowledge about SGM individuals and relationships, use currently preferred language for individual identities and relationships, attend to issues of confidentiality regarding sexual/gender identity or relationship involvement, and adhere to the norms of the particular community and recruitment venue.

Intersectional stigma and mental health: Interactions with identity authenticity and SGM community in sexual and gender minoritized young adults of color.

OBJECTIVES: Sexual and gender minoritized people (SGM) of color experience stigma unique to their intersection of identities, such as racism from SGM and heterosexism from people of color (POC) in their same racial/ethnic group. SGM POC who experience enacted stigma, like microaggressions, have been found to have poorer mental health outcomes. SGM identity authenticity and connections to the SGM community have been associated with better mental health. We sought to test if intersectional enacted stigma, identity authenticity, community connectedness, and the interactions between enacted stigma and authenticity and community were associated with mental health in assigned female at birth (AFAB) SGM young adults of color. METHOD: Data come from 341 racial/ethnic minoritized SGM-AFAB (Mage = 21.23, SD = 3.80). Multivariate linear regressions tested main effects of intersectional enacted stigma (heterosexism from POC and racism from SGM) and authenticity and community on mental health, as well as interaction effects on mental health. RESULTS: SGM-AFAB POC who experienced more heterosexism from POC reported more anxiety and depression symptoms. Greater connection to the SGM community was associated with fewer anxiety and depression symptoms. Heterosexism from POC and community connection interacted such that SGM-AFAB who experienced less heterosexism from POC reported fewer mental health symptoms if they were more connected to the SGM community, but SGM-AFAB who experienced more heterosexism did not benefit from stronger community connection. CONCLUSIONS: Heterosexism from other POC may put SGM POC at higher exposure for negative mental health outcomes and reduce the mental health benefits of a stronger connection to the SGM community. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Help-Seeking for Severe Intimate Partner Violence Among Sexual and Gender Minority Adolescents and Young Adults Assigned Female at birth: A Latent Class Analysis.

Sexual and gender minority adolescents and young adults assigned female at birth (SGM-AFAB) report high rates of intimate partner violence (IPV) victimization. Despite adverse health outcomes of IPV, many survivors, particularly SGM-AFAB, do not seek help. This study (1) examined the proportion of SGM-AFAB who reported severe IPV victimization who sought help; (2) elucidated patterns of help-seeking facilitators and barriers; and (3) identified associations between sociodemographic characteristics, IPV victimization types, and minority stressors and latent classes of help-seeking facilitators and barriers. Participants included 193 SGM-AFAB (Mage = 20.6, SD = 3.4; 65.8% non-monosexual; 73.1% cisgender; 72.5% racial/ethnic minority; 16.6% annual household income $20,000 or less). Most participants who experienced severe IPV did not seek help (62.2%). Having a person or provider who was aware of the participant's abusive relationship was the most common reason for seeking help (50; 68.5%). Minimizing IPV was the most common reason for not seeking help (103; 87.3%). Fewer than 5% of SGM-AFAB who experienced severe IPV and who did not seek help reported SGM-specific help-seeking barriers, including not wanting to contribute to negative perceptions of the LGBTQ community, not disclosing their SGM status, and perceiving a lack of tailored services. Help-seeking facilitators and barriers varied by sociodemographic characteristics. Three classes of help-seeking facilitators and two classes of help-seeking barriers emerged. SGM-AFAB subgroups based on sexual and gender identity, recent coercive control, and identity as IPV victims differed in latent classes. This study's findings confirm SGM-AFAB IPV survivors' low likelihood of seeking help. Our results also underscore the importance of continuing to bolster SGM-AFAB survivors' access to trauma-informed, culturally sensitive, and affirming support. Further, multilevel prevention and intervention efforts are needed to reduce minimization of abuse and anticipatory judgment and blame among SGM-AFAB who hold multiple marginalized identities, experience coercive control, and identify as IPV victims.

Evaluation of Traditional Risk Factors for Intimate Partner Violence among Sexual and Gender Minority Youth.

Objective: Sexual and gender minority youth assigned female at birth (SGM-AFAB) experience higher rates of intimate partner violence (IPV) than heterosexual and cisgender youth. To inform efforts to reduce these disparities, we explored whether IPV risk factors identified in the general population are associated with IPV among SGM-AFAB young people. Method: Using multiwave longitudinal data from a 400 SGM-AFAB youth (ages 16-20 at baseline), we estimated between- and within-persons effects of demographic/contextual characteristics (gender, sexual identity, race/ethnicity, socioeconomic status), developmental/background factors (childhood violence), and psychological/behavioral factors (antisocial behavior, depression, problematic alcohol and cannabis use) on a range of IPV experiences (victimization and perpetration of psychological, physical, sexual, and SGM-specific IPV). Results: In this SGM-AFAB sample, IPV experiences were associated with many traditional risk factors identified in the general population, including race, economic stress, childhood violence, antisocial behavior, depression, and use of substances (particularly cannabis). In contrast to previous research, we did not find that SGM youth with transgender or gender nonbinary identities, or with bi- or pan-sexual identities, were at greater risk for IPV than other SGM youth. Very few putative risk factors were associated with SGM-specific IPV. Conclusion: Findings suggest SGM youth could benefit from IPV prevention approaches that target common risk factors at multiple ecological levels (policies to reduce poverty and racism, parenting programs, interventions to reduce mental health and substance use problems). Continued research is needed to explore how risk for IPV among SGM-AFAB youth may vary by gender identity, sexual identity, and stigma-based experiences.

Minority stressors and suicidal ideation in sexual and gender minority youth assigned female at birth: Prospective associations and racial differences.

INTRODUCTION: Suicidal ideation (SI) disproportionately affects sexual and gender minority (SGM) versus cisgender/heterosexual youth, likely due to the minority stressors (MS) they face. Research has shown cross-sectional associations between SGM MS and suicidality; however, few studies have used longitudinal data or examined racial differences in the effects of MS on SI. The current study tested whether MS prospectively predict next-year SI and whether race moderates these prospective associations. METHOD: Three hundred and sixty-nine Black, Latinx, and White SGM youth completed baseline measures of MS, SI, and demographics, and SI 6 and 12 months later. RESULTS: Internalized stigma, microaggressions, and low support from family and from significant others demonstrated associations with next-year SI. When controlling for baseline SI, however, only low significant other support predicted next-year SI. Moderation analyses indicated that internalized stigma predicted SI for White, but not Black or Latinx, individuals and that lower friend support was associated with SI for Latinx, but not White or Black, individuals. CONCLUSIONS: Though minority stressors appear to raise risk for SI among SGM, effects may differ by race. Internalized stigma may be particularly influential for SI among White SGM whereas lack of support from friends may be most influential for SI among Latinx SGM youth.

Protocol for an attention-matched randomized controlled trial of 2GETHER: a relationship education and HIV prevention program for young male couples.

BACKGROUND: Young men who have sex with men (YMSM) are disproportionately impacted by the HIV epidemic in the USA, and a large number of new infections among YMSM occur in the context of main or primary partnerships. At the same time, healthy romantic relationships promote health and wellbeing by improving social support and encouraging healthy behaviors. Thus, we created 2GETHER: a relationship education and HIV prevention program for young male couples. 2GETHER is delivered face-to-face in a university setting and is composed of two group sessions and two individualized skills coaching sessions. We observed strong support of the feasibility, acceptability, and preliminary efficacy of 2GETHER in a pilot trial. METHODS: We are conducting an attention-matched randomized controlled trial (RCT) to test the efficacy of 2GETHER relative to a control condition based on a well-validated positive affect enhancement program. Enrollment occurred between August 2017 and March 2021 in Chicago and surrounding areas, and we enrolled and randomized 128 dyads (N = 256 individuals). Follow-up is ongoing and we will examine primary and secondary behavioral outcomes at 12 months post-intervention, with interim follow-up at 3, 6, and 9 months post-intervention. The primary biomedical outcome is sexually transmitted infection incidence at a 12-month follow-up. DISCUSSION: 2GETHER is innovative in that it places an equal emphasis on relationship skill building and HIV prevention. Thus, the program has the potential to impact numerous health-related outcomes. Despite challenges related to the recruitment of couples and the COVID-19 pandemic, we were able to enroll a robust sample of young male couples with sufficient power to detect effects on study outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT03186534 .

Relationship, marriage, and parenthood aspirations among sexual and gender minority youth assigned female at birth.

This study examined aspirations for future long-term committed relationships, marriage, and parenthood in a sample of 392 racially diverse sexual and gender minority (SGM) youth assigned female at birth (AFAB) aged 16-20. Differences by gender identity, sexual identity, and race/ethnicity were assessed, as were associations with contextual variables including minority stressors, SGM community involvement, perceived partner availability, and relationship experiences. Results showed that the majority of SGM-AFAB youth viewed long-term committed relationships as important and likely, whereas only about half of participants had high aspirations to get married and have children someday. Those who did view marriage and parenthood as important perceived that it is feasible for them to achieve these outcomes someday. These constructs did not differ by race/ethnicity. There were differences by gender identity and sexual identity, such that cisgender women reported higher aspirations for marriage and parenthood than did gender minorities, and those with binary sexual identities reported higher aspirations for marriage than did those with nonbinary sexual identities. Examination of the contextual variables revealed that relationship experience variables were the most consistently associated with aspirations for committed relationships, marriage, and parenthood. In contrast, victimization and perceived partner availability were not associated with any of the family formation aspirations. As SGM individuals are increasingly granted legal rights affecting their ability to marry and form families, research is needed to help inform efforts to promote their relationship health while considering that they may have unique aspirations for relationships, marriage, and parenthood compared to the general public. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Association Between Bi+ Stigma and Problematic Cannabis Use: Testing Coping Motives as an Underlying Mechanism.

OBJECTIVE: Bi+ individuals (i.e., people with attractions to more than one gender) are at heightened risk for cannabis use disorders compared with heterosexual and lesbian/gay individuals, and their heightened risk has been attributed to the unique stressors that they experience as bi+ individuals. Limited research has quantitatively examined the association between enacted bi+ stigma (i.e., biased treatment by others based on one's bi+ identity/attractions) and cannabis use problems among bi+ individuals. Existing studies have been limited by their cross-sectional designs and their lack of attention to potential mechanisms underlying this association. METHOD: We used four waves of data (6 months between waves) from 317 bi+ individuals assigned female at birth who reported cannabis use. The goals of our analyses were to examine (a) the prospective association between enacted bi+ stigma and problematic cannabis use; and (b) coping motives (i.e., motivations to use cannabis to cope with negative emotions) as a mediator of this association. RESULTS: At the within-person level, when participants experienced more enacted bi+ stigma than usual at a given wave (time t-2), they experienced a subsequent increase in their motivation to use cannabis to cope (time t-1), which in turn, predicted a subsequent increase in problematic cannabis use (time t). This within-person indirect effect was significant. CONCLUSIONS: These findings suggest that enacted bi+ stigma contributes to problematic cannabis use by increasing motivations to use cannabis to cope with negative emotions. As such, coping motives may be an important treatment target to reduce problematic cannabis use among bi+ individuals.

Longitudinal Transitions in Intimate Partner Violence among Female Assigned at Birth Sexual and Gender Minority Youth.

Female-assigned at birth sexual and gender minorities (FAB SGM) are at elevated risk of experiencing intimate partner violence (IPV), yet little longitudinal research has been conducted with this population. In the current study, we attempted to understand how patterns of IPV victimization and perpetration, measured across a wide range of IPV behaviors (psychological, physical, sexual, cyber, and SGM-specific), changed over time for FAB SGM youth. Participants came from a longitudinal cohort study of FAB SGM late adolescents and young adults (FAB400; N = 488) and included anyone who reported a romantic partner at one of the first three waves (six months apart; N = 433). Latent class analysis (LCA) was run at each wave to determine the best-fitting class structure across IPV experiences. These were followed up with latent transition analyses (LTAs) to determine patterns of movement between classes over the course of the three waves. Lastly, we looked at the effects of staying with the same romantic partner on transitions. We found that the same three-class structure replicated across all three waves of the study. That class structure identified no/low, psychological, and high IPV classes at each wave. In the LTA, when transitions occurred for FAB SGM, they were much more likely to transition to a class defined by lower likelihoods of experiencing IPV (i.e., psychological to no/low) than they were to a class defined by higher likelihoods of IPV (i.e., psychological to high). However, we found that FAB SGM youth were less likely to transition to a less severe IPV class if they maintained the same serious romantic partner across waves. This finding, in particular, suggests that IPV is often relationship specific for FAB SGM and that efforts to reduce IPV in SGM communities must consider intervening at the relationship level to effect meaningful change.

Intersectional Minority Stress and Intimate Partner Violence: The Effects of Enacted Stigma on Racial Minority Youth Assigned Female at Birth.

Many sexual minority youth of color experience enacted stigma based on each of their minority identities. We examined whether experiences of racist discrimination and heterosexist microaggressions were associated with intimate partner violence (IPV) among female-assigned at birth (FAB) sexual minority youth of color. Data were drawn from a larger study of FAB sexual and gender minority youth (FAB400; N = 488). We selected racial/ethnic minority participants who reported a sexual minority identity and reported a romantic relationship in the previous 6 months (N = 249). Negative binomial models were used to test for associations between enacted stigma (racial discrimination and heterosexist microaggressions) and IPV (psychological, physical, sexual, and sexual minority-specific) perpetration and victimization. When considered separately, both forms of enacted stigma was positively associated with perpetration and victimization across all four types of IPV. In multivariate models, racial discrimination and heterosexist microaggressions both had unique, additive effects on psychological IPV perpetration and physical- and sexual minority-specific IPV victimization. Only racial discrimination was uniquely associated with physical perpetration and psychological victimization. Only heterosexist microaggression was uniquely associated with sexual minority-specific perpetration and sexual IPV perpetration and victimization. Findings illustrate how enacted stigma based on each minority identity intersect to raise risk for IPV among sexual minority youth of color.