Same-sex sexual behaviour and psychological health: CONSTANCES, a population survey in France.

Rationale: Having same-sex partners is linked to poor psychological health and increased risk of suicide attempt. This link seems to be stronger for men than women. However, in France, there have been few studies of population samples, and the size of these studies does not always allow an in-depth analysis of these associations. Methods and results: This study explored these associations by analysing data from a large epidemiological survey conducted in France from 2012 to 2019 that included 84,791 women and 75,530 men. The frequencies and risk ratios of depression, suicide attempts, alcohol dependence and regular cannabis use were calculated regarding two groups: those with only the other sex partners and those with any same sex partners. Risk of alcohol addiction and cannabis use was greatly increased for women who had homosexual relations, even after adjustment for social, demographic and sexual life factors, which was not the case for men. However, risk of depression and suicide attempts was increased for men who had homosexual relations; this was also true for women but to a lesser extent. The estimates remained unchanged after stratifying the population by three distinct social groups defined by education level. Conclusions: The analysis of these differences was possible because of the large sample size of the CONSTANCES survey and its recruitment in the general population. This study helps increase knowledge of the health of sexual minorities. It can help clinicians pay more attention to the potential distress of their patients and can continue to inform policymakers of the effects of discrimination and stigmatisation linked to homosexual behaviour.

A multidimensional measure of sexual orientation, use of psychoactive substances, and depression: results of a national survey on sexual behavior in france.

Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity.

Conceptualization and measurement of homosexuality in sex surveys: a critical review

O artigo traz uma revisão das principais pesquisas nacionais sobre sexualidade que apresentam perguntas sobre homossexualidade, com foco nas questões conceituais e metodológicas sobre as definições de sexo, os aspectos de medição da homossexualidade, as técnicas de amostragem e de entrevistas e o formato do questionário. As taxas de declaração sobre atração pelo mesmo sexo, comportamento, parceiros e identidade também são apresentadas e comparadas. O estudo da homossexualidade em inquéritos populacionais foi moldado com base em tradições de investigação e questões provenientes desde a sexologia até a epidemiologia do HIV/AIDS. O comportamento sexual é assunto central nas pesquisas sobre sexualidade desde Kinsey. Os temas sobre atração sexual, identidade e/ou orientação sexual surgem mais recentemente. São abordadas e discutidas as diferenças no tratamento de homens e mulheres na formulação e análise das pesquisas, assim como as taxas de respostas em diferentes pesquisas, em distintos países e momentos históricos. Ressaltamos a relevância de que sejam consideradas tanto mudanças metodológicas quanto sociais para interpretar as diferenças constatadas.

Conceptualization and measurement of homosexuality in sex surveys: a critical review.

This article reviews major national population sex surveys that have asked questions about homosexuality focusing on conceptual and methodological issues, including the definitions of sex, the measured aspects of homosexuality, sampling and interviewing technique, and questionnaire design. Reported rates of major measures of same-sex attraction, behavior, partners, and sexual identity from surveys are also presented and compared. The study of homosexuality in surveys has been shaped by the research traditions and questions ranging from sexology to the epidemiology of HIV/AIDS. Sexual behavior has been a central topic at least since Kinsey. Issues of sexual attraction and/or orientation and sexual identity have emerged more recently. Differences in the treatment of men and women in the design and analysis of surveys as well as in the reported rates in different surveys, in different countries and time periods are also presented and discussed. We point out the importance of the consideration of both methodological and social change issues in assessing such differences.

Violence against women and suicide risk: the neglected impact of same-sex sexual behaviour.

We used data from the National Survey on Violence against Women in France carried out in 2000 on a representative sample of 6,970 women to compare the social characteristics of women who had sex with women (WSW) and women who had sex only with men (WSM). The WSW were more likely to be of a high socio-economic level and living in large cities. They were more frequently unmarried, without children, and had a more diverse sexual life, generally beginning younger, with more partners, mainly men. They were also more likely to use tobacco, alcohol and drugs. WSW reported more physical violence in the recent past and more suicide attempts than WSM, despite a lack of difference in psychological distress and stress. These results, in a field little studied in France, are consistent with international findings attesting to the difficulties faced by women in situations involving autonomy and marginality.