Loyola Generativity Scale e Generative Behavior Checklist: Um estudo psicométrico com idosos espanhóis LGBT+ / Loyola Generativity Scale and Generative Behavior Checklist: A Psychometric Study with Spanish LGBT+ Older Adults / Loyola Generativity Scale y Generative Behavior Checklist: Un estudio psicométrico con personas mayores españolas LGBT+

Resumo Enquadramento: A generatividade tem sido associada à resiliência e à satisfação com a vida na velhice, incluindo entre a população lésbica, gay, bissexual e transgénero (LGBT+) mais velha. Objetivo: Analisar as propriedades psicométricas da Loyola Generativity Scale (LGS) e da Generative Behavior Checklist (GBC) para idosos espanhóis LGBT + (com mais de 50 anos). Metodologia: Foi realizado um estudo psicométrico com 141 idosos espanhóis LGBT+ com o objetivo de examinar a validade de construto (análise fatorial exploratória), a validade convergente e a fiabilidade (consistência interna) da LGS e da GBC. Resultados: Os métodos de análise paralela e a análise fatorial exploratória sugeriram um modelo de dois fatores para ambos os instrumentos com boa adequação da amostra. A LGS explicou 45,1% da variância e apresentou uma consistência interna de 0,78. O GBC explicou 41,76% da variância e apresentou uma consistência interna de 0,879. Foi encontrada uma correlação positiva e estatisticamente significativa entre a satisfação com a vida e as escalas generativas. Foi também observada uma correlação positiva e significativa (rs = 0,310) entre os dois instrumentos. Conclusão: Ambos os instrumentos demonstraram ser válidos e fiáveis para medir a generatividade em idosos espanhóis LGBT+.

Abstract Background: Generativity has been associated with resilience and life satisfaction in older age, including among lesbian, gay, bisexual, and transgender (LGBT+) older adults. Objective: To examine the psychometric properties of the Loyola Generativity Scale (LGS) and Generative Behavior Checklist (GBC) for Spanish LGBT+ older adults (over the age of 50). Methodology: A psychometric study was conducted with 141 Spanish LGBT+ older adults to examine the construct validity (exploratory factor analysis), convergent validity, and reliability (internal consistency) of the LGS and the GBC. Results: Parallel and exploratory factor analyses suggested a two-factor model with good sample adequacy for both scales. The LGS explained 45.1% of the variance and had an internal consistency of 0.78. The GBC explained 41.76 % of the variance and had an internal consistency of 0.879. A positive and statistically significant correlation was found between life satisfaction and the generative scales. A positive and significant correlation (rs = 0.310) was also observed between both instruments. Conclusion: Both instruments proved valid and reliable for measuring generativity in Spanish LGBT+ older adults.

Resumen Marco contextual: La generatividad se asocia con la resiliencia y la satisfacción con la vida en la vejez, incluidas las de las personas adultas lesbianas, gays, bisexuales y transexuales (LGBT+). Objetivo: Examinar las propiedades psicométricas de la Loyola Generativity Scale (LGS) y la Generative Behavior Checklist (GBC) en adultos mayores LGBT+ españoles (mayores de 50 años). Metodología: Estudio psicométrico con 141 adultos mayores LGBT+. Se analizó la validez de constructo (análisis factorial exploratorio), la validez convergente y la consistencia interna de cada escala. Resultado: Los análisis factoriales paralelos y exploratorios sugieren un modelo bifactorial para ambas escalas con una buena adecuación a la muestra. La LGS explica el 45,1% de la varianza y tiene una consistencia interna de 0,78. La GBC explica el 41,76% de la varianza y tiene una consistencia interna de 0,879. Se encontró una correlación positiva estadísticamente significativa entre la satisfacción con la vida y las escalas de generatividad. Las dos escalas mostraron una correlación positiva y significativa (rs = 0,310). Conclusión: Ambas escalas han demostrado ser válidas y fiables para medir la generatividad en adultos mayores LGBT+ españoles.

Feeling good mother/father and other regimes.LGBT people’s emotions and parenthoods / Sentirse buena madre/buen padre y otros regímenes. Emociones y parentalidades de personas LGBT

En el presente artículo analizamos y discutimos la dimension emocional que las personas LGBT asocian al ejercicio de la maternidad/paternidad. Basadas en las teorías feministas y las contribuciones de la subalternidad y la interseccionalidad, aplicamos el método biográfico, en un proceso de investigación dialógico-recursivo. Las personas participantes fueron 21 personas LGBT e informantes clave, pertenecientes a la academia, la psicoterapia, la política, y el activismo de la diversidad, de Chile (16), Mexico (4), y Colombia (1); entre 21 y 57 años, con una media de edad de 37.19 y una desviación estándar de 10.03. Encontramos emociones relacionadas al mandato social de “ser una buena madre/un buen padre”; emociones resultantes de la situación de desprotección social y legal; y emociones devenidas de la experiencia de parentalidad. Concluimos que las dinámicas de represión/resistencia atraviesan los cuerpos y las emociones son un aspecto fundamental de esta encarnación; dado ello, el desarrollo de investigaciones enfocadas en emociones puede abrir caminos para alcanzar sociedades más justas a través del cultivo de la sentimentalidad como elemento base de las relaciones que nos mantienen como miembros dignos de la sociedad y considerando el efecto performativo de las demandas emocionales.(AU)

In this article, we analyze and discuss the emotional dimension that LGBT people associate with the exercise of motherhood/fatherhood. Based on feminist theory and subalternity and intersectionality theory con-tributions, we applied the biographical method to a dialogical-recursive in-vestigative process. Participants were 21 LGBT people and key informants, belonging to academia, psychotherapy, politics, and diversity activism, over 18 years old, from Chile (16), Mexico (4), and Colombia (1); the partici-pantswere people between 21 and 57 years of age, with a mean age of 37.19 and a standard deviation of 10.03. We found emotions related to the social mandate to "be a good mother/father"; emotions resulting from so-cial situations such as discrimination and legal lack of protection, and emo-tions derived from the parenting experience. We conclude that repres-sion/resistance dynamics go through the bodies, and emotions are funda-mental to this incarnation. Given this, the development of research fo-cused on emotion can open ways to achieve more just societies through cultivated sentimentality, societies aware of the type of bonds that keep us as worthy members of a society and the performative effect of our emo-tional demands.(AU)

Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand.

This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.

Family reaction to coming out (FRCO): A Spanish adaptation and validation of perceived parental reactions scale.

Family reactions to coming out can affect the mental health of individuals who disclose their sexual orientation or gender identity. Therefore, it is important to have an appropriate tool to assess them. The Perceived Parental Reactions Scale (PPRS) assessed perceived parental reactions to the disclosure of gay, lesbian, or bisexual sexual orientation by their children. We adapted the PPRS so that it can be answered by any individual belonging to a sexual or gender minority, and can be answered regarding any member of the family, not just parents. A total of 2627 individuals from Spain participated in this study, with a mean age of 31.59 (SD = 11.26). Participants completed the adapted PPRS questionnaire, now named the Family Reaction to Coming Out (FRCO). The FRCO assessed family reactions when disclosing their sexual orientation or gender identity. The majority of participants identified as cisgender men (47.5%) or cisgender women (44.9%), and as gay/lesbian (51.9%). A one-factor model emerged through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The FRCO displayed excellent internal consistency and demonstrated good levels of invariance for participants' gender (male vs female vs nonbinary gender), family member's gender (male vs female), and type of family member (parents vs other family member). Supporting convergent validity, the FRCO has shown a positive correlation with fear of family reaction to coming out. These findings support the validity and reliability of the FRCO tool in assessing the reactions of any family member within the Spanish context.

Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report.

Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.

Towards inclusive healthcare: evaluating knowledge, confidence and awareness of LGBTQ + health among Internal Medicine Trainees in London.

BACKGROUND: Patients from the lesbian, gay, bisexual, transgender, queer plus (LGBTQ +) community face various health inequalities and report poor healthcare experiences. Little is known about how knowledgeable and confident UK doctors are around LGBTQ + health, and previous research demonstrates that UK medical schools rarely deliver teaching in this area. This research evaluated the level of knowledge, awareness and confidence of LGBTQ + health among Internal Medical Trainees (IMTs) in London. METHODS: London IMTs were invited to complete an online questionnaire evaluating knowledge, awareness and confidence in LGBTQ + health. Stratified analysis of results by demographics was performed. RESULTS: Three hundred and fifteen surveys were analysed from 796 eligible trainees (40%). Confidence in caring for LGBTQ + patients was variable. Confidence in discussing gender identity was lower than for sexual orientation. Knowledge of health issues affecting LGBTQ + patients varied. Most participants had never received training on LGBTQ + health at undergraduate (n = 201, 64%) or postgraduate level (n = 252, 80%), but the majority of participants felt that training would be useful (n = 233, 74%). Stratified analysis revealed that IMTs who received previous LGBTQ + teaching at undergraduate or postgraduate level were considerably more confident discussing sexual orientation with patients, compared to those who received no previous teaching. CONCLUSIONS: There is a clear need for education on LGBTQ + health, given the varied levels of knowledge and confidence identified. A significant majority of IMTs in London have never received teaching on LGBTQ + health, although there exists a strong desire for this. LGBTQ + health topics should be integrated into undergraduate and postgraduate training and examinations for IMTs. This would support IMTs in delivering high quality and inclusive care for all patients, particularly those of sexual orientation and gender identity minorities. There are relatively few published studies exploring competency in LGBTQ + health among doctors, and this is the first among UK Internal Medicine Trainees.

Sexual Identity Continuity and Change in a U.S. National Probability Sample of Sexual Minority Adults: Associations With Mental Health and Problematic Substance Use.

OBJECTIVE: Sexual minority disparities in behavioral health (e.g., mental health and substance use) are well-established. However, sexual identity is dynamic, and changes are common across the life course (e.g., identifying with a monosexual [lesbian or gay] label and later with a plurisexual [queer, pansexual, etc.] label). This study assessed whether behavioral health risks coincide with sexual identity change among sexual minority people. METHODS: Associations in a 3-year U.S. national probability sample of sexual minority adults were assessed between sexual minority identity change (consistently monosexual [N=400; 44.3% weighted], consistently plurisexual [N=239; 46.7% weighted], monosexual to plurisexual [N=19; 4.2% weighted], and plurisexual to monosexual [N=25; 4.8% weighted]) and five behavioral health indicators (psychological distress, social well-being, number of poor mental health days in the past month, problematic alcohol use, and problematic use of other drugs), controlling for demographic characteristics and baseline behavioral health. RESULTS: Among female participants, monosexual-to-plurisexual identity change (vs. consistently monosexual identity) was associated with greater psychological distress (B=3.41, SE=1.13), lower social well-being (B=-0.61, SE=0.25), and more days of poor mental health in the past month (B=0.69 [Bexp=1.99], SE=0.23). Among male participants, plurisexual-to-monosexual identity change (vs. consistently plurisexual identity) was associated with lower social well-being (B=-0.56, SE=0.25), and identity change (regardless of type) was generally associated with increased problematic use of alcohol and other drugs. CONCLUSIONS: Sexual identity change is an important consideration for sexual minority behavioral health research, with changes (vs. consistency) in identity being an important risk factor for compromised behavioral health. Prevention and treatment interventions may need to tailor messaging to sexual minority men and women differently.

Which LGBTQ+ Inclusive School Strategies Support LGBTQ+ Student, Staff and Parent Perceptions of School Climate? A Latent Class Analysis.

Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) students, LGBTQ+ staff and LGBTQ+ parents report schools can be unsafe and unwelcoming environments. Yet few studies have explored LGBTQ+ student, LGBTQ+ staff and LGBTQ+ parent perceptions of the school climate simultaneously or adopted person-centered perspectives. The present study sought to identify LGBTQ+ related strategies adopted by schools, and whether these were differentially related to perceptions of school safety and community. Data were collected in 2021 via online sampling of the current Australian school (1,937) students, (124) staff and (75) parents. Four distinct inclusion strategy profiles were identified via latent class analysis: Comprehensive Inclusion, Curriculum & Pedagogical Inclusion, Extracurricular Inclusion and Limited Inclusion. Just under half (48.2%) of schools lacked LGBTQ+ strategies, with participants from these schools reporting greater safety concerns. Our findings suggest that curriculum and pedagogical strategies are likely the most effective and should be a key focus for improving the school climate. Schools that employed LGBTQ+ affirming practices and included LGBTQ+ resources and activities, like Gay-Straight Alliances (GSAs), saw improved perceptions of safety and community.

Medical student clinical cultural awareness in cancer care of sexual gender minority patients.

OBJECTIVE: Health disparities in lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+), or sexual and gender minority (SGM) people are known. SGM people have higher cancer risk, but lower rates of screenings, resulting in a higher likelihood of late-stage disease. This study evaluates medical students' clinical cultural awareness in cancer care of SGM patients to identify gaps in education. METHODS: This was a cross-sectional survey distributed to medical students at a academic center. There were 38 questions on demographics, attitudes, and knowledge of SGM topics. Descriptive statistics were used for demographic information and stratified analyses assessed responses by demographic subgroups. RESULTS: There were 238 responses from 1145 students (response rate = 20.7 %). Of the responders, 91.2 % and 79 % were comfortable treating lesbian, gay, bisexual (LGB) and transgender patients respectively. Only 28.6 % and 21.8 % were confident treating LGB and transgender patients respectively after taking the survey. 91.2 % of students were interested receiving education regarding SGM health needs. CONCLUSION: While most medical students are comfortable treating LGBTQ+ patients, most are not confident in their knowledge. This difference is most profound in knowledge of transgender patients. PRACTICE IMPLICATIONS: Schools must provide more education in SGM topics to improve student knowledge to produce competent providers.

Sexual healthcare to meet the needs of sexuality and gender diverse aboriginal young people: imagined possibilities.

In Australia, Aboriginal young people who are lesbian, gay, bisexual, trans, queer or otherwise sexuality and gender diverse (LGBTQ+) are recognised within several overlapping priority populations in state and federal sexually transmissible infection and HIV strategies. However, limited research has documented their unique sexual health experiences, needs and preferences. In this qualitative study, semi-structured interviews were conducted with 10 LGBTQ+ Aboriginal young people aged 16-24 years in New South Wales. Interviews incorporated questions about service access, positive and negative experiences and self-determined healthcare priorities. We conducted a strengths-based thematic analysis to understand the issues of greatest importance in sexual healthcare for participants. Using the framework of 'imaginaries', we explored how participants imagined sexual healthcare that would meet their individual and cultural needs. The dominant imaginary centred on respect, representation and the as-yet-unrealised possibility of sexual healthcare designed by and for people who shared the intersection of Aboriginal and LGBTQ+ experience. We identified individual-level, service-level and societal-level factors influencing this imaginary, including relationships, accessibility and experiences of racism. Analysing the imaginaries constructed by LGBTQ+ Aboriginal young people of empowering, culturally safe sexual healthcare that is 'for them' provides insight into potential service design to improve sexual health outcomes for this population.

Common and Unique Risk Factors for Intimate Partner Violence Victimization Among Sexual and Gender Minority Individuals Assigned Female at Birth.

Sexual and gender minority youth assigned female at birth (SGM-AFAB) are at disproportionately high risk for intimate partner violence victimization (IPVV), yet remain understudied. Using two time points of data collected from 367 SGM-AFAB young people (aged 16-31 years), we tested whether common, general population risk factors (childhood violence, depression, alcohol and cannabis use, and low social support) and unique stigma-related factors (enacted stigma, microaggressions, and internalized stigma) prospectively predicted psychological, physical, sexual, and identity abuse IPVV in the following 6 months. Results indicated that some traditional risk factors, including child abuse, depression, cannabis use, and low social support, raise IPVV risk among SGM-AFAB youth. Microaggressions and internalized stigma represent additional, unique IPVV risk factors in this population. SGM-affirmative efforts to prevent IPVV should address these common and SGM-specific risk factors.

The beliefs and practices used to promote physical and mental health in youth who identify as lesbian, gay, bisexual, transgender, intersex, or queer plus (LGBTIQ+) experiencing housing insecurity: An integrative review.

PURPOSE: The purpose of this integrative review was to explore the beliefs and practices used to promote physical and mental health among youth ages 18-25 years, identifying as LGBTIQ+ experiencing housing insecurity. METHOD: The approach used strategies described by Whittemore and Knafl. Peer-reviewed, published research articles in English were identified using eight electronic databases. Eighteen research reports using qualitative, quantitative, and mixed methods were identified. Articles were evaluated for quality using the American Association of Critical Care Nurses Evidenced-Level Hierarchy evaluation tool. Data were analyzed and synthesized using Braun and Clarke's method. FINDINGS: Four themes related to the purpose were extracted: pervasive experiences of stigma and discrimination, constantly attuned to navigating risks, inconsistent engagement in health information and care, and inner strength developed through personal and community experiences. DISCUSSION: There are strong implications for future research, public health nursing practice, and health policy. Public health nurses should incorporate social determinants of health (addressing harmful social processes such as homophobia and racism) as well as a strength-based upstream approach in research, education, and health care practices. More research must also be done to assess engagement in physical and mental health information and care.

Hysterical lesbians and respectable gays. Lesbian anonymity in mainstream LGBT+ and grassroots activisms.

This article is informed by sixteen in-depth interviews with LGBT + activists in Romania, my archive and notes during my involvement in feminist and queer activist circles, as well as archival materials of an LGBT + NGO. It proposes the concept of lesbian anonymity as a means of investigating the way in which marginal positions within mainstream movements are anonymized and their contributions to the movement dispersed within the generic queer/gay activism. By looking at specific case studies from Romaniás transition period (1989 to mid 2000s), I analyze how matters of representation were tackled within the LGBT + mainstream movements in relation to grassroots activist circles. The article explores what happens when queer gatekeepers fail to engage with internal criticisms concerning the selective erasure of certain categories of voices such as queer women, trans people, racialized people, sex workers. I argue that lesbian anonymity offers another angle of analyzing the clashes between and within different LGBT + groups in post-socialist spaces. How does lesbian anonymity shape the queer movements and why is it important to keep representational issues in mind while working on non-normative sexualities, gender, and women´s reproductive rights? This contribution offers a necessary critique of the representational gaps within queer movements.

A Multistakeholder Qualitative Study to Inform Sexual Orientation and Gender Identity Data Collection in the Cancer Care Setting.

Purpose: Sexual and gender minoritized (SGM) populations face health disparities along the cancer care continuum, although attempts to define these disparities are limited by a lack of comprehensive sexual orientation and gender identity (SOGI) data collection. The objective of this study was to interview a diverse group of stakeholders to understand attitudes, barriers, and facilitators to inform data collection approaches in a cancer care setting. Methods: This was a qualitative study conducted from March to July 2023 with paired surveys of stakeholders including patients, caregivers, providers, and cancer registry staff. Twenty participants across these categories, including half who identified as SGM, completed surveys and interviews. Qualitative data were reduced to themes with exemplar quotations using rapid qualitative analysis methods and compared to survey data. Results: Themes revealed general support for SOGI data collection as part of holistic cancer care, and all participants acknowledged that specific SOGI-related information, particularly correct pronoun usage, was essential to inform patient-centered care. Themes revealed tensions around optimal SOGI data collection methods, mixed opinions on the relevance of sexual orientation, experiences of discrimination and discomfort related to SOGI, and limited acknowledgment of population benefits of SOGI data collection. Conclusion: Themes demonstrated overall support for SOGI data collection but also revealed several barriers, such as a lack of recognition of population benefits and experiences of discrimination and discomfort, that will need to be addressed to comprehensively collect these data. Based on diverse preferences and limitations of all methods of collection, a multimodal approach may be needed to optimize completion.

Mentoring LGBT Students: Perspectives from Volunteers at a Taiwanese Buddhist University.

An increasing number of studies related to LGBT inclusion on university campuses have emerged over the past few years. While a number of these studies address complex challenges encountered in Western religious universities, very little research has investigated religious universities in Eastern, Sinophone communities. This study sheds light on a mentor system at a prominent Buddhist university in Taiwan to investigate mentors' understandings of and interactions with LGBT students. Through the use of both qualitative and quantitative measures, the researchers found very few mentors were even aware of interactions with LGBT students. A thematic analysis of focus group data found the mentors' understandings and attitudes could be classified into three distinct categories ranging from very supportive to unintentionally discriminatory. Overall, it seems Confucian values, rather than Buddhist doctrines, is a far more influential factor on mentors' understandings and attitudes toward LGBT individuals. In particular, conflicts between Confucian thought and LGBT inclusive practices may arise when individuals concurrently display a strong desire to help, Confucian understandings of "family," and very little understanding of gender or sexuality. Finally, this study offers recommendations for future research and universities.

Tailoring Interpersonal Psychotherapy for Gender-Expansive Journeys.

This article introduces an innovative adaptation of interpersonal psychotherapy tailored to the needs of individuals identifying as gender diverse and navigating the complexities of gender transition. The few available therapeutic models designed for this population are reviewed, and the novel intervention, grounded in clinical insights and empirical research, is presented. Key components of this adaptation include expanding the interpersonal inventory with targeted processing questions and developing a disclosure timeline-a structured tool designed to guide patients through gender transition-while bolstering social support, reducing distress, and improving interpersonal effectiveness. An illustrative case vignette is included to elucidate the practical applications of this approach and to underscore essential therapeutic considerations.

Measuring sexual behavior stigma among cisgender men who have sex with men: an assessment of cross-country measurement invariance.

Objectives: Globally, cisgender men who have sex with men experience sexual stigma, but limited investigation of cross-population scale performance hinder comparisons. As measurement invariance is a necessary but seldom-established criterion of valid cross-cultural comparisons, we assessed invariance in scales of stigma related to sexual behavior across 9 countries. Methods: This secondary analysis used data collected from adult (mean age=29.6, standard deviation=12.5) cisgender men who have sex with men (n=8,669) in studies from 6 West African, 2 Southern African, and 1 North American country from 2012-2016. A common item set assessed 2 sexual behavior stigma domains. A sequential process was used to test the factor structure and measurement invariance, which included multigroup confirmatory factor analyses (CFA). Individual countries, items, living with HIV, and disclosure were explored as possible sources of noninvariance. Results: Goodness-of-fit statistics indicated adequate fit of the same 2-factor model in 7 of the 9 countries. The chi2 difference test comparing a constrained and unconstrained 7-country model in which loadings and thresholds were freely estimated was significant (p<0.001), indicating metric and scalar noninvariance, but removing the US provided evidence of invariance and freeing certain items led to a finding of partial invariance. Sexuality disclosure exhibited a direct relationship with select stigma items in several countries. Conclusions: Our findings point to the utility of the two stigma scale dimensions in making cross-country comparisons, but also to the necessity of assessing invariance with explicit attention to several factors including differential disclosure of sexuality across contexts to ensure valid comparisons.

Long-term trends in mental health disparities across sexual orientations in the UK: a longitudinal analysis (2010-2021).

BACKGROUNDS: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies. METHODS: Waves 2-12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations. RESULTS: Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with "other" orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures. CONCLUSIONS: The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.

Taiwanese nurse educators' behaviour or intention to teach LGBT health content: A qualitative study.

AIM: To explore factors associated with Taiwanese nurse educators' behaviour or intention to teach lesbian, gay, bisexual and transgender (LGBT) health content. BACKGROUND: Nurse educators were found to have limited experiences and readiness to teach LGBT health content. However, limited evidence exists to comprehensively understand factors associated with nurse educators' behaviour and intentions to teach LGBT health content. METHODS: A qualitative descriptive study design was adopted. A total of 24 nurse educators were interviewed. One-on-one interviews were conducted employing a semi-structured topic guide and were audio-recorded. Interview data were analysed using the socio-ecological model and constant comparative technique. This article was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. FINDINGS: Most nurse educators had no experience of teaching LGBT health content and expressed their low or no intention to teach it. Factors associated with nurse educators' behaviour and intention to teach LGBT content were categorised by the socio-ecological model level: intrapersonal factors, interpersonal factors, community factors and societal and policy factors. CONCLUSION: This study identified multilevel factors associated with Taiwanese nurse educators' behaviour and intention to teach LGBT health content. Recommendations were provided to address multilevel barriers to diminish nurse educators' challenges in teaching LGBT health content. IMPLICATIONS FOR NURSING AND NURSING POLICY: Supervisors of nurse educators should assess and discuss nurse educators' concerns and competencies regarding teaching LGBT health content. To address schools' or organisations' adverse climates and conventional societal atmosphere, related policies and regulations should be developed and implemented.