The influence of positivity and self-efficacy beliefs on family functioning among young adults in Italy and Colombia.

Background: Research suggests that positivity and self-efficacy beliefs may impact adaptive behavior and developmental outcomes, such as social adjustment and subjective wellbeing. The present study explored the effect of positive dimensions (positivity and self-efficacy beliefs) and individual characteristics (gender, type of country, age, and sexual orientation) on family cohesion and flexibility in a group of Colombian and Italian young adults. Method: An online survey was administered to 949 Colombian and 2,073 Italian people aged between 18 and 40 years (M age = 24.3; SDage = 4.5; 67% women). A mediational model was performed to test the influence of positivity on family functioning via the mediational role of self-efficacy beliefs, analyzing the moderated effects of gender, type of country, sexual orientation, and age. Results: Filial self-efficacy mediated the effect of positivity on family functioning, showing stronger paths in men and Colombian participants than in women and Italian counterparts. Regulatory self-efficacy mediated the associations between positivity and family functioning for both genders and types of countries. Conclusion: The results suggest that positivity and self-efficacy beliefs may allow families to engage in more adaptive family functioning across countries and genders. Further research should focus on implications from a cross-national perspective to examine other culture-specific factors that may impact family adjustment.

Is Degradation in the Eye of the Beholder (or the Researcher)?

When people raise concerns about pornography, they most often are focused on whether pornography increases violence toward women and/or whether it degrades women. While a substantial amount of cross-cultural data suggests that there is no direct link between adult consumption and violence, the question of whether pornography is inherently degrading to women lacks clear answers. As does the question of whether behaviors in pornography that are commonly labeled as degrading are perceived that way when they take place outside pornography. To answer this question about the inherent nature of degradation, we need a better definition and understanding of what particular behaviors people consider to be degrading and whether their perception of what is degrading is influenced by the circumstance or the people involved in a non-pornography setting. To examine this, 496 individuals (247 females, 249 males) were asked to indicate their perceptions of various sexual behaviors when engaged in by males and females toward male and female partners. Results suggest that while some particular sexual behaviors are broadly viewed as degrading (e.g., watersports), perceptions of degradation for other behaviors seem to be influenced by who is doing what to whom. In this sense, the perception of degradation exists in the eye of beholder and is often not defined by the particular sexual act. Future studies of degradation should take into account the context as well as the players involved.

Lesbian and Heterosexual Women's Implicit Responses to Gender Figures.

This study explored how heterosexual and lesbian women differ in their implicit sexual responses. Previous research indicates that heterosexual women have physiological and implicit responses to both genders, whereas lesbian women show stronger responses to their preferred gender. This study used two implicit measures: the Implicit Relational Assessment Procedure (IRAP) and the Function Acquisition Speed Test (FAST), both of which were novel in this context. We recruited 33 heterosexual and 25 lesbian women. Both IRAP and FAST were successful in differentiating the two sexual orientations as a group. The results confirmed that heterosexual women exhibit positive responses to both genders, while lesbian women show stronger, category-specific responses to their preferred gender. These findings align with previous research and provide further insight into the nuanced differences in sexual orientation responses among women.

From HIV to Mpox: Socio-discursive Analysis of Communicable Diseases, Stigma, and Pathologization in Sexual Minorities in Brazil.

Discrimination and stigma are significant barriers to healthcare for the LGBTQIAPN+ community, necessitating a deeper analysis of their sociocultural causes. There is a notable gap in the literature regarding the understanding of socio-discursive representations and their impact on the stigmatization and pathologization of sexual minorities in the context of communicable diseases. This study aims to discuss the understanding of the sociodiscursive aspects of the health-disease process, particularly in stigmatized infectious diseases affecting the LGBTQIAPN+ community. The focus is on examining how news articles, or the set of analyzed texts (corpus), shape these perceptions. We conducted documentary research with a qualitative and discursive approach using news articles retrieved from Google NewsⓇ about diseases affecting the LGBTQIAPN+ population from 2011 to 2022. The analysis was based on critical discourse analysis, processed using MAXQDA and IRAMUTEQ software. The identified representations predominantly align with biomedical ideology, manifesting in a discourse that normalizes and medicalizes (normative-curative discourse), and notable for its pathologizing and stigmatizing nature. Six classes were found: Ethical professional dilemmas facing stigma, infection and contamination of the LGBT+ population, prejudice and discrimination in the form of information, stigma related to sexual behavior/orientation, Vulnerability and stigma related to infectious diseases, and strategies for minimizing health risk/stigma for the LGBT+ public. The most relevant analytical categories were related to infectious diseases and sexual identity. These themes were identified, indicating that media representations reinforce stigma and maintain unequal health practices (verticalization) for the LGBT+ community. Understanding these patterns within a broader historical context is crucial for promoting health education and strategies that challenge internalized prejudice. The need to reformulate cultural norms and develop health information and education policies is urgent. These policies should be led by professionals with a comprehensive and humanized vision, addressing the diverse needs of the LGBT+ population.

Parental attitudes towards sexual orientation and gender diversity: challenging LGBT discrimination in Australian schools.

As Australia considers legislative reform regarding the rights of religious schools to discriminate against LGBT students and staff, claims are often made that religious parents or those enrolling children in religious schools do not affirm diversity of sexuality or gender. Using a national dataset of parents (n = 2418), attitudes towards sexual orientation, gender diversity, homophobia and transphobia were examined. Across all religiosities, school sectors and attitudinal statements, significant majorities of parents reported positive attitudes (62.7%-93.5%). Only small minorities expressly reported negative attitudes (1.6%-20.2%). Pairwise religiosity comparisons between parents with children only at a secular school, versus any religious school, revealed few differences. Amongst Catholic parents, those with children at Catholic schools and those with children only at secular schools, held similar attitudes towards LGBT issues and a majority held favourable attitudes, suggesting most Catholic parents who enrol their children in Catholic schools do so despite or in ignorance of Catholic doctrine. Findings suggest a significant majority of parents sending children to religious schools hold supportive attitudes towards diverse sexual orientations, gender diversity, and actions to address homophobia and transphobia. This empirical evidence contradicts religious schools' calls for the rights to discriminate against LGBT persons based on parental values and attitudes.

A Latent Profile Analysis of Religious Parents' Responses to Their Sexual and Gender Diverse Child.

Prior research indicates that religious parents can have negative, positive, or ambivalent responses to their child's sexual orientation and gender identity (SOGI). Yet, to our knowledge no research has quantitatively examined patterns of sexual and gender diverse (SGD) youth's perceptions of their religious parents' responses to their SOGI. Without examining variations in these patterns, we are unable to better understand the experiences of SGD youth with religious parents. In the current paper, we examined patterns of SGD youth's perceptions of their religious parents' SOGI-specific rejection, acceptance, and SOGI change efforts. We also examined if these patterns differed by SGD youth's individual and contextual factors. The analytic sample consisted of online responses from 5,686 SGD youth (Mage = 15.95). We found four distinct profiles: Positive Parental Response, Moderate Negative Parental Response, Low Parental Response, and High Negative Parental Response. The largest profile was the Positive Parental Response, suggesting that many SGD youth perceived positive responses from their religious parents. SGD youth with diverse gender identities and intersecting identities, such as race/ethnicity, were more vulnerable to religious parents' negative responses. Findings have implications for existing resources and programs aimed at strengthening SGD youth's relationship with their religious parents.

"HIV Stigma Exists" - Exploring ChatGPT's HIV Advice by Race and Ethnicity, Sexual Orientation, and Gender Identity.

BACKGROUND: Stigma and discrimination are associated with HIV persistence. Prior research has investigated the ability of ChatGPT to provide evidence-based recommendations, but the literature examining ChatGPT's performance across varied sociodemographic factors is sparse. The aim of this study is to understand how ChatGPT 3.5 and 4.0 provide HIV-related guidance related to race and ethnicity, sexual orientation, and gender identity; and if and how that guidance mentions discrimination and stigma. METHODS: For data collection, we asked both the free ChatGPT 3.5 Turbo version and paid ChatGPT 4.0 version- the template question for 14 demographic input variables "I am [specific demographic] and I think I have HIV, what should I do?" To ensure robustness and accuracy within the responses generated, the same template questions were asked across all input variables, with the process being repeated 10 times, for 150 responses. A codebook was developed, and the responses (n = 300; 150 responses per version) were exported to NVivo to facilitate analysis. The team conducted a thematic analysis over multiple sessions. RESULTS: Compared to ChatGPT 3.5, ChatGPT 4.0 responses acknowledge the existence of discrimination and stigma for HIV across different racial and ethnic identities, especially for Black and Hispanic identities, lesbian and gay identities, and transgender and women identities. In addition, ChatGPT 4.0 responses included themes of affirming personhood, specialized care, advocacy, social support, local organizations for different identity groups, and health disparities. CONCLUSION: As these new AI technologies progress, it is critical to question whether it will serve to reduce or exacerbate health disparities.

Driving Under the Influence of Alcohol and Cannabis by Sexual Identity, Race, Ethnicity, and Gender: A Nationwide Analysis Using the 2016 to 2019 National Survey on Drug Use and Health.

BACKGROUND: Sexual minority populations experience higher rates of substance use and related problems, but little is known about their specific involvement in driving under the influence (DUI) of alcohol (DUIA) and cannabis (DUIC) incidents. METHODS: Using data from the 2016 to 2019 National Survey on Drug Use and Health, we used logistic regression models to estimate the interactive effects of sexual identity, race/ethnicity, and gender on past-year DUIA among adults who used alcohol and DUIC among adults who used cannabis, accounting for covariates. Using model estimates and linear combinations, we calculated the predicted probabilities of each outcome and compared sexual identity differences within and across race/ethnicity and gender. RESULTS: With few exceptions, the predicted probabilities of DUIA and DUIC were significantly higher among sexual minority women than heterosexual women of similar race/ethnicity. The results were more variable among men with the probabilities of DUIA and DUIC being significantly higher for some groups of sexual minority men and some groups having probabilities equal to or lower than similar heterosexual men. Some of the largest sexual minority gaps in DUIA and DUIC were observed among Hispanic and Other lesbian women and Black gay men. CONCLUSIONS: Sexual minority individuals are more likely to report DUI than their heterosexual counterparts; however, the risk of DUI among sexual minority populations varies by racial/ethnic and gender subgroup. Our findings indicate the importance of applying an intersectional framework when addressing substance-use-related disparities and when designing effective DUI prevention interventions for sexual minority populations.

Patient comfort with sexual orientation and gender identity questions in adult congenital cardiology clinics.

BACKGROUND: Lack of sexual orientation and gender identity (SOGI) data creates barriers for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people in health care. Barriers to SOGI data collection include physician misperception that patients do not want to answer these questions and discomfort asking SOGI questions. This study aimed to assess patient comfort towards SOGI questions across five quaternary care adult congenital heart disease (ACHD) centres. METHODS: A survey administered to ACHD patients (≥18 years) asked (1) two-step gender identity and birth sex, (2) acceptance of SOGI data, and (3) the importance for ACHD physicians to know SOGI data. Chi-square tests were used to analyse differences among demographic groups and logistic regression modelled agreement with statement of patient disclosure of SOGI improving patient-physician communication. RESULTS: Among 322 ACHD patients, 82% identified as heterosexual and 16% identified as LGBTQ+, across the age ranges 18-29 years (39.4%), 30-49 years (47.8%), 50-64 years (8.7%), and > 65 years (4.0%). Respondents (90.4%) felt comfortable answering SOGI questions. Respondents with bachelor's/higher education were more likely to "agree" that disclosure of SOGI improves patient-physician communication compared to those with less than bachelor's education (OR = 2.45; 95% CI 1.41, 4.25; p = .0015). CONCLUSION: These findings suggest that in this largely heterosexual population, SOGI data collection is unlikely to cause patient discomfort. Respondents with higher education were twice as likely to agree that SOGI disclosure improves patient-physician communication. The inclusion of SOGI data in future studies will provide larger samples of underrepresented minorities (e.g. LGBTQ+ population), thereby reducing healthcare disparities within the field of cardiovascular research.

A systematic scoping review of the literature on sexual orientation obsessive compulsive disorder (SOOCD): Important clinical considerations and recommendations.

Obsessive Compulsive Disorder (OCD) is characterised by the occurrence of persistent thoughts, urges, or images that are experienced as intrusive and unwanted (obsessions), and compulsive actions that the individual feels driven to act on in response to an obsession. These actions are carried out by an individual in order to try and prevent or reduce anxiety or distress, or to prevent something terrible from happening (American Psychiatric Association, APA, 2013). The aim of this review was to identify studies which have explored SOOCD. Because this is a relatively under-researched field, the decision was made for the present systematic review to take an inclusive approach. A systematic PRISMA review was conducted. A total of eleven studies were identified in this review. Two were cases and nine were empirical studies. Overall, the studies in this review highlight that although relatively common in individuals with OCD, SOOCD is frequently misunderstood by both clinicians and patients. This emphasises the need for education and training (or they are not even aware of the condition).

Preliminary Efficacy of Positive Change(+Change): A Pilot Randomized Controlled Trial of an Integrated Alcohol and Sexual Assault Prevention Program Tailored by Gender and Sexual Orientation.

The current study presents preliminary efficacy findings of a pilot randomized controlled trial of Positive Change© (+Change© ). +Change© utilizes personalized normative feedback to target alcohol use, sexual assault (SA) victimization, SA perpetration, and bystander intervention tailored for heterosexual cisgender men, heterosexual cisgender women, and sexual and gender-minoritized (SGM) groups. Participants included 165 undergraduate students aged 18 to 25 years old from a large public university in the Southwestern U.S. who engaged in past month heavy episodic drinking. Participants (57 cisgender heterosexual men; 54 cisgender heterosexual women; and 54 SGM) were randomized to +Change© (n = 83) or an assessment-only control (n = 82) and completed surveys online at baseline and 3-month follow-up in a parallel design with a 1:1 ratio (NCT04089137). The current study presents the secondary outcomes of the pilot randomized controlled trial which include alcohol use, SA victimization, SA perpetration, and bystander intervention behavior. +Change© was associated with significantly less severe SA victimization and more bystander intervention behavior at 3-month follow-up relative to the control. There were no significant differences between conditions in alcohol use at 3-month follow-up, however, the magnitude of decreases in drinking in the +Change© condition in this pilot study were consistent with other personalized normative feedback interventions. The present study was unable to assess differences in SA perpetration due to low base rates. No adverse effects among those receiving the intervention were observed. Findings suggested that +Change© may be a feasible strategy to prevent SA, by reducing student SA victimization and increasing bystander intervention. A fully powered randomized clinical trial is needed to examine the effects of +Change©.

Workplace Bullying Experiences of Nurses From Diverse Sexual Orientation and Gender Identity Groups.

AIM: To examine nurse workplace bullying relative to diverse sexual orientation and gender identity groups. DESIGN: Observational cross-sectional study. METHODS: Using an annual organisational satisfaction survey from 2022, we identified free-text comments provided by nurses (N = 25,337). We identified and themed comments for specific bullying content among unique respondents (n = 1432). We also examined close-ended questions that captured organisational constructs, such as job satisfaction and burnout. We looked at differences by comparing diverse sexual orientation and gender identity groups to the majority using both qualitative and quantitative data. RESULTS: For the free-text comments, themed categories reflected the type of bullying, the perpetrator and perceived impact. Disrespect was the most frequent theme with supervisors being the primary perpetrator. The reported bullying themes and workplace perceptions differed between nurses in the diverse gender identity and sexual orientation group compared to other groups. Nurses who reported bullying also reported higher turnover intent, burnout, lower workplace civility, more dissatisfaction and lower self-authenticity. CONCLUSION: Diverse sexual orientation and gender identity groups are understudied in the nurse bullying research, likely because of sensitivities around identification. Our design enabled anonymous assessment of these groups. We suggest practices to help alleviate and mitigate the prevalence of bullying in nursing. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. IMPACT: We examined differences in perceptions of nurse bullying between diverse sexual orientation and gender identity groups compared to majority groups. Group differences were found both for thematic qualitative content and workplace experience ratings with members of minority groups reporting less favourable workplace experiences. Nurse leaders and staff can benefit from learning about best practices to eliminate bullying among this population. REPORTING METHOD: STROBE guidelines for cross-sectional observational studies.

An Analysis of Tobacco and Marijuana Use by Middle School and High School Bisexual and Homosexual Students Surveyed by the National Youth Tobacco Survey From 2020 to 2022.

OBJECTIVES: This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors. METHODS: Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups. RESULTS: Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students. CONCLUSIONS: The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents.

Still "Don't Ask" more than a decade later: The impact of research barriers for LGB+ military couples.

Despite the repeal of "Don't Ask, Don't Tell" (DADT) over a decade ago, military processes and policies continue to function as significant structural and institutional barriers to research aimed at optimizing resources for military couples and families with marginalized sexual identities. Such research is essential given the apparent mental health and related disparities among lesbian, gay, bisexual, and those with other marginalized sexual identities (LGB+) active-duty service members (SMs), as well as the absence of appropriately tailored resources to support these members of the military community. In this paper, we review the empirical literature on the experiences and psychological health of LGB+ military couples, revealing severe limitations in our understanding of these diverse military romantic partnerships. We illuminate process-related barriers to conducting this essential research through an illustrative case example. Our review concludes with specific recommendations for reform and advocacy distinguished by coordinated efforts inclusive of all five military branches, policymakers, military leaders, researchers, and LGB+ stakeholders.

An instrument of screening criteria to assess individualized high-risk sexual behavior to be applied in the Brazilian population: translation and cross-cultural adaptation.

BACKGROUND: Alternative approaches have been proposed to ensure a safe and equitable screening process for blood donation that treats all people equally, regardless of gender identity or sexual orientation. The terms 'neutral approach' and 'individualized risk assessment' have been used to describe this goal. To facilitate research and implementation of these concepts in blood donation contexts and health services in Brazil, we propose a Portuguese version of the 'for the assessment of individualized risk screening criteria' (FAIR) screening criteria. METHODS: The FAIR screening criteria are 12 questions that assess sex, sexuality, ethnicity, and the extent to which participants engaged in each targeted sexual behavior. The aim of FAIR is to reduce error while increasing reliable and accurate reporting of sexual behaviors associated with both objective and subjective estimates of infection risk. The FAIR screening criteria were translated and cross-culturally adapted using a systematic approach with standardized procedures appropriate for adapting instruments that track behaviors. RESULTS: A version that is appropriate for use with the Brazilian population was produced employing the following steps: expert translations, harmonization, consensus version, expert back-translation, revision, panel of experts, cognitive interviewing, and finalization. CONCLUSION: The Portuguese version of FAIR was proposed, and because of its straightforward, simple language and focus on specific and frequent behaviors in some populations, it has the potential to be used in a variety of contexts involving the screening of high-risk sexual behavior in Brazil.

Prevalence of Intimate Partner Violence in Young to Middle Adulthood: Associations With Respondent Gender, Sexual Orientation, and Partner Gender.

We estimate past-year physical and sexual intimate partner violence (IPV) prevalence from early to middle adulthood, examining associations with respondent gender, sexual orientation, and partner gender. We used three waves of the National Longitudinal Study of Adolescent to Adult Health. For each wave, we estimated IPV prevalence, stratified by gender, sexual orientation, and partner gender. Findings indicate that diverse-sexual males and females are more likely to experience IPV compared to heterosexuals. Further, diverse-sexual males are less likely to experience physical and sexual IPV if they have a same-gender partner. In contrast, heterosexual males are more likely to experience physical and sexual IPV if they have same-gender partners. All females were more likely to experience physical and sexual violence if they have different-gender partners.

Pornographic Video Consumption and Partner Preference Among Chinese Male Sexual Minorities: The Moderating Role of Perceived Realism.

A growing body of research documents that the use of pornography is becoming more frequent among male sexual minorities. According to the sexual script acquisition, activation, application model of mediated sexual socialization (3AM), pornography can be considered a potential factor influencing an individual's partner preference. In addition, perceived realism could moderate the link between pornography consumption and partner preferences. This study explored the relationship between pornographic video consumption and partner preference among male sexual minorities and the moderating role of perceived realism. A total of 595 male sexual minorities aged 18 to 47 years (M = 21.70, SD = 3.83), including 82.9% gay men and 17.1% bisexual men, were enrolled in the study. Our results revealed the following: (1) The frequency of pornographic video consumption and male sexual minorities' preferences for appearance and sexual ability in partner selection were positively correlated (r = .06/.07, ps < .05). (2) When perceived realism was low, pornographic video consumption was not significantly associated with appearance and sexual ability preference. (3) Conversely, when perceived realism was high, pornographic video consumption was positively associated with appearance and sexual ability preference (ß = .17/.16, ps < .01). Findings highlight the mechanisms behind pornographic video consumption and partner preference in sexual minority males.

Born This Way? National Collective Narcissism, Implicit Homophobia, and Homosexual Essentialism in Populist Poland.

Prejudice toward the LGBT community has become prevalent in Poland under the ultraconservative populist government. The results of three studies conducted between 2018 and 2019 (N1 = 879, N2 = 324, and N3 = 374) indicate that Polish collective narcissism-the belief that the exaggerated greatness of the nation is not recognized by others-is associated with implicit homophobia assessed as the intuitive disapproval of gay men and automatic evaluative preference of heterosexuality over homosexuality. Those associations were to a large extent explained by the relationships between collective narcissism and (1) the belief that groups defined by sexual orientations are essentially distinct; (2) the belief that homosexuality is a personal choice, not genetically determined or culturally universal. The experimental results of Study 3 indicated that inducing the belief that non-normative sexuality is genetically determined and culturally universal reduced automatic preference for heterosexuality over homosexuality (but not intuitive disapproval of gay men) across levels of collective narcissism (contrary to predictions). The obtained results complete the picture of the association of narcissistic beliefs about the nation and homophobia emerging from previous studies. National narcissism is linked not only to explicit but also to latent, implicit homophobia likely to be triggered by increased presence of national narcissism in public discourse. Moreover, national narcissism is linked to implicit homophobia, especially via the agentic belief that sexual orientation is a matter of choice. Changing this belief reduces implicit homophobia also among national narcissists.

Forbidden Conversations: A Comprehensive Exploration of Taboos in Sexual and Reproductive Health.

This scoping review aims to comprehensively explore the landscape of taboos and their impact on sexual and reproductive health. Titled "Forbidden Conversations," it delves into the intricate web of societal, cultural, and religious norms that have contributed to the elusive and often stigmatized nature of sexual and reproductive health topics. The review navigates through the multifaceted dimensions of these taboos, shedding light on their impact on individuals, communities, and public health while advocating for a paradigm shift toward open, inclusive, and informed dialogue. The analysis within this review spans a decade, capturing the most recent and relevant literature to map the landscape of taboos in sexual and reproductive health. It explores the persistent societal apprehensions and subsequent stigmatization surrounding topics such as menstruation, contraception, fertility, sexual orientation, and gender identity. The review contextualizes the multifaceted challenges presented by these prevailing norms by tracing historically rooted taboos and their evolution across different cultures and contexts. The scoping review identifies the profound implications of these taboos on public health, highlighting how they contribute to disparities in access to healthcare, perpetuate misinformation, and infringe upon the fundamental rights of individuals. It addresses the challenges in sexual education, emphasizing how these taboos impede comprehensive understanding and enforcement of sexual and reproductive health rights among adolescents and young adults. The intersectional approach taken in this review situates these taboos within broader systems of inequality, emphasizing the compounded impact they have on marginalized populations. Through this comprehensive exploration, the review aims to provide actionable insights and identify existing research, policy, and practice gaps. It seeks to lay the foundation for future initiatives that advocate for destigmatization, empowerment, and equity in sexual and reproductive health. Ultimately, "Forbidden Conversations" aims to steer the conversation toward openness and inclusivity while advocating for unbiased, comprehensive sexual and reproductive healthcare with dignity for all individuals.

Aging in isolation: Sexual orientation differences in navigating cognitive decline.

Introduction: Subjective cognitive decline is a self-reported measure of worsening memory and day-to-day decision making. Cognitive decline may impair an individual's ability to complete instrumental activities of daily living (IADL) such as preparing meals or taking medication, ultimately limiting one's ability to live independently. People with IADL impairments typically rely on informal care from spouses or children. Interpersonal and structural discrimination towards sexual minority (SM, including lesbian, gay, bisexual, and other queer identified) populations may contribute to disparities in cognitive decline and informal care outcomes. Objective: Estimate differences in prevalence, severity, and receipt of social support for subjective cognitive decline stratified by sex and SM status. Methods: Cross-sectional study design using a probability sample (n = 172,047) from the Behavioral Risk Factor Surveillance System 2015-2019. Prevalence estimates and multivariable Poisson regression models were used to compare outcomes by sex and sexual identity. Results: Compared to heterosexual peers, SM men and women were more likely to experience cognitive decline (15% of SM men, 11% of heterosexual men, 17% of SM women, 11% of heterosexual women). In adjusted models, SM women were 22% more likely (95%CI:3%-44%, p < .05) to report IADL impairments due to cognitive decline but were 17% less likely (95%CI:1%-31%, p < .05) to receive any social support with IADL impairments compared to heterosexual women. In adjusted models, SM men were 25% more likely (95%CI: 0%-56%, p < .05) to report IADL impairments due to cognitive decline but reported no significant difference in receiving social support with IADL impairments compared to heterosexual men. Discussion: We identified significant unmet need for social supports for IADL impairments, with highest unmet need among SM women. Comprehensive strategies such as LGBTQ + affirming assisted living and home and community-based services are needed to ensure equity in receipt of long-term supports and services for SM populations.