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Article: Sexual identity fluidity, identity management stress, and depression among sexual minority adolescents.

Srivastava, Ankur / Hall, William J / Krueger, Evan A / Goldbach, Jeremy T

2023 Volume 13, Page(s) 1075815

Abstract: Introduction: Sexual identity is mutable and evolving, particularly during adolescence. Sexual identity fluidity could be stressful for some adolescents and may differ by birth-sex. Evidence suggests chronic stress can lead to negative mental health ... ...

Abstract	Introduction: Sexual identity is mutable and evolving, particularly during adolescence. Sexual identity fluidity could be stressful for some adolescents and may differ by birth-sex. Evidence suggests chronic stress can lead to negative mental health outcomes. However, it is unknown if these two processes (stress and depression) differ by sexual identity fluidity. Methods: This paper studied time-sequential associations between identity management stress and depression over time by sexual identity fluidity, in a national longitudinal data from sexual minority adolescents (SMA) aged 14-17 years using a multigroup autoregressive cross-lagged model ( Results: In the sample, 40% of SMA reported at least one change in sexual identity over 18-month period. Greater number of cisgender females reported sexual identity fluidity compared to their male counterparts (46.9% vs. 26.6%). A temporal cross-lagged effect was reported between depression and identity management stress among cisgender females who reported fluidity in sexual identity; and no cross-lagged effect was reported among those females who did not report fluidity. However, among cisgender male sample depression predicted subsequent identity management stress, irrespective of their change sexual identity fluidity status. Conclusion: Public health programs and practice must be responsive to the sexual identity fluidity processes among adolescents, with particular attention to minority stress and depression. In addition, our results indicate that sexual identity development and fluidity processes differ between cisgender females and males; and the nuances associated with these processes of change need further investigation.
Language	English
Publishing date	2023-01-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2022.1075815
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Article ; Online: Sexual Identity Fluidity and Depressive Symptoms: Findings From a National Longitudinal Study of Sexual Minority Adolescents.

Srivastava, Ankur / Hall, William J / Krueger, Evan A / Goldbach, Jeremy T

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

2023 Volume 73, Issue 5, Page(s) 873–879

Abstract: Purpose: Sexual minority adolescents (SMAs) consistently report elevated risk of mental health symptoms, including depression. Sexual identities may change over time (referred as sexual identity fluidity), particularly during adolescence. This study ... ...

Abstract	Purpose: Sexual minority adolescents (SMAs) consistently report elevated risk of mental health symptoms, including depression. Sexual identities may change over time (referred as sexual identity fluidity), particularly during adolescence. This study examined the effect of sexual identity fluidity on depressive symptoms over time. Methods: National longitudinal data were analyzed from SMAs aged 14-17 years (N = 1,077) in the adolescent stress experiences over time study during an 18-month period. Multigroup time-varying covariate latent growth models were employed to examine the effect of sexual identity fluidity on depressive symptoms. Results: In the sample, 40% of SMAs reported at least 1 change in sexual identity during an 18-month period. Cisgender females reported sexual identity fluidity at a higher rate than their male counterparts (46.9% vs. 26.6%, respectively). In our first model (total sample), a change in sexual identity was associated with reporting fewer depressive symptoms (b = -0.591, p = .004). In our multigroup model (by sex assigned at birth), a change in sexual identity was significantly associated with reporting fewer depressive symptoms among cisgender females (b = -0.591, p < .01). However, there was no significant effect found among cisgender males. The models controlled for age and race or ethnicity. Discussion: The results add to the limited knowledge on the complex relationship between sexual identity fluidity and mental health risks over time among adolescents. Our results indicate that sexual identity development and change processes differ between cisgender females and males. The nuances associated with these sexual identity processes need further investigation.
MeSH term(s)	Female ; Infant, Newborn ; Humans ; Male ; Adolescent ; Depression/epidemiology ; Depression/psychology ; Longitudinal Studies ; Sexual and Gender Minorities ; Gender Identity ; Ethnicity ; Sexual Behavior/psychology
Language	English
Publishing date	2023-08-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1063374-1
ISSN	1879-1972 ; 1054-139X
ISSN (online)	1879-1972
ISSN	1054-139X
DOI	10.1016/j.jadohealth.2023.06.008
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Article: Sexual orientation, social support, and mental health resilience in a U.S. national sample of adults.

Krueger, Evan A / Upchurch, Dawn M

Behavioral medicine (Washington, D.C.)

2020 Volume 48, Issue 3, Page(s) 207–215

Abstract: Sexual minority mental health disparities can be attributed, in large part, to chronic exposure to stress. There is growing interest in understanding the factors associated with psychological resilience, or the ability to positively cope with life's ... ...

Abstract	Sexual minority mental health disparities can be attributed, in large part, to chronic exposure to stress. There is growing interest in understanding the factors associated with psychological resilience, or the ability to positively cope with life's stressors. Using nationally representative data (2012-2013; N = 14,470), this study compared differences in resilience status (operationalized empirically using SF-12 mental health score among respondents reporting 2+ past-year stressful life events; respondents were categorized as "flourishing," "average," or "languishing") by sexual orientation and assessed whether social support mediated sexual minority disparities in resilience. Comparisons were made across four sexual orientation groups: heterosexuals and three sexual minority subgroups (lesbians/gay men, bisexual, heterosexual-identified sexual minorities [HSM]). Generally, heterosexual respondents were more likely to be flourishing, less likely to be languishing, and reported more social support, compared to sexual minority respondents. In multivariable analysis, bisexual women, HSM women, and gay men had lower odds of resilience than heterosexual women and men, respectively. In mediation models, lower social support was associated with reduced resilience for all sexual minority subgroups except lesbian/gay women. This study demonstrated that sexual orientation is an important determinant of resilience, and further, that social support contributes to sexual minority peoples' abilities to flourish when faced with stress.
MeSH term(s)	Adult ; Bisexuality ; Female ; Heterosexuality/psychology ; Humans ; Male ; Mental Health ; Sexual Behavior/psychology ; Sexual and Gender Minorities ; Social Support
Language	English
Publishing date	2020-10-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	623101-9
ISSN	0896-4289
ISSN	0896-4289
DOI	10.1080/08964289.2020.1825922
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Article ; Online: Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation.

Fish, Jessica N / Krueger, Evan A

LGBT health

2020 Volume 7, Issue 4, Page(s) 198–207

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Adolescent ; Adult ; Female ; Gender Identity ; Health Status Disparities ; Health Surveys ; Humans ; Male ; Mental Disorders ; Mental Health ; Middle Aged ; Risk Assessment ; Sexual Behavior ; Sexual Partners ; Sexual and Gender Minorities ; Sexuality ; Substance-Related Disorders ; Surveys and Questionnaires
Language	English
Publishing date	2020-04-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2727303-9
ISSN	2325-8306 ; 2325-8292
ISSN (online)	2325-8306
ISSN	2325-8292
DOI	10.1089/lgbt.2019.0182
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Article ; Online: Examining Factors Associated with Cannabis Use Among Sexual and Gender Minority and Cisgender Heterosexual Emerging Adults in California.

Jauregui, Juan C / Hong, Chenglin / Assaf, Ryan D / Cunningham, Nicole J / Krueger, Evan A / Flynn, Risa / Holloway, Ian W

LGBT health

2024

Abstract: Purpose: ...

Abstract	Purpose:
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2727303-9
ISSN	2325-8306 ; 2325-8292
ISSN (online)	2325-8306
ISSN	2325-8292
DOI	10.1089/lgbt.2023.0050
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Article ; Online: Are sociodemographic, lifestyle, and psychosocial characteristics associated with sexual orientation group differences in mental health disparities? Results from a national population-based study.

Krueger, Evan A / Upchurch, Dawn M

Social psychiatry and psychiatric epidemiology

2019 Volume 54, Issue 6, Page(s) 755–770

Abstract: Purpose: Sexual minority mental health disparities are well documented. However, distinct sexual minority subgroups are often collapsed into a single "lesbian, gay, or bisexual" (LGB) analytic group. While limited research has shown sexual minority ... ...

Abstract	Purpose: Sexual minority mental health disparities are well documented. However, distinct sexual minority subgroups are often collapsed into a single "lesbian, gay, or bisexual" (LGB) analytic group. While limited research has shown sexual minority subgroup differences in mental health, little is known about the factors underlying these differences. This study examines whether sociodemographic, lifestyle, and psychosocial characteristics are associated with sexual orientation subgroup differences in mental health. Methods: Using the National Epidemiologic Survey on Alcohol and Related Conditions, Wave III, differences in various mental health measures, and sociodemographic, lifestyle, and psychosocial characteristics were assessed across three sexual minority subgroups [lesbians/gay men, bisexuals, and heterosexuals reporting same-sex attractions or behaviors ("heterosexual-identified sexual minorities, HSM")] and heterosexuals reporting only opposite-sex attractions and behaviors ("heterosexuals"). Sequential linear regressions evaluated the degrees to which different factors attenuated mental health (SF-12) disparities between heterosexuals and sexual minority subgroups. Analyses were sex-stratified. Results: Several sociodemographic, lifestyle, and psychosocial characteristic differences existed between sexual orientation groups. Further, all sexual minority subgroups had lower SF-12 scores than heterosexuals, except lesbian women. Sociodemographic factors attenuated the disparity for bisexual men. Sociodemographic, lifestyle, plus psychosocial factors attenuated the disparity for HSM men. However, sociodemographic, lifestyle, and psychosocial factors partially, but did not fully, attenuate the disparity for gay men, bisexual women, or HSM women. Conclusions: Different factors are associated with mental health disparities for sexual minority subgroups. To maximize health intervention efforts, additional research is needed to uncover the specific mechanisms contributing to health disparities across diverse sexual minority populations.
MeSH term(s)	Adult ; Female ; Health Status Disparities ; Humans ; Life Style ; Male ; Mental Health/statistics & numerical data ; Middle Aged ; Sexual and Gender Minorities/psychology ; Sexual and Gender Minorities/statistics & numerical data ; Sexuality/psychology ; Sexuality/statistics & numerical data
Language	English
Publishing date	2019-01-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	623071-4
ISSN	1433-9285 ; 0037-7813 ; 0933-7954
ISSN (online)	1433-9285
ISSN	0037-7813 ; 0933-7954
DOI	10.1007/s00127-018-1649-0
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Article ; Online: Sexual orientation in transgender adults in the United States.

Reisner, Sari L / Choi, Soon Kyu / Herman, Jody L / Bockting, Walter / Krueger, Evan A / Meyer, Ilan H

BMC public health

2023 Volume 23, Issue 1, Page(s) 1799

Abstract: Background: Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures ...

Abstract	Background: Sexual orientation refers to a person's enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures inclusive of transgender people and characterize sexual orientation identity, behavior, and attraction in a representative sample of the U.S. transgender population. Methods: Between April 2016-December 2018, a U.S. national probability sample of transgender (n = 274) and cisgender (n = 1,162) adults were invited to complete a self-administered web or mailed paper survey. We assessed sexual identity with updated response options inclusive of recent identity terms (e.g., queer), and revised sexual behavior and attraction measures that included transgender people. Multiple response options were allowed for sexual behavior and attraction. Weighted descriptive statistics and sexual orientation differences by gender identity groups were estimated using age-adjusted comparisons. Results: Compared to the cisgender population, the transgender population was more likely to identify as a sexual minority and have heterogeneity in sexual orientation, behavior, and attraction. In the transgender population, the most frequently endorsed sexual orientation identities were "bisexual" (18.9%), "queer" (18.1%), and "straight" (17.6%). Sexually active transgender respondents reported diverse partners in the prior 5 years: 52.6% cisgender women (CW), 42.7% cisgender men (CM), 16.9% transgender women (TW), and 19.5% transgender men (TM); 27.7% did not have sex in the past 5 years. Overall, 73.6% were "somewhat"/ "very" attracted to CW, 58.3% CM, 56.8% TW, 52.4% TM, 59.9% genderqueer/nonbinary-females-at-birth, 51.9% genderqueer/nonbinary-males-at-birth. Sexual orientation identity, behavior, and attraction significantly differed by gender identity for TW, TM, and nonbinary participants (all p < 0.05). Conclusions: Inclusive measures of sexual orientation captured diverse sexual identities, partner genders, and desires. Future research is needed to cognitively test and validate these measures, especially with cisgender respondents, and to assess the relation of sexual orientation and health for transgender people.
MeSH term(s)	Female ; Adult ; Humans ; Male ; Transgender Persons ; Gender Identity ; Sexual Behavior ; Sexual and Gender Minorities ; Bisexuality
Language	English
Publishing date	2023-09-15
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-16654-z
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Article ; Online: Prevalence of Nicotine and Tobacco Product Use by Sexual Identity, Gender Identity, and Sex Assigned at Birth Among Emerging Adult Tobacco Users in California, United States.

Krueger, Evan A / Hong, Chenglin / Cunningham, Nicole J / Berteau, Lorree Katy / Cordero, Luisita / Wu, Elizabeth S C / Holloway, Ian W

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

2023 Volume 25, Issue 7, Page(s) 1378–1385

Abstract: Introduction: Sexual and gender minority (SGM) nicotine and tobacco use disparities are well-documented among youth and young adults (YYA), and despite decades of prevention efforts, these disparities stubbornly persist. To better understand tobacco use ...

Abstract	Introduction: Sexual and gender minority (SGM) nicotine and tobacco use disparities are well-documented among youth and young adults (YYA), and despite decades of prevention efforts, these disparities stubbornly persist. To better understand tobacco use disparities and craft tailored interventions, tobacco use patterns must be assessed in a contemporary sample of YYA across lines of sexual and gender identity, sex assigned at birth, and tobacco product types. Aims and methods: Data were from an online survey of a diverse sample of emerging adult tobacco users (ages 18-29; N = 1491) in California, United States (2020-2021). Participants were recruited from various online and in-person locations. Bivariate and adjusted models assessed differences in four nicotine and tobacco use outcomes (past 30-day use of cigarettes, e-cigarettes, other tobacco products, and multiple tobacco product types) across six groups: Cisgender heterosexual males, cisgender heterosexual females, cisgender sexual minority (SM) males, cisgender SM females, transfeminine participants, and transmasculine participants. Results: Compared to cisgender heterosexual males, both transfeminine (OR = 2.25, 95% confidence intervals (CI) = 1.29 to 4.05) and transmasculine (OR = 1.85, 95% CI = 1.32 to 2.80) participants had higher odds of using cigarettes. Few differences were noted between groups in use of e-cigarettes. Cisgender heterosexual males had higher odds of other tobacco product use, compared to most other groups (eg, cisgender SM males: OR = 0.57, 95% CI = 0.37 to 0.87). Transmasculine participants had higher odds of multiple product use, compared to cisgender heterosexual females. Among multiple product users, transfeminine participants had the highest prevalence of using all three individual product types (35.6%). Conclusions: Results highlight the need for different tobacco control approaches across sexual and gender identities, sex assigned at birth, and nicotine and tobacco products. Implications: SGM nicotine and tobacco use disparities remain entrenched, despite concerted efforts to reduce them. The SGM population is heterogeneous and different SGM subgroups may have different needs. This study assessed, among young adult nicotine and tobacco users in California, U.S. patterns of tobacco use across sexual and gender identities, sex assigned at birth, as well as specific tobacco products used-a necessity to craft tailored tobacco control measures. We found patterns of nicotine and tobacco product use across several of these characteristics, highlighting how different prevention and cessation interventions may be needed to meaningfully address SGM nicotine and tobacco use disparities.
MeSH term(s)	Adolescent ; Young Adult ; Infant, Newborn ; Humans ; Female ; Male ; United States/epidemiology ; Gender Identity ; Nicotine ; Prevalence ; Electronic Nicotine Delivery Systems ; Sexual Behavior ; Tobacco Use/epidemiology ; Tobacco Use Disorder/epidemiology ; Tobacco Products ; California/epidemiology
Chemical Substances	Nicotine (6M3C89ZY6R)
Language	English
Publishing date	2023-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1452315-2
ISSN	1469-994X ; 1462-2203
ISSN (online)	1469-994X
ISSN	1462-2203
DOI	10.1093/ntr/ntad048
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Article ; Online: Sexual Orientation Disparities in Substance Use: Investigating Social Stress Mechanisms in a National Sample.

Krueger, Evan A / Fish, Jessica N / Upchurch, Dawn M

American journal of preventive medicine

2019 Volume 58, Issue 1, Page(s) 59–68

Abstract: Introduction: Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders, but relatively little is known about differences in substance use disorders across diverse sexual minority subgroups. There is ... ...

Abstract	Introduction: Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders, but relatively little is known about differences in substance use disorders across diverse sexual minority subgroups. There is also limited understanding of how different social stressors account for sexual orientation disparities in substance use disorders. Methods: Using nationally representative data collected in 2012-2013 (n=34,597), differences in past-year DSM-5 alcohol, cannabis, and tobacco use disorders were assessed across 4 sexual orientation groups (heterosexuals and 3 sexual minority subgroups, lesbian/gay-, bisexual-, and heterosexual-identified sexual minorities). This study assessed whether stressful life events mediated substance use disorder disparities between heterosexuals and each sexual minority subgroup, and whether stressful life events and lesbian, gay, and bisexual discrimination events mediated these substance use disorder differences. Analyses were conducted in 2019. Results: For both men and women, substance use disorders and stress experiences varied by sexual identity. For example, compared with heterosexual men, larger proportions of gay and bisexual men had a past-year alcohol use disorder. Among women, all sexual minority subgroups had higher rates of each substance use disorder than heterosexuals. For each substance use disorder, stressful life events mediated disparities between heterosexuals and sexual minority subgroups, except for heterosexual-identified sexual minority men. Both stressful life events and lesbian, gay, and bisexual discrimination mediated substance use disorder differences between sexual minority subgroups, with stronger indirect effects through lesbian, gay, and bisexual discrimination for lesbians/gay men and stronger indirect effects through stressful life events for bisexual adults, generally. Conclusions: Sexual minority subgroups have a greater prevalence of substance use disorders, mediated through both stressful life events and lesbian, gay, and bisexual discrimination. More research is needed to comprehensively assess the processes underlying sexual orientation substance use disparities.
MeSH term(s)	Alcoholism/epidemiology ; Female ; Heterosexuality/statistics & numerical data ; Humans ; Male ; Marijuana Abuse/epidemiology ; Prevalence ; Sex Factors ; Sexual Behavior/psychology ; Sexual and Gender Minorities/statistics & numerical data ; Socioeconomic Factors ; Stress, Psychological/psychology ; Substance-Related Disorders/epidemiology ; Tobacco Use Disorder/epidemiology ; United States/epidemiology
Language	English
Publishing date	2019-11-21
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	632646-8
ISSN	1873-2607 ; 0749-3797
ISSN (online)	1873-2607
ISSN	0749-3797
DOI	10.1016/j.amepre.2019.08.034
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Article: Partnership Status and Mental Health in a Nationally Representative Sample of Sexual Minorities.

Wilson, Bianca D M / Krueger, Evan A / Pollitt, Amanda M / Bostwick, Wendy B

Psychology of sexual orientation and gender diversity

2021 Volume 9, Issue 2, Page(s) 190–200

Abstract: Research has consistently shown mental health differences between sexual minority subgroups with bisexual people often reporting higher levels of psychological distress than lesbians and gay men. Relationship status has been suggested, but not well ... ...

Abstract	Research has consistently shown mental health differences between sexual minority subgroups with bisexual people often reporting higher levels of psychological distress than lesbians and gay men. Relationship status has been suggested, but not well studied, as a potential factor contributing to subgroup differences in mental health. Using a national probability sample of non-transgender sexual minority adults across 3 age cohorts (18-25, 34-41, 52-59 years), we assessed group differences in psychological distress (Kessler 6) between lesbian/gay (N = 505), bisexual (N = 272), and queer/pansexual (N=75) respondents. We examined whether relationship status (single/partnered) moderated the relationship between sexual identity and psychological distress. Among those that were partnered, we tested whether key partner characteristics related to sexual identity - gender of partner (cisgender same-sex/transgender or cisgender different-sex) and partner sexual identity (same or mixed sexual orientation relationship) - were significantly associated with psychological distress. In bivariate analyses, bisexual and queer/pansexual respondents reported more psychological distress than gay/lesbian respondents, among both men and women. In multivariable analyses, there was not a significant main effect of sexual identity, but there was a significant interaction between sexual identity and partnership status on psychological distress among women. Specifically, while there were no significant differences in psychological distress between subgroups of single women, among partnered women, queer/pansexual women had more distress than lesbian/gay women. Further, partnership was associated with reduced distress among lesbian/gay women, but not among bisexual or queer/pansexual women. Among men, there were no significant interaction effects between sexual identity and partnership status on psychological distress. Being in a mixed orientation relationship, but not gender of partner, was a significant predictor of psychological distress among both women and men across sexual identities. Additional research should assess the partnership dynamics contributing to the association between partnership characteristics and mental health among sexual minority populations.
Language	English
Publishing date	2021-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747789-7
ISSN	2329-0390 ; 2329-0382
ISSN (online)	2329-0390
ISSN	2329-0382
DOI	10.1037/sgd0000475
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