Margaret Rosario

The Coming‐Out Process and Its Adaptational and Health‐Related Associations Among Gay, Lesbian, and Bisexual Youths: Stipulation and Exploration of a Model

A model is proposed and explored that links the coming-out process to the psychological functioning (i.e., self-esteem and distress) and sexual behaviors of gay, lesbian, and bisexual youths recruited from gay-focused community-based and college organizations in New York City. The coming-out process is multidimensional, consisting, as defined here, of involvement in gay/lesbian activities, attitudes toward homosexuality, comfort with homosexuality, self-disclosure of sexual identity to others, and sexual identity. The coming-out dimensions were related to self-esteem, distress, and unprotected sexual behaviors. In addition, the relations between the coming-out dimensions and unprotected sexual behaviors were explained by psychological functioning. In particular, limited involvement in gay/lesbian activities was associated with more unprotected sex. Negative attitudes toward homosexuality were related directly to more unprotected sex, and they were related indirectly to more unprotected sex by means of increasing emotional distress. These and other findings have implications for designing preventive interventions to increase the youths psychological functioning and reduce their unprotected sexual behaviors.

Sexual identity development among lesbian, gay, and bisexual youths: Consistency and change over time

A longitudinal report of 156 lesbian, gay, and bisexual youths examined changes in sexual identity over time. Fifty‐seven percent of the youths consistently self‐identified as gay/lesbian, 18% transitioned from bisexual to gay/lesbian, and 15% consistently identified as bisexual over time. Although youths who consistently identified as gay/lesbian did not differ from other youths on time since experiencing sexual developmental milestones, they reported current sexual orientation and sexual behaviors that were more same‐sex centered and they scored higher on aspects of the identity integration process (e.g., more certain, comfortable, and accepting of their same‐sex sexuality, more involved in gay‐related social activities, more possessing of positive attitudes toward homosexuality, and more comfortable with others knowing about their sexuality) than youths who transitioned to a gay/lesbian identity and youths who consistently identified as bisexual. Contrary to the hypothesis that females are more sexually fluid than males, we found that female youths were less likely to change identities than males. The finding that youths who transitioned to a gay/lesbian identity differed from consistently gay/lesbian youths suggests that sexual identity development continues after the adoption of a gay/lesbian sexual identity.

Ethnic/racial differences in the coming-out process of lesbian, gay, and bisexual youths: a comparison of sexual identity development over time.

This longitudinal report of 145 lesbian, gay, and bisexual (LGB) youths examined ethnic/racial differences in the coming-out process. No significant differences emerged in sexual developmental milestones, sexual orientation, sexual behavior, or sexual identity. However, Black youths reported involvement in fewer gay-related social activities, reported less comfort with others knowing their sexual identity, and disclosed that identity to fewer people than did White youths. Latino youths disclosed to fewer people than did White youths. Analyses of change indicated Black youths had greater increases in positive attitudes toward homosexuality and in certainty in their sexual identity over time than did White youths. These findings support the authors hypothesis that cultural factors do not impede the formation of identity but may delay identity integration.

Disclosure of Sexual Orientation and Subsequent Substance Use and Abuse Among Lesbian, Gay, and Bisexual Youths: Critical Role of Disclosure Reactions

Research on whether disclosure of sexual orientation promotes lower substance use among lesbian, gay, and bisexual (LGB) individuals has been inconsistent. One reason for this may be that disclosure results in accepting and rejecting reactions. The current report longitudinally examines whether the types of reactions to disclosure are associated with substance use and abuse among 156 LGB youths (ages 14-21). Neither the number of disclosures nor the numbers of accepting or neutral disclosure reactions were associated with substance use or abuse. However, the number of rejecting reactions to disclosure was associated with current and subsequent alcohol, cigarette, and marijuana use, even after controlling for demographic factors, social desirability, and emotional distress. Further, accepting reactions were found to moderate or protect youths from the negative role of rejecting reactions on alcohol use, but not other substances. This research indicates that, rather than disclosure per se, it is the number of accepting and rejecting reactions in response to disclosure that are critical to understanding substance use among LGB youths. Further, the results suggest that to be maximally effective, substance use prevention and treatment efforts should address rejecting reactions. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

The psychosexual development of urban lesbian, gay, and bisexual youths

An examination of cognitive sexual orientation, sexual partner activity, and sexual identity was conducted among 76 lesbian/bisexual female youths and 80 gay/bisexual male youths (age range of 14–21 years) recruited from community‐based or college organizations for lesbian / gay youths in New York City. Self‐identification as lesbian / gay or bisexual changed over time; more than half the youths who identified as lesbian / gay at the interview had considered themselves bisexual in the past, and vice versa. A modal developmental sequence of cognitions and behaviors was found: Most youths first became aware of a cognitive sexual orientation (e.g., attractions and fantasies) toward the same or other sex, then considered a lesbian / gay or bisexual identity, and finally felt certain of a lesbian / gay or bisexual identity. Age at initiation of sexual activity with females or males was inconsistently related to this pattern. Significant gender differences indicated that females were older than males when they ...

Childhood Gender Nonconformity: A Risk Indicator for Childhood Abuse and Posttraumatic Stress in Youth

OBJECTIVES: Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth. METHODS: We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation. RESULTS: Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation. CONCLUSIONS: We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed.

Different Patterns of Sexual Identity Development over Time: Implications for the Psychological Adjustment of Lesbian, Gay, and Bisexual Youths

Despite research documenting variability in the sexual identity development of lesbian, gay, and bisexual (LGB) youths, it remains unclear whether different developmental patterns have implications for the psychological adjustment of LGB youths. This report longitudinally examines whether different patterns of LGB identity formation and integration are associated with indicators of psychological adjustment among an ethnically diverse sample of 156 LGB youths (ages 14–21) in New York City. Although differences in the timing of identity formation were not associated with psychological adjustment, greater identity integration was related to less depressive and anxious symptoms, fewer conduct problems, and higher self-esteem both cross-sectionally and longitudinally. Individual changes in identity integration over time were associated with all four aspects of psychological adjustment, even after controlling for rival hypotheses concerning family and friend support, gay-related stress, negative social relationships, and other covariates. These findings suggest that difficulties in developing an integrated LGB identity may have negative implications for the psychological adjustment of LGB youths and that efforts to reduce distress among LGB youths should address the youths identity integration.

Stability and change in self-reported sexual orientation identity in young people: application of mobility metrics.

This study investigated stability and change in self-reported sexual orientation identity over time in youth. We describe gender- and age-related changes in sexual orientation identity from early adolescence through emerging adulthood in 13,840 youth ages 12–25 employing mobility measure M, a measure we modified from its original application for econometrics. Using prospective data from a large, ongoing cohort of U.S. adolescents, we examined mobility in sexual orientation identity in youth with up to four waves of data. Ten percent of males and 20% of females at some point described themselves as a sexual minority, while 2% of both males and females reported ever being “unsure” of their orientation. Two novel findings emerged regarding gender and mobility: (1) Although mobility scores were quite low for the full cohort, females reported significantly higher mobility than did males. (2) As expected, for sexual minorities, mobility scores were appreciably higher than for the full cohort; however, the gender difference appeared to be eliminated, indicating that changing reported sexual orientation identity throughout adolescence occurred at a similar rate in female and male sexual minorities. In addition, we found that, of those who described themselves as “unsure” of their orientation identity at any point, 66% identified as completely heterosexual at other reports and never went on to describe themselves as a sexual minority. Age was positively associated with endorsing a sexual-minority orientation identity. We discuss substantive and methodological implications of our findings for understanding development of sexual orientation identity in young people.

Childhood Gender Nonconformity, Bullying Victimization, and Depressive Symptoms Across Adolescence and Early Adulthood: An 11-Year Longitudinal Study

OBJECTIVEnChildhood gender nonconformity has been associated with increased risk of caregiver abuse and bullying victimization outside the home, but it is unknown whether as a consequence children who are nonconforming are at higher risk of depressive symptoms.nnnMETHODnUsing data from a large national cohort (N = 10,655), we examined differences in depressive symptoms from ages 12 through 30 years by gender nonconformity before age 11 years. We examined the prevalence of bullying victimization by gender nonconformity, then ascertained whether increased exposure to abuse and bullying accounted for possible increased risk of depressive symptoms. We further compared results stratified by sexual orientation.nnnRESULTSnParticipants in the top decile of childhood gender nonconformity were at elevated risk of depressive symptoms at ages 12 through 30 years (for females, 0.19 standard deviations more depressive symptoms than conforming females; for males, 0.34 standard deviations more symptoms than conforming males). By ages 23 to 30 years, 26% of participants in the top decile of childhood nonconformity had probable mild or moderate depression versus 18% of participants who were conforming (p<.001). Abuse and bullying victimization accounted for approximately half the increased prevalence of depressive symptoms in youth who were nonconforming versus conforming. Gender-nonconforming heterosexuals and males were at particularly elevated risk for depressive symptoms.nnnCONCLUSIONnGender nonconformity was a strong predictor of depressive symptoms beginning in adolescence, particularly among males and heterosexuals. Physical and emotional bullying and abuse, both inside and outside the home, accounted for much of this increased risk.

Sexual-orientation disparities in substance use in emerging adults: a function of stress and attachment paradigms.

More lesbian, gay, and bisexual (LGB) youths than heterosexuals report substance use. We examined a theoretical model to understand these disparities in lifetime and past-year substance use by means of stress and attachment paradigms, using the longitudinal Growing Up Today Study (GUTS) and Nurses Health Study II (NHSII). GUTS participants are the children of participants in NHSII; thus, child and maternal data are available. In addition, GUTS contains siblings, allowing for comparisons of LGB and heterosexual siblings. Of 5,647 GUTS youths (M = 20.6 years old in 2005), 1.6% were lesbian/gay (LG), 1.6% bisexual (BI), 9.9% mostly heterosexual (MH), and 86.9% completely heterosexual (CH). After adjusting for sibling clustering in GUTS and covariates, significantly more sexual minorities (LGs, BIs, and MHs) than CHs reported lifetime and past-year smoking, nonmarijuana illicit drug use, and prescription drug misuse. More sexual minorities also reported marijuana use in the past year. The relations between sexual orientation and substance use were moderated by the stress markers: As mothers discomfort with homosexuality increased, more BIs and MHs than CHs used substances. As childhood gender nonconforming behaviors increased, more LGs than CHs used substances. The relations between sexual orientation and substance use were mediated by attachment and maternal affection (percent of effect mediated ranged from 5.6% to 16.8%% for lifetime substance use and 4.9% to 24.5% for past-year use). In addition, sibling comparisons found that sexual minorities reported more substance use, more childhood gender nonconforming behaviors, and less secure attachment than CH siblings; mothers reported less affection for their sexual minority than CH offspring. The findings indicate the importance of stress and attachment paradigms for understanding sexual-orientation disparities in substance use.