No abstract

Sexual and gender minority (SGM) breast cancer patients have begun embracing the choice to "go flat" or opt out of reconstruction after bilateral mastectomy, though little is known about this population. SGM breast cancer survivors were identified through purposive and referral sampling and invited to participate in a web-based survey containing both closed- and open-ended items. Of the sixty-eight SGM breast cancer survivors aged 18-75 years who completed the survey between May 2015 and January 2016, 25 percent reported "going flat" (flattoppers®). Bivariate analyses revealed that flattoppers® were significantly more likely to have been diagnosed in the past five years, to identify as genderqueer, to have disclosed their sexual orientation or gender identity (SOGI) to providers, and to report participating in lesbian, gay, bisexual, or transgender cancer support groups, compared to other participants. More flattoppers® believed that SOGI mattered in terms of getting the support they needed regarding their cancer; this difference was not statistically significant. Thematic analysis of qualitative comments from flattoppers® revealed themes related to reasons for making this treatment choice, interactions with health-care providers around treatment choice, and physical and emotional outcomes of treatment choice. Providers would benefit from training about SOGI as they relate to treatment choices.

These findings demonstrate that cumulative disadvantage and a history of psychiatric problems shape later-life cognition and cognitive decline. This evidence can enhance public understanding of the trajectories of cognitive decline experienced by groups living with disadvantage and can enable policy makers and human services providers to better design and implement preventative interventions and support services for affected populations.

This study provides quantitative and qualitative evidence that many SGM breast cancer patients face a dearth of appropriate social supports, both from breast cancer survivor organizations and from within the medical system. These findings confirm the need for research on the physical and emotional effects of breast cancer treatment on SGM breast cancer survivors, as well as further exploration of the social support needs and experiences of SGM breast cancer patients and their partners.

This article focused on the relationship between parent–child religious discordance (affiliation, intensity, and attendance) in early adulthood and children’s perceived affectual and associational solidarity with their parents across 20 years. The data derived from eight waves of the Longitudinal Study of Generations between 1971 and 2005. We selected 635 young adult children whose mothers and/or fathers also reported their religious orientations in 1971 and then constructed mother–child dyads (n = 584) and father–child dyads (n = 475). Results showed that religious affiliation discordance between parents and children negatively and consistently lowered children’s affectual and associational solidarity with parents over several decades regardless of parents’ gender. However, intergenerational discordance in religious intensity and religious attendance showed no such association. These findings indicate that discontinuity in denominational identification is more disruptive to intergenerational relations than discontinuity in religious strength and practice.