Some lesbians and gay men tend to be more gender nonconforming, on average and for certain traits, than their heterosexual counterparts. Gender nonconformity in childhood has also been linked to adult homosexuality. Studies of both lesbians and gay men also find elevated rates of psychological distress. We hypothesized that these facts may be related. Individuals who violate social norms for gender-appropriate behavior may suffer from stigmatization by both heterosexual and homosexual people, leading to higher levels of psychological distress. We examined whether several measures of gender nonconformity were related to psychological distress in a community-based sample of gay men and lesbians. These included self-reports of childhood and adulthood gender nonconformity, as well as observer ratings of current behavior. Several measures of gender nonconformity were related to each other for both lesbians and gay men. In addition, gender nonconformity was related to psychological distress, but only for gay men. Finally, both lesbian and gay male participants reported more positive attitudes towards gender conformity than nonconformity, although the pattern was somewhat different for each group. We discuss the implications of these results for future studies of gender nonconformity and for the promotion of psychological health in lesbians and gay men.

The frequency of potentially traumatic events (PTEs) and associated symptoms were examined in a cross-sectional study of 97 transgender participants who had been classified as male at birth. A total of 98% reported at least one PTE and 91% endorsed multiple events. Of those with PTE exposures, 42% reported that at least one event was transgender bias-related. Among those with PTEs, 17.8% endorsed clinically significant symptoms of PTSD and 64% reported clinically significant depressive symptoms. The percentage of transgender individuals in this sample reporting clinically significant symptoms was higher than in trauma-exposed samples of men in the general population, but roughly similar to rates of female trauma survivors. Amount of time spent dressed consistent with gender identity was associated with increased risk for PTE exposure and was positively associated with mental health symptoms. No differences in symptoms were observed when comparing those with and without transgender bias-related PTEs. Overall, transgender individuals endorsed high prevalence of PTE exposure along with elevated PTSD and depressive symptoms, when compared to other traumatized populations.

This study explored relations among childhood physical abuse, internalized homophobia, experiential avoidance, and current psychological symptoms in a community sample of 122 adult lesbians and 115 adult gay men. Childhood physical abuse predicted depression and posttraumatic stress disorder (PTSD) symptoms. Furthermore, for gay men, internalized homophobia completely mediated the relation between childhood physical abuse and depression symptoms and partially mediated the relation between childhood physical abuse and PTSD symptoms. However, experiential avoidance did not mediate these relations. In contrast, experiential avoidance partially mediated the relation between childhood physical abuse and PTSD symptoms among lesbians; however, internalized homophobia did not mediate these relations. These findings suggest that internalized homophobia and experiential avoidance may have differential mediating roles in predicting psychological symptoms among lesbians and gay men who have experienced childhood physical abuse.

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Support and treatment for military veterans and active duty service members is a national priority. Furthermore, there is increased need for professionals with experience and interest in working with these brave individuals. Veterans and service members face significant challenges both during their service and after transitioning back to civilian settings. One such challenge for some veterans is substance use and its multidimensional effects on mental and physical health. The current article presents a brief but comprehensive overview of the prevalence and comorbidity of substance use disorders in veterans and service members. It also reviews practical information about assessment, treatment, and general clinical issues from the authors' clinical experience that is relevant to providers working with veterans and service members with substance use disorders. This information may be of particular interest to professionals with an interest in helping veterans, those who have limited experience working with veterans, or those who may work outside of standard military or Department of Veterans Affairs settings. Finally, future directions in this important area are discussed.