Disproportionate exposure to early-life adversity and sexual orientation disparities in psychiatric morbidity

Abstract

Objectives Lesbian, gay, and bisexual (LGB) populations exhibit elevated rates of psychiatric disorders compared to heterosexuals, and these disparities emerge early in the life course. We examined the role of exposure to early-life victimization and adversity—including physical and sexual abuse, homelessness, and intimate partner violence—in explaining sexual orientation disparities in mental health among adolescents and young adults. Methods Data were drawn from the National Longitudinal Study of Adolescent Health, Wave 3 (2001–2002), a nationally representative survey of adolescents. Participants included gay/lesbian (n=227), bisexual (n=245), and heterosexual (n=13,490) youths, ages 18–27. We examined differences in the prevalence of exposure to child physical or sexual abuse, homelessness or expulsion from one’s home by caregivers, and physical and sexual intimate partner violence according to sexual orientation. Next we examined the associations of these exposures with symptoms of psychopathology including suicidal ideation and attempts, depression, binge drinking, illicit drug use, tobacco use, alcohol abuse, and drug abuse. Finally, we determined whether exposure to victimization and adversity explained the association between sexual orientation and psychopathology. Results Gay/lesbian and bisexual respondents had higher levels of psychopathology than heterosexuals across all outcomes. Gay/lesbian respondents had higher odds of exposure to child abuse and housing adversity, and bisexual respondents had higher odds of exposure to child abuse, housing adversity, and intimate partner violence, than heterosexuals. Greater exposure to these adversities explained between 10–20% of the relative excess of suicidality, depression, tobacco use, and symptoms of alcohol and drug abuse among LGB youths compared to heterosexuals. Exposure to victimization and adversity experiences in childhood and adolescence significantly mediated the association of both gay/lesbian and bisexual orientation with suicidality, depressive symptoms, tobacco use, and alcohol abuse. Conclusions Exposure to victimization in early-life family and romantic relationships explains, in part, sexual orientation disparities in a wide range of mental health and substance use outcomes, highlighting novel targets for preventive interventions aimed at reducing these disparities.

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

“…The higher rate of functional pelvic pain among bisexuals could be linked to lifestyle factors. Sexual minorities are exposed to more adverse childhood experiences than heterosexuals, including child abuse, housing adversity and intimate partner violence 42. Roberts et al34 suggested that dysregulation of the hypothalamic–pituitary–adrenal system and related inflammatory processes resulting from abuse or violence victimisation may predispose individuals to experience functional pain.…”

Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals

“…16 Although gender identity and sexual orientation are conceptually distinct, research demonstrates that discrimination and victimization are associated with mental health problems in sexual minorities. 17 For example, researchers have used Meyer's minority stress model, 18,19 one of the most wellsupported models for understanding sexual minority health disparities, to demonstrate that both subtle and overt stressors related to one's sexual orientation are associated with health problems. Although the minority stress model has been helpful in understanding health disparities for sexual minority individuals, no comprehensive model has been proposed specifically for minority stress experienced by the trans population.…”

What Is Sexual Orientation All About? Explaining an Evolutionary Paradox

“…Consistent with how sexual abuse can have variable impacts on expressed sexual orientation (Bramblett & Darling, 1997;Brown, 1963;Harrison et al, 2008;McLaughlin et al, 2012), deactivation of the corresponding sexual dimension can occur when the event is sufficiently traumatic at the time. Consequently, the person"s level of motivation will not be expressed.…”

“…Another puzzling occurrence that can be explained by sexual dimension activation/deactivation is sexual abuse having variable effects on sexual behavior, in some instances seemingly intensifying motivation for individuals of the same sex as the perpetrator, and in other instances reducing it (Bramblett & Darling, 1997;Brown, 1963;Harrison et al, 2008;McLaughlin et al, 2012). Sexual abuse, and particularly during a vulnerable period of development, can activate the sexual dimension corresponding to the sex of the perpetrator; the homoerotic dimension in the case of same-sex perpetrators and heteroerotic with other-sex perpetrators.…”