Reply to: Are stressful childhood experiences relevant in non-monosexual women?

Abstract

We thank the commentator for his thoughtful response (Schneeberger, 2015) to our study entitled, "Explaining Mental Health Disparities for Non-monosexual Women: Abuse History and Risky Sex, or the Burdens of Non-disclosure?" (Persson et al., 2014) To summarize, Schneeberger (2015) highlights three aspects of our methodological approach: (1) how the participants were grouped;(2) how sexual orientation was evaluated; and (3) how a history of childhood abuse was assessed. We will reflect on these three issues while further considering future research directions in the study of female sexual orientation and childhood abuse.We grouped our participants into one of two sexual orientation categories, namely, monosexual versus non-monosexual. The commentator describes this novel methodology as "forward-looking" because "it focuses on the knowledge that analyzing LGBT populations as a whole neglects many noteworthy features that affect only subgroups." As has been demonstrated by research, non-monosexual women may report worse mental health, may experience more lifetime adversity, and may face more stigma and discrimination than monosexual women (Friedman et al., 2011(Friedman et al., , 2014Kerr et al., 2013). Further, bisexual individuals may not feel part of the LGBT community (Herek et al., 2010). In short, although non-monosexual women have often been grouped into monosexual categories, doing so may compromise ecological validity. Schneeberger (2015) argues that future studies "should follow the lead" of our study by analyzing subgroups of sexual minority women. We agree, and would go further: future studies should continue to explore not only, how mostly lesbian, bisexual, and mostly heterosexual women might differ from monosexual women, but also how women in these more fine-grained categories might differ from one another. We recommend, if participant numbers allow, a five-category approach (heterosexual, mostly heterosexual, bisexual, mostly lesbian, lesbian) for sexual orientation self-identification (Vrangalova and Savin-Williams, 2012). In addition, sexual orientation research should move beyond the North American or Western European context. As we pointed out in the original paper, combining lesbian and heterosexual women may not be valid in societies less accepting of lesbian/gay rights than, for example, in Canada. In short, researchers need to account for the sociocultural context of study participants (Ryder et al., 2011).Outcomes in sexual orientation research may vary depending on how sexual orientation is defined and assessed. For instance, McCabe et al. (2012) found that when using a three-category approach, namely heterosexual, bisexual, gay/lesbian, bisexual participants reported the highest level of substance abuse. However, when using a five-category approach, namely heterosexual, mostly heterosexual, bisexual, mostly lesbian, lesbian, the mostly heterosexual group was at the highest risk of substance abuse. Based on findings such as these, we opted to analyze results based on both sexual orientati...