Sexual Risk in “Mostly Heterosexual” Young Women: Influence of Social Support and Caregiver Mental Health

Abstract

Background: Female youth who describe their sexual orientation as ''mostly heterosexual,'' rather than exclusively heterosexual, display greater sexual risk, yet reasons for this greater risk are not understood. Research is needed to identify factors responsible for health disparities in this population comprising the majority of youth who report a minority sexual orientation. Methods: We compared indicators of perceived social support, parental=caregiver mental health, and sexual risk (age at first sexual intercourse, lifetime history of a sexually transmitted infection (STI), lifetime number of sexual partners) among 33 young women describing themselves as mostly heterosexual and 337 indicating they were 100% heterosexual (aged 18-24 years) participating in an urban, multiethnic, community-based cohort study. Linear, logistic, and Cox proportional hazards regression were used to test whether social support and caregiver mental health explained greater sexual risk among mostly heterosexual compared with heterosexual participants. Results: Compared with exclusively heterosexuals, mostly heterosexuals reported less social support from family ( p ¼ 0.01) and friends ( p ¼ 0.02) and were more likely to report primary male caregiver (though not primary female caregiver) histories of depression ( p < 0.0001), treatment for depression ( p < 0.0001), and problems with drug use ( p ¼ 0.005). Differences in perceived family social support and caregiver mental health and substance use partially mediated relationships between sexual orientation and sexual risk. Conclusions: Compared with exclusively heterosexual female youth, mostly heterosexual female youth may have poorer relationships with their family and others in their social networks, and this may contribute to their elevated health risks. Additional research is needed to understand causal mechanisms responsible for sexual orientation disparities in sexual risk.

Disparities in Weight and Weight Behaviors by Sexual Orientation in College Students

“…78 Findings from previous studies have highlighted notable differences between "mostly heterosexuals" or "homosexually experienced heterosexuals" and other orientation groups. 57,58,79 Our findings suggest that unhealthy weight control behaviors may be particularly problematic among both male and female discordant heterosexuals. However, our analyses did not quantify the frequency of same-sex behavior, or the number of same-sex partners, and thus it is difficult to draw extensive conclusions on the basis of these findings.…”

Sexual Orientation and Differences in Mental Health, Stress, and Academic Performance in a National Sample of U.S. College Students

“…Additionally, bisexual individuals engage in more self-injurious behaviors (Balsam et al, 2005) and suicidal ideation (Conron et al, 2010;Jorm et al, 2002) than gay, lesbian, and heterosexual people. Similarly, Corliss, Austin, Roberts, and Molnar (2009) found that young women who report some same-sex attraction but do not identify as lesbian or bisexual report higher levels of depression and problems with drug use than exclusively heterosexual individuals. These findings are in contrast to Zhao Montoro, Igartua, and Thombs' (2010) findings that adolescent youth who identify as heterosexual and have same-sex attraction or fantasy did not have increased suicidal ideation or attempts.…”

Explaining mental health disparities for non-monosexual women: Abuse history and risky sex, or the burdens of non-disclosure?

“…Data have suggested that these women's reported rates of childhood abuse, risky sexual behavior, and substance abuse are similar to bisexual women's (Alvy et al, 2013;Austin et al, 2008;Corliss et al, 2009;Hughes et al, 2010b;Loosier and Dittus, 2010;McCabe et al, 2012). Although the reasons for these similarities are still unclear, mostly heterosexual and mostly lesbian women, as bisexual women, may experience marginalization and low levels of social support (Corliss et al, 2009;Hughes et al, 2010b).…”

“…First, studies have indicated non-monosexual women face mental health disparities compared to both heterosexual and lesbian women, and that mostly heterosexual and mostly lesbian women may be more similar to bisexual than to monosexual women (Alvy et al, 2013;Austin et al, 2008;Corliss et al, 2009;Hughes et al, 2010b;Loosier and Dittus, 2010;McCabe et al, 2012). Second, a meta-analysis found that bisexuality moderated the relationship between sexual orientation and childhood physical abuse; the differences between bisexual and heterosexual individuals were larger than those between gay/lesbian and heterosexual individuals (Friedman et al, 2011).…”