Internalized Homonegativity and Sexual Quality of Life in Italian Lesbian and Bisexual Women
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measures and Procedure
2.3. Statistical Analyses
3. Results
3.1. Demographic Data
3.2. t-Tests
3.3. Linear Regression
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- World Health Organization. Developing Sexual Health Programmes: A Framework for Action; World Health Organization: Geneva, Switzerland, 2010.
- Grabski, B.; Kasparek, K.; Müldner-Nieckowski, Ł.; Iniewicz, G. Sexual quality of life in homosexual and bisexual men: The relative role of minority stress. J. Sex. Med. 2019, 16, 860–871. [Google Scholar] [CrossRef]
- Flanagan, S. Mental health disparities by identity among gender and sexual minorities. Sch. Horiz. Univ. Minn. Morris Undergrad. J. 2017, 4, 1. [Google Scholar] [CrossRef]
- Burgess, D.; Lee, R.; Tran, A.; van Ryn, M. Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons. J. LGBT Health Res. 2007, 3, 1–14. [Google Scholar] [CrossRef]
- McCarthy, M.A.; Fisher, C.M.; Irwin, J.A.; Coleman, J.D.; Pelster, A.D.K. Using the minority stress model to understand depression in lesbian, gay, bisexual, and transgender individuals in Nebraska. J. Gay Lesbian Ment. Health 2014, 18, 346–360. [Google Scholar] [CrossRef]
- Chan, R.C.; Operario, D.; Mak, W.W. Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels. J. Affect. Disord. 2020, 260, 292–301. [Google Scholar] [CrossRef]
- Meyer, I.H. Resilience in the study of minority stress and health of sexual and gender minorities. Psychol. Sex. Orientat. Gend. Divers. 2015, 2, 209–213. [Google Scholar] [CrossRef]
- Meyer, I.H. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol. Bull. 2003, 129, 674–697. [Google Scholar] [CrossRef]
- Douglass, R.P.; Conlin, S.E. Minority stress among LGB people: Investigating relations among distal and proximal stressors. Curr. Psychol. 2020, 41, 3730–3740. [Google Scholar] [CrossRef]
- Kuyper, L.; Vanwesenbeeck, I. Examining sexual health differences between lesbian, gay, bisexual, and heterosexual adults: The role of sociodemographics, sexual behavior characteristics, and minority stress. J. Sex Res. 2011, 48, 263–274. [Google Scholar] [CrossRef]
- Mongelli, F.; Perrone, D.; Balducci, J.; Sacchetti, A.; Ferrari, S.; Mattei, G.; Galeazzi, G.M. Minority stress and mental health among LGBT populations: An update on the evidence. Minerva Psichiatr. 2019, 60, 27–50. [Google Scholar] [CrossRef]
- Scandurra, C.; Pennasilico, A.; Esposito, C.; Mezza, F.; Vitelli, R.; Bochicchio, V.; Maldonato, N.M.; Amodeo, A.L. Minority stress and mental health in Italian bisexual people. Soc. Sci. 2020, 9, 46. [Google Scholar] [CrossRef]
- Meyer, I.H.; Dean, L. Internalized homophobia, intimacy, and sexual behavior among gay and bisexual men. In Stigma and Sexual Orientation: Understanding Prejudice against Lesbians, Gay Men, and Bisexuals; Herek, G.M., Ed.; Sage Publications: Thousand Oaks, CA, USA, 1998; pp. 160–186. [Google Scholar]
- Herek, G.M. Beyond “Homophobia”: Thinking about sexual prejudice and stigma in the twenty-first century. Sex. Res. Soc. Policy 2004, 1, 6–24. [Google Scholar] [CrossRef]
- Pachankis, J.E.; Mahon, C.P.; Jackson, S.D.; Fetzner, B.K.; Bränström, R. Sexual orientation concealment and mental health: A conceptual and meta-analytic review. Psychol. Bull. 2020, 146, 831–871. [Google Scholar] [CrossRef] [PubMed]
- Frost, D.M.; Meyer, I.H. Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. J. Couns. Psychol. 2009, 56, 97–109. [Google Scholar] [CrossRef]
- Yolaç, E.; Meriç, M. Internalized homophobia and depression levels in LGBT individuals. Perspect. Psychiatr. Care 2021, 57, 304–310. [Google Scholar] [CrossRef]
- Ventriglio, A.; Castaldelli-Maia, J.M.; Torales, J.; De Berardis, D.; Bhugra, D. Homophobia and mental health: A scourge of modern era. Epidemiol. Psychiatr. Sci. 2021, 30, e52. [Google Scholar] [CrossRef]
- Williamson, I.R. Internalized homophobia and health issues affecting lesbians and gay men. Health Educ. Res. 2000, 15, 97–107. [Google Scholar] [CrossRef]
- Rowen, C.J.; Malcolm, J.P. Correlates of internalized homophobia and homosexual identity formation in a sample of gay men. J. Homosex. 2003, 43, 77–92. [Google Scholar] [CrossRef] [PubMed]
- Newcomb, M.E.; Mustanski, B. Internalized homophobia and internalizing mental health problems: A meta-analytic review. Clin. Psychol. Rev. 2010, 30, 1019–1029. [Google Scholar] [CrossRef]
- Brewster, M.E.; Moradi, B. Perceived experiences of anti-bisexual prejudice: Instrument development and evaluation. J. Couns. Psychol. 2010, 57, 451. [Google Scholar] [CrossRef]
- Berg, R.C.; Munthe-Kaas, H.M.; Ross, M.W. Internalized homonegativity: A systematic mapping review of empirical research. J. Homosex. 2016, 63, 541–558. [Google Scholar] [CrossRef]
- Pignatiello, G.G. Countering anti-LGBTI+ bias in the European Union. A comparative analysis of criminal policies and constitutional issues in Italian, Spanish and French legislation. Women’s Stud. Int. Forum 2021, 86, 102466. [Google Scholar] [CrossRef]
- Monaco, S. Being bisexual in contemporary Italy: Between stigma and desire of visibility. Int. J. Sociol. Soc. Policy 2021, 41, 673–688. [Google Scholar] [CrossRef]
- Balsam, K.F.; Szymanski, D.M. Relationship quality and domestic violence in women’s same-sex relationships: The role of minority stress. Psychol. Women Q. 2005, 29, 258–269. [Google Scholar] [CrossRef]
- Šević, S.; Ivanković, I.; Štulhofer, A. Emotional intimacy among coupled heterosexual and gay/bisexual Croatian men: Assessing the role of minority stress. Arch. Sex. Behav. 2016, 45, 1259–1268. [Google Scholar] [CrossRef]
- Nichols, M. Lesbian sexuality/female sexuality: Rethinking “lesbian bed death”. Sex. Relatsh. Ther. 2004, 19, 363–371. [Google Scholar] [CrossRef]
- McLaren, S.; Castillo, P. What about me? Sense of belonging and depressive symptoms among bisexual women. J. Bisexuality 2020, 20, 166–182. [Google Scholar] [CrossRef]
- Björkenstam, C.; Mannheimer, L.; Löfström, M.; Deogan, C. Sexual orientation–related differences in sexual satisfaction and sexual problems—A population-based study in Sweden. J. Sex. Med. 2020, 17, 2362–2369. [Google Scholar] [CrossRef]
- Pavanello Decaro, S.; Pessina, R.; Biella, M.; Prunas, A. Italian women who have sex with women: Prevalence and co-occurrence of sexual practices. Sex Med. 2024. [Google Scholar]
- Flebus, G.B.; Montano, A. Contribution to the Italian translation and adaptation of the Lesbian Internalized Homophobia Scale of Szymanski and Chung. Giunti Organ. Spec. 2009, 258, 23–32. [Google Scholar]
- Szymanski, D.M.; Chung, Y.B. The Lesbian Internalized Homophobia Scale: A rational/theoretical approach. J. Homosex. 2001, 41, 37–52. [Google Scholar] [CrossRef]
- Symonds, T.; Boolell, M.; Quirk, F. Development of a questionnaire on sexual quality of life in women. J. Sex Marital. Ther. 2005, 31, 385–397. [Google Scholar] [CrossRef]
- Knight, D.A.; Jarrett, D. Preventive Health Care for Women Who Have Sex with Women. Am. Fam. Physician 2017, 95, 314–321. [Google Scholar]
- Elakman, A.K. Brief Sexuality Education Intervention for Women Who Have Sex with Women (WSW). Ph.D. Thesis, Xavier University, OhioLINK Electronic Theses and Dissertations Center, Cincinnati, OH, USA, 2021. Available online: http://rave.ohiolink.edu/etdc/view?acc_num=xupsy161851957338882 (accessed on 10 November 2023).
- Van, E.E.D.; Mereish, E.H.; Woulfe, J.M.; Katz-Wise, S.L. Perceived discrimination, coping mechanisms, and effects on health in bisexual and other non-monosexual adults. Arch. Sex. Behav. 2019, 48, 159–174. [Google Scholar] [CrossRef]
- Hayfield, N.; Clarke, V.; Halliwell, E. Bisexual women’s understandings of social marginalisation: ‘The heterosexuals don’t understand us but nor do the lesbians’. Fem. Psychol. 2014, 24, 352–372. [Google Scholar] [CrossRef]
- Kuyper, L.; Fokkema, T. Minority stress and mental health among Dutch LGBs: Examination of differences between sex and sexual orientation. J. Couns. Psychol. 2011, 58, 222. [Google Scholar] [CrossRef]
- Zinik, G. Identity Conflict or Adaptative Flexibility? Bisexuality Reconsidered; Rodriguez, R., Ed.; Bisexuality in the United States; Columbia University Press: New York, NY, USA, 2000; pp. 55–60. [Google Scholar]
- Fredriksen-Goldsen, K.I.; Kim, H.-J.; Barkan, S.E.; Balsam, K.F.; Mincer, S.L. Disparities in health-related quality of life: A comparison of lesbians and bisexual women. Am. J. Public Health 2010, 100, 2255–2261. [Google Scholar] [CrossRef]
- Batejan, K.L.; Jarvi, S.M.; Swenson, L.P. Sexual orientation and non-suicidal self-injury: A meta-analytic review. Arch. Suicide Res. 2015, 19, 131–150. [Google Scholar] [CrossRef]
- Ross, L.E.; Salway, T.; Tarasoff, L.A.; MacKay, J.M.; Hawkins, B.W.; Fehr, C.P. Prevalence of depression and anxiety among bisexual people compared to gay, lesbian, and heterosexual individuals: A systematic review and meta-analysis. J. Sex Res. 2018, 55, 435–456. [Google Scholar] [CrossRef]
- Watson, R.J.; Allen, A.; Pollitt, A.M.; Eaton, L.A. Risk and protective factors for sexual health outcomes among black bisexual men: Internalized heterosexism, sexual orientation disclosure, and religiosity. Arch. Sex. Behav. 2019, 48, 243–253. [Google Scholar] [CrossRef]
- Flanders, C.E.; Anderson, R.E.; Tarasoff, L.A.; Robinson, M. Bisexual stigma, sexual violence, and sexual health among bisexual and other plurisexual women: A cross-sectional survey study. J. Sex Res. 2019, 56, 1115–1127. [Google Scholar] [CrossRef]
- Mark, K.P.; Vowels, L.M.; Bunting, A.M. The impact of bisexual identity on sexual and relationship satisfaction of mixed sex couples. J. Bisexuality 2020, 20, 119–140. [Google Scholar] [CrossRef]
- Shepler, D.K.; Smendik, J.M.; Cusick, K.M.; Tucker, D.R. Predictors of sexual satisfaction for partnered lesbian, gay, and bisexual adults. Psychol. Sex. Orientat. Gend. Divers. 2018, 5, 25. [Google Scholar] [CrossRef]
- Henderson, A.W.; Lehavot, K.; Simoni, J.M. Ecological models of sexual satisfaction among lesbian/bisexual and heterosexual women. Arch. Sex. Behav. 2009, 38, 50–65. [Google Scholar] [CrossRef]
- Breyer, B.N.; Smith, J.F.; Eisenberg, M.L.; Ando, K.A.; Rowen, T.S.; Shindel, A.W. The impact of sexual orientation on sexuality and sexual practices in North American medical students. J. Sex. Med. 2010, 7, 2391–2400. [Google Scholar] [CrossRef]
- Bailey, J.M. The minority stress model deserves reconsideration, not just extension. Arch. Sex. Behav. 2020, 49, 2265–2268. [Google Scholar] [CrossRef]
- Holt, L.L.; Chung, Y.B.; Janssen, E.; Peterson, Z.D. Female sexual satisfaction and sexual identity. J. Sex Res. 2021, 58, 195–205. [Google Scholar] [CrossRef]
- Brown-Beresford, E.; McLaren, S. The relationship between self-compassion, internalized heterosexism, and depressive symptoms among bisexual and lesbian women. J. Bisexuality 2022, 22, 90–115. [Google Scholar] [CrossRef]
- Williams, S.L.; Mann, A.K.; Fredrick, E.G. Proximal minority stress, psychosocial resources, and health in sexual minorities. J. Soc. Issues 2017, 73, 529–544. [Google Scholar] [CrossRef]
Variable | Lesbian 31.63% (N = 217) | Bisexual 68.37% (N = 469) | |
---|---|---|---|
Age (Mean–SD) | (31.05–8.24) | (28.16–6.07) | |
Age (range) | (18–70) | (18–59) | |
Education level | Elementary School | 0% (0) | 0% (0) |
% (N) | Middle School | 1.38% (3) | 1.07% (5) |
Professional Diploma | 4.61% (10) | 1.07% (5) | |
High school diploma | 34.56% (75) | 30.70% (144) | |
University degree or Postgraduate education | 57.60% (125) | 64.82% (304) | |
Other | 1.84% (4) | 1.92% (9) | |
I prefer not to answer | 0% (0) | 0.43% (2) | |
Self-label % (N) | Lesbian vs. bisexual | 31.5% (217) | 68.4% (469) |
Relationship Status % (N) | Monogamous relationship | 65.44% (142) | 47.97% (225) |
Consensual non-monogamy (open relationship, polyamory, etc.) | 7.37% (16) | 20.04% (94) | |
Non-consensual non-monogamy relationship | 0.92% (2) | 2.56% (12) | |
Single (monogamous) | 17.97% (39) | 13.65% (64) | |
Single (consensual non-monogamous) | 3.69% (8) | 10.23% (48) | |
Not interested in dating someone | 2.76% (6) | 2.13% (10) | |
Other | 1.84% (4) | 3.41% (16) |
Variable | t-Value | df | p-Value | Standard Error | CI (Lower, Upper) | Hedges’g | Mean Score Lesbian | Mean Score Bisexual |
---|---|---|---|---|---|---|---|---|
Sexual Quality of Life | 3.88 | 474.77 | <0.001 | 0.06 | (0.12, 0.36) | 0.303 | 4.71 (SD = 0.72) | 4.47 (SD = 0.82) |
Internalized Homo-bi- negativity | −2.92 | 465.41 | 0.004 | 0.69 | (−3.36, −0.66) | 0.312 | M = 25.30, (SD = 8.07) | M = 27.31, (SD = 9.01) |
Predictor | Coefficient | Standard Error | p-Value | Mean Lesbian | Mean Bisxual |
---|---|---|---|---|---|
(Intercept) | 5.22 | 0.20 | <0.001 | ||
Age | 0.00 | 0.00 | 0.72 | good internal consistency (Cronbac 31.04 | 28.16 |
Internalized Homonegativity | −0.01 *** | 0.00 | <0.001 | 4.71 | 4.47 |
Sex Orientation | −0.21 ** | 0.7 | 0.002 | 25.30 | 27.31 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Pavanello Decaro, S.; Prunas, A. Internalized Homonegativity and Sexual Quality of Life in Italian Lesbian and Bisexual Women. Healthcare 2024, 12, 638. https://doi.org/10.3390/healthcare12060638
Pavanello Decaro S, Prunas A. Internalized Homonegativity and Sexual Quality of Life in Italian Lesbian and Bisexual Women. Healthcare. 2024; 12(6):638. https://doi.org/10.3390/healthcare12060638
Chicago/Turabian StylePavanello Decaro, Sofia, and Antonio Prunas. 2024. "Internalized Homonegativity and Sexual Quality of Life in Italian Lesbian and Bisexual Women" Healthcare 12, no. 6: 638. https://doi.org/10.3390/healthcare12060638
APA StylePavanello Decaro, S., & Prunas, A. (2024). Internalized Homonegativity and Sexual Quality of Life in Italian Lesbian and Bisexual Women. Healthcare, 12(6), 638. https://doi.org/10.3390/healthcare12060638