Search Results (131)

Background: Migration and place of birth are increasingly recognised as social determinants of health among sexual minority populations. Among men who have sex with men (MSM), being born outside the country of residence may shape access to healthcare, community resources, and social capital networks. In Japan, however, little is known about how being born outside Japan is associated with social capital, health behaviours, and mental health among MSM. Methods: Data were drawn from a large cross-sectional online survey conducted in 2025 of 8150 MSM living in Japan, recruited via community-based in-person outreach and targeted geo-social networking application advertisements. Multivariable logistic regression analyses examined associations between country of birth and social, behavioural, and health-related outcomes. Results: Foreign-born MSM were younger and more concentrated in the Greater Tokyo metropolitan region. Being born outside Japan was associated with higher odds of HIV testing across all timeframes and higher levels of both gay and heterosexual social capital. Foreign-born MSM were also more likely to have disclosed their sexuality to friends and family. However, they were less likely to be aware of LGBT or HIV prevention organisations, despite higher participation once engaged. No differences were observed in suicidal ideation or unprotected anal intercourse with casual partners, although foreign-born MSM were more likely to report unmet need for mental health care. Conclusions: Foreign-born MSM in Japan demonstrate strong engagement in HIV prevention and higher social capital, alongside persistent barriers to community awareness and mental health service access. These findings highlight the importance of addressing structural and informational barriers and supporting community-based organisations to improve equitable health and wellbeing outcomes among MSM in Japan. Full article

In 2000, during the Great Jubilee, the Catholic Church opposed the celebration of the International Gay Pride in Rome. Twenty-five years later, in 2025, the LGBT+ Jubilee pilgrimage was included in the official Jubilee program. This article analyzes both the narratives of those who participated in the pilgrimage and the sociohistorical factors that made this event possible. Using digital content analysis of 50 testimonies collected by La Tenda di Gionata, the Catholic LGBT+ organization responsible for organizing the LGBT+ Jubilee pilgrimage, the study shows that the principle of dignity emerges as the main narrative legitimizing the belonging of LGBT+ Catholics within the Church, expressed through recurrent claims for recognition rather than through mere welcoming. Furthermore, the article identifies two endogenous factors that contributed to the conditions under which this event took place: the pragmatic strategy of Pope Francis’s pontificate and the alignment and convergence of the Catholic LGBT+ movement with the wider culture of rights. The study suggests that these developments were made possible by the unexpected consequences of religious freedom within the religious field, which enabled a major shift in the understanding of religion, from a duty-centered to right-centered framework, in the contemporary world. Full article

Background/Objectives: Lesbian, gay, bisexual, and transgender (LGBT) cancer survivors face disproportionately high structural and psychosocial barriers to post-diagnosis care. However, heterogeneity within this population remains understudied. This study aimed to characterize healthcare utilization (HCU) barriers among LGBT cancer survivors, assess psychosocial vulnerabilities (discrimination, stress, and social support), and identify survivor subgroups at greatest risk for care disengagement. Methods: Data were drawn from the All of Us Research Program. A sample of 3502 LGBT cancer survivors was analyzed, including lesbian (n = 730), gay (n = 1285), bisexual (n = 1296), and transgender/gender expansive (TGE) (n = 209) individuals. HCU barriers were assessed using 21 binary indicators. Psychosocial measures included the Everyday Discrimination Scale, Perceived Stress Scale, and MOS Social Support Survey. Agglomerative hierarchical cluster analysis identified latent HCU barrier profiles. Differences across clusters and identity groups were assessed using ANOVA and chi-square tests, and multinomial logistic regression examined demographics, socioeconomic, and psychosocial predictors of cluster membership. Results: Three distinct HCU barrier clusters were identified: low (59.7%), moderate (27.8%), and high (12.5%). Bisexual and TGE survivors were disproportionately represented in the high-barrier cluster, which was characterized by widespread cost-related nonadherence, structural delays in care, and higher levels of perceived discrimination and stress. In adjusted models, bisexual identity, lower income, female sex assigned at birth, and higher discrimination and perceived stress were independently associated with increased odds of high-barrier cluster membership. Conclusions: Substantial heterogeneity exists in HCU barriers among LGBT cancer survivors. Bisexual and TGE survivors experience a concentrated burden of structural and psychosocial barriers to survivorship care, highlighting the relevance of targeted, data-driven approaches to reduce access inequities within this population. Full article

Transgender and gender-expansive (TGE) communities face persistent health inequities that are reproduced through everyday administrative and clinical encounters across care systems. A feedback-focused lens can clarify how those inequities are generated and sustained. Objective: To identify and validate feedback loops that create policy exposure and institutional gatekeeping in TGE healthcare and to surface leverage points to stabilize their continuity of care. Methods: Two facilitated, Zoom-based Group Model Building (GMB) sessions were conducted in March 2021 with eight TGE participants (mean age 38 years; range 22–63; transfeminine and transmasculine identities; multiracial, White, and SWANA racial identities) recruited through a Lesbian Gay Bisexual and Transgender (LGBT) community center, followed by a participant member-checking session to validate loop structure, causal direction, and interpretive accuracy. Analysis focused explicitly on identifying reinforcing and balancing feedback structures, rather than isolated barriers, to explain how policy exposure and institutional gatekeeping are generated over time. Results: Participants co-constructed a nine-variable Causal Loop Diagram (CLD) with six feedback structures, four reinforcing and two balancing that interact dynamically to amplify or dampen policy exposure, institutional gatekeeping, and continuity of care, which were organized across structural, institutional/clinical, and individual/community tiers. Reinforcing dynamics linked structural stigma, exclusion from formal employment, institutionalized provider bias, and enacted stigma to degraded care experience, increased trauma and distrust, and disrupted continuity, manifesting as policy exposure (e.g., coverage volatility, denials) and gatekeeping (e.g., discretionary documentation, referral hurdles). Community-based supports and peer/elder navigation functioned as balancing loops that reduced trauma, improved continuity and encounters, and, over time, dampened provider bias. A salient theme was the visibility/invisibility paradox: symbolic inclusion without workflow redesign can inadvertently increase exposure and reinforce harmful loops. Full article

Background: Pride may play a role in eating disorders and related symptomatology. This PRISMA-informed scoping review explores the emotion of pride in eating disorders and in related symptoms. Methods: Four databases (PubMed, PsycINFO, Web of Science, Scopus) were searched (July 2025). This systematic scoping review followed PRISMA guidelines and PICOS procedures. The included reports were written in English language and assessed pride in relation to eating disorder-related symptoms both in diagnosed individuals and in the general population. Results: Twenty-three studies were selected, including sixteen quantitative and seven qualitative studies. Pride was evaluated in various forms, including appearance-related pride, body pride, and LGBT pride. In general population samples, high levels of maladaptive pride and low levels of adaptive pride were associated with greater eating disorder-related symptomatology. In patients, pride was associated with control and illness identification and was found to contribute to illness onset, maintenance, and recovery. Conclusions: Integrating pride experiences in the assessment of eating disorders may be clinically useful and provide guidance for treatment planning. Main gaps consist in the great heterogeneity of the instruments used to assess pride and in the major focus on anorexia nervosa, with only a few studies investigating bulimia nervosa and binge-eating disorder. Full article

Nutrition is a cornerstone of public health, yet the unique nutrition needs and considerations of lesbian, gay, bisexual, transgender, and others (LGBT+) communities remain largely invisible in the field of dietetics. These populations face disproportionate burdens of obesity, eating disorders, body dysmorphia, metabolic risks, and food insecurity, often driven by stigma, minority stress, and structural inequities. This narrative review aimed to synthesize current evidence on nutrition-related disparities among LGBT+ populations and identify opportunities for dietitians to advance equity in care. A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies addressing diet quality, obesity, eating disorders, food insecurity, and metabolic health in sexual and gender minorities. Evidence indicates clear subgroup differences: lesbian and bisexual women are more likely to experience obesity and food insecurity; gay and bisexual men report lower BMI but greater body image concerns and disordered eating; transgender individuals face nutritional challenges linked to gender-affirming therapy and high rates of food insecurity; and people living with HIV encounter additional metabolic risks associated with treatment. Despite these findings, LGBT+ health remains rarely reflected in dietary guidelines or professional training. Embedding inclusivity into dietetic education and clinical encounters, adopting culturally competent and structurally aware practices, and tailoring interventions to subgroup-specific needs are key priorities. Inclusive, equity-driven, and person-centered nutrition care is essential to closing health gaps for LGBT+ populations and ensuring that every patient receives guidance that affirms their identity and lived experience. Full article

Persons with disabilities face barriers to accessing sexuality education. For those who identify as queer, these challenges are compounded by stigma, ableism, and heteronormativity, resulting in distinct and overlooked experiences. This study explored the sexuality education needs of persons with disabilities who identify as queer in Kenya—a neglected demographic—using a phenomenological approach. Data were collected through a focus group discussion with six participants and analyzed thematically. Three themes emerged: invisibility and erasure; unprepared institutions and constrained support networks; and agency and everyday resistance. Educational institutions often overlook the intersectional needs of persons with disabilities who identify as queer, leaving them without adequate tools to navigate relationships, sexuality, and rights. Support systems are often unprepared or unwilling to address these needs. Societal attitudes that desexualize disability and marginalize queerness intersect to produce compounded exclusion. Despite these challenges, participants demonstrated agency by using digital spaces and informal networks to resist exclusion. This calls for policy reforms that move beyond tokenism to address the lived realities of multiply marginalized groups. Policy reform means not only a legal or governmental shift but also a broader cultural and institutional process that creates space for recognition, protection, and participation. Full article

There has been a growing trend of young people coming out as Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) in recent years. Research on the relationship between LGBTQ grandchildren and their grandparents is limited and primarily focuses on the grandchildren’s perspective. This pilot study seeks to understand the relationship between grandparents and their LGBT grandchildren, from the grandparents’ perspective. Six Israeli grandparents were interviewed using a qualitative methodology, guided by a semi-structured interview protocol. Analysis of the interviews revealed three main themes: grandparents’ exposure to the grandchildren’s sexual orientation and their gender identity; the shattering of the grandparents’ dream and concern for the grandchild; and the relations between the grandparents and their LGBT grandchildren. The research findings in this pilot study indicate that the relations remained close and did not change following disclosure of the sexual orientation. However, some grandparents needed time to resume their regular relationship. The insights learned from the research findings regarding the process undergone by the grandparents upon discovering their grandchildren’s sexual orientation can help professionals treat and counsel family members, when necessary, how to bridge the gaps, and rebuild the relations between the grandparent and the grandchild, as these relations are important for the well-being of both. Full article

This article presents a structured review of literature published between 2015 and 2025 on the experiences of rural LGBTQIA+ youth. Using targeted search terms—including “LGBT*,” “rural,” “country,” “young people,” “sexual and gender minority (SGM),” “small town,” “youth,” and “students”—a research team identified 26 peer-reviewed articles that met inclusion criteria. Through team-based thematic analysis, six core themes emerged: (1) gaps in intersectional analysis, (2) mental health outcomes, (3) culturally responsive services and resources, (4) community climate and context, (5) experiences of victimization, and (6) policy. Across these themes, the review highlights the resilience, agency, and strength of LGBTQIA+ youth navigating rural environments. The literature consistently demonstrates how experiences of victimization are closely linked to mental health outcomes, while access to social support—particularly from affirming adults in systems (such as schools)—can mitigate harm and foster well-being. Implications for social work research, practice, and policy are discussed, with an emphasis on supporting LGBTQIA+ youth in U.S. Southern rural settings. Full article

The latest Relationships Education, Relationships and Sex Education, and Health Education (RSHE) Draft Guidance seeks to reduce the inclusion of LGBT themes in English schools. Additionally, the Gender Questioning Draft Guidance for Schools and Colleges and the Cass Review overlook the rights of trans and non-binary young people, further intensifying the heated debates surrounding their lives. In response, the author draws upon research conducted in a primary school in Greater London in 2021, when statutory RSHE, including LGBT content, was first introduced. The research aimed to understand how teachers felt about teaching RSHE and to collaborate with them to enhance pupil learning within and beyond the RSHE curriculum. This paper critiques lesson observations and teachers’ reflections on their lessons using a Framework for Sexuality Education and Queer Theory. The researcher’s call to rethink how RSHE is taught should not be taken to mean it should not be taught. To the contrary, the findings suggest a need for the school to broaden its curriculum, teaching methods, and strategies to become a truly ‘LGBT-inclusive’ environment. However, the paper also illuminates the apprehensions these primary school teachers experienced, which in turn influenced pedagogical decisions. The article concludes by recommending specific whole-school approaches and effective pedagogical practices for RSHE in the school, which could be beneficial to other primary school settings. Effective teaching of LGBT themes requires clear support for educators, especially within the complexity of a primary school setting and given the changing political and social climate. Full article

Background: Loneliness is both a social and a health-related problem, and among LGBT people, feelings of loneliness are often exacerbated. According to the minority stress theory, stress and loneliness can be directly related to the discrimination and stigma that are experienced over time in a heteronormative society. Exposure to social stigma causes mental health problems, stress, and loneliness, coupled with increased social and economic vulnerability. Method: The aim of this study was to conduct an exploratory analysis of homosexual men’s feelings of loneliness and their relationship with experiences of discrimination throughout their life. A qualitative methodology involving focus groups and individual interviews was utilized. Results: The results show the double or overlapping discriminations that gay men experience as a result of their age and sexual orientation and, in some cases, their HIV status, and the relationship between said discrimination and the feeling of unwanted loneliness. Exposure to such intolerance is more common among those with a reduced social network, which limits their social participation and has a negative impact on their well-being. Conclusion. The aging process of LGBT people implies a new context of intervention and research that must be addressed to prevent episodes of unwanted loneliness that negatively affect the quality of life among this demographic. Full article

Sexual minority women (SMW) are a resilient yet vulnerable population who may experience poor psychosocial outcomes due to minority stress associated with their marginalized status and traumatic experiences resulting from interpersonal and structural violence. When SMW are incarcerated, the trauma of this experience can exacerbate existing mental health challenges. Self-concept is a key measure of mental health that is associated with increased self-efficacy and positive psychosocial outcomes. This analysis explores the ways in which incarceration impacts the self-concept of SMW. Secondary data analysis of three qualitative interviews with formerly incarcerated SMW was conducted. Specifically, Gilligan’s Listening Guide was used to create “I poems” that articulate the participants’ narratives and contrapuntal voices. These poems were then analyzed to build knowledge about participants’ self-concept. This analysis informs our understandings of self-concept among SMW, violence against women, the vulnerability of binary constructs, and the ways in which people negotiate past, present and future selves. The findings can inform interventions that seek to mitigate the psychosocial risks faced by SMW and formerly incarcerated people and improve outcomes for these populations. Full article

Background/Objectives: Social support is essential to development, mental and emotional health, and reducing risk for psychological distress. Youth are exposed to various opportunities for socialization with peers, including through social media. Strong online social networks may be most critical for youth from isolated communities, including those from rural areas or LGBT+ (lesbian, gay, bisexual, transgender, etc.) youth. With this study, we investigated associations between social media use and online social support among adolescents. Additionally, we compared the online experiences of rural and urban youth. We also examined associations between online social support and psychological functioning and investigated whether the strength of these relationships was moderated by community type (rural versus urban). Finally, we evaluated the online experiences of LGBT+ youth. Methods: Two hundred seventy-five participants (ages 13–19) from seven high schools located in either rural or urban communities completed a paper and pencil survey on their mental health, social media use, and online social support. Results: Social media use was positively associated with online social support. Rural youth were found to report greater social media use and online social support compared to urban youth. Online social support was not associated with depression or anxiety; community type (rural versus urban) did not moderate the strength of these relationships. LGBT+ youth in rural communities reported greater social media use and support online compared to LGBT+ youth in urban communities. Conclusions: These findings shed light on the potential positive benefits of social media use as it is related to perceptions of social support among online friends. They demonstrate that interactions online may contribute to stronger support networks within adolescents, particularly among vulnerable youth. Findings suggest social media may increase accessibility to social support for youth who may be at risk for social isolation. Full article

Background: LGBTQ+ persons with cancer and their families consistently face discriminatory care. In addition, clinicians report inadequate population-specific knowledge and communication skills to effectively promote LGBTQ+ inclusion. To fill this gap, we designed a communication skills training based on extant literature; multidisciplinary perspectives; and patient, family, and clinician expert engagement. Methods: Training content comprised didactic information, including exemplar videos of communication strategies, and experiential learning roleplay opportunities with standardized patient and family member actors. Two training sessions were conducted virtually with invited multidisciplinary clinicians using convenience sampling. Each training was followed by a one-hour, semi-structured focus group to solicit feedback on participants’ experiences and recommendations for improvement. Focus group transcripts were thematically analyzed using a constant comparative approach. Results: Two major themes were identified: key takeaways from the training and recommendations for improvement. Participants reported favorable learning experiences and believed the training would have a positive influence on future clinical interactions. We synthesized recommendations into five discrete pieces of feedback related to (1) the advanced level of training material; (2) diversity throughout the training; (3) complexity of family dynamics; and (4) recovery from communication mistakes; and (5) additional topics for future training. Based on feedback, corresponding changes for each item and a refined communication skills blueprint are provided. Conclusions: Our innovative training on inclusive cancer care for LGBTQ+ patients’ families will provide both knowledge-based and experiential learning opportunities to advance clinicians’ confidence in communicating empathically with members of diverse sexual orientation and gender identities. The training is poised for feasibility and efficacy testing. Full article

Background/Objectives: Sexuality is part of everyone’s life, especially during adolescence, when young people are discovering themselves and experiencing several changes. Adolescents need to be informed about their sexuality, so they seek and receive information about it from a variety of sources and on different topics. This systematic review aimed to synthesize studies that explored the sources adolescents use and topics they search for. Methods: Quantitative, qualitative, and mixed articles published in Portuguese, Spanish, or English and with respondents aged between 12 and 20 years were included in this study. To fulfill the proposed objectives, three online databases (EBSCOhost, PubMed, and Web of Science) were used, including a total of 48 studies. Results: The most common sources of information are family, friends, school, and the Internet, depending mainly on the reliability of the source and the anonymity when using it. The main topics adolescents search for are sexual intercourse, contraception, relationships, and LGBT issues, since these are less addressed topics. Conclusions: These results are useful in a practical way as a basis for the development of sex education programs that correspond to the needs of adolescents, since they allow us to know which information they are looking for and the sources from which they can receive it. Full article