A Review of Mory Strs as a Risk Factor for Cognive Decle Lbian, Gay, Bisexual, and Transgenr (LGBT) Elrs - PMC

Contents:

• CHRONIC PHYSLOGIC EFFECTS OF STRS AMONG LBIAN, GAY, AND BISEXUAL ADULTS: RULTS OM THE NATNAL HEALTH AND NUTRN EXAMATN SURVEY
• UNRSTANDG THE OF STRS ON HEALTH OF GAY OR LBIAN ADOLCENTS
• CHRONIC PHYSLOGIC EFFECTS OF STRS AMONG LBIAN, GAY, AND BISEXUAL ADULTS: RULTS FROM THE NATNAL HEALTH AND NUTRN EXAMATN SURVEY
• VERBAL AND PHYSIL ABE AS STRSORS THE LIV OF LBIAN, GAY MALE, AND BISEXUAL YOUTHS: ASSOCIATNS WH SCHOOL PROBLEMS, NNG AWAY, SUBSTANCE ABE, PROSTUTN, AND SUICI
• GAY MEN’S STRS RPONSE TO A GENERAL AND A SPECIFIC SOCIAL STRSOR
• GAY MEN’S STRS RPONSE TO A GENERAL AND A SPECIFIC SOCIAL STRSOR
• A REVIEW OF MORY STRS AS A RISK FACTOR FOR COGNIVE DECLE LBIAN, GAY, BISEXUAL, AND TRANSGENR (LGBT) ELRS

CHRONIC PHYSLOGIC EFFECTS OF STRS AMONG LBIAN, GAY, AND BISEXUAL ADULTS: RULTS OM THE NATNAL HEALTH AND NUTRN EXAMATN SURVEY

Usg a natnally-reprentative Uned Stat sample, we examed whether: (1) people who self-intified as homosexual or bisexual display higher levels of AL than heterosexual dividuals and (2) subgroups of sexual inty would further differ om each other as a nsequence of distct experienc of margalizatn.

Employg multivariate regrsn methods wh sex-specific analys, we examed AL sre differenc among lbian/gay (n = 211), bisexual (n = 307), homosexually experienced (n = 424), and exclively heterosexual (n = 12, 969) dividuals, adjtg for possible nfoundg due to mographics, health ditors, and, among men, HIV fectn stat.

To date, however, the nsequenc of the experienc on the health of lbian, gay, and bisexual (LGB) dividuals outsi of HIV rearch have seldom been studied g blogil approach monly employed bbehavral studi. First at the dividual level, proximal mory strs procs refers to ternalized homophobia and ncealment of one’s sexual orientatn or genr inty for transgenr dividuals (33).

UNRSTANDG THE OF STRS ON HEALTH OF GAY OR LBIAN ADOLCENTS

First, Doyle and Molix showed that discrimatn predicts elevated terlk-6 levels gay men; however, this relatnship was prent only among gay men who engaged ls verg, a strategy that volv downplayg one’s stigmatized inty (34).

Send, Parra and lleagu showed that LGB-related strsful life events, ternalized homonegativy, and flatter diurnal rtisol slop were posively associated wh prsive symptoms (35).

Consistent wh this hypothis, rearch has shown that bisexual men and women report signifintly lower levels of nnectn to their muny than their lbian and gay peers (40). Siarly, “homosexually experienced heterosexual” dividuals (41) are those who fall between heterosexual and bisexual dividuals on spectm of sexual orientatn, attractns, and behavrs. Acrdg to a systemic review, homosexually experienced heterosexuals also experience psychologil and physil health problems that are greater than heterosexual dividuals, but lower than bisexual dividuals (42) current study vtigated AL differenc as a functn of sexual orientatn g the populatn sample public data NHANES while adjtg for key variat.

CHRONIC PHYSLOGIC EFFECTS OF STRS AMONG LBIAN, GAY, AND BISEXUAL ADULTS: RULTS FROM THE NATNAL HEALTH AND NUTRN EXAMATN SURVEY

Fally, we clud a fourth stratifitn of homosexually experienced dividuals of both sex that otherwise intified as heterosexual to ntrast potential gradients AL as a functn of sexual behavr. Participants were next grouped as follows: (i) those reportg a lbian or gay inty, regardls of sexual history (n = 211); (ii) those reportg a bisexual inty, regardls of sexual history (n = 307); (iii) those ditg posive lifetime histori of same-sex sexual partners (homosexually experienced; n = 424) the absence of a current lbian, gay or bisexual inty (92% currently intified as heterosexual); or (iv) exclively heterosexual (n = 12, 969) cludg those who explicly self-intified as heterosexual (n = 12, 671) or reported no same-sex sexual partners or gay/bisexual inty (n = 282) or, barrg that, evinced maral and reproductive histori nsistent wh heterosexualy (n = 15)(45).

VERBAL AND PHYSIL ABE AS STRSORS THE LIV OF LBIAN, GAY MALE, AND BISEXUAL YOUTHS: ASSOCIATNS WH SCHOOL PROBLEMS, NNG AWAY, SUBSTANCE ABE, PROSTUTN, AND SUICI

Adults, age 20 to 59 years, by sexual orientatn, NHANES (2001–2010)CharacteristicsGay(n = 211)Bisexual(n = 307)Homosexuallyexperienced(n = 424)ExclivelyHeterosexual(n = 12, 969)%(SE)%(SE)%(SE)%(SE)Female genr**38. Adults, age 20 to 59 years, by genr and sexual orientatn: Weighted timat and standard errors shown, NHANES (2001–2010)WomenMenGay(n = 87)Bisexual(n = 201)Homosexuallyexperienced(n = 272)Heterosexual(n = 6, 230)Gay(n = 124)Bisexual(n = 106)Homosexuallyexperienced(n = 152)Heterosexual(n = 6, 739)%(SE)%(SE)%(SE)%(SE)%(SE)%(SE)%(SE)%(SE)Health ditors, %Currently sured70. Adults, age 20 to 59 years, by genr: Adjted odds rats1 and 95% nfince tervals shown, NHANES (2001–2010)Health statWomenMenGayBisexualHomosexuallyexperiencedGayBisexualHomosexuallyexperiencedHealth ditors Currently sured0.

Adults age 20 to 59 years, by genr, NHANES (2001–2010): Partial rults shownWomenMenTotal sampleAge 20–49 onlyMol 1Adj β(CI)Mol 2Adj β(CI)Mol 1Adj β(CI)Mol 2Adj β(CI)Mol 1Adj β(CI)Mol 3Adj β(CI)Sexual orientatn1Gay/lbian0.

Homosexually experienced men evinced signifintly lower levels of diastolic blood prsure pared wh exclively heterosexual women, sexual orientatn was not associated wh AL (adjted Wald F(3) = 0. We theorize that social margalizatn affects both pathogenic and/or salutogenic procs that ntribute to AL profil unique ways wh subgroups of sexual rults are nsistent wh an earlier Jter and lleagu’ study (36) showg that gay men evince lower AL levels pared to heterosexual men and where women show no AL differenc.

GAY MEN’S STRS RPONSE TO A GENERAL AND A SPECIFIC SOCIAL STRSOR

Another ADD HEALTH analysis of dividual bmarkers found that gay/bisexual men had higher c-reactive prote, diastolic blood prsure, and pulse, but lower glysylated hemoglob pared to heterosexual men (68). Our study expands measurement factors this lerature and dit a need for future studi to analytilly divi wh-sex (if sufficiently powered to do so) when asssg strs bmarkers and fdgs om the current study and those of Jter and lleagu (36) suggt that gay men evince lower levels of AL pared to heterosexual men. It may be the se that the health dispari experienced by gay men are not mediated by physlogil dysregulatn per se, but may be fluenced through other psychosocial pathways.

The strs-health dysregulatg hypothis racial/ethnic mori, particularly Ain Amerins, is also highly related to macroenomic ndns which may be que different for non-racial/ethnic mory gay men. Examg wh gay men the extent to which the socenomic ndns are prent and play a role may be important future efforts to intify how strs, mory, sex/genr (69), objective and subjective SES stat (70), and physlogic procs clter to protect or nfer risk for negative physlogil health out. In our study, we ajted for psychologil distrs and key health and mographic factors; however, the NHANES do not measure many of the factors that we advote would benef better unrstandg AL, sex/genr, and sexual mory stat to refg our knowledge of gay men’s strs and is also another explanatn that may be a factor acuntg for why gay men show lower levels of AL which volv their experienc of socially rerced ials of body thns and mculary that fluence their health behavrs.

Compared to exclively heterosexual men, gay-intified men evinced lower BMI (73) and the current study glysylated hemoglob while adjtg for exercise and other health behavrs. Ined, gay men are more likely to endorse a mcular physique (75), disorred eatg (76, 77), and experience body dissatisfactn pared to both heterosexual men (54, 55) and bisexual men (56). G., exercise, body fat, eatg patterns, eatg disorrs) to further explite fluencg factors AL variatns among gay our study, bisexual men evinced signifintly higher levels of AL pared to exclively heterosexual men.

GAY MEN’S STRS RPONSE TO A GENERAL AND A SPECIFIC SOCIAL STRSOR

In addn to experiencg the typil sexual mory strsors associated wh heterosexism and homophobia, has been reported that bisexual dividuals also face unique forms of hostily, prejudice, stigma, and discrimatn based on attus both the heterosexual and lbian/gay muny (81, 85). Specifilly, lbian/bisexual women showed higher rtisol ncentratns than heterosexual women, while gay/bisexual men showed lower overall rtisol productn than heterosexual men rponse to the Trier Social Strs Tt. ACRONYMS:ALallostatic loadBMIbody mass xHDLhigh-nsy lipoproteLGBlbian, gay, and bisexualNCHSNatnal Center for Health StatisticsNHANESNatnal Health and Nutrn Examatn SurveyFootnotConflicts of IntertThe thors have no nflicts of tert to report.

Usg a natnally reprentative US sample, we examed whether (1) people who self-intified as homosexual or bisexual display higher levels of AL than heterosexual dividuals and (2) subgroups of sexual inty would further differ om each other as a nsequence of distct experienc of margalizatn. Comparison of Health and Health Risk Factors Between Lbian, Gay, and Bisexual Adults and Heterosexual Adults the Uned Stat: Rults From the Natnal Health Interview Survey. A mon theme intified empiril studi and clil reports of lbian, gay male, and bisexual youths is the chronic strs that is created by the verbal and physil abe they receive om peers and adults.

A REVIEW OF MORY STRS AS A RISK FACTOR FOR COGNIVE DECLE LBIAN, GAY, BISEXUAL, AND TRANSGENR (LGBT) ELRS

This rponse to gay male, lbian, and bisexual adolcents by signifint others their environment is often associated wh several problematic out, cludg school-related problems, nng away om home, nflict wh the law, substance abe, prostutn, and suici.

Lbian, Gay, Bisexual, and Transgenred (LBGT) dividuals are at an creased risk for psychiatric morbidy pared to heterosexuals due to stigma rultg om perceived discrimatn; which also ntribut to LGBT youth havg higher rat of externalizg behavrs, such as alhol, tobac and poly-substance e (McCabe et al, 2010; Lehavot & Simoni, 2011).