Sexual orientation group disparities in several critical health domains are now well documented, with sexual minorities reporting more psychological distress, substance use and dependence, and eating disorders symptoms. Little is known about the reasons underlying higher risk behaviors among sexual minorities relative to heterosexuals. Herein, we propose to explain these sexual orientation disparities by testing our Sexual Minority Stress Theory (SMST). SMST is based on society's stigmatization of homosexuality. Gay-related stress, the experience by a sexual-minority individual of society's stigmatization, consists of external stressors (such as prejudice, discrimination, verbal abuse, physical violence) perpetrated by known individuals (such as kin, heterosexual friends) and strangers in the community. Gay-related stress also consists of internal stress, in which the sexual-minority individual internalizes society's stigmatization, such as possessing negative attitudes toward homosexuality. Our proposed research will address the impact of gay-related stress on disparities between and among sexual orientation subgroups in psychological distress, physiological distress (cortisol, DHEA), health behaviors, chronic pain, adaptation, and adjustment in emerging adulthood, and examine moderators, such as the effect of parent-child relationships on the relations between sexual orientation and gay-related stress and the effect of coping on the relations between gay-related stress and both psychological and physiological distress. Gay-related stress may be particularly important in influencing a sexual minority youth's development and psychosocial adjustment in emerging adulthood. Our research will be sensitive to important precursors of gay-related stress, such as gender nonconformity. It will also examine how sex, age at experiencing gay-related stress, sexual minority status and transitions in status, concordant vs. nonconcordant orientation patterns among sexual minorities, and sexual identity development vary with gay-related stress, health, adaptation, and adjustment outcomes. We will collect new self-report survey and biological data to investigate these critical issues in the Growing Up Today Study (GUTS), a longitudinal cohort study of 16,882 U.S. adolescents and emerging adults begun in 1996 and ongoing. Specifically, we will add 3 data collection phases to more than 10 years of data collected from GUTS and link the youths'data with those of their mothers, who comprise the Nurses'Health Study II. We will examine disparities in violence victimization in childhood and adolescence and other forms of gay-related stress and the impact of these over time on subsequent psychological and physiological distress, substance use and eating disordered behaviors, chronic pain, adaptation, and adjustment in emerging adulthood.

Public Health Relevance

Disturbing evidence exists of disparities in tobacco, alcohol, and other substance use and dependence, eating disorder symptoms, and a number of other important health indicators adversely affecting sexual-minority youth relative to heterosexual peers. Our proposed research will address the critical need for new epidemiologic investigations into the impact of violence victimization, harassment, and other gay- related stressors on the health of this underserved and understudied population, providing valuable data to researchers and clinicians working to improve the health of all youth.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD057368-04
Application #
8307952
Study Section
Psychosocial Development, Risk and Prevention Study Section (PDRP)
Program Officer
Haverkos, Lynne
Project Start
2009-09-15
Project End
2014-06-30
Budget Start
2012-07-01
Budget End
2013-06-30
Support Year
4
Fiscal Year
2012
Total Cost
$619,436
Indirect Cost
$129,844
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Jiang, Lai; Penney, Kathryn L; Giovannucci, Edward et al. (2018) A genome-wide association study of energy intake and expenditure. PLoS One 13:e0201555
Drucker, Aaron M; Field, Alison E; Li, Wen-Qing et al. (2018) Childhood Atopic Dermatitis and Risk of Problematic Substance Use. Dermatitis 29:168-170
Charlton, Brittany M; Roberts, Andrea L; Rosario, Margaret et al. (2018) Teen Pregnancy Risk Factors Among Young Women of Diverse Sexual Orientations. Pediatrics 141:
Roberts, Andrea L; Gladish, Nicole; Gatev, Evan et al. (2018) Exposure to childhood abuse is associated with human sperm DNA methylation. Transl Psychiatry 8:194
Bezold, Carla P; Banay, Rachel F; Coull, Brent A et al. (2018) The Association Between Natural Environments and Depressive Symptoms in Adolescents Living in the United States. J Adolesc Health 62:488-495
Bezold, Carla P; Banay, Rachel F; Coull, Brent A et al. (2018) The relationship between surrounding greenness in childhood and adolescence and depressive symptoms in adolescence and early adulthood. Ann Epidemiol 28:213-219
Charlton, Brittany M; Gordon, Allegra R; Reisner, Sari L et al. (2018) Sexual orientation-related disparities in employment, health insurance, healthcare access and health-related quality of life: a cohort study of US male and female adolescents and young adults. BMJ Open 8:e020418
Austin, S Bryn; Rosario, Margaret; McLaughlin, Katie A et al. (2018) Sexual orientation and salivary alpha-amylase diurnal rhythms in a cohort of U.S. young adults. Psychoneuroendocrinology 97:78-85
Chen, Ying; VanderWeele, Tyler J (2018) Associations of Religious Upbringing With Subsequent Health and Well-Being From Adolescence to Young Adulthood: An Outcome-Wide Analysis. Am J Epidemiol 187:2355-2364
Gordon, Allegra R; Krieger, Nancy; Okechukwu, Cassandra A et al. (2017) Decrements in health-related quality of life associated with gender nonconformity among U.S. adolescents and young adults. Qual Life Res 26:2129-2138

Showing the most recent 10 out of 47 publications