Stigma and stress:Studies on attitudes towards sexual minority orientations and the association between sexual orientation and mental health

Stigma and prejudice towards sexual diversity negatively affect the mental health of sexual minority individuals. This dissertation contains five empirical studies that tried to fill lacunae in scientific knowledge regarding this association. The first two sought to further insights into antecedents of that link, by studying attitudes towards sexual minority orientations, focusing on the role of education in explaining these attitudes. The effect of educational attainment appeared to be limited, as its association with acceptance of homosexuality was largely confounded by family and individual factors. Within schools, friends affected and were affected by the homophobic attitudes of their peers over time. The last three empirical chapters studied whether minority stress processes explained mental health disparities between heterosexual and sexual minority individuals, as well as between subgroups of sexual minority individuals. Experiences of parental rejection and bullying victimization partly explained mental health disparities between heterosexual and sexual minority youth, but sociometric analyses did not find sexual minority youth to be more socially isolated in schools than their heterosexual counterparts. Bisexual individuals reported worse mental health than other sexual minority individuals, but dimensions of sexual identity were of limited use in explaining this difference

Attitudes in motion:acculturation in views on family, sexuality and gender roles among immigrant-background youth in Sweden

Swedes uphold progressive attitudes regarding family, sexuality, and gender norms. At the same time, Sweden has had generous immigration policies for decades. This leads to challenges for children of immigrants, who must navigate between expectations from their family and the surrounding society. Therefore, this study asks whether children of immigrants’ attitudes relating to family, sexuality and gender roles adapt and approach those of their Swedish-background peers, using the Swedish branch of the CILS4EU survey (n = 5434). We account for dynamics in three ways: We compare attitudes of first- and second-generation immigrants; compare attitudes of youth to those of their parents; and study change in youth’s attitudes over time. In favour of acculturation, we find that second-generation immigrants have more liberal attitudes than first-generation immigrants, that immigrant-background youth are closer to majority peers in attitudes than their parents are to majority parents, and that gender norms of immigrant-background youth move closer to those of Swedish-background youth over time. For attitudes relating to family and sexuality, however, we find a divergence in attitudes over time, but not because immigrant-background youth become less liberal: Their views do become more liberal, but majority youth see an even stronger change in the same direction.</p

Stigma and stress:Studies on attitudes towards sexual minority orientations and the association between sexual orientation and mental health

Stigma and prejudice towards sexual diversity negatively affect the mental health of sexual minority individuals. This dissertation contains five empirical studies that tried to fill lacunae in scientific knowledge regarding this association. The first two sought to further insights into antecedents of that link, by studying attitudes towards sexual minority orientations, focusing on the role of education in explaining these attitudes. The effect of educational attainment appeared to be limited, as its association with acceptance of homosexuality was largely confounded by family and individual factors. Within schools, friends affected and were affected by the homophobic attitudes of their peers over time. The last three empirical chapters studied whether minority stress processes explained mental health disparities between heterosexual and sexual minority individuals, as well as between subgroups of sexual minority individuals. Experiences of parental rejection and bullying victimization partly explained mental health disparities between heterosexual and sexual minority youth, but sociometric analyses did not find sexual minority youth to be more socially isolated in schools than their heterosexual counterparts. Bisexual individuals reported worse mental health than other sexual minority individuals, but dimensions of sexual identity were of limited use in explaining this difference

Sexual identity disparities in mental health among U.K. adults, U.S. adults, and U.S. adolescents:Examining heterogeneity by race/ethnicity

Lesbian, gay, and bisexual (LGB) people report poorer mental health than heterosexual people. However, there is heterogeneity in this disparity, and a racial/ethnic minority identity can contribute to this heterogeneity. When studying the intersecting effect of sexual identity and race/ethnicity on mental health, research often limits race/ethnicity categories, often uses adult samples from the U.S., and often uses samples that are not nationally representative. To overcome these limitations, the present study examined racial/ethnic heterogeneity in mental health disparities between heterosexual and LGB people in three nationally representative samples. The samples used were the 2011–2012 Understanding Society (U.K. adults; N = 43,904), the 2015 National Survey on Drug Use and Health (U.S. adults; N = 43,313), and the 2015 Youth Risk Behavior Survey (U.S. adolescents; N = 15,122). Using these samples enabled us to contrast the intersection of sexual identity and race/ethnicity across countries (for adults), and between life phases (in the U.S.). Across all three samples, LGB people—and particularly bisexual people—had a higher risk of impaired mental health than heterosexual people. For U.K. adults and U.S. adults, no intersecting effect of sexual identity and race/ethnicity were found. LGB adolescents of color reported better mental health compared with White LGB adolescents. More specifically, Black LGB adolescents reported better mental health compared to White LGB adolescents. Together, the present study contributes to a better understanding of the heterogeneity in mental health disparities for LGB people

Benefits of Bullying? A Test of the Evolutionary Hypothesis in Three Cohorts

Recent work on bullying perpetration includes the hypothesis that bullying carries an evolutionary advantage for perpetrators in terms of health and reproductive success. We tested this hypothesis in the National Child Development Study (n = 4998 male, n = 4831 female), British Cohort Study 1970 (n = 4261 male, n = 4432 female), and TRacking Adolescents’ Individual Lives Survey (n = 486 male, n = 521 female), where bullying was assessed in adolescence (NCDS, BCS70: age 16, TRAILS: age 14) and outcomes in adulthood. Partial support for the evolutionary hypothesis was found as bullies had more children in NCDS and engaged in sexual intercourse earlier in TRAILS. In contrast, bullies reported worse health in NCDS and BCS70

Peers and Homophobic Attitudes in Adolescence:Examining Selection and Influence Processes in Friendships and Antipathies

Homophobic attitudes and behavior are a widespread problem among adolescents, but what the role of peer relationships such as friendships and antipathies is in shaping these attitudes remains unclear. Therefore, this study examined to what extent homophobic attitudes are influenced by friends' and foes' homophobic attitudes, and whether homophobic attitudes serve as a selection criterion for the formation of friendships and antipathies. Participants came from three Dutch high schools across two waves (wave 1 November 2014, wave 2 March/April 2015, ages 11-20, N = 1935, 51.5% girls). Stochastic actor-oriented models were estimated for testing hypotheses. The results showed that adolescents adjusted their homophobic attitudes to their friends' homophobic attitudes, but homophobic attitudes were not consistently related to friendship selection. Further, findings indicated that being dissimilar in homophobic attitudes increased the likelihood to dislike cross-sex peers. Together, the findings suggest that adolescents' homophobic attitudes were to some extent subject to peer influence, but homophobic attitudes did not steer who adolescents befriended or disliked

Explaining Health Disparities between Heterosexual and LGB Adolescents by Integrating the Minority Stress and Psychological Mediation Frameworks:Findings from the TRAILS Study

Lesbian, gay, and bisexual (LGB) adolescents experience elevated levels of internalizing problems and use more substances than heterosexual adolescents. The minority stress and psychological mediation framework are complementary theoretical frameworks that were developed to explain these disparities. However, limited empirical research has integrated both frameworks to study health disparities between heterosexual and LGB adolescents. This study attempts such an integration, using data from the first five waves (participant age 11–22) of the TRacking Adolescents’ Individual Lives Survey (TRAILS), a cohort study of Dutch adolescents (N = 1738; 151 LGB; 54.8% girls). It was tested whether an LGB identity was linked to internalizing problems and substance use through a serial mediation process, in which sexual identity would be associated with peer victimization and negative relationships with parents (first set of mediators, in keeping with the minority stress framework), which in turn would be associated with fear of negative social evaluation and a lack of social support (second set of mediators, in keeping with the psychological mediation framework), and eventually increasing the risk for internalizing problems and elevated levels of substance use. Moreover, it was tested whether the link between minority stress and substance use was mediated by peers’ substance use levels, as hypothesized by the psychological mediation framework. Compared to heterosexual participants, LGB participants reported more internalizing problems, smoked more cigarettes, and used more marijuana, but did not consume more alcohol. The relation between sexual identity and internalizing problems was mediated by peer victimization and parental rejection, which is in line with the minority stress framework. No statistically significant support was found for the psychological mediation framework. These findings provide a better understanding of the pathways through which sexual identity disparities in mental wellbeing and substance use come about