Sexual orientation health inequality: Evidence from Understanding Society , the UK Longitudinal Household Study

Few studies from the United Kingdom have fully investigated inequalities between members of different sexual minority groups and heterosexuals over range of health outcomes. Using data from over 40,000 individuals, this study explores the health inequalities of sexual minority UK adults. We include respondents who identify as other and those who prefer not to say (PNS). Data come from wave three (2011–2012) of the nationally-representative Understanding Society, the UK Household Longitudinal Study. Sexual orientation was asked in the self-completion portion of the study. Markers of health include physical and mental functioning, minor psychological distress, self-rated health, substance use and disability. Multiple linear and logistic regression analyses tested for differences in markers of health between sexual orientation groups. Overall, heterosexual respondents had the best health while bisexual respondents had the worst. Gay and lesbian respondents reported poorer health than heterosexuals, specifically with regards to mental functioning, distress and illness status. The other and PNS respondents were most similar to each other and generally experienced fewer health inequalities than gay and lesbian respondents; they were less likely to use tobacco or alcohol. In sum, sexual minorities experience health inequality. The inclusion of other and PNS respondents has not been done in other studies and shows that while they may be healthier than gay/lesbian and bisexual respondents they still experiences poorer health than heterosexuals. Health promotion interventions are needed for these other and PNS individuals, who might not participate in interventions targeted toward known sexual minority groups

Multisensory signalling enhances pupil dilation.

Detecting and integrating information across the senses is an advantageous mechanism to efficiently respond to the environment. In this study, a simple auditory-visual detection task was employed to test whether pupil dilation, generally associated with successful target detection, could be used as a reliable measure for studying multisensory integration processing in humans. We recorded reaction times and pupil dilation in response to a series of visual and auditory stimuli, which were presented either alone or in combination. The results indicated faster reaction times and larger pupil diameter to the presentation of combined auditory and visual stimuli than the same stimuli when presented in isolation. Moreover, the responses to the multisensory condition exceeded the linear summation of the responses obtained in each unimodal condition. Importantly, faster reaction times corresponded to larger pupil dilation, suggesting that also the latter can be a reliable measure of multisensory processes. This study will serve as a foundation for the investigation of auditory-visual integration in populations where simple reaction times cannot be collected, such as developmental and clinical populations

Sexual arousal and masculinity-femininity of women.

Studies with volunteers in sexual arousal experiments suggest that women are, on average, physiologically sexually aroused to both male and female sexual stimuli. Lesbians are the exception because they tend to be more aroused to their preferred sex than the other sex, a pattern typically seen in men. A separate research line suggests that lesbians are, on average, more masculine than straight women in their nonsexual behaviors and characteristics. Hence, a common influence could affect the expression of male-typical sexual and nonsexual traits in some women. By integrating these research programs, we tested the hypothesis that male-typical sexual arousal of lesbians relates to their nonsexual masculinity. Moreover, the most masculine-behaving lesbians, in particular, could show the most male-typical sexual responses. Across combined data, Study 1 examined these patterns in women’s genital arousal and self-reports of masculine and feminine behaviors. Study 2 examined these patterns with another measure of sexual arousal, pupil dilation to sexual stimuli, and with observer-rated masculinity-femininity in addition to self-reported masculinity-femininity. Although both studies confirmed that lesbians were more male-typical in their sexual arousal and nonsexual characteristics, on average, there were no indications that these 2 patterns were in any way connected. Thus, women’s sexual responses and nonsexual traits might be masculinized by independent factors

Bisexual Men with Bisexual and Monosexual Genital Arousal Patterns

Some research suggests that bisexual-identified men show bisexual genital arousal, whereas other research indicates monosexual arousal: they are aroused to one sex only. These seemingly contradictory findings may be due to the type of men identifying as bisexual and the performed analyses. We examined whether both bisexual and monosexual arousal patterns could co-occur within the same sample. 114 men of different sexual orientations viewed erotic videos of males or females while their penile circumference was measured. On average, bisexual-identified men were more aroused to males than females, and especially if they identified as “bisexual leaning gay.” However, also on average, bisexual men showed bisexual arousal, and especially if they were “bisexual leaning straight”. Furthermore, there was more variability in the arousal patterns of bisexual-identified men, compared with other men. Based on their physiological sexual arousal, bisexual men appear to be a more diverse group than men who identified as heterosexual or homosexual

The relationship between finger length ratio, masculinity, and sexual orientation in women: A correlational study.

Homosexual women are, on average, more masculine in their appearance and behavior than heterosexual women. We hypothesized that their masculinity was influenced by exposure to elevated levels of prenatal androgen during early development. We recruited 199 women (including 67 homosexual women) and measured their masculinity via self-report and observer ratings. Our measure of prenatal androgen exposure was the ratio of the index to ring finger (2D:4D), which is hypothesized to be lower in women exposed to elevated levels of androgens during prenatal development. Homosexual women were substantially more masculine than heterosexual women in both self-report and observer ratings. However, homosexual women neither had more male-typical finger length ratios, nor did their finger length ratios relate to their masculinity in any predicted direction. Thus, we found no evidence that increased prenatal androgen exposure influenced masculinity in homosexual women

Stability and change in sexual orientation and genital arousal over time

These studies, however, may be susceptible to the bias of self-report. The current study therefore examined self-reported sexual orientation in addition to an objective correlate: genital arousal to erotic videos showing males or females. For 52 men (19 heterosexual, 19 bisexual, 14 homosexual) and 67 women (31 heterosexual, 18 bisexual, 18 homosexual), these measures were taken twice, with approximately one year between sessions. For self-reported sexual orientation, women reported lower relative stability (weaker correlation) than men over time, even though women did not change more overall (no stronger mean difference) than men between sessions. Bisexual individuals reported lower relative stability and more mean change than heterosexual and homosexual individuals. For genital arousal, across all groups, response patterns were correlated over time to a similar extent and showed little difference between sessions. Moreover, change in self-reported sexual orientation did not correspond with the change in genital arousal, regardless of sex. Perhaps self-reports overestimate changes in sexual orientation, since these changes were not reflected in physiological sexual response

Familiality of Gender Nonconformity Among Homosexual Men.

We examined whether recalled childhood gender nonconformity and self-reported adult gender nonconformity is familial, using data from 1154 families selected for having at least two homosexual brothers. Specifically, we examined the extent to which homosexual men's variation in gender nonconformity runs in families by examining pairs of genetic brothers who were both homosexual (N = 672-697 full sibling concordant pairs). We also examined similarity between homosexual and heterosexual brothers (N = 79-82 full sibling discordant pairs). Consistent with past studies, concordant pairs yielded modest positive correlations consistent with moderate genetic and/or familial environmental effects on gender nonconformity. Unlike results of smaller past studies, discordant pairs also yielded modest positive, though nonsignificant, correlations. Our results support the feasibility of supplementing genetic studies of male sexual orientation with analyses of gender nonconformity variation

Sexual arousal: the correspondence of eyes and genitals.

Men's, more than women's, sexual responses may include a coordination of several physiological indices in order to build their sexual arousal to relevant targets. Here, for the first time, genital arousal and pupil dilation to sexual stimuli were simultaneously assessed. These measures corresponded more strongly with each other, subjective sexual arousal, and self-reported sexual orientation in men than women. Bisexual arousal is more prevalent in women than men. We therefore predicted that if bisexual-identified men show bisexual arousal, the correspondence of their arousal indices would be more female-typical, thus weaker, than for other men. Homosexual women show more male-typical arousal than other women; hence, their correspondence of arousal indices should be stronger than for other women. Findings, albeit weak in effect, supported these predictions. Thus, if sex-specific patterns are reversed within one sex, they might affect more than one aspect of sexual arousal. Because pupillary responses reflected sexual orientation similar to genital responses, they offer a less invasive alternative for the measurement of sexual arousal

Gender Nonconformity of Bisexual Men and Women

The degree to which bisexual-identified individuals are distinct from either heterosexual or homosexual individuals in their sexual orientation is an ongoing debate. We examined potential differences between these groups with respect to a strong correlate of sexual orientation, gender nonconformity (femininity in males, masculinity in females). Across pooled data, we compared self-reports of childhood gender nonconformity (n = 919) and adulthood gender nonconformity (n = 1265) and observer ratings of adulthood gender nonconformity (n = 915) between sexual orientations. Most analyses suggested a steady increase in gender nonconformity from exclusively heterosexual to exclusively homosexual. However, in some analyses, bisexual men were closer to homosexual men than to heterosexual men in their gender nonconformity. The intermediate status of bisexual people in gender nonconformity was not due to the sample having a mixture of very gender-conforming and very gender-nonconforming individuals. In total, men and women with bisexual orientations appeared neither like heterosexual nor homosexual individuals, at least with respect to their gender-related traits

Robust evidence for bisexual orientation among men

The question whether some men have a bisexual orientation—that is, whether they are substantially sexually aroused and attracted to both sexes—has remained controversial among both scientists and laypersons. Skeptics believe that male sexual orientation can only be homosexual or heterosexual, and that bisexual identification reflects nonsexual concerns, such as a desire to deemphasize homosexuality. Although most bisexual-identified men report that they are attracted to both men and women, self-report data cannot refute these claims. Patterns of physiological (genital) arousal to male and female erotic stimuli can provide compelling evidence for male sexual orientation. (In contrast, most women provide similar physiological responses to male and female stimuli.) We investigated whether men who self-report bisexual feelings tend to produce bisexual arousal patterns. Prior studies of this issue have been small, used potentially invalid statistical tests, and produced inconsistent findings. We combined nearly all previously published data (from eight previous studies in the United States, United Kingdom, and Canada), yielding a sample of 474 to 588 men (depending on analysis). All participants were cisgender males. Highly robust results showed that bisexual-identified men’s genital and subjective arousal patterns were more bisexual than were those who identified as exclusively heterosexual or homosexual. These findings support the view that male sexual orientation contains a range, from heterosexuality, to bisexuality, to homosexuality