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The Longitudinal Associations Between Outness and Health Outcomes Among Gay/Lesbian Versus Bisexual Emerging Adults

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Abstract

Sexual minorities are at increased risk for substance use and mental health problems. Although previous studies have examined the associations between outness and health outcomes, few have used longitudinal designs or examined differences across subgroups of sexual minorities. To address these gaps, the current study examined sexual orientation and gender as moderators of the longitudinal associations between outness and substance use (cigarettes, marijuana, illicit drugs, and alcohol) and mental health (depression and anxiety). Data were from a sample of 169 sexual minority emerging adults (98 women and 71 men) who provided self-report data at four times over 3.5 years. Results indicated that sexual orientation moderated the within-person associations between outness and changes in health. For bisexual individuals, being more out was associated with increases in marijuana use, illicit drug use, and depression. In contrast, for gay/lesbian individuals, being more out was associated with decreases in illicit drug use and it was not significantly associated with changes in marijuana use or depression. Additionally, outness was not significantly associated with changes in cigarette use, alcohol use, or anxiety for gay/lesbian or bisexual individuals, and gender did not moderate any of the associations. In sum, being more open about one’s sexual orientation had negative consequences for bisexual individuals but not for gay/lesbian individuals. Professionals who work with sexual minorities need to be aware of the potential risks of being open about one’s sexual orientation for bisexual individuals. Interventions are needed to facilitate disclosure decisions and to promote the health of sexual minorities.

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Notes

  1. First, alcohol and marijuana use values were Winsorized at 3 SD above the mean, but outliers remained. Therefore, we Winsorized the top 5% of values instead of Winsorizing at 3 SD to reduce the influence of outliers.

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Funding

This research was supported by grants from the National Institute of Mental Health (R21MH095413; PI: Mustanski), the National Institute on Drug Abuse (U01DA036939; PI: Mustanski), the National Institute on Child and Human Development (R01HD089170; PI: Whitton), the American Foundation for Suicide Prevention (PI: Mustanski), the William T. Grant Foundation Scholars Award (PI: Mustanski), and the David Bohnett Foundation (PI: Mustanski). Brian A. Feinstein’s time was also supported by a grant from the National Institute on Drug Abuse (F32DA042708; PI: Feinstein). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

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  1. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave., #14-047, Chicago, IL, 60611, USA

    Brian A. Feinstein, Dennis H. Li, Michael E. Newcomb & Brian Mustanski

  2. Department of Psychology, University of Cincinnati, Cincinnati, OH, USA

    Christina Dyar & Sarah W. Whitton

  3. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Dennis H. Li, Michael E. Newcomb & Brian Mustanski

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Feinstein, B.A., Dyar, C., Li, D.H. et al. The Longitudinal Associations Between Outness and Health Outcomes Among Gay/Lesbian Versus Bisexual Emerging Adults. Arch Sex Behav 48, 1111–1126 (2019). https://doi.org/10.1007/s10508-018-1221-8

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