Military service experiences and reasons for service separation among lesbian, gay, and bisexual individuals in a large military cohort.

The well-being of lesbian, gay, and bisexual (LGB) individuals is a topic of increasing concern within the military where significant institutional barriers, targeted aggression, and differential organizational policies such as "Don't Ask Don't Tell" have historically contributed to experiences of exclusion and discrimination. However, limited research has examined specific military and post-separation experiences among LGB service members and veterans. The goal of this study was to examine differences in military and service separation experiences by sexual orientation among a large representative sample of United States service members and veterans. Survey data from the 2016 Millennium Cohort Study follow-up questionnaire were used to assess sexual orientation and multiple outcomes of interest: military experiences (morale, feelings about the military, missed workdays) and service separation experiences (reasons for separation, post-separation employment). The associations between sexual orientation (LGB versus heterosexual) and each of these outcomes were evaluated in a series of adjusted logistic regression models, stratified by sex when interactions were observed. Of the 99,599 participants, 3.4% identified as LGB. In adjusted models, LGB service members had significantly higher odds than heterosexual service members of feeling: unimpressed by the quality of unit leadership, unsupported by the military, and negative about the military overall. Bisexual women were more likely than heterosexual women to feel less unit camaraderie; both gay and bisexual men felt less camaraderie than heterosexual men. LGB veterans were more likely than heterosexual peers of the same sex to separate from service due to unplanned administrative reasons. Compared to heterosexual women, lesbian and bisexual women were more likely to separate from service due to dissatisfaction with promotions/pay and disability/medical reasons, while bisexual women specifically separated due to dissatisfaction with leadership and incompatibility with the military. Gay and bisexual men also reported separating due to incompatibility with the military, but only bisexual men were more likely to report separating due to disability/medical reasons compared to heterosexual men. Less positive military- and separation-specific experiences disproportionately affected LGB service members in this study. Promoting inclusion and increasing support for LGB service members may improve satisfaction with military service and retention.

Carey FR ，Jacobson IG ，Lehavot K ，LeardMann CA ，Kolaja CA ，Stander VA ，Rull RP ... -  《BMC PUBLIC HEALTH》

Health Disparities Among Lesbian, Gay, and Bisexual Service Members and Veterans.

This study investigated whether health disparities exist among lesbian, gay, and bisexual individuals serving in the U.S. military by examining the associations of sexual orientation with mental, physical, and behavioral health among a population-based sample of service members and veterans. Sexual orientation and health outcomes were self-reported on the 2016 Millennium Cohort Study follow-up questionnaire (N=96,930). Health outcomes were assessed across 3 domains: mental health (post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger), physical health (multiple somatic symptoms, physical functioning, BMI), and behavioral health (smoking, problem and risky drinking, insomnia). Adjusted logistic regression models conducted between 2019 and 2022 estimated the associations between sexual orientation and each health outcome. Lesbian, gay, and bisexual individuals (3.6% of the sample) were more likely to screen positive for post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger, multiple somatic symptoms, and insomnia than heterosexual individuals. Gay/lesbian and bisexual women reported more adverse health outcomes (overweight and obesity, smoking, problem/risky drinking) than heterosexual women. Gay and bisexual men reported some adverse health outcomes (e.g., smoking and problem drinking) but better physical health (e.g., less overweight/obesity) than heterosexual men. Lesbian, gay, and bisexual service members reported poorer mental, physical, and behavioral health than heterosexual peers, most notably among gay/lesbian women and bisexual individuals. Findings suggest that lesbian, gay, and bisexual service members experience health disparities, despite many having equal eligibility for health care, highlighting the need for improved equity initiatives that promote cultural responsiveness, acceptance, and approaches to support the healthcare needs of lesbian, gay, and bisexual military members.

Carey FR ，LeardMann CA ，Lehavot K ，Jacobson IG ，Kolaja CA ，Stander VA ，Rull RP ，Millennium Cohort Study Team ... -  《-》

Gender Nonconformity and Minority Stress Among Lesbian, Gay, and Bisexual Individuals: A Meta-Analytic Review.

Thoma BC ，Eckstrand KL ，Montano GT ，Rezeppa TL ，Marshal MP ... -  《-》

Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States: Results From the National Health Interview Survey.

Gonzales G ，Przedworski J ，Henning-Smith C 《-》

Prevalence of self-reported cancer based on sexual orientation in the United States: a comparative analysis between lesbian, bisexual, gay, and heterosexual individuals.

Our study aimed to compare the prevalence and likelihood of self-reported (SR) cancer diagnosis between lesbian, gay, and bisexual (LGB) groups and the heterosexual population in the United States between 2017 and 2021. This study analyzed data from the National Health Interview Survey (NHIS) 2017-2021, which included 134,372 heterosexual and 4576 LGB individuals aged 18 and above. The prevalence of any SR cancer and some selected cancers were calculated for the LGB and compared with heterosexual adults. Sexual orientation was used to predict SR cancer diagnosis for each sex using multiple logistic regression, adjusting for other sociodemographic determinants. The unadjusted prevalence of any SR cancer among the LGB population was 9.0%. Lesbian and Bisexual women had higher prevalence of SR cancer of the cervix, uterus, ovary, thyroid, bone, skin melanoma, leukemia, and other blood cancers than Heterosexual women. Gay and Bisexual men had a higher prevalence of SR cancer of the bladder, kidney, skin (non-melanoma, and other kinds), bone, lymphoma, and leukemia than Heterosexual men. After adjusting for other socio-demographic factors, gay men were 1.73 (CI 1.14-2.63, p = 0.01) times more likely than heterosexual men to be diagnosed with cancer, while lesbian women were 2.26 (CI 1.24-4.16, p = 0.009) times more likely to be diagnosed with cancer than heterosexual women. Some sexual minority subgroups are more likely to be diagnosed with cancer than their heterosexual counterparts. As a result, more research and SM-specific intervention efforts should focus on cancer risk assessment, screening, prevention, treatment, and survivorship in SM populations.

Tundealao S ，Sajja A ，Titiloye T ，Egab I ，Odole I ... -  《-》