Substance use and mental health disparities among sexual minority girls: results from the Pittsburgh girls study

PurposeTo examine substance use and mental health disparities between sexual minority girls and heterosexual girls.MethodsData from the Pittsburgh Girls Study were analyzed. All girls were 17 years old. Girls were included if they were not missing self-reported sexual orientation and mental health data (N = 527). Thirty-one girls (6%) endorsed same-sex romantic orientation/identity or current same-sex attraction. Bivariate analyses were conducted to test group differences in the prevalence of substance use and suicidal behavior, and group differences in depression, anxiety, borderline personality disorder (BPD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms.ResultsCompared with heterosexual girls, sexual minority girls reported higher past-year rates of cigarette, alcohol, and heavy alcohol use, higher rates of suicidal ideation and self-harm, and higher average depression, anxiety, BPD, ODD, and CD symptoms.ConclusionsSexual minority girls are an underrepresented group in the health disparities literature, and compared with heterosexual girls, they are at higher risk for mental health problems, most likely because of minority stress experiences such as discrimination and victimization. The disparities found in this report highlight the importance of discussing sexual orientation as part of a comprehensive preventive care visit.     

Dating Violence in Adolescence: Implications for Girls’ Sexual Health

Adolescents in the United States are too often involved in relationships characterized by coercion and violence. An emerging body of research suggests that dating violence is linked with other health risks in adolescent relationships, particularly sexual risk behavior. The confluence of risks conferred by dating violence and sexual risk behavior are particularly acute for adolescent girls. Adolescent gynecology providers need to understand the nature of dating violence in adolescence and the ways in which dating violence and sexual risk behavior are mutually influential. This article reviews the literature on the links between dating violence and sexual risk in adolescent girls’ relationships. The prevalence, risk factors, and consequences of dating violence in adolescence are discussed, followed by a review of the research linking dating violence and sexual risk, with a focus on common mechanisms underlying these relationship risk behaviors. The review concludes with implications for screening, prevention, intervention, and future directions for research.     

Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population?

IntroductionSexual minority individuals have a higher risk of anxiety and depression compared with heterosexuals. However, whether the higher risk is spread equally across the sexual minority population is not clear.AimTo investigate the association between sexual orientation and self-reported current anxiety and a history of diagnosis of depression, paying particular attention to possible subgroup differences in risks within the sexual minority population, stratified by sex and to examine participants' history of medical care for anxiety disorders and depression.MethodsWe conducted a population-based study of 874 lesbians and gays, 841 bisexuals, and 67,980 heterosexuals recruited in 2010 in Stockholm County. Data were obtained from self-administered surveys that were linked to nationwide registers.Main Outcome MeasuresBy using logistic regression, we compared risks of current anxiety, histories of diagnosed depression, and register-based medical care for anxiety and/or depression in lesbian and gay, bisexual, and heterosexual individuals.ResultsBisexual women and gay men were more likely to report anxiety compared with their heterosexual peers. Bisexual individuals and gay men also were more likely to report a past diagnosis of depression. All sexual minority groups had an increased risk of having used medical care for anxiety and depression compared with heterosexuals, with bisexual women having the highest risk.ConclusionBisexual women appear to be a particularly vulnerable sexual minority group. Advocating for non-discrimination and protections for lesbian, gay, and bisexual people is a logical extension of the effort to lower the prevalence of mental illness.Björkenstam C, Björkenstam E, Andersson G, et al. Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population? J Sex Med 2017;14:396–403.     

Are the Predictors of Sexual Violence the Same as Those of Nonsexual Violence? A Gender Analysis

IntroductionViolence manifests itself in such multifarious ways as sexual, physical, and psychological abuse. What has hitherto eluded the medical community, however, is whether sexual and nonsexual abuse share the same predictors.AimDrawing upon a representative sample of married men and women in the Iranian capital, Tehran, we aimed to determine: (i) the overlap between sexual abuse and physical and psychological violence, and (ii) the predictors that sexual violence victimization share with physical and psychological violence victimization.Main Outcome MeasuresVictimization through any type of sexual coercion by the husband in the context of the current marital relationship, as determined via the conflict tactic scales-revised (CTS-2).MethodsIn a cross-sectional survey in Tehran in 2007, 460 married Iranian men and women were selected via a multicluster sampling method from four different randomized regions. Independent variables comprised sociodemographic characteristics, subscores of psychological, and personality characteristics known to be allied with intimate abuse (personal and relationship profile), and dichotomus data on victimization history through all types of violence by the spouse including psychological aggression, physical assault, and sexual coercion (CTS-2).ResultsIn both genders, the experience of physical or psychological violence increased the likelihood of sexual violence victimization. In both genders, higher conflict was a predictor of sexual and psychological violence victimization. In addition, the common predictors of sexual and physical violence victimization were low self-control and high violent socialization in the men and women, respectively.ConclusionsSexual violence victimization shares some factors with the victimization of nonsexual types of marital abuse, but this seems to be partially gender dependent. Mohammadkhani P, Forouzan AS, Khooshabi KS, Assari S, and Moghani Lankarani M. Are the predictors of sexual violence the same as those of nonsexual violence? A gender analysis. J Sex Med 2009;6:2215–2223.     

Sexting and Young Adolescents: Associations with Sexual Abuse and Intimate Partner Violence

Study ObjectiveTo explore whether sexting by young adolescent girls and boys is associated with adverse life experiences including exploitative or violent sexual relationships.Design and SettingCross-sectional, anonymous survey of a convenience sample of minor adolescents younger than age 18 years recruited while waiting for care in clinics affiliated with a children's hospital in a low-resource, high-poverty, urban community.ParticipantsFive hundred fifty-five adolescents aged 14-17 years, 63% girls and 37% boys.Main Outcome MeasuresWe measured sexting by asking, “Have you ever sent a sexually suggestive or naked picture of yourself to another person through text or e-mail?” The survey also measured risk behaviors, sexual abuse, intimate partner violence (IPV), and arrest and included a validated depression scale.ResultsMean age was 15.6 ± 1.1 years; 59% were Hispanic, 28% were black; 44% of girls and 46% of boys ever had sex; 24% of girls and 20% of boys ever sent a sext. More girls than boys reported sexual abuse (16% vs 3%; P < .01), IPV victimization (15% vs 7%; P < .01), and depression (33% vs 17%; P < .01). More boys than girls reported arrest (15% vs 7%; P < .01). Independent associations with sexting for girls were: ever had sex (odds ratio [OR], 4.59; 95% confidence interval [CI], 2.29-9.19; P < .001); sexual abuse (OR, 3.81; 95% CI, 1.80-8.05; P < .001); IPV victim (OR, 2.72; 95% CI, 1.11-6.62; P < .05), and for boys: ever had sex (OR, 4.26; 95% CI, 1.47-12.32; P < .01); sexual abuse (OR, 38.48; 95% CI, 1.48-999.46; P < .05); IPV perpetration (OR, 16.73; 95% CI, 1.64-170.75; 95% CI, P < .05), as well as cannabis use, older age, other race, and arrest.ConclusionFor young adolescents, sexting is independently associated with exploitative and abusive sexual relationships including sexual abuse and IPV with similarities and differences in predictors of sexting for girls and boys.     

A Review of the Health Effects of Sexual Assault on African American Women and Adolescents

ObjectiveTo review the research findings for mental and physical health outcomes and health behaviors of African American women and adolescents after sexual assault.Data SourcesSearches of the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO, and PubMed from January 2001 through May 2012 using the terms Blacks, African Americans, sexual abuse, sexual offenses, and rape.Study SelectionCriteria for inclusion included (a) results of primary research conducted in the United States and published in English, (b) African American females age 13 and older, (c) sexual assault or sexual abuse reported as distinct from other types of abuse, and (d) health status as an outcome variable. Twenty‐one publications met inclusion criteria.Data ExtractionArticles were reviewed for the mental and physical health and health behavior outcomes associated with sexual assault of African American women and adolescents.Data SynthesisSexual assault was associated with increased risk of poor mental and physical health outcomes in the general population of women and adolescents. There was an increased risk of unhealthy behaviors (e.g., drinking, drug use, risky sexual behaviors) for all women and adolescents, with the highest risk reported for African American women and adolescents. Help seeking from family and friends demonstrated conflicting results. Cumulative effects of repeated assaults appear to worsen health outcomes.ConclusionSexual assault has significant effects on the physical and mental health and health behaviors of women and adolescents in the general population. Less evidence is available for differences among African American women and adolescents. More research is needed to understand the influence of race on women's and adolescents’ responses to assault.     

Racial/Ethnic Disparities in Female Sexual Health from Adolescence to Young Adulthood: How Adolescent Characteristics Matter?

Study ObjectiveTo describe sexual initiation patterns in female adolescents and examine their association with adolescent characteristics and racial disparities in adverse sexual health across adolescence into early adulthood.DesignA prospective, longitudinal, observational study from adolescence to adulthood.SettingNationally representative, the National Longitudinal Study of Adolescent to Adult Health data, in the range of 24-32 years old at final assessment.ParticipantsData from 43,577 US women from 1994 to 2008.Interventions and Main Outcome MeasuresAdolescent sex-related characteristics at the individual-, family-, and school peer-level were assessed, and multiple sex partners, sexually transmitted infections (STIs)/HIV, and intimate partner violence (IPV) were longitudinally tracked. The sexual initiation pattern and its longitudinal association with sexual health were analyzed using latent class analysis and mixed effects Poisson regression models.ResultsOf the 43,577 subjects, the sexual initiation patterns were determined as normative (n = 28,712, 65.9%), late (n = 10,799, 24.8%), and early but unempowered (n = 4,066, 9.3%). The highest rate of the early-unempowered group was shown in Hispanic individuals (1,054/7,307 = 14.4%); they were more likely to be depressed, unsatisfied with their bodies, receiving welfare, and have less educated/permissive parents to their sexual initiation than others. The late group had a higher body mass index and greater satisfaction with their bodies. The highest number of STIs/HIV and IPV victimization was shown in non-Hispanic Black (NHB) and Hispanic individuals, respectively. However, NHB females’ higher number of STIs/HIV was shown in the late/normative groups, not in the early-unempowered group. Among Hispanic females, adolescent sexual initiation patterns were not directly associated with their frequent IPV victimization.ConclusionNHB females' higher STI/HIV in late/normative groups and Hispanic females’ frequent IPV victimization regardless of their sexual initiation patterns might indicate that racial/ethnic disparities in female sexual health was not directly determined by adolescent risk behaviors.     

Dating conflicts: rethinking dating violence and youth conflict

Dating couples are tied to each other's friends who have expectations about dating, such as who constitutes an acceptable date and how to balance friendship and dating. We explore the place of friends in dating conflicts (i.e., conflicts and violence associated with heterosexual teen dating) and ask: (a) How are friends implicated in teen dating/violence not only as targets or confidants, but also as participants in conflict that stems from their friends' relationships, and (b) in what ways do dating conflicts conserve or challenge the power of gender and sexual conformity that underlies heterosexual dating and dating violence?     

Consequences of teen dating violence: understanding intervening variables in ecological context

Increasing attention has been given to the problem of teen dating violence with more research needed on mediating and moderating factors in the relationship between victimization and negative consequences. This article explores mental health and educational consequences of physical and sexual abuse by peers in a convenience sample of adolescents. Dating violence was associated with higher levels of depression, suicidal thoughts, and poorer educational outcomes. The use of alcohol and depression complicated the relationship between victimization and outcomes. Sex differences in patterns of perceived social support as a moderator were also examined with more significant effects for girls.     

Increased Body Mass Index Associated with Increased Risky Sexual Behaviors

Study ObjectiveThe increasing prevalence of adolescent obesity has led to consideration of the potential effect of obesity on risky sexual behaviors. In the current study we examined whether body mass index (BMI) was related to age at sexual debut, type of sexual behavior, partner number, and condom use in a population of adolescent women at high risk for obesity and risky sexual behaviors.Design, Setting, and ParticipantsCross-sectional examination of 860 sexually active, predominantly minority, adolescent women who received medical care at an urban health center from 2007 through 2013.Intervention and Main Outcome MeasuresSelf-reported age at sexual debut, types of sexual intercourse, number of partners and condom use was compared with clinically assessed BMI.ResultsBMI was positively associated with number of sexual partners (P = .001) and history of attempted anal intercourse (P = .002). An inverse association was observed with age at first anal intercourse (P = .040).ConclusionIn this sample of adolescent women, increased BMI was associated with riskier sexual practices at a younger age. Results of this study suggest that overweight and obese adolescents are a vulnerable population who might need targeted sexual health counseling.     

A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual,Cisgender Adolescents’ Pornography Use Characteristics

BackgroundThe ease of access to pornography has made its use common among adolescents. Although sexual and gender minority (SGM) (eg, gay, transgender) adolescents may be more prone to use pornography owing to sexual orientation–related information seeking and/or scarcity of potential romantic or sexual partners, relatively little attention has been paid to their pornography use and to the quantitative examination of the similarities and differences between heterosexual, cisgender (HC) and SGM adolescents’ pornography use characteristics.AimThe aim of the present study was to compare SGM and HC adolescents’ pornography use considering potential sex differences.MethodsWe used a sample of 2,846 adolescents (52.5% girls; M_age = 14.5 years, SD = 0.6), which was collected as part of an ongoing longitudinal study on adolescents’ sexual health. Data were analyzed with 5 groups: HC boys; HC girls; SGM boys; SGM girls; and SGM non-binary individuals.OutcomesAdolescents completed a self-report questionnaire about sexual and gender minority status and pornography use (ie, lifetime use, age at first exposure, and frequency of use in the past 3 months.)ResultsResults indicated significant differences between all groups: 88.2% of HC boys, 78.2% of SGM boys, 54.2% of SGM girls, 39.4% of HC girls, and 29.4% of SGM non-binary individuals reported having ever viewed pornography by the age of 14 years. SGM girls indicated a significantly younger age at first pornography use than HC girls, but this difference was not significant among boys. SGM boys reported the highest (median: many times per week), whereas HC girls reported the lowest (median: less than once a month) frequency of pornography use.Clinical TranslationResults suggest that SGM and HC boys' pornography use characteristics are rather similar, whereas SGM and HC girls’ pornography use patterns may be considered different presumably because of the varying underlying motivations (eg, using pornography to confirm sexual orientation).Strengths & LimitationsSelf-report measures and cross-sectional designs have potential biases that should be considered. However, the present study involved a large sample of adolescents including SGM adolescents, a population group that is understudied.ConclusionApproximately two-thirds of teenagers had gained their first experience with pornography in the present sample, and 52.2% reported using it once a week or more often in the past 3 months, indicating that pornography use may play an important role in both HC and SGM adolescents’ sexual development. Gender-based differences concerning pornography use seem to be robust regardless of SGM status.Bőthe B, Vaillancourt-Morel, MP, Girouard A, et al. A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual, Cisgender Adolescents’ Pornography Use Characteristics. J Sex Med 2020;17:1156–1167.     

The Sexual Functioning Profile of a Nonforensic Sample of Individuals Reporting Sexual Aggression Against Women

IntroductionSexual offenders are believed to present marked sexual difficulties. However, most of the studies characterizing sex offenders' sexual functioning were conducted with samples of documented/incarcerated sexual aggressors. At the present state of the knowledge there is limited information on the sexual functioning profile of individuals reporting some form of sexual violence but who were not documented/apprehended by the judicial system.AimThe aim of this preliminary study was to characterize a sample of community sexual aggressors (college students) according to their sexual functioning. Results were expected to add information about the relationship between sexual functioning and sexual violence, and to impact strategies aimed at preventing sexual aggression on college campus.MethodsOne hundred sixty‐one male college students participated in a cross‐sectional study. Students were recruited at a Portuguese university using nonrandom methods. Among these students, 35 reported sexual aggression against women. The measures were completed individually and anonymously.Main Outcome MeasuresParticipants completed a modified version of the International Index of Erectile Function, the Sexual Inhibition and Sexual Excitation Scales, the Sexual Self‐Consciousness Scale, the Questionnaire of Cognitive Schema Activation in Sexual Context, and the Sexual‐Esteem Scale.ResultsResults indicated that students reporting sexual aggression against women presented significantly more erectile and orgasmic difficulties, and more sexual inhibition due to the threat of performance failure than the control peers. Additionally, students reporting sexual aggression presented more sexual embarrassment, and more schemas of undesirability and incompetence.ConclusionsResults pointed toward a possible relationship between sexual violence as reported by college students and sexual performance anxiety. These findings are expected to impact conceptual models on sexual aggression perpetrated by nonforensic individuals. Carvalho J, Quinta‐Gomes A, and Nobre PJ. The sexual functioning profile of a nonforensic sample of individuals reporting sexual aggression against women. J Sex Med 2013;10:1744–1754.     

“Macho” Beliefs Moderate the Association Between Negative Sexual Episodes and Activation of Incompetence Schemas in Sexual Context,in Gay and Heterosexual Men

BackgroundDespite the existence of conceptual models of sexual dysfunction based on cognitive theory, few studies have tested the role of vulnerability factors such as sexual beliefs as moderators of the activation of cognitive schemas in response to negative sexual events.AimTo test the moderator role of dysfunctional sexual beliefs in the association between the frequency of negative sexual episodes and the activation of incompetence schemas in gay and heterosexual men.MethodsFive-hundred seventy-five men (287 gay, 288 heterosexual) who completed an online survey on cognitive-affective dimensions and sexual functioning were selected from a larger database. Hierarchical regression analyses were conducted to test the hypothesis that dysfunctional sexual beliefs moderate the association between the frequency of unsuccessful sexual episodes and the activation of incompetence schemas.OutcomeParticipants completed the Sexual Dysfunctional Beliefs Questionnaire and the Questionnaire of Cognitive Schemas Activated in Sexual Context.ResultsFindings indicated that men's ability for always being ready for sex, to satisfy the partner, and to maintain an erection until ending sexual activity constitute “macho” beliefs that moderate the activation of incompetence schemas when unsuccessful sexual events occur in gay and heterosexual men. In addition, activation of incompetence schemas in response to negative sexual events in gay men was moderated by the endorsement of conservative attitudes toward moderate sexuality.Clinical ImplicationsThe main findings suggested that psychological interventions targeting dysfunctional sexual beliefs could help de-catastrophize the consequences of negative sexual events and facilitate sexual functioning.Strengths and LimitationsDespite being a web-based study, it represents the first attempt to test the moderator role of dysfunctional sexual beliefs in the association between the frequency of unsuccessful sexual episodes and the activation of incompetence schemas in gay and heterosexual men.ConclusionOverall, findings support the role of sexual beliefs as facilitators of the activation of incompetence schemas in the face of negative sexual events in gay and heterosexual men, emphasizing the need to develop treatment and prevention strategies aimed at challenging common male beliefs about sexuality.Peixoto MM, Nobre P. “Macho” Beliefs Moderate the Association Between Negative Sexual Episodes and Activation of Incompetence Schemas in Sexual Context, in Gay and Heterosexual Men. J Sex Med 2017;14:518–525.     

Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation

BackgroundWhile preliminary research suggests non-heterosexual men and women view more pornography than their heterosexual counterparts, few studies have examined how problematic use differs across sexual and gender identity groups.AimWe sought to test measurement invariance across popular measures of problematic pornography use (PPU) and examine mean PPU differences across heterosexual men, non-heterosexual men, heterosexual women, and non-heterosexual women.MethodsWe used 3 large archival datasets to examine psychometrics/group differences on the Brief Pornography Screen (BPS; N = 1,439), Problematic Pornography Use Scale (PPUS; N = 5,859), and Cyber Pornography Use Inventory-4 (CPUI-4; N = 893).OutcomesMost PPU scales/subscales demonstrated acceptable fit, and non-heterosexual men and women tended to report more PPU than heterosexual men and women (though exceptions were evident).ResultsConfirmatory factor analyses revealed good fit across each group and instrument, with exception to sexual minority women on the CPUI-4. Each instrument demonstrated at least metric invariance between groups, with exception to one item between heterosexual and sexual minority men on the CPUI-4. Mean differences suggested that sexual minority men and women tend to report more PPU than heterosexual men and women, though several exceptions were evident depending on the PPU dimension. Men tended to report more PPU than women, though exceptions were also evident. Effect sizes ranged from large-to-non-significant depending on PPU dimension.Clinical ImplicationsResearchers and clinicians should consider sexual orientation, gender, and PPU dimension when addressing PPU concerns.Strengths & LimitationsA primary strength of this study is the use of multiple large samples, meaning our results are likely highly generalizable. However, this study is limited in that it only examined sexual orientation groups broadly and did not account for non-cisgender identities.ConclusionsThe BPS, PPUS, and CPUI-4 are all appropriate tools to measure PPU depending on researcher and clinician needs.Borgogna NC, Griffin KR, Grubbs JB, and Kraus SW. Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation. J Sex Med 2022;19:1290–1302.     

Lifetime Sexual Behavior of Psychiatric Inpatients

IntroductionSexual life of psychiatric patients, including risk behaviors related to sexually transmitted diseases, remains a poorly studied area, especially in those with severe mental illnesses.AimsTo assess some aspects of lifetime sexual behavior of psychiatric inpatients.MethodsPatients consecutively admitted to a psychiatric unit in a general hospital were interviewed about partner-related lifetime sexual behavior.Main Outcome MeasuresA semi-structured interview developed by the authors was used to collect information concerning their general sexual experience throughout life, homosexual and heterosexual relations, and relations with partners who were intravenous drug users (IVDU), HIV carriers or suffering from AIDS, and with sex workers. In each of these areas, time elapsed since last sexual contact; number of partners in previous year, frequency of these relations and condom use were investigated.ResultsFive hundred forty-six patients (306 men and 240 women) were assessed, and 87.7% of them reported sexual relations at some point during their life. Of these, 90% reported heterosexual and 10% homosexual or bisexual sexual contacts. Further, 11.06% had had at least one partner who was an IVDU; 8.1% an HIV-positive partner, and 32.4% (50% of the men) had paid for sex. Overall 49.79% of the total sample reported never using condoms in their sexual relations, with similar percentages for those with HIV-positive (46%) and IVDU (47%) partners. Of those who paid for sex, 29% never used condoms.ConclusionsPsychiatric patients admitted to a general hospital psychiatric unit have sexual experience close to the general population, with a higher percentage of homosexual contacts and lower rates of condom use, even in higher risk situations, such as men having sex with men, and partners who are HIV-positive or IVDUs. This information obliges clinicians to systematically explore the sexual behavior of psychiatric patients, evaluate risk behaviors, and adopt measures to promote safe sex practices in this population. Gonzalez-Torres MA, Salazar MA, Inchausti L, Ibañez B, Pastor J, Gonzalez G, Carvajal MJ, Fernandez-Rivas A, Madrazo A, Ruiz E, and Basterreche E. Lifetime sexual behavior of psychiatric inpatients.     

Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States

BackgroundSexual minority (lesbian, bisexual, mostly heterosexual) young women face many sexual and reproductive health disparities, but there is scant information on their experiences of chronic pelvic pain, including an absence of information on prevalence, treatment, and outcomes.AimThe purpose of this study was to describe the characteristics of chronic pelvic pain experiences of young women by sexual orientation identity and gender of sexual partners.MethodsThe analytical sample consisted of a nationwide sample of 6,150 U.S. young women (mean age = 23 years) from the Growing Up Today Study who completed cross-sectional questionnaires from 1996 to 2007.OutcomesAge-adjusted regression analyses were used to examine groups categorized by sexual orientation identity (completely heterosexual [ref.], mostly heterosexual, bisexual, lesbian) and gender of sexual partner (only men [ref.], no partners, both men, and women). We examined differences in lifetime and past-year chronic pelvic pain symptoms, diagnosis, treatment, and quality of life outcomes. Sensitivity analyses also examined the role of pelvic/gynecologic exam history and hormonal contraceptive use as potential effect modifiers.ResultsAround half of all women reported ever experiencing chronic pelvic pain, among whom nearly 90% had past-year chronic pelvic pain. Compared to completely heterosexual women, there was greater risk of lifetime chronic pelvic pain among mostly heterosexual (risk ratio [RR] = 1.30, 95% confidence interval [CI]: 1.22–1.38), bisexual (RR = 1.30, 95% CI: 1.10–1.52), and lesbian (RR = 1.23, 95% CI: 1.00–1.52) young women. Additionally, compared to young women with only past male sexual partners, young women who had both men and women as past sexual partners were more likely to report chronic pelvic pain interfered with their social activities (b = 0.63, 95% CI: 0.25–1.02), work/school (b = 0.55, 95% CI: 0.17–0.93), and sex (b = 0.53, 95% CI: 0.05–1.00).Clinical ImplicationsHealthcare providers, medical education, and field-wide standards of care should be attentive to the way sexual orientation-based healthcare disparities can manifest into differential prognosis and quality of life outcomes for women with chronic pelvic pain (particularly bisexual women).Strengths & LimitationsOur study is the first to examine a variety of chronic pelvic pain outcomes in a nationwide U.S. sample across different outcomes (ie, past-year and lifetime). Though limited by sample homogeneity in terms of age, race, ethnicity, and gender, findings from this article provide foundational insights about chronic pelvic pain experiences of sexual minority young women.ConclusionOur key finding is that sexual minority women were commonly affected by chronic pelvic pain, and bisexual women face pain-related quality of life disparities.Tabaac AR, Chwa C, Sutter ME, et al. Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. J Sex Med 2022;19:1012–1023.     

Similarity and Differences in Sexual Violence Against Adolescents and Adult Women: The Need to Focus on Adolescent Victims

Study ObjectiveTo explore whether there are differences in characteristics, clinical findings and management in cases of sexual violence in adolescent and adult women.DesignRetrospective study.SettingSVSeD–Service for Sexual and Domestic Violence, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.ParticipantsFemale victims of sexual violence aged 10 years and older. Two study groups were analysed: an adolescent group and an adult group.InterventionsNone; this was an observational study.Main Outcome MeasuresCharacteristics of the perpetrator, time spent between the episode of sexual violence and the access to SVSeD, presence of genital and/or extragenital injuries; tests for sexually transmitted diseases, spermatozoa research; and toxicological screening;ResultsAdolescent victims of sexual violence requested help later than the adult victims. The majority of the perpetrators were well known to the victims in both groups. In both groups, we observed genital injuries in 1 of 3 patients. We found a strong association between the presence of genital injuries and a positive screening test for sexually transmitted diseases, in particular with regard to the adolescent victims.ConclusionAdolescents’ delayed disclosure of sexual violence may affect the ability to properly manage these crimes. Prevention programs and public awareness campaigns should be implemented to highlight the importance of a prompt disclosure after sexual assault has occurred. Gynecologists should be made increasingly aware of this delicate issue, to better assist victims of sexual violence, especially adolescent victims.