Ela Elizabeth J, Budnick Jamie
Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48106-1248, USA.
Demography. 2017 Jun;54(3):887-909. doi: 10.1007/s13524-017-0578-y.
Non-heterosexual young women have a higher rate of unintended pregnancy than their heterosexual peers, but their fertility behaviors are understudied. We use longitudinal data from the Relationship Dynamics and Social Life study to investigate mechanisms contributing to non-heterosexual women's higher pregnancy risk. These data include weekly reports of relationships, sex, and contraceptive use over 30 months. We compare the relationships and fertility behaviors of three groups: exclusively heterosexual (consistent heterosexual behavior, identity, and attraction); mostly heterosexual (heterosexual identity with same-sex behavior and/or same-sex attraction); and LGBTQ (any non-heterosexual identity). We find that mostly heterosexual and LGBTQ women behave differently from exclusively heterosexual women in ways likely to elevate their risk of unintended pregnancy: more distinct partners during the study period, more sexual intercourse with men, less frequent contraceptive use, less use of a dual method (condom plus hormonal method), and more gaps in contraceptive coverage. Mostly heterosexual women resemble LGBTQ women in their contraceptive behavior but have significantly more intercourse with men, which may increase their pregnancy risk relative to both LGBTQ and exclusively heterosexual women. We conclude by considering implications for LGBTQ health and the measurement of sexual minority populations.
非异性恋年轻女性意外怀孕的比率高于其异性恋同龄人,但对她们的生育行为研究不足。我们利用“关系动态与社会生活研究”中的纵向数据,来探究导致非异性恋女性怀孕风险较高的机制。这些数据包括30个月内关于恋爱关系、性行为和避孕措施使用情况的每周报告。我们比较了三组人群的恋爱关系和生育行为:完全异性恋(始终保持异性性行为、认同异性身份且只被异性吸引);大多为异性恋(认同异性身份,但有同性性行为和/或同性吸引);以及女同性恋、男同性恋、双性恋、跨性别者(任何非异性恋身份)。我们发现,大多为异性恋和女同性恋、男同性恋、双性恋、跨性别者身份的女性在一些可能会提高其意外怀孕风险的方面,与完全异性恋的女性表现不同:在研究期间有更多不同的伴侣,与男性发生性行为的频率更高,避孕措施使用频率更低,较少使用双重避孕法(避孕套加激素避孕法),以及避孕措施覆盖方面存在更多空白期。大多为异性恋的女性在避孕行为上与女同性恋、男同性恋、双性恋、跨性别者身份的女性相似,但与男性发生性行为的频率显著更高,这可能使其相对于女同性恋、男同性恋、双性恋、跨性别者身份的女性和完全异性恋的女性而言,怀孕风险更高。我们最后考虑了对女同性恋、男同性恋、双性恋、跨性别者健康以及性少数群体测量的影响。