Mishra Aura Ankita, Yanz Ainsley, Schwab-Reese Laura M, Halpern Carolyn T, Harris Kathleen Mullan
Department of Psychology, North Carolina State University, Raleigh, North Carolina.
Department of Psychology, North Carolina State University, Raleigh, North Carolina.
Am J Prev Med. 2025 Aug;69(2):107650. doi: 10.1016/j.amepre.2025.107650. Epub 2025 May 8.
Sexual minority individuals experience higher rates of victimization and chronic physical health conditions. There are also known differences by gender in both victimization rates and victimization-linked chronic physical health conditions. However, few studies have examined gender differences regarding the association between sexual minority identity and chronic physical health conditions through cumulative life-course victimization, cumulative childhood victimization, and cumulative adult victimization.
This research uses a nationally representative dataset-the National Longitudinal Study of Adolescent to Adult Health (data collected from 1994 to 2018)-to examine (1) cumulative violence victimization across the life course and (2) the relative importance of violence victimization in childhood and adulthood as pathways between sexual minority identity and chronic physical health conditions while estimating differences by gender. Data processing and analysis were conducted between August 2021 and December 2024.
Women who identified as mostly heterosexual and bisexual were more likely to experience chronic physical health disparities through indirect associations through victimization accumulation across the life course and violence victimization both in childhood and adulthood. Among lesbian women, there was an indirect association between sexual orientation and chronic physical health conditions through cumulative life-course victimization and childhood victimization.
Findings demonstrate that for women who identify as mostly heterosexual and bisexual, victimization-related chronic physical health vulnerabilities may manifest even before midlife, and both childhood and adult exposures are critical for physical health disparities in these groups. In contrast, childhood victimization maybe a more pervasive factor for chronic physical health conditions among lesbian women.
性少数群体遭受侵害的比率更高，且患有慢性身体健康问题。在遭受侵害的比率以及与侵害相关的慢性身体健康问题方面，性别差异也为人所知。然而，很少有研究通过累积生命历程侵害、累积童年期侵害和累积成年期侵害，来考察性少数群体身份与慢性身体健康问题之间关联的性别差异。
本研究使用一个具有全国代表性的数据集——青少年到成人健康全国纵向研究（1994年至2018年收集的数据）——来考察：（1）生命历程中的累积暴力侵害；（2）童年期和成年期暴力侵害作为性少数群体身份与慢性身体健康问题之间路径的相对重要性，同时评估性别差异。数据处理和分析于2021年8月至2024年12月进行。
自我认同为主要异性恋和双性恋的女性，更有可能通过生命历程中的侵害累积以及童年期和成年期的暴力侵害所产生的间接关联，经历慢性身体健康差异。在女同性恋女性中，性取向与慢性身体健康问题之间存在通过累积生命历程侵害和童年期侵害产生的间接关联。
研究结果表明，对于自我认同为主要异性恋和双性恋的女性，与侵害相关的慢性身体健康脆弱性可能在中年之前就已显现，童年期和成年期遭受的侵害对这些群体的身体健康差异都至关重要。相比之下，童年期侵害可能是女同性恋女性慢性身体健康问题中一个更普遍的因素。
