The study aims to describe inadequate, disrespectful, and abusive palliative and hospice care received by lesbian, gay, and bisexual (LGB) patients and their spouses/partners due to their sexual orientation or gender identity.

A national sample of 865 healthcare professionals recruited from palliative and hospice care professional organizations completed an online survey. Respondents were asked to describe their observations of inadequate, disrespectful, or abusive care to LGB patients and their spouses/partners.

There were 15.6% who reported observing disrespectful care to LGB patients, 7.3% observed inadequate care, and 1.6% observed abusive care; 43% reported discriminatory care toward the spouses/partners. Disrespectful care to LGB patients included insensitive and judgmental attitudes and behaviors, gossip and ridicule, and disrespect of the spouse/partner. Inadequate care included denial of care; care that was delayed incomplete, or rushed; dismissive or antagonistic treatment; privacy and confidentiality violations; and dismissive treatment of the spouse/partner.

These findings provide evidence of discrimination faced by LGB patients and partners while receiving care for serious illness. Hospice and palliative care programs should promote respectful, inclusive, and affirming care for the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, including policies and practices that are welcoming and supportive to both employees and patients. Staff at all levels should be trained to create safe and respectful environments for LGBTQ patients and their families.

Sexual orientation is known to have some influence in alcohol consumption patterns and outcomes. Sexual minority women (SMW) are more likely to develop binge drinking and alcohol use disorder than heterossexual women. Because women tend to be more secretive with their drinking and hesitant to get help, and alcohol is particularly harmful to the female body, SMW pose particular challenges.

Review the latest research on alcoholism in SMW, focusing on various specificities of this population.

Literature review in the PubMed database, using the MESH terms “alcohol use disorder”, “women”, “female”, “trans woman”, “adult”. Free full text, publication in the last 5 years, English or Portuguese and article typology filters were applied. Following primary hits, secondary references were checked and a total of 10 articles were included. Results were grouped in epidemiological, etiological, therapeutical and prognostic specificities.

Data indicate that lesbian and bisexual women, compared to heterosexuals, are twice as likely to engage in binge drinking. AUD prevalence and patterns of alcohol use are especially higher among younger SMW. The influence of sexual orientation on alcohol use and related outcomes seems to be greater among women than men. Regarding etiology, internalized stigma, minority stress, victimization experiences, social norms and policies are the main culprits Even though SMW are more likely to report and ask hor help, many do not receive adequate treatment. SMW show an incresed risk of developing other complications, such as physical injuries, sexual assault, liver or cardiac disease.

Sexual minority women are particularly vulnerable to alcohol-related harms. Interventions especially directed to SMW need to be developed.

No significant relationships.

Data suggest poorer bereavement outcomes for lesbian, gay and bisexual people, but this has not been estimated in population-based research. This study compared bereavement outcomes for partners of same-gender and different-gender decedents.

In this population-based, cross-sectional survey of people bereaved of a civil partner or spouse 6–10 months previously, we used adjusted logistic and linear regression to investigate outcomes of interest: (1) positive screen on Inventory of Complicated Grief (ICG), (2) positive screen on General Health Questionnaire (GHQ), (3) grief intensity (ICG) and (4) psychiatric symptoms (GHQ-12).

Among 233 same-gender partners and 329 of different-gender partners, 66.1% [95% confidence interval (CI) 60.0–72.2] and 59.2% [95% CI (53.9–64.6)] respectively screened positive for complicated grief on the ICG, whilst 76.0% [95% CI (70.5–81.5)] and 69.3% [95% CI (64.3–74.3)] respectively screened positive on the GHQ-12. Same-gender bereaved partners were not significantly more likely to screen positive for complicated grief than different-gender partners [adjusted odds ratio (aOR) 1.56, 95% CI (0.98–2.47)], p = 0.059, but same-gender bereaved partners were significantly more likely to screen for psychiatric caseness [aOR 1.67 (1.02, 2.71) p = 0.043]. We similarly found no significant association of partner gender with grief intensity [B = 1.86, 95% CI (−0.91to 4.63), p = 0.188], but significantly greater psychological distress for same-gender partners [B = 1.54, 95% CI (−0.69–2.40), p < 0.001].

Same-gender bereaved partners report significantly more psychological distress. In view of their poorer sub-clinical mental health, clinical and bereavement services should refine screening processes to identify those at risk of poor mental health outcomes.

The context of stigma, in which many homosexuals live, exposes them to discrimination/stigmatization and promotes the internalization of negative attitudes about sexuality. Battle feelings of rejection and isolation may lead to the development of internalized homophobia (IH).

To elucidate the risk factors of IH and how the latter affects mental health.

Literature review (PubMed).

IH has been associated with lower levels of emotional stability, rejection sensitivity, impairments in emotion regulation and a tendency to turn against the self. Studies have connected IH to depression, poor self/relationship wellbeing, sexual discrimination, addictions, shame, body dissatisfaction, suicidal ideation, binge eating/drinking, partner violence and victimization. Higher levels of attachment anxiety and avoidance, outness, religiosity and internalized stigma were correlated with higher IH levels. The key factors relating to suicide include lack of acceptance by family and/or self, negative feelings about sexuality/gender and appearance dissatisfaction. In traditional/religious societies, heterosexual orientation is a strong norm and homosexuality is considered unacceptable leading LGBT individuals to report higher depressive symptoms and increased levels of IH. Due to heterosexist ideals, IH is a predictor for heterosexual marital intention, protests against LGBT and use of masculinity as a compensatory strategy.

Policies in support of individuals who have recently come out should be improved to reduce the development/effects of IH and take the social and sexual environments of rural gay men into account considering ways to increase service accessibility (e.g internet). Future research is needed to further understand the association between IH and mental health, social and cognitive mechanisms.

This is a quasi-experimental and pioneering study in Portugal.

(1) to provide assessment materials for symptoms of internalized homophobia, depression, and anxiety targeted at LGBT people; (2) offer support materials for psychotherapeutic work-oriented in the areas of internalized homonegativity, depression, and anxiety; and (3) offer monitoring measures throughout the program to demonstrate changes. It consists of three phases (pre-program evaluation, therapeutic activities and post-program evaluation).

38 LGBT + individuals participated, average age was 34.15 years, 30 self-identified as male. Measures used for the pre and post-intervention assessment were the sociodemographic questionnaire, the LGBT identity questionnaire, the Rosenberg self-esteem scale, and the BSI-18. Participants were invited to join the program online, through a platform created for this purpose, where ethical aspects were clarified, namely: confidentiality and commitment to adherence. Therapeutic tasks were sent by email or WhatsApp depending on the preference of each participant.

Relevant differences in internalized homophobia, depressive, and anxious symptoms between the pre and post-intervention moments were observed, indicating that the program is effective in changing these symptoms.

The importance of validating this type of program allows reaching “hidden” populations by offering online support that minimizes the effects of sexual stigma on LGBT + populations.

People with mental disorders who had same-sex experience (SSE) are at increased risk of self-injurious behavior probably due to the double stigma phenomenon, which severity varies in different societies. So far, there is a knowledge gap on factors associated with SSE in Russian psychiatric patients.

We aimed to investigate variables associated with homosexual experience in Russian patients with non-psychotic mental disorders (NPMD) and suicidal ideation (SI).

In a case-control study (1:1.5): 92 female patients with NPMD and SI with lifetime SSE were compared with 138 patients without homosexual experience. All patients underwent a psychiatric examination, Self-Injurious Thoughts and Behaviors Interview (Nock MK, 2007) and semi-structured interview to assess demographic, clinical, and behavioral features. Mann-Whitney, Fishers exact test and Pearson’s chi-squared were used as statistical methods.

Groups did not differ in education level, marital status, family history of suicidal behavior, traumatic events exposure and lifetime eating disorders (all:p>0.05). More patients with SSE had family history of non-suicidal self-injuries (NSSI), were dissatisfied with their parenting style, had a higher number of unprotected sexual contacts with unfamiliar persons, practiced group sex, had a history of sexual abuse, illicit drug use experience, were smokers, had piercing and severe body modifications. Lifetime history of suicide plan, attempts and NSSI were significantly more common in people with SSE (all:<0.05).

A number of suicide risk factors were found to be more prevalent in people with SSE. Homosexual experience in people with mental disorders is associated with an increased risk of NSSI, suicide plan development and suicide attempts.

No significant relationships.