Disparities in Child Abuse Victimization in Lesbian, Bisexual, and Heterosexual Women in the Nurses' Health Study II

Abstract

A growing body of research documents multiple health disparities by sexual orientation among women, yet little is known about the possible causes of these disparities. One underlying factor may be heightened risk for abuse victimization in childhood in lesbian and bisexual women. Using survey data from 63,028 women participating in the Nurses' Health Study II, we investigated sexual orientation group differences in emotional, physical, and sexual abuse in childhood and adolescence. Multivariable log-binomial and linear regression models were used to examine orientation group differences in prevalence and severity of abuse, with heterosexual as the referent and controlling for sociodemographics. Results showed strong evidence of elevated frequency, severity, and persistence of abuse experienced by lesbian and bisexual women. Comparing physical abuse victimization occurring in both childhood and adolescence, lesbian (30%; prevalence ratio [PR] 1.61; 95% confidence interval [CI] 1.40, 1.84) and bisexual (24%; PR 1.26; 95% CI 1.00, 1.60) women were more likely to report victimization than were heterosexual women (19%). Similarly, comparing sexual abuse victimization occurring in both age periods, lesbian (19%; PR 2.16; 95% CI 1.80, 2.60) and bisexual (20%; PR 2.29; 95% CI 1.76, 2.98) women were more likely to report victimization than were heterosexual women (9%). This study documents prevalent and persistent abuse disproportionately experienced by lesbian and bisexual women.

Sexual and Reproductive Health Indicators and Intimate Partner Violence Victimization Among Female Family Planning Clinic Patients Who Have Sex with Women and Men

“…One potential explanation is that sexual minority status may compromise economic stability, increasing women's likelihood of sex trade. Studies have also found that sexual minority women are more likely to have experienced adverse childhood experiences (e.g., childhood sexual abuse), 33,34 which are associated with sex trade. 35 Despite these potential hypotheses, causal mechanisms underpinning this finding are unclear.…”

Explaining mental health disparities for non-monosexual women: Abuse history and risky sex, or the burdens of non-disclosure?

“…This approach has not previously been used in research. Traditionally, in diverse types of studies, mostly heterosexual and mostly lesbian women have been placed into heterosexual or lesbian categories, respectively, comparing those two groups to bisexual women (Austin et al, 2007;Chivers et al, 2007;Kerr et al, 2013;King et al, 2008;McLaughlin et al, 2012).…”

“…Further, a meta-analysis investigating the link between female childhood sexual abuse and adult revictimization found that studies which used more inclusive definitions of childhood abuse yielded smaller effect sizes than studies with narrower definitions (Roodman and Clum, 2001). Further, it is possible that childhood abuse was not found to interact with mental health because the childhood abuse rates reported by the lesbian women may have been more similar to those reported by the non-monosexual than the heterosexual women (Austin et al, 2007). If the lesbian women included did in fact experience similar levels of childhood abuse as the nonmonosexual women, this could imply that our mediation analyses may have been compromised due to the previously documented link between childhood abuse, risky sex, and mental health.…”

“…Some studies have explored the association between childhood adversity, sexual orientation, and mental health (Alvy et al, 2013;Austin et al, 2007Austin et al, , 2008; Drabble et al, 2013;Hequembourg et al, 2013;Lehavot et al, 2012;Rothman et al, 2011;Schneeberger et al, 2014). A metaanalysis demonstrated that bisexual females report higher prevalence for both sexual and parental physical abuse compared to lesbian and heterosexual females (Friedman et al, 2011).…”

An Ecological Framework for Sexual Minority Women’s Health: Factors Associated With Greater Body Mass

“…In one study, lesbians with a BMI greater than 30 reported higher rates of lifetime sexual abuse (64%) than heterosexual women with similar BMIs (44%; Lehavot, Molina, & Simoni, 2012). Since several studies have found higher reports of childhood abuse, both sexual and other forms, among lesbian and bisexual women (Aaron & Hughes, 2007;Alvy, Hughes, Kristjanson, & Wilsnack, 2013;Austin et al, 2008;Balsam et al, 2005;Corliss et al, 2002;Stoddard et al, 2009;Wilsnack, Kristjanson, Hughes & Benson, 2012), this may be an important factor in the higher weight of sexual minority women. Some researchers have found child and adolescent abuse experiences to be linked to anti-gay beliefs of the perpetrators, particularly in women who are gender non-conforming (Alanko et al, 2009;D'Augelli et al, 2006).…”