OBJECTIVE Sexual minority disparities in behavioral health (e.g., mental health and substance use) are well-established. However, sexual identity is dynamic, and changes are common across the life course (e.g., identifying with a monosexual [lesbian or gay] label and later with a plurisexual [queer, pansexual, etc.] label). This study assessed whether behavioral health risks coincide with sexual identity change among sexual minority people. METHODS Associations in a 3-year U.S. national probability sample of sexual minority adults were assessed between sexual minority identity change (consistently monosexual [N=400; 44.3% weighted], consistently plurisexual [N=239; 46.7% weighted], monosexual to plurisexual [N=19; 4.2% weighted], and plurisexual to monosexual [N=25; 4.8% weighted]) and five behavioral health indicators (psychological distress, social well-being, number of poor mental health days in the past month, problematic alcohol use, and problematic use of other drugs), controlling for demographic characteristics and baseline behavioral health. RESULTS Among female participants, monosexual-to-plurisexual identity change (vs. consistently monosexual identity) was associated with greater psychological distress (B=3.41, SE=1.13), lower social well-being (B=-0.61, SE=0.25), and more days of poor mental health in the past month (B=0.69 [Bexp=1.99], SE=0.23). Among male participants, plurisexual-to-monosexual identity change (vs. consistently plurisexual identity) was associated with lower social well-being (B=-0.56, SE=0.25), and identity change (regardless of type) was generally associated with increased problematic use of alcohol and other drugs. CONCLUSIONS Sexual identity change is an important consideration for sexual minority behavioral health research, with changes (vs. consistency) in identity being an important risk factor for compromised behavioral health. Prevention and treatment interventions may need to tailor messaging to sexual minority men and women differently.

中文翻译：

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美国全国性少数成年人概率样本中的性别认同连续性和变化：与心理健康和问题药物使用的关联。


目标 行为健康（例如心理健康和物质使用）方面的性少数群体差异是显而易见的。然而，性别认同是动态的，并且在整个生命过程中变化很常见（例如，用单性恋[女同性恋或男同性恋]标签来识别，然后用多性恋[酷儿、泛性恋等]标签来识别）。这项研究评估了性少数人群的行为健康风险是否与性别认同的变化相一致。方法 对美国性少数成年人全国性概率样本进行 3 年评估，评估性少数身份变化（一贯单性恋 [N=400；44.3% 加权]、一贯多性恋 [N=239；46.7% 加权]、单性恋到多性恋之间的关联） [N=19；4.2% 加权]，以及多性恋到单性恋 [N=25；4.8% 加权]）和五项行为健康指标（心理困扰、社会福祉、过去一个月心理健康状况不佳的天数、有问题的情况）酒精使用和其他药物的问题使用），控制人口特征和基线行为健康。结果在女性参与者中，从单性恋到多性恋身份的转变（与一贯的单性恋身份相比）与更大的心理困扰（B = 3.41，SE = 1.13）和较低的社会幸福感（B = -0.61，SE = 0.25）相关，以及过去一个月心理健康状况不佳的天数（B=0.69 [Bexp=1.99]，SE=0.23）。在男性参与者中，多性向单性身份的改变（相对于一贯的多性身份）与较低的社会幸福感相关（B = -0.56，SE = 0.25），而身份改变（无论类型如何）通常与增加的社会幸福感相关。有问题地使用酒精和其他药物。 结论 性身份的改变是性少数群体行为健康研究的一个重要考虑因素，身份的改变（与一致性）是行为健康受损的重要风险因素。预防和治疗干预措施可能需要以不同的方式向性少数男性和女性传达信息。