in a community sample of 193 self-identified white, black, and Latino gay and bisexual men and found that 33 percent of the sample had experienced childhood physical abuse, and 34 percent had experienced childhood sexual abuse. They also found that childhood sexual abuse was a predictor of subclinical or full-syndrome eating disorders. Little is known about racial and ethnic variation in the prevalence of childhood sexual abuse, but a recent study of 669 LGB men and women found that black and Latino participants reported the highest rates of childhood sexual abuse, while Latinos and Asian Americans reported the highest rates of childhood physical abuse (Balsam et al., 2010). In a nonprobability sample of 181 transgender seminar participants in Minnesota, 23 percent of participants reported childhood sexual abuse and 38 percent childhood physical abuse (Bockting et al., 2005b).

Protective Factors

Although research on protective factors is sparse, small studies suggest the possibility of a few factors that may be protective, all of which require more research. For example, one protective factor may be living and/or working in supportive environments. Hatzenbuehler and colleagues (2010) examined the psychological impact on sexual minorities of living in states with constitutional amendments banning marriage among same-sex couples and found a statistically significant increase in the rates of generalized anxiety disorder and mood and alcohol use disorders among LGB participants over a 3-year period. Sexual minorities who lived in states that did not have such amendments showed no significant increases in psychiatric morbidities. Similarly, a national study of lesbians, gay men, and bisexual people explored the antecedents affecting the degree to which they disclosed their LGB identities in the workplace. The authors found that employees had less fear of disclosing and disclosed more often when they worked in a group that seemed supportive and shared their stigma (Ragins et al., 2007). An earlier study that focused on workplace discrimination found that organizational policies and practices were strongly associated with perceived discrimination (Ragins and Cornwell, 2001).

Support from family and friends may be another protective factor. A study found that perceived social support for romantic relationships predicted greater relationship well-being and, in turn, more positive mental and physical health outcomes; this was true for both same-sex and mixed-sex partners (Blair and Holmberg, 2008). In surveying 340 self-identified gay men aged 18–78, illoughby and colleagues (2008) found that social networks of adult gay men may play important roles in both the promotion and prevention of health risk. Similarly, in a study of 106 self-identified Latino lesbians and gay men aged 20–53, social support, active coping, and



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