Table 3.
Theoretical Frameworks, Prevalence of Abuse, and Study Outcomes.
| Author | Theoretical Framework | Independent Variable | Dependent Variable | Prevalence of Abuse | Main Outcomes |
|---|---|---|---|---|---|
| Mental Health | |||||
| Andrés-Hyman et al. (2004) | None specified | Demographic variables (e.g., education) | PTSD symptoms | CSA: 100% of participants (a criteria for admission to treatment program where participants were recruited) | Asexual women recognized the least number of intrusive and total PTSD symptoms compared to heterosexual, lesbian, and bisexual subgroups. Compared to non-Latinx Caucasian women, Latinx women recognized fewer intrusive PTSD symptoms. |
| Flynn et al. (2016) | Minority stress (Meyer, 2003) | CSA, CPA, CN | Attempted suicide | CSA: SM women: 37%, heterosexual:10.3%, CPA: SM women 11.1%, heterosexual: 3.9%, CN: SM women 10.4%, heterosexual: 3.4% | For men and women, CSA mediated the relationship between LGB identity and attempted suicide. For women only, CPA also mediated this relationship. |
| Gold et al. (2011) | Emotional processing theory (Foa & Riggs, 1993; Foa & Rothbaum, 2001) | CPA | Depression, PTSD, EA, IH | Lesbian: CPA 26.2% CSA 26.2% | Compared to gay men, lesbians were significantly more likely to recognize CPA. Lesbians reporting CPA were also more likely to report lifetime sexual victimization than those who did not (chi square p < .05). Lesbian CPA survivors reported more symptoms of depression (t test p < .05), greater PTSD symptoms (t test p < .001), and greater EA (t test p < .01) than those who did not report CPA. However, lesbian CPA survivors did not differ from nonvictims on measures of IH. In lesbians, CPA was not associated with IH nor was IH found to mediate the relationship between CPA and depression or PTSD. CPA and EA predicted depression when entered individually in the regression analysis. However, when entered together, CPA no longer predicted depression, whereas EA remained significant, suggesting complete mediation. When examining PTSD, both CPA and EA predicted PTSD when entered in the regression individually and when entered together. When examining CPA through EA, the indirect effect was between 0.67 and 4.50 (95% CI), significant with p < .05. |
| Gilmore et al. (2014) | Social norms approach to drinking and self-medication hypothesis | CSA severity | Drinking norms and behavior, ASA | CSA without penetration: 16.20% CSA with penetration: 22.00% | Higher CSA severity was associated with more severe alcohol-involved adult sexual assault and with more severe physically forced adult sexual assault. Higher CSA severity had an indirect relationship with higher drinking behaviors and higher drinking norms. Higher alcohol-involved ASA severity was associated with higher drinking norms and behavior. |
| Hughes et al. (2007) | None specified | CSA, CPA, parental drinking problems, parental strictness | Lifetime alcohol abuse, psychological distress (via age at first heterosexual intercourse) | Lesbians: CSA 31%, CPA 22%, Parental drinking problems (one parent 32%, two parents 4%) | Among lesbian women, CSA had a direct relationship with alcohol abuse and CPA had a direct relationship with psychological distress. CSA had an indirect relationship with elevated risk of lifetime alcohol abuse through negative effects on age at first heterosexual intercourse. Parent-related variables (i.e., parental strictness and parental drinking problems) were directly associated with lifetime psychological distress, which was directly associated with lifetime alcohol abuse. Age of drinking onset mediated the association between parental drinking problems and lifetime alcohol abuse and lifetime psychological distress. |
| Matthews et al. (2002) | None specified | Physical violence, CSA, stress, social support, coping strategies | Depressive symptoms | CSA: lesbian: 45% heterosexual: 41 % |
Education, race, sexual identity, CSA, physical abuse, global stress, current stress, coping skills, and emotionality were associated with one or more correlates of depressive distress among lesbian and heterosexual women. Education, sexual orientation, CSA, physical abuse, and emotionality were associated with suicide attempts, while the other variables were not significantly associated. Associations between independent variables and depressive symptoms differed between lesbian and heterosexual women (i.e., different variables had significant associations based on sexual identity). Reported suicide attempts were substantially higher among lesbian than heterosexual women. |
| Morris and Balsam (2003) | None specified | CSA | Sexual revictimization and mental health | CSA: 39.3% | Of participants who reported CSA, 25.7% reported that the abuse was perpetrated by a relative and 23.7% by an acquaintance. CSA was found to predict current psychological distress. Multiple forms of victimization more strongly predicted current psychological distress. Individuals who experienced sexual abuse in childhood were also significantly more likely to report adult physical abuse and ASA. |
| Persson et al. (2015) | Mentions minority stress (Meyer, 2003) | CA, risky sexual behavior, sexual identity disclosure | depression and anxiety | CA: non-monosexual women: 33.6% Monosexual women: 15.5% |
The relationships of sexual identity with depression and anxiety were mediated by sexual orientation disclosure and risky sexual behavior: lower levels of disclosure and higher levels of risky sexual behavior were positively associated with higher depression and anxiety. CA did not moderate the relationships between sexual identity or sexual behavior with depression, anxiety, or risky sexual behavior. |
| Robohm et al. (2003) | Finkelhor and Browne (1985) CSA survivors experience “traumatic sexualization” (i.e., sexuality shaped in a confusing way) | CSA | Emotional/behavioral difficulties, feelings about one’s sexuality and coming out | CSA: 37.9% | Individuals who reported CSA also reported significantly more emotional/behavioral difficulties than those who did not report CSA. Of the individuals who reported CSA, 46.4% indicated that the experience of CSA affected their feelings about their sexuality or how they came out. |
| Zietsch et al. (2012) | Common cause (shared genetic or environmental etiology) explanations | Risky childhood family environment, CSA, CPA | Depression | Family dysfunction: SM: males: 41%, females: 42% heterosexual: males: 24%, females: 30%, CSA SM: males: 12%, females: 24%, heterosexual: males: 4.2%, females 11%, CPA SM: males: 38%, females: 40% heterosexual: males: 40%, females: 27%, | Sexual minorities had significantly higher rates of depression in the study sample. Twin pairs with one heterosexual and one sexual minority had higher rates of depression than hetero pairs. (2) CSA partially explained the correlation between sexual orientation and depression. |
| Substance use | |||||
| Drabble et al. (2013) | References minority stress theory (Meyer, 2003) in the introduction | CSA, CPA, ASA, physical abuse in adulthood, lifetime victimization | HD | CPA: only heterosexual: 18.3%, heterosexual w same sex partners: 24.5%, bisexual: 35.5%, lesbian: 31.3% CSA: only heterosexual: 10.6%, heterosexual w same sex partners: 18%, bisexual: 25.5%, lesbian:23% | Women with same-sex partners, regardless of sexual identity (i.e., lesbian, bisexual, heterosexual) reported higher rates of lifetime victimization than heterosexual women without same-sex partners. 2. SMW had higher odds of HD than only heterosexual women. Physical and sexual CV were strongly associated with HD. Odds of HD were higher among SMW; this relationship was not fully attenuated by adding demographics and victimization into the model, suggesting that victimization only partially explains elevated HD among SMW. |
| Hequembourg et al. (2013) | No a priori theory, although minority stress theory (Meyer, 2003) was used in discussion | CSA | risky alcohol use | CSA: 51.2% | 75.2% of women reported at least one day of heavy episodic drinking in the last 6 months. There was a significant relationship between adult victimization severity and bisexual identity, more severe CSA, more lifetime sex partners, and higher alcohol severity scores. Bisexual women reported more severe adult victimization, greater revictimization, riskier drinking patterns, and more lifetime male sexual partners than lesbian counterparts. |
| Hughes et al. (2010b) | References minority stress theory (Meyer, 2003) | CSA, ASA, Revictimization | HD | CSA: heterosexual 17%, mostly lesbian 42%, bisexual 40%, only lesbian 39%, mostly heterosexual 33% | Levels of HD were significantly higher among SMW (mostly heterosexual M = 1.50, bisexual M = 1.89, mostly lesbian M = 1.42, only lesbian M = 1.08) than heterosexual women (M = 0.74). Heterosexual women reported the least victimization. Of all groups, bisexual women reported the highest revictimization. HD differed by victimization history. Compared to SMW without a history of sexual trauma (M = 0.88) and those who reported one form of trauma (ASA only, M = 0.85), women with a history of adulthood revictimization reported significantly higher HD (M = 1.35). Sexual identity significantly moderated the relationship between victimization and HD (F[12,792{=1.99, p = .02}]) after controlling for demographics and age of drinking onset. Bisexual women who reported CSA alone had the highest level of HD. |
| Hughes et al. (2001) | No a priori theory, references minority stress theory (Meyer, 2003) | Sexual orientation, CSA, ASA | Lifetime alcohol abuse, CSA | Wyatt CSA: lesbian: 68%, heterosexual: 47%, Self-perceived CSA: lesbian: 37%, heterosexual: 19% | Compared to heterosexual women, lesbian women reported more childhood sexual experiences and were more likely to both meet CSA criteria and to perceive that they had experienced CSA. Among lesbian and heterosexual women, CSA was associated with lifetime alcohol abuse. |
| Hughes et al. (2010a) | References minority stress theory (Meyer, 2003) | CSA, Childhood neglect, CPA | SUDs | CSA: lesbian 34.7%, bisexual 38.8%, not sure 9.2%, heterosexual 10.3%, CPA: lesbian 11.3%, bisexual 11.1%, not sure 4.5%, heterosexual 3.8% Neglect: lesbian 12.4%, bisexual 8.7%, Not sure 7.1%, heterosexual 3.4% | Compared to heterosexual women, bisexual women were more likely to report CSA, CPA, partner violence, and non-partner violence, whereas lesbian women were only more likely to report CSA. Compared to heterosexual and unsure women, lesbian and bisexual women were twice as likely to meet criteria for any past year SUD and to report any victimization. Among lesbian women, prevalence of SUDs was higher for those reporting CPA, CN, and partner violence. Among bisexual women, SUD prevalence was higher for those reporting CSA, partner violence, and assault with a weapon. Reporting CN strengthened the association between lesbian identity and alcohol dependence. |
| Hughes et al. (2014) | Minority Stress (Meyer, 2003) | Lifetime victimization xperiences | HD, depression | CSA: 35.5%, CPA: 39.5%, Parental drinking problems: 27.2% | Number of types of victimization (of six total types) was significantly associated with HD. Each additional type of victimization reported by participants corresponded with 20% increased odds of HD. Compared to participants who did not report victimization, those who experienced CV were significantly more likely to report depression. |
| Johnson et al. (2013) | Self-medication hypothesis versus impaired functioning | Parental Drinking, CSA | HD | CSA: 32.3% | There was no significant association between CSA and age of drinking onset. At Wave 1, there was a significant association between CSA and depression. |
| McCabe et al. (2020a) | No a priori theory, minority stress theory (Meyer, 2003) used in the discussion to explain gender differences | Household dysfunction | DSM-5 Alcohol, tobacco, and other SUDs | Parental/household history of alcohol or drug problems—lesbian/Gay: 34.7%, Bisexual: 34.0%, Not sure: 37.1%, Heterosexual: 26.2% | The risk of SUDs was the same for individuals reporting one indicator of household dysfunction and those who reported multiple indicators of household dysfunction. This was somewhat moderated by sexual identity (marginal significance at p < .05). The “not sure” subgroup (SM) had the highest risk, followed by bisexuals, then gay/lesbian, then discordant heterosexual, then concordant heterosexual. SM had consistently higher ACE means and risk of comorbid disorders than heterosexual, especially concordant heterosexuals. |
| Lehavot et al. (2014) | Discussed self-medication hypothesis in the discussion | CPA, CSA, CEA, EN, and PN | Alcohol misuse | CTQ Score: Heterosexual: 1.96 (0.83), Lesbian/bisexual: 2.28 (0.93) | SMW were more likely to report CV compared to heterosexual veterans and greater severity of CV. SMW also had higher levels of alcohol misuse, greater number of depressive symptoms, and worse PTSD. Path analysis revealed that CV was associated with depressive symptoms, PTSD symptoms, and alcohol misuse. Sexual identity was indirectly associated with alcohol misuse via CT and depression, civilian physical victimization and PSTD, and military physical victimization/depression/PSTD. |
| Lehavot and Simpson (2014) | Minority stress (Meyer, 2003) | CA, ASA, military trauma or stress, adult physical victimization | PTSD and depression | CTQ Score: Heterosexual: 1.97 (0.84), Lesbian/bisexual: 2.28 (0.93) | Lesbian and bisexual women were more likely to report CV compared to heterosexual women. In logistic regression models, CT and trauma experienced during the military added the most variance to models of PTSD and depression. |
| Reisner et al. (2013) | Life course framework (Pearlin et al., 2005) | Any CA | Substance misuse | CA: lesbian: 26.2%, Bisexual: 36.2%, Other SM: 22.2%, heterosexual: 13% | Disparities in substance misuse for heterosexual vs. lesbian/bisexual women, with SMW reporting greater substance abuse. CA was significantly associated with lifetime substance abuse for all participants. However, disparities in substance misuse were attenuated by adding CA to the regression model. |
| Roberts et al. (2005) | No theory but mentioned risk factors for alcohol (e.g., lesbians may be more likely to socialize in bars) | CSA | Use and abuse of alcohol | CSA and alcoholism: 67% CSA and no alcoholism; 47% | 71% of lesbian women in the sample reported that they currently drink alcohol. 28% self-reported not being a “normal” drinker, 7% said others “complain or worry” about their drinking, 14% that they “feel bad about their drinking,” 22% that they are not “always able to stop drinking” when they want to, 3% that they have “trouble at work due to drinking”, 3% that have been “arrested for drunk driving, and 12% that they are an alcoholic. No statistical analyses performed.” |
| Sigurvinsdottir and Ullman (2016) | Minority stress (Meyer, 2003) and intersectional minority stress | CSA | Sexual assault recovery (depression and PTSD) | CSA 65.9% | Only data from bisexual and heterosexual female respondents were analyzed. Participants who experienced CSA and/or adult revictimization reported a higher number of PTSD symptoms than other participants. Looked at trajectory of PTSD recovery by sexual identity and found that black bisexual women had the highest number of PTSD symptoms. |
| Talley et al. (2016) | No a priori theory, although self-medication hypothesis mentioned in the discussion | CSA and CPA | Alcohol and other drug use and internalizing symptoms | CSA: mostly heterosexual 19%, bisexual 50%, only heterosexual 11%, mostly lesbian 11%, lesbian 20% CPA: only heterosexual 4%, mostly heterosexual 18%, bisexual 27%, mostly lesbian 0%, lesbian 4% | Compared to mostly heterosexual women, bisexual women were more likely to report CSA, whereas no other sexual identity subgroups significantly differed from mostly heterosexual women. Compared to only heterosexual women, mostly heterosexual women were more likely to report CPA. Mostly heterosexual did not differ significantly from all other sexual identity subgroups. Mostly heterosexual women were more likely to report lifetime substance abuse (e.g., tobacco, marijuana) and AUD than only heterosexual women. No regression analyses were done to examine associations between CSA, sexual identity, and AUD. |
| Wilsnack et al. (2008) | Environmental, social role, and minority stress theory (Meyer, 2003) | CSA | Drinking levels (mean ounces ethanol per day), HD | CSA: only heterosexual: 28.8%, Mostly heterosexual: 41.9%, Bisexual: 73.8%, Mostly lesbian: 57.9%, Only lesbian: 59.1% | Compared to every SMW group, heterosexual women abstained more from alcohol use and were lower in all HD indicators (e.g., heavy drinking, lifetime problem consequences, concerns about having a drinking problem, receiving help for a drinking problem, dependence). Compared to all other subgroups (e.g., heterosexual, only lesbian, mostly lesbian), bisexual women recognized more HD indicators, past year depression, and lifetime depression. Bisexual women were also most likely to report CSA. |
| Yuan et al. (2014) | No a priori theory. Proximal stressors hypothesized to explain the lack of association between CT and alcohol misuse | CT (i.e., CPA, PN, CSA, CEA) | Alcohol misuse | CSA TS women: 70.1%, TS men: 50.8%, CPA TS women: 68.4%, TS men: 62.7% PN TS women: 70.1%, TS men: 61.6%, EN-TS women: 46.2%, TS men: 34.5%, CEA TS women 71.4%, TS men 60.5% | Among two-spirit participants, women reported higher levels of all forms of abuse than men including CSA, CPA, PN, EN, and CEA. There were no significant associations between CSA and substance-related outcomes (i.e., alcohol dependence, hazardous and harmful use, binge drinking). Further, the relationship between number of ACEs and past-year binge drinking or spree drinking was not significant. |
| Physical Health | |||||
| Aaron and Hughes (2007) | None specified | CSA | BMI | CSA: 31% of total sample. Latinx women (40%), Black women (33%), White women: 26% | More Latinx women and Black women reported CSA than White women (p = .05). BMI was or >25 among 57% of the sample. Among women who reported CSA, mean BMI was significantly higher (29.4) than among women who did not (27.1, p < .01). Obesity was significantly higher among women who reported CSA (39%) versus women who did not report CSA (25%, p = .0004). Obesity and severe obesity were also significantly higher among Black (33%, 11%) and Latinx lesbians (23%, 5%) than White lesbians (15%, 7%, p < .001). Women who reported CSA had higher odds of obesity (OR = 1.9, 95% CI [1.1, 3.4]) and severe obesity (OR = 2.3, [1.1, 5.2]) when controlling for sociodemographic variables. |
| Lee et al. (2020) | Minority stress (Meyer, 2003) and Health Equity Promotion Framework (Fredriksen-Goldsen et al., 2014) | Childhood food insecurity, childhood exposure to drug abuse, CPA, CEA | Smoking | Not reported | For SGM adults (all genders combined, age 18–24) who experienced CPA, the unadjusted odds of smoking were 2.03 (CI [1.02, 4.05]) times higher than among those who did not experience CPA; there was no significant difference in odds of smoking among young SGM adults based on childhood food insecurity, substance abuse in the home, or CEA. Among adults (age 25+), there were no significant associations between any ACEs and smoking. Among bisexual adults (all genders), those who reported substance abuse in the home had 1.45 [1.01, 2.09] times higher odds of smoking than those who did not. Those who reported CPA had 1.54 [1.07, 2.24] times higher odds of smoking than those who did not. There was no significant difference in odds of smoking among bisexual adults based on food insecurity or CEA. ACEs were not associated with smoking among lesbians. |
| Smith et al. (2010) | Protective measures theory (CSA survivors maintain higher BMI to protect against sexualization) (Gustafson & Sarwer, 2004) | CSA | Obesity | Intrafamilial CSA: 16.2% heterosexual women, 29.6% lesbian women Extrafamilial CSA: 14.3% heterosexual 30.7%, lesbian women |
In the full sample, odds of obesity were 1.94 (CI [1.39, 2.72]) times higher among those who reported intrafamilial CSA and 1.46 (CI [1.04, 2.06]) times higher among those who reported extrafamilial CSA, adjusting for sexual identity and whichever form of CSA was not the independent variable being analyzed. In multiple logistic regression models, intrafamilial CSA was the only form of abuse (i.e., intrafamilial CSA, extrafamilial CSA, and ASA) significantly associated with obesity (AOR 1.58, CI [1.10, 2.27]). Having a bachelor’s degree or higher was protective against obesity for extrafamilial CSA and adult SA, whereas household income of $75,000 or higher was protective in all models. |
| Matthews et al. (2013) | None specified | CPA | Current smoking, age of smoking onset, health status | CPA 21.5% of SMW | There were no significant associations between sexual identity with CPA, health status, age of smoking onset, or current smoking. 25% were current smokers, mean age of smoking onset was 19–20, and mean perceived health was fair to good. CPA was significantly indirectly associated with self-reported health status, mediated by age of smoking onset and current smoking status. |
| Sweet and Welles (2012) | None specified | CSA | HIV/STI risk | CSA: bisexual 43.5%, lesbian 38.1%, heterosexual w/same-sex partners: 28%, heterosexual w/same-sex attraction but no partners: 17%, heterosexual w/no same-sex attraction or partners: 14.2% | Compared to heterosexual women with no same-sex attraction or partners, bisexual women had 5.3 times the odds of sometimes/frequent CSA, lesbians had 3.4 times the odds, heterosexual women with same-sex partners had 2.9 times the odds, and heterosexual women with same-sex attraction but not same-sex partners had 1.6 times the odds of reporting CSA. Among SMW, those who reported CSA “almost never” were 7.1 times as likely and those who reported CSA sometimes/frequently were 3.8 times as likely to have an HIV or STI diagnosis in the past 12 months compared to SMW who reported no CSA. |
| Caceres et al. (2019) | Minority stress (Meyer, 2003) and Traumatic Stress Model of Cardiovascular Disease (Dedert et al., 2010) | CA, adult trauma, lifetime trauma | Psychosocial and behavioral risk factors, self-reported cardiometabolic risk) | 1 type: 40.2%, 2 types: 33.3%, 3 types: 6.8% | Compared to white SMW, SMW of color reported higher CT rates. Compared to SMW aged 18 to 30, SMW aged 41 to 75 reported higher rates of CT. SMW who completed graduate school were less likely to report CT than those with less education. There were significant associations between all forms of trauma and probable PTSD diagnosis and lower perceived social support. All forms of trauma were significantly associated with depression. CT was significantly associated with higher odds of past-3-month overeating. When controlling for demographics and psychosocial and behavioral risk factors, there remained a significant association between CT and diabetes. |
| Wright (2018) | Minority stress (Meyer, 2003) | CSA | Attitudes toward obesity and BMI | CSA: 37.6% | 35.3% had BMI ≥ 30, with a mean BMI of 28.9 (SD: 8.47) with mean attitude scores showing high acceptance of obese people. There were no significant associations between CSA and attitudes toward obesity or between BMI and attitudes toward obesity, although there was a negative association between CSA and BMI (i.e., SMW who reported CSA had lower BMI). Neither BMI nor CSA predicted attitudes toward obesity, nor was there an interaction between BMI and CSA. There were no differences in attitudes toward obesity based on combinations of BMI and CSA. |
| Crump and Byers (2017) | Traumagenic Dynamics Model (Finkelhor & Browne, 1985) | CSA | Frequency/duration of sex, thoughts during sex, sexual desire, esteem, satisfaction, and anxiety | CSA involving fondling only: 18%, CSA involving vaginal/anal/oral penetration: 14% | SMW who reported penetrative CSA were significantly more likely to report adolescent/adult sexual abuse compared to SMW who reported fondling CSA and those who reported no CSA (77%, 56%, and 32%, respectively). There were significant differences between the four groups (no lifetime sexual abuse, adolescent/adult sexual abuse only, CSA limited to fondling, CSA involving attempted/completed penetration on sexual desire, sexual satisfaction, and automatic sexual thoughts, but not on frequency, duration, sexual esteem, or sexual anxiety. SMW reporting penetrative CSA had significantly lower desire and satisfaction and more frequent negative automatic thoughts compared to the other groups. |
| Katz-Wise et al. (2014) | Minority stress (Meyer, 2003) | Sexual identity; CA, weight-related behaviors, demographic variables | 1 year change in BMI | 1 Type: lesbian 19.2%, bisexual 16.5%, mostly heterosexual 21.8%, only heterosexual 17.8% 2 Types: lesbian 17.3%, bisexual 14.7%, mostly heterosexual 14.7%, only heterosexual 10.1% 3 to 4 Types: lesbian 13.5%, bisexual 19.4% mostly heterosexual 12.1%, only heterosexual 5.5% | Compared to heterosexual women, bisexual women had larger 1-year increases in BMI. 2. Child abuse and weight-related behaviors slightly attenuated the relationship between sexual orientation and BMI. |
| Sweet et al. (2013) | None specified | CSA | HIV/STI incidence | Not reported | Individuals reporting CSA had higher odds of a mental health disorder and AUD. Compared to heterosexual women who reported no CSA, SMW had higher risk of HIV/STI incidence (1.9 times the risk for SMW who reported no CSA, 8.3 times for SMW who reported experiencing CSA rarely, and 6.3 times the risk for SMW who reported sometimes/frequent CSA). The relationship between CSA and HIV/STI risk was more than 34% mediated by mental health among SMW sometimes/frequently abused. |
| Lehavot and Simoni (2011) | None specified | 5 types of CA | Chronic physical health problems, ASA, smoking | CEA: 59%, CPA: 35%, CSA 40%, EN: 61%, PN: 41% | 45% of women reporting any form of CA reported ASA, compared to 20% of those not reporting any CA (p < .01). CA had a significant direct association with ASA, smoking, and physical health problems. ASA was not associated with smoking or physical health problems, controlling for CA. Smoking did not mediate the relationship between CA and chronic physical health problems. |
| Greene et al. (2019) | Intersectionality theory (Crenshaw, 1990) | CPA, CSA | Past-year cervical cancer screening | CSA: 38.4% CPA: 23.3% | CPA was one of six predictor variables deemed most important (out of 25 potential variables initially) in predicting self-report of past-year Pap. SMW who did not report CA, along with women under 62, who began drinking before age 14, who had health insurance, who reported lower internalized homonegativity, and had fewer than 28 lifetime sexual partners, were less likely to report a past-year Pap test (30%). |
| Andersen et al. (2014) | None specified | CSA, CPA, cumulative CV | Physical health problems | CSA: bisexual 71.4%, lesbian 59.2%, mostly heterosexual 43.9%, heterosexual 31.2% CPA: bisexual 40.9%, lesbian 21.6%, mostly heterosexual 19.0%, heterosexual 9.4% | Bisexual, lesbian, and mostly heterosexual women had higher CSA and CPA than heterosexual women (p < .001). Neither CSA nor CPA were independently associated with physical health problems, adjusting for demographics and health correlates. Women who reported both CSA and CPA were 1.44 times (95% CI [0.99, 2.10], p = .056) more likely to report physical health problems than those who didn’t report either CA. Sexual identity did not moderate the association between victimization and physical health problems. |
| Multiple Health and Social Outcomes | |||||
| Hyman (2000) | Used a model (Frank & Gertler, 1991) combining socialization and human capital formulations of earnings | CSA | Physical health, mental health, educational attainment, economic welfare | Not reported | Among lesbian women, CSA survivors were more likely to have poorer physical and mental health and to earn less money; additionally, they were less likely to earn a college degree. Extrafamilial CSA by a stranger and intrafamilial CSA with coercion were the most strongly associated with lower earnings both directly and indirectly, through physical and mental health and education. Intrafamilial CSA without coercion was indirectly associated with lower earnings through physical and mental health and education. Extrafamilial CSA with a known perpetrator was not associated with lower earnings. |
| Revictimization and other experiences of interpersonal violence | |||||
| Austin et al. (2008b) | None specified | Sexual identity | Sexual risk indicators | CSA: 45% mostly heterosexual, 15% heterosexual | Mostly heterosexual women were more likely to have experienced CSA, and to report having an STI compared to heterosexual women. Mostly heterosexual women also reported an earlier age at first intercourse and more sexual partners than heterosexual women. CSA did not mediate the relationship between sexual identity and these sexual risk factors. |
| Han et al. (2013) | None specified | CSA, alcohol use, PTSD | ASA | CSA only: 22.1% Adulthood revictimization and CSA: 13.9% | Alcohol use was the best predictor of ASA among lesbians. CSA was the best predictor of ASA among gay men. |
Note. CA = Child abuse; CSA = childhood sexual abuse; CPA = child physical abuse; CN = childhood neglect; CEA = childhood emotional abuse; TS = two-spirit; IH = internalized homophobia; EA = experiential avoidance; EN = emotional neglect; PN = physical neglect; CTQ = CT Questionnaire; SUDs = substance use disorders; AUD = alcohol use disorder; HD = hazardous drinking; CV = childhood victimization; CT = childhood trauma; PTSD = posttraumatic stress disorder; ACE = adverse childhood experiences (ACEs); BMI = Body Mass Index; CI = confidence interval; LGB = lesbian, gay, bisexual; SM = sexual minority; SMW = sexual minority women.