Robert-Paul Juster1, Mark L Hatzenbuehler2, Adrianna Mendrek3, James G Pfaus4, Nathan Grant Smith5, Philip Jai Johnson6, Jean-Philippe Lefebvre-Louis7, Catherine Raymond8, Marie-France Marin9, Shireen Sindi10, Sonia J Lupien11, Jens C Pruessner12. 1. Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada. Electronic address: robert.juster@mail.mcgill.ca. 2. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York. 3. Department of Psychiatry, University of Montreal, Montreal; Department of Psychology, Bishop's University, Sherbrooke, Quebec, Canada. 4. Department of Psychology, Concordia University, Montreal, Quebec, Canada. 5. Department of Educational Psychology, University of Houston, Houston, Texas. 6. Center for Sexual Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota. 7. Department of Social Work, University of Quebec in Montreal, Montreal, Quebec, Canada. 8. Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Department of Neuroscience, University of Montreal, Montreal. 9. Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 10. Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada. 11. Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, University of Montreal, Montreal. 12. Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada; Douglas Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Abstract
BACKGROUND: Biological sex differences and sociocultural gender diversity influence endocrine stress reactivity. Although numerous studies have shown that men typically activate stronger stress responses than women when exposed to laboratory-based psychosocial stressors, it is unclear whether sexual orientation further modulates stress reactivity. Given that lesbian, gay, and bisexual (LGB) individuals frequently report heightened distress secondary to stigma-related stressors, we investigated whether cortisol stress reactivity differs between LGB individuals and heterosexual individuals in response to a well-validated psychosocial stressor. METHODS: The study population comprised 87 healthy adults (mean age, 25 years) who were grouped according to their biological sex and their gendered sexual orientation: lesbian/bisexual women (n = 20), heterosexual women (n = 21), gay/bisexual men (n = 26), and heterosexual men (n = 20). Investigators collected 10 salivary cortisol samples throughout a 2-hour afternoon visit involving exposure to the Trier Social Stress Test modified to maximize between-sex differences. RESULTS: Relative to heterosexual women, lesbian/bisexual women showed higher cortisol stress reactivity 40 min after exposure to the stressor. In contrast, gay/bisexual men displayed lower overall cortisol concentrations throughout testing compared with heterosexual men. Main findings were significant while adjusting for sex hormones (estradiol-to-progesterone ratio in women and testosterone in men), age, self-esteem, and disclosure status (whether LGB participants had completed their "coming out"). CONCLUSIONS: Our results provide novel evidence for gender-based modulation of cortisol stress reactivity based on sexual orientation that goes beyond well-established between-sex differences. This study raises several important avenues for future research related to the physiologic functioning of LGB populations and gender diversity more broadly.
BACKGROUND: Biological sex differences and sociocultural gender diversity influence endocrine stress reactivity. Although numerous studies have shown that men typically activate stronger stress responses than women when exposed to laboratory-based psychosocial stressors, it is unclear whether sexual orientation further modulates stress reactivity. Given that lesbian, gay, and bisexual (LGB) individuals frequently report heightened distress secondary to stigma-related stressors, we investigated whether cortisol stress reactivity differs between LGB individuals and heterosexual individuals in response to a well-validated psychosocial stressor. METHODS: The study population comprised 87 healthy adults (mean age, 25 years) who were grouped according to their biological sex and their gendered sexual orientation: lesbian/bisexual women (n = 20), heterosexual women (n = 21), gay/bisexual men (n = 26), and heterosexual men (n = 20). Investigators collected 10 salivary cortisol samples throughout a 2-hour afternoon visit involving exposure to the Trier Social Stress Test modified to maximize between-sex differences. RESULTS: Relative to heterosexual women, lesbian/bisexual women showed higher cortisol stress reactivity 40 min after exposure to the stressor. In contrast, gay/bisexual men displayed lower overall cortisol concentrations throughout testing compared with heterosexual men. Main findings were significant while adjusting for sex hormones (estradiol-to-progesterone ratio in women and testosterone in men), age, self-esteem, and disclosure status (whether LGB participants had completed their "coming out"). CONCLUSIONS: Our results provide novel evidence for gender-based modulation of cortisol stress reactivity based on sexual orientation that goes beyond well-established between-sex differences. This study raises several important avenues for future research related to the physiologic functioning of LGB populations and gender diversity more broadly.
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