(020) Identity Uncertainty May Contribute to Why Sexual and Gender Minority Young Adults Report Higher Distress With Sexual Dysfunction

Abstract Introduction Most current assessments and treatments for sexual (dys)function were developed in cisgender and heterosexual (cishetero) populations. However, sexual and gender minority (SGM) people may experience sexual dysfunction differently than cishetero people, and thus may have different treatment needs. Data from our lab suggests that relative to cishetero people, SGM young adults are not only twice as likely to report key sexual dysfunction symptoms (eg, low desire), they are also twice as likely to report distress associated with each symptom (Fig. 1). Objective We sought to explore a novel theory: SGM people experience increased distress associated with sexual dysfunction due to the centrality of sex in popular conceptions of queerness. That is, if one believes that enjoying certain types of sex is what “makes someone gay,” disruptions in sexual enjoyment may lead to questioning of sexual identity, adding to the distress associated with these symptoms. Methods Participants include 206 SGM students at a large university in the midwestern United States. We coded each symptom of sexual dysfunction ordinally (0 if no symptom was reported, 1 if reported but without associated distress, and 2 if reported with associated distress). Analysis involved ordinal logistic regressions for each symptom, with identity uncertainty as the predictor and the combined dysfunction/distress ordinal variable as the outcome. Results These preliminary findings should be interpreted with caution and will require replication and validation. Identity uncertainty did not predict reporting symptoms vs no symptoms, but did significantly predict distress related to low desire (0-1: β = -0.29, p = .408, OR = 0.75; 1-2: β = 0.85, p = .017, OR = 2.34), high desire (0-1: β = 0.56, p = .138, OR = 1.75; 1-2: β = 1.51, p .001, OR = 4.50), and lubrication dysfunction (0-1: β = 0.54, p = .158, OR = 1.72; 1-2: β = 1.07, p = .006, OR = 2.91). Identity uncertainty did not predict either symptom presentation nor distress for delayed or absent orgasm (0-1: β = -0.31, p = .387, OR = 0.73; 1-2: β = 0.39, p = .283, OR = 1.47) nor vaginal pain (0-1: β = 0.09, p = .800, OR = 1.10; 1-2: β = 0.60, p = .102, OR = 1.83). Conclusions These results suggest that identity uncertainty may influence the likelihood that SGM young adults report associated distress with certain symptoms of sexual dysfunction. Recognizing the limits of these exploratory analyses, this tentatively serves as initial support for the novel theory that some aspects of sexual dysfunction may be distressing to SGM people in unique ways. If further supported, this may mean that treatments for sexual dysfunction in SGM populations could be more effective if they target sexual identity uncertainty in concert with other medical and psychological treatments. Disclosure No.