title: Sexual orientation modulates endocrine stress reactivity.
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.
authors.affiliation: 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.
authors.forename: Robert-Paul
authors.initials: RP
authors.lastname: Juster
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Hatzenbuehler
authors.affiliation: Department of Psychiatry, University of Montreal, Montreal; Department of Psychology, Bishop's University, Sherbrooke, Quebec, Canada.
authors.forename: Adrianna
authors.initials: A
authors.lastname: Mendrek
authors.affiliation: Department of Psychology, Concordia University, Montreal, Quebec, Canada.
authors.forename: James G
authors.initials: JG
authors.lastname: Pfaus
authors.affiliation: Department of Educational Psychology, University of Houston, Houston, Texas.
authors.forename: Nathan Grant
authors.initials: NG
authors.lastname: Smith
authors.affiliation: Center for Sexual Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Philip Jai
authors.initials: PJ
authors.lastname: Johnson
authors.affiliation: Department of Social Work, University of Quebec in Montreal, Montreal, Quebec, Canada.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lefebvre-Louis
authors.affiliation: Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Department of Neuroscience, University of Montreal, Montreal.
authors.forename: Catherine
authors.initials: C
authors.lastname: Raymond
authors.affiliation: Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Marin
authors.affiliation: Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada.
authors.forename: Shireen
authors.initials: S
authors.lastname: Sindi
authors.affiliation: Centre for Studies on Human Stress, Fernand-Seguin Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, University of Montreal, Montreal.
authors.forename: Sonia J
authors.initials: SJ
authors.lastname: Lupien
authors.affiliation: Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada; Douglas Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
authors.forename: Jens C
authors.initials: JC
authors.lastname: Pruessner
mesh_terms: D000328:Adult; D000375:Aging / Q000378:metabolism; D001727:Bisexuality / Q000502:physiology*; D004958:Estradiol / Q000378:metabolism; D005260:Female; D020010:Heterosexuality / Q000502:physiology*; D018452:Homosexuality, Female; D018451:Homosexuality, Male; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D011374:Progesterone / Q000378:metabolism; D012463:Saliva / Q000378:metabolism; D012649:Self Concept; D012727:Sex Characteristics; D013315:Stress, Psychological / Q000378:metabolism* / Q000523:psychology; D013739:Testosterone / Q000378:metabolism; D055815:Young Adult
chemical_list: D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D006854:Hydrocortisone
keywords: Cortisol; Gender diversity; Sex differences; Sexual orientation; Stress reactivity; Trier Social Stress Test