Thinking different

Kevin Lewis

January 09, 2016

Backlash, Consensus, Legitimacy, or Polarization: The Effect of Same-Sex Marriage Policy on Mass Attitudes

Andrew Flores & Scott Barclay
Political Research Quarterly, forthcoming

What are the effects of judicial action and policy implementation on attitude change? The previous literature indicates that attitudes may change, but there is some debate about its direction. According to some theories, legislation or litigation should strike a backlash, resulting in greater disapproval of the issue. Other perspectives contend that these acts reflect consensus, legitimate, or polarize the issue. We analyze panel data on attitudes toward same-sex marriage and feelings toward lesbians and gay men. In 2013, the U.S. Supreme Court made historic decisions on same-sex marriage, and residents in some states had same-sex marriage legalized. Given this variation, we decompose the multiple pathways attitudes change among residents in different policy contexts over time. We find that residents of states that had same-sex marriage policy introduced had the greatest reduction of anti-gay attitudes. We consider consensus and legitimacy as most applicable and provide minimal indication of backlash or polarization.


Gay On-Screen: The Relationship Between Exposure to Gay Characters on Television and Heterosexual Audiences' Endorsement of Gay Equality

Bradley Bond & Benjamin Compton
Journal of Broadcasting & Electronic Media, Fall 2015, Pages 717-732

The current study, grounded in the parasocial contact hypothesis, employed a survey of emerging adults to investigate the relationship between exposure to gay characters on television and heterosexuals' endorsement of gay equality. A positive relationship existed between exposure to on-screen gay characters and gay equality endorsement. The relationship was stronger for racial minority participants than for White participants, and for participants who had no or few interpersonal relationships with openly gay individuals than for participants who had more than three respective relationships. Results are discussed in terms of the parasocial contact hypothesis and television as an agent of social change.


Invisible Asian Americans: The intersection of sexuality, race, and education among gay Asian Americans

Anthony Ocampo & Daniel Soodjinda
Race Ethnicity and Education, forthcoming

Most research on Asian American education has centered on addressing and deconstructing the model minority stereotype. While recent studies have highlighted the socioeconomic and cultural heterogeneity among Asian American students, few have examined how sexual identity and masculinity mitigate their academic experiences. In this article, we draw on the educational narratives of 35 Asian American gay men to address this gap. Though research on lesbian, gay, bisexual and transgender (LGBT) students has emphasized bullying, our findings show that the relationship between sexuality and schooling is more nuanced than studies suggest. Our article reveals that while anti-gay bullying is prevalent, Asian American gay students play up aspects of their racial identity and even strategically capitalize on the model minority stereotype to evade harassment. Ultimately, our study highlights the need for educators to remain mindful of how the intersection of sexuality and race affect the school climate and educational experiences among gay students of color.


Scientific Communication about Biological Influences on Homosexuality and the Politics of Gay Rights

Jeremiah Garretson & Elizabeth Suhay
Political Research Quarterly, forthcoming

In recent decades, Americans' thinking regarding the causes of human behavior has changed considerably. In particular, there has been a swing toward attributing a variety of behaviors to biological factors, and perhaps nowhere is this more evident than for sexual orientation. In this paper, we draw on two overtime survey datasets to argue that new scientific evidence on the biological bases of homosexuality in the 1990s rapidly changed commonly held beliefs. However, because these scientific explanations were perceived to be relevant to gay rights, persuasion tended to be conditioned on citizens' political values. In short, liberals were considerably more likely than conservatives to embrace biological attributions for homosexuality during this period. Furthermore, these changing - and diverging - causal beliefs about homosexuality appear to have contributed to both increasing support for, and left-right disagreements over, gay rights.


Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis

William Padula, Shiona Heru & Jonathan Campbell

Journal of General Internal Medicine, forthcoming

Background: Recently, the Massachusetts Group Insurance Commission (GIC) prioritized research on the implications of a clause expressly prohibiting the denial of health insurance coverage for transgender-related services. These medically necessary services include primary and preventive care as well as transitional therapy.

Objective: To analyze the cost-effectiveness of insurance coverage for medically necessary transgender-related services.

Design: Markov model with 5- and 10-year time horizons from a U.S. societal perspective, discounted at 3 % (USD 2013). Data on outcomes were abstracted from the 2011 National Transgender Discrimination Survey (NTDS).

Patients: U.S. transgender population starting before transitional therapy.

Main measures: Cost per quality-adjusted life year (QALY) for successful transition or negative outcomes (e.g. HIV, depression, suicidality, drug abuse, mortality) dependent on insurance coverage or no health benefit at a willingness-to-pay threshold of $100,000/QALY. Budget impact interpreted as the U.S. per-member-per-month cost.

Key results: Compared to no health benefits for transgender patients ($23,619; 6.49 QALYs), insurance coverage for medically necessary services came at a greater cost and effectiveness ($31,816; 7.37 QALYs), with an incremental cost-effectiveness ratio (ICER) of $9314/QALY. The budget impact of this coverage is approximately $0.016 per member per month. Although the cost for transitions is $10,000-22,000 and the cost of provider coverage is $2175/year, these additional expenses hold good value for reducing the risk of negative endpoints - HIV, depression, suicidality, and drug abuse. Results were robust to uncertainty. The probabilistic sensitivity analysis showed that provider coverage was cost-effective in 85 % of simulations.

Conclusions: Health insurance coverage for the U.S. transgender population is affordable and cost-effective, and has a low budget impact on U.S. society. Organizations such as the GIC should consider these results when examining policies regarding coverage exclusions.


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