The dark side of the rainbow: Homosexuals and bisexuals have higher Dark Triad traits than heterosexuals

Summary Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men's and women's health.

There has been an exponential increase of interest in the dark side of human nature during the last decade. To better understand this dark side, the authors developed and validated a concise, 12-item measure of the Dark Triad: narcissism, psychopathy, Machiavellianism. In 4 studies involving 1,085 participants, they examined its structural reliability, convergent and discriminant validity (Studies 1, 2, and 4), and test-retest reliability (Study 3). Their measure retained the flexibility needed to measure these 3 independent-yet-related constructs while improving its efficiency by reducing its item count by 87% (from 91 to 12 items). The measure retained its core of disagreeableness, short-term mating, and aggressiveness. They call this measure the Dirty Dozen, but it cleanly measures the Dark Triad.