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Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017-2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27-1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk.

Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression – subtle/ambiguous slights against one's marginalized identity – is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups. Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure. Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (OR Micro = 1.42, OR Discrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (OR Depress = 1.24, OR Sleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents. Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences. The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits. • One in five college students experienced microaggression/discrimination the past year. • Exposure rates were higher in racially marginalized students than in Whites. • Microaggression and discrimination each predicted increased odds of all symptoms. • Pathways from the exposures to anxiety, depression, and sleep varied for microaggression versus discrimination. • Clinicians must proactively address identity-based exposures to advance mental health equity. [ABSTRACT FROM AUTHOR]

The current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from adverse childhood experiences (ACEs) to adulthood suicidal thoughts and behaviors. ACEs were measured at year one, potential mediators at year two, and suicidal thoughts and behaviors (suicidal ideation, intent, plan, and attempt) at year three. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidal thoughts and behaviors. Ten candidate mediators were examined: social well-being, felt stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. Participants were 1518 adults who identified as lesbian or gay (n = 833; 55 %), bisexual (n = 493; 33 %), or with other sexual minority identities (n = 181; 12 %) and were on average 36.48 years (SD = 14.7) of age. Psychological distress served as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACEs and suicide plan. Potential recall bias due to retrospective reporting of ACEs may be a limitation. Future studies should broaden the measurement scope of ACEs and implement intersectional methods. The current findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support. • Psychological distress is a universal mediator linking adverse childhood experiences to suicidal thoughts and behaviors. • Everyday discrimination and social support are specific mediators for suicidal intent and plan, respectively. • Pathways related to suicide attempts are less stable compared to other forms of suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

LGBT2Q+ (lesbian, gay, bisexual, transgender, Two-Spirit, queer, plus) Canadians face minority stressors that lead to higher mental health inequalities such as worse self-reported mental health and increased risk of mental health issues when compared to their heterosexual/straight and cisgender counterparts. However, there are within-group (intracategorical) differences within a community as large as LGBT2Q+ peoples. Guided by the Andersen Model of Healthcare Utilization, we sought to explore intracategorical differences in LGBT2Q+ Canadian predisposing, enabling, and need factors in mental health service utilization within the past year. Using data from the 2020 LGBT2Q+ Health Survey (N = 1542), modified Poisson logistic regression found that more polysexual respondents and trans/gender-diverse respondents were more likely to have utilized mental health services within the past year than their gay, lesbian, and cis male counterparts. As well, compared to White respondents, Indigenous respondents were more likely to have utilized mental health services, while other racialized respondents were associated with less utilization. Backwards elimination of Andersen model of healthcare utilization factors predicting mental health service utilization retained two predisposing factors (ethnoracial groups and gender modality) and two need factors (self-reporting living with a mood disorder and self-reporting living with an anxiety disorder). Results suggest that polysexual, trans and gender-diverse, and racialized LGBT2Q+ peoples have an increased need for mental health services due to increased specific minority stressors that cisgender, White, monosexual peoples do not face. Implications for healthcare providers are discussed on how to improve service provision to LGBT2Q+ peoples. [ABSTRACT FROM AUTHOR]

Sexual and gender minority youth, who experience high mental and behavioral health needs, are overrepresented in the criminal legal system, which may exacerbate these needs. This study examined the associations between arrest history and mental and behavioral health among sexual and gender minority youth. Using cross-sectional survey data from the 2022 LGBTQ+ National Teen Survey, this study created a case–control sample of 287 sexual and gender minority youth with an arrest history and 1,148 propensity-matched sexual and gender minority youth without an arrest history. Associations between arrest history and sexual and gender minority developmental milestones, minority stressors, and mental and behavioral health outcomes were examined. Statistical analyses were conducted between 2022 and 2024. Arrest history was significantly associated with several sexual and gender minority developmental milestones (e.g., earlier age of identity realization and disclosure) and minority stressors (e.g., greater bullying and parental rejection). Sexual and gender minority youth with an arrest history had poorer mental and behavioral health, including greater sleep disturbance (AOR=1.46; 95% CI=1.08, 2.00) and positive screenings for depression (AOR=1.60; 95% CI=1.20, 2.14), anxiety (AOR=1.35; 95% CI=1.01, 1.82), and risk for substance use disorder development (AOR=5.81; 95% CI=4.26, 7.94). Arrest history is associated with the mental and behavioral health of sexual and gender minority youth, highlighting systemic inequities. Tailored public health interventions are needed to reduce criminal–legal contact in this population. [ABSTRACT FROM AUTHOR]

This study examines the effects of racist microaggressions and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)-related minority stressors (i.e., identity concealment, family rejection, internalized LGBTQ-phobia, victimization, and racialized heterosexism/cisgenderism) on psychological distress among Latinx LGBTQ+ young people, specifically college students. Participants are a Latinx subset (n = 80) from a national online nonprobability cross-sectional survey of LGBTQ+ college students. The study aim was examined using linear/logistic regression. Findings indicated that racist microaggressions and family rejection were associated with psychological distress. In addition, racist microaggressions were the only stressor associated with clinically significant psychological distress that may warrant psychiatric/psychological treatment. Therefore, racist microaggressions and family rejection are unique stressors that may saliently affect mental health among Latinx LGBTQ+ students. There is a great need to integrate minority stress theory with other critically-oriented theories, such as intersectionality, in research and intervention to eliminate mental health inequities faced by Latinx LGBTQ+ young people. [ABSTRACT FROM AUTHOR]

Objectives: To examine the associations of two measures of minority stress, non-affirmation minority stress and internalized transphobia, with subjective cognitive decline (SCD) among transgender and gender diverse (TGD) veterans. Method: We administered a cross-sectional survey from September 2022 to July 2023 to TGD veterans. The final analytic sample included 3,152 TGD veterans aged ≥45 years. We used a generalized linear model with quasi-Poisson distribution to calculate prevalence ratios (PR) and 95% confidence intervals (CIs) measuring the relationship between non-affirmation minority stress and internalized transphobia and past-year SCD. Results: The mean age was 61.3 years (SD = 9.7) and the majority (70%) identified as trans women or women. Overall, 27.2% (n = 857) reported SCD. Adjusted models revealed that TGD veterans who reported experiencing non-affirmation minority stress or internalized transphobia had greater risk of past-year SCD compared to those who did not report either stressor (aPR: 1.09, 95% CI: 1.04–1.15; aPR: 1.19, 95% CI: 1.12–1.27). Conclusion: Our findings demonstrate that proximal and distal processes of stigma are associated with SCD among TGD veterans and underscore the need for addressing multiple types of discrimination. Above all, these results indicate the lasting sequelae of transphobia and need for systemic changes to prioritize the safety and welfare of TGD people. [ABSTRACT FROM AUTHOR]

Syndemic theory proposes that co-occurring, mutually reinforcing psychosocial challenges (mental health, substance use, minority stress [discrimination/stigma], abuse, unmet basic needs) drive HIV risk behavior and create barriers to care for marginalized populations. It is thus necessary to address this holistic, complex picture in HIV prevention. Emergency department (ED) visits are a prime opportunity to engage key risk groups, given their low engagement in regular clinic-based care and high utilization of drop-in care via EDs. Yet, EDs are overburdened and under-resourced; mHealth may be a vehicle for intervention delivery in this context. This study aimed to 1) characterize demographics, syndemic profiles, and HIV risk behavior among ED patients and 2) assess the acceptability of addressing syndemic issues, particularly via an mHealth approach, in the ED. A sample of N = 198 ED patients with an indication of HIV risk completed a cross-sectional psychosocial assessment. Descriptive statistics and bivariate correlations between syndemic issues were examined. Patients presenting to the ED reported marginalized identities and complex syndemic profiles including mental health issues (77%), at risk substance use (30%), childhood abuse (35%), adult abuse (31%), minority stress (63%), and unmet basic needs (37%). Over half the sample reported at least three syndemic issues (54%). All syndemic issues were significantly correlated with each other, supporting a synergistic nature. The sample reported indicators of HIV risk including lack of PrEP awareness (33%)/uptake (94%), condomless sex (37%), and not testing for HIV (41%). Majority reported syndemic profiles have never been addressed in the ED (71%), think it would be helpful (88%), and willing to utilize mHealth during an ED visit (76%). The current study provides information to guide next steps for ED-based point-of-care HIV prevention, and more broadly, working towards equitable HIV prevention services reaching those missed by existing interventions. [ABSTRACT FROM AUTHOR]

In our meta-analytic study, we aimed to specifically focus on the relationship between IH and depressive symptoms among LGBTQ+ (lesbian, gay, bisexual, transgender, queer) individuals across studies conducted internationally. The meta-analysis included studies conducted between 2000 and 2022, encompassing data from 13 countries. Studies retrieved from the literature search were screened based on inclusion and exclusion criteria, resulting in the inclusion of 95 effect sizes. The results revealed a positive, small-to-medium effect size between IH and depressive symptoms (r = 0.2979, p < .001), with significant heterogeneity among the effect sizes (Q(95) = 638.4979, p < .001). We tested the following moderators: country-level LGBTQ+ acceptance scores, age, and year of data collection. However, the results did not support the moderating effects of these variables. This study contributes to the existing literature by confirming that the strength of the relationship between IH and depressive symptoms remains significant. Further research may explore this relationship in diverse cultural contexts, considering cohort effects and other theoretical factors (e.g. individual resilience, social support, community involvement) that may influence this association. [ABSTRACT FROM AUTHOR]

Bisexual+ (e.g., bisexual, pansexual, queer) women experience higher rates of sexual violence (SV) and posttraumatic stress disorder (PTSD) than heterosexual and lesbian women, as well as unique identity‐related minority stress. We examined between‐ and within‐person associations between bisexual minority stress and PTSD symptoms related to SV in a sample of young bisexual+ women (N = 133) who reported adult SV (Mage = 22.0 years, range: 18–25 years; 85.0% White; 99.3% cisgender). We analyzed data from four waves of data collection (baseline to 3‐month follow‐up) using multilevel models. Controlling for SV severity, there was a significant within‐person effect of antibisexual stigma from lesbian/gay people on PTSD, β = .17, p = .010, suggesting that at waves when women experienced more stigma, they also reported higher PTSD symptom levels. At the between‐person level, women who reported higher levels of antibisexual stigma from heterosexual people, β = .26, p = .043, and anticipated binegativity, β = .29, p = .005, on average across study waves also reported higher average levels of PTSD. Additionally, anticipated binegativity explained the association between average antibisexual stigma and PTSD, β = .15, p = .014, 95% CI [0.45, 4.61]. Bisexual minority stress may be associated with higher PTSD symptom severity following SV among young bisexual+ women, and the anticipation of binegativity may be a target mechanism in this association. Study findings highlight the importance of examining the joint contributions of SV and minority stress to identify novel targets for future research and practice to address PTSD symptoms. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionsThis pre-registered analysis aimed to examine the moderating role of nicotine-use motives on the association between minority stress and nicotine use and craving among sexual minority youth.Data stem from a 30-day ecological momentary assessment study conducted among 83 sexual minority youth ages 15–19 years old (M age = 17.96, SD = 1.10; 56.63% cisgender women; 73.5% non-Hispanic White). Participants were instructed to complete at least four assessments per day on wireless devices. Two types of multilevel models were estimated: models predicting day-level nicotine use and models predicting momentary nicotine use craving.Experiencing minority stressors was not associated with day-level nicotine use, but it was associated with greater momentary nicotine craving. Nicotine use-motives did not moderate the association between minority stress and nicotine use. In contrast, stress-reduction motives, assessed as a person-level trait, moderated the association between minority stress and nicotine craving, such that nicotine craving after experiencing a minority stressor was consistently higher relative to when minority stress had not been reported. Sensitivity analyses that examined associations between minority stress and nicotine use on a given day, regardless of temporal order, showed that minority stress was associated with higher odds of nicotine use on that day.Experiencing minority stressors did not predict day-level nicotine use but does contribute to greater momentary nicotine craving, informing minority stress theory. Consistency of the minority stress and nicotine craving relation, largely regardless of trait-level motives, highlights the potential context dependence of nicotine craving among sexual minority youth.Preregistration: This study was preregistered at osf.io/w5sz9. [ABSTRACT FROM AUTHOR]

AbstractSexual minority men (SMM), and bisexual men in particular, show elevated risks of depressive symptoms relative to heterosexual men. A breadth of research shows that internalized heterosexism, a primary minority stressor, partially explains the disproportionately high levels of depressive symptoms among SMM. However, it is less clear which factors buffer this relationship. The present study investigated whether hope and its subfactors, agency and pathways, moderated the relationship between internalized heterosexism and depressive symptoms, and whether this was contingent on sexual orientation (gay versus bisexual). An international sample of 412 mostly cisgender gay (59.7%) and bisexual men (40.3%) aged 18–81 years (M = 37.32 years, SD = 14.26) completed the Revised Internalized Homophobia Scale, the Adult Dispositional Hope Scale, and the Center for Epidemiological Studies Depression Scale. Results indicated that internalized heterosexism, hope, agency, and pathways were independently associated with depressive symptoms. Hope, agency, and pathways did not moderate the internalized heterosexism-depressive symptoms relationship, nor were these moderation relationships conditional on sexual orientation. Findings substantiate previous research suggesting that internalized heterosexism is a risk factor for depressive symptoms and hope, agency, and pathways are protective factors. Clinicians working with SMM should consider integrating strategies to mitigate internalized heterosexism and cultivate hope, and scholars should aim to expand research focused on the role of hope in influencing SMM’s mental health outcomes. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsGrowing attention is given to LGBTQ+ well-being, mainly using the minority stress model, although it’s seldom applied in group therapy research. This study aims to investigate individual experiences and identity processes related to minority stress while exploring the effectiveness of group psychodrama on LGBTQ+ well-being and stress levels.Seven LGBTQ+ participants aged 19 to 27 years attended 10 weekly sessions of group psychodrama. The study utilized a qualitative exploratory case study design, where interview data underwent inductive thematic analysis and were triangulated with quantitative data concerning well-being, alexithymia, and LGBT Minority Stress.Participants manage their minority-contextualized identity and stigma within their narratives, indicating that group psychodrama may benefit young LGBTQ+ adults by raising awareness and resolving stressors.The study validates the minority stress model but suggests broader theoretical integration, emphasizing the role of social identity and therapeutic impact of psychodrama in managing minority stress. [ABSTRACT FROM AUTHOR]

The current study examines the links between anxiety and depression symptoms and COVID-19-related racism amongst Asian Americans living in western New York, United States. Based on the findings of survey data (n = 333) and in corroboration with minority stress theory, all forms of racism are positively correlated with anxiety and depression levels. There are differences across different forms of racism. Experiences of avoidance and verbal harassment are primarily linked to increased levels of anxiety, while encountering discrimination in business and social settings is more likely to contribute to depression. Indirect discrimination and stigma consciousness tend to heighten anxiety more than depression. Moreover, individuals who are native-born and female tend to report worse mental health outcomes than those who are foreign-born Asians or males. There is a contrasting relationship with income, where higher earnings are linked to reduced depression but can correlate with more significant anxiety. The study findings reveal that COVID-19-related racism may lead to stigma consciousness, race- and racism-based stress, anxiety, and depression. The study contributes to the literature by connecting theories on mental health effects of racism, as well as by distinguishing the links between different forms and intensities of racism and mental well-being, rather than treating all racism as uniform. Considering the detrimental effects on mental health, public policies must confront and address racial prejudice and discrimination that individuals from marginalized communities encounter, particularly during times of crisis. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death among youth in custodial settings. Prior research investigating risk factors for suicide among system-impacted youth fail to incorporate an intersectional framework to contextualize suicide risk among system-impacted girls of color. Profiles of risk for self-injurious thoughts and behaviors (SITBs) were investigated in a sample of 240 racially and ethnically diverse system-impacted girls (mean [SD] age = 14.5 [1.7] years, Hispanic/Latinx 49.6%, Black 37.1%). Participants completed self-report measures evaluating traditional risk factors for suicide (mental health symptoms, trauma exposure) as well as assessments of minority stress (eg, daily discrimination) and recent engagement in SITBs at baseline and 3-month follow-up. Latent profile analysis revealed 3 distinct profiles: low-risk, characterized by relatively low levels of suicide risk indicators (n = 102); high-risk internalizing, characterized by elevations in internalizing symptom indicators (n = 96); and high-risk comorbid, characterized by relatively high levels of suicide risk indicators (n = 42). Girls in the high-risk profiles reported more SITBs at baseline and 3-month follow-up than girls in the low-risk profile. Results suggest that indicators of suicide risk can be used to classify system-impacted girls into profiles that differ concurrently and prospectively on SITBs. Findings could be used to inform more accurate risk and referral assessments for system-impacted girls of color, whose SITB-related challenges may be overlooked or framed as criminal. These findings highlight the continued need for assessments evaluating multiple indicators of risk for SITBs in the juvenile legal system. System-impacted girls of color represent an understudied subset of youth at elevated risk for engagement in self-injurious thoughts and behaviors (SITBs). This study investigated profiles of risk for SITBs in a sample of 240 racially and ethnically diverse system-impacted girls of color (mean age = 14.5 years) utilizing frequently studied factors associated with SITBs, including mental health symptoms and trauma experiences along with understudied risk factors such as minority stress. The authors found that three distinct profiles of risk for SITBs: "Low-Risk," characterized by relatively low levels of suicide risk indicators (n = 102); "High-Risk Internalizing," distinguished by elevations in internalizing symptoms (n = 96); and "High-Risk Comorbid," defined by relatively high levels of internalizing and externalizing symptoms (n = 42). Participants in both high-risk groups had high levels of trauma, minority stress, and were more likely to identify as a member of a sexually minoritized group. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. [ABSTRACT FROM AUTHOR]

Background Aims Method Results Conclusion Mental health professionals play a crucial role in either alleviating or exacerbating stress among queer clients.Drawing on minority stress theory, we conducted a study to examine the experiences of lesbian, gay, bisexual and/or consensually non‐monogamous clients with current or recent psychotherapy or counselling experiences in Germany.A convenience sample of 492 queer individuals participated in an online survey, providing insights into their most recent experiences with psychotherapy or counselling and evaluating the success of these processes. Among the participants, 92% identified as lesbian, gay, bisexual, or another non‐heterosexual identity, while 8% identified as heterosexual. Additionally, 54% reported being in consensually non‐monogamous relationships, and 23% identified as gender‐diverse.The majority (92%) had prior experience with psychotherapy, with over half reporting their last session within the last month. The remaining 8% reported counselling experience. Most participants rated their recent psychotherapy or counselling process as successful. Exemplary practices were more common than inappropriate ones. While overt discrimination by mental health professionals was rare, subtle inappropriate behaviours were still prevalent. Affirmative and actively reassuring practices were strongly linked to subjective therapy success.The study's findings warrant cautious optimism regarding a non‐discriminative stance in German mental health professionals while highlighting the need for further research, training and guidelines for therapists and counsellors. [ABSTRACT FROM AUTHOR]

Background Little is known about weight stigma in sexual minority women, and even less is known about weight stigma in those who have attained substantial weight loss and maintenance. Purpose This study examined weight stigma experiences and internalization in sexual minority women from the National Weight Control Registry (NWCR) who had lost ≥30 pounds and maintained this weight loss for ≥1 year, and compared weight stigma levels between sexual minority women versus heterosexual women in the NWCR. Methods NWCR participants completed an electronic survey. Women who identified as a sexual minority (n = 64; 98% White; M BMI = 29 ± 8; M age = 47 ± 13) and heterosexual women matched on body mass index (BMI), age, and race (n = 64; 98% White; M BMI = 28 ± 7; M age = 51 ± 13) were included. Participants completed assessments of experienced and internalized weight stigma. Results Generalized linear models showed that a significantly larger proportion of sexual minority women in the NWCR reported experiencing weight stigma in the past year (24.2%) compared with heterosexual women (4.7%; p <.05). Furthermore, sexual minority (vs. heterosexual) women reported significantly higher levels of internalized weight stigma (p <.001), and a greater proportion of sexual minority women (35%) reported clinically significant internalized weight stigma relative to heterosexual women (2%; p <.001). Conclusions Sexual minority women are at greater risk for experienced and internalized weight stigma than their heterosexual counterparts among women who have attained significant long-term weight loss. It is critical to expand research on weight stigma in sexual minority women. [ABSTRACT FROM AUTHOR]

Sexual minority men (SMM) living with HIV report significantly greater methamphetamine use compared with heterosexual and HIV-negative peers. Greater use may be related to stressors (e.g., HIV-related stigma) faced by SMM living with HIV and subsequent psychological and behavioral sequelae. We tested an integrated theoretical model comprised of pathways between stigma, discrimination, childhood sexual abuse, psychological distress, sexual compulsivity, and cognitive escape in predicting methamphetamine use among SMM living with HIV. Among 423 SMM living with HIV, we tested a structural equation model examining factors hypothesized to be directly and indirectly associated with methamphetamine use. Analyses were adjusted for demographic covariates and sampling bias. The model showed good fit (CFI = 0.96, RMSEA = 0.01). Heterosexist discrimination was associated with psychological distress (β = 0.39, p < 0.001) and psychological distress was associated with sexual compulsivity (β = 0.33, p < 0.001). Sexual compulsivity was associated with cognitive escape (β = 0.31, p < 0.001), which was associated with methamphetamine use (β = 0.51, p < 0.001). Psychological distress was associated with methamphetamine use via serial indirect effects of sexual compulsivity and cognitive escape (β = 0.05, p < 0.05). Heterosexist discrimination contributed to psychological distress among SMM living with HIV. Psychological distress is linked to methamphetamine use via sexual compulsivity and cognitive avoidance. Interventions seeking to reduce the likelihood that SMM living with HIV use methamphetamine should include coping strategies specific to heterosexism and related psychological distress. [ABSTRACT FROM AUTHOR]

Internalized sexual stigma is an important contributor to LGBT mental health disparities. In Thailand, the absence of validated instruments represents a research barrier. The study's purpose was to translate and evaluate the psychometric properties of the Revised Internalized Homophobia (IHP-R) scale. Based on the cross-cultural principle, team translation was applied. The IHP-R was translated by the principal author and reviewed by bilingual Thai nurses, and clarifications were made. Multidisciplinary experts provided back translation and reconciled the finalized Thai version. The psychometric properties were established in 412 Thai LGBT individuals. Data was collected via online and paper-pencil surveys and analyzed using SPSS. Most participants were male, age ranged 18–53, with moderate levels of internalized homophobia (M = 2.3, SD = 1.04). The inter-item and item-total correlations were.38-.63 and.55-.68. The content validity index was high (I-CVI, S-CVI/UA/Ave = 1). The exploratory factor analysis confirmed one construct of internalized sexual self-stigma (factor loading =.702–.816). Scores on IHP-R were correlated with stress and experiences of discrimination (r =.14 and.12). Internal consistency reliability was also high (Cronbach's alpha coefficient =.83). The IHP-R Thai version has high psychometric properties and is appropriate for LGBT research in Thailand. [ABSTRACT FROM AUTHOR]

Growing research suggests that minority stress adversely affects relationship functioning among same-gender couples. However, studies have predominantly focused on concurrent, between-persons associations and neglected the relationships sexual minority people have with partners of other genders. We used multiwave longitudinal data from 200 young sexual minority women in relationships with cisgender men, cisgender women, and transgender or nonbinary individuals to assess between- and within-person associations between minority stress and relationship functioning and to test for differences in these associations by partner gender. Participants reported on minority stressors (couple marginalization; microaggressions; internalized heterosexism) and relationship functioning (quality; destructive conflict) from the same partnership at 3–7 assessments (M = 4.44), collected at 6-month intervals. Multilevel models assessing each minority stressor separately revealed between-person associations of each stressor with worse relationship quality and conflict; however, only couple marginalization showed within-person associations with relationship functioning. In multilevel models including all three minority stressors, couple marginalization showed unique within- and between-persons associations with worse relationship functioning; microaggressions were only uniquely associated with couple conflict at the between-persons level. Moderation analyses revealed a negative between-persons association of microaggressions with relationship quality only for participants with cisgender male partners, and a positive within-person association of microaggressions with relationship quality only for those with cisgender female partners. Several associations were weaker for participants with transgender or nonbinary compared to cisgender partners. Findings highlight the importance of couple-level minority stress and partner gender in understanding how sexual minority stress affects relationship functioning. [ABSTRACT FROM AUTHOR]

Sleep is essential to adolescent development. Sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender) adults are at high risk for poor sleep, partially due to minority stress (e.g., discrimination). However, sleep has rarely been studied among SGM adolescents. In a national sample of early adolescents, we analyzed sexual minority (SM) and gender minority (GM) identity, gender incongruence, and gender nonconformity in association with sleep and tested minority and general stressors as mediators. We cross-sectionally analyzed data from 10,070 adolescents aged 10–14 in the Adolescent Brain Cognitive Development℠ Study. Using logistic regression models, we analyzed associations between identity (SM and GM), sexual identity discrimination, minority and general stressors (sexual identity discrimination, teasing, and conflict with parents) and sleep health (duration, latency, and disturbance). We used Baron and Kenny's method to test for mediation. Participants reported sexual identity (4% SM, 4% questioning) and gender identity (0.4% GM, 0.6% questioning); 65% were White, 20% were Hispanic, and 52% were assigned male at birth. Compared to heterosexual, SM participants had higher odds of short sleep duration, long sleep latency, and sleep disturbance. GM participants and those reporting gender incongruence and nonconformity had higher odds of long sleep latency and sleep disturbance. Sexual identity discrimination and general social stressors partially mediated some associations. SGM participants reported poorer sleep. Minority and general social stressors partially accounted for some disparities. Policies need to address SGM identity-based discrimination and challenge social norms that produce minority stress for SGM early adolescents. [ABSTRACT FROM AUTHOR]

Objective: To test whether internalized heterosexism, a form of minority stress, heightens the effect of hazardous or harmful alcohol use on frequency of intimate partner violence (IPV) perpetration among sexual minority and same-sex-attracted men. Method: We recruited participants online via Amazon Mechanical Turk (MTurk). Inclusion criteria were adult cisgender men living in the United States who identified as a sexual minority (i.e., gay, bisexual) or who endorsed being sexually attracted to men and who reported a male partner in the preceding year. Participants (N = 198) completed self-report questionnaires measuring sexual orientation and attraction, internalized heterosexism, IPV perpetration (sexual, physical, and psychological), and hazardous or harmful alcohol use. Results: Hazardous or harmful alcohol use and internalized heterosexism were associated with frequency of IPV perpetration. Internalized heterosexism moderated the effect of hazardous or harmful alcohol use on IPV perpetration, such that greater hazardous or harmful alcohol use and higher levels of internalized heterosexism were associated with the greatest rates of IPV perpetration. Results were consistent for each type of IPV (sexual, physical, and psychological). Conclusions: Our findings highlight the association between high levels of internalized heterosexism, magnified by the presence of hazardous or harmful alcohol use, and physical, sexual, and psychological IPV. Alleviating internalized heterosexism is a potential target for decreasing IPV in this at-risk population. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth experience chronic and acute stress associated with their gender identity contributing to their increased risk of suicide and suicide ideation (SI) compared to non-TGD peers. This study examined how invalidating and accepting gender-related experiences with a parent impact SI severity among TGD adolescents cross-sectionally and longitudinally, within-person. Participants were 15 TGD adolescents with past month SI recruited across community and clinical settings. Adolescents completed a baseline assessment of validated interviews and self-report measures on parental invalidation and SI severity. Over a 14-day follow-up period, adolescents reported instances of parental gender invalidation and acceptance, relative stress of those experiences, and SI severity multiple times/day via ecological momentary assessment (EMA). Bivariate associations of parental invalidation and acceptance with SI were examined at baseline, while multilevel models examined the relationship within-person over follow-up. Cross-sectionally, greater perceived invalidation and non-affirmation by their parents was associated with more severe SI. Over the follow up, instances of perceived parental invalidation were associated with passive SI within-person. Findings partially support the minority stress theory and social safety perspective by showing that perceived gender-invalidation from parents affects SI in TGD adolescents, both cross-sectionally and longitudinally. Further research is needed to identify specific emotional and cognitive factors, such as perceived stress, that contribute to the risk of SI among TGD youth and inform the development of targeted interventions for this vulnerable population. [ABSTRACT FROM AUTHOR]

Introduction: One way that transgender and gender diverse (TGD) people may affirm their gender is through a legal name and/or gender marker change. Legal gender affirmation is associated with less psychological distress, but research has yet to expand upon the mechanisms that may help explain this association. We examined associations between legal gender affirmation, psychological distress, and physical health in TGD people, as well as the mediating effect of exposure to enacted stigma. Methods: Data are from the baseline portion of a longitudinal mixed-methods study of how sociopolitical contexts influence marginalization, health, and resilience for TGD people. The study included 158 TGD participants from Oregon, Michigan, Nebraska, and Tennessee. Baseline data were collected September 2019–March 2020 (the overall study concluded Fall 2021). Results: Latent variable structural equation model analyses revealed that participants who had legally affirmed their gender reported less enacted stigma, which was associated with less psychological distress and physical health issues. There was a significant indirect effect via enacted stigma, such that this variable may partially help explain why legal gender affirmation is associated with better health outcomes. Conclusions: Legal gender affirmation is likely to influence TGD people's health and well-being by shaping exposure to minority stress—specifically, enacted stigma. Our findings demonstrate the importance of sociopolitical factors in health outcomes for TGD people. Policy Implications: Given the health benefits of legal gender affirmation and the potential protection from enacted stigma, policies should be revised to make legal name and/or gender marker changes more accessible for TGD people. [ABSTRACT FROM AUTHOR]

Introduction: Individuals in sexual minority groups experience unique forms of stress and are at increased risk of mental health problems compared to their heterosexual counterparts; however, research is scarce on the underlying mechanisms that contribute to this relationship. The present study aimed to explore the mediating effects of irrationality and self-compassion in the relationship between minority stress and anxiety and depressive symptoms. Methods: Between March 2022 to June 2022, we recruited online a sample of 304 Romanian adults who identified as sexual minorities (Mage = 22.65, SD = 5.23). They completed questionnaires that addressed minority stress, irrational beliefs, self-compassion, and symptoms of anxiety or depression. Results: The findings showed significant associations between minority stress, irrationality, self-compassion, anxiety, and depressive symptoms. Minority stress was related to anxiety and depressive symptoms both directly and indirectly, through two paths (a self-compassion path and an irrationality and self-compassion path). Conclusions: Our results indicated that self-compassion and irrationality are serial mediators in the relationship between minority stress and anxiety and depressive symptoms. Policy Implications: These findings contribute to a deeper understanding of how minority stress is related to anxiety and depressive symptoms and provide important guidance to reduce psychological distress in sexual minority young adults. Furthermore, it has important implications for developing prevention and intervention programs designed for sexual minorities individuals. [ABSTRACT FROM AUTHOR]

Introduction: Increased rates of mental health issues among LGBTQ+ people have been reported during the COVID-19 pandemic, particularly among young people. Method: Semi-structured interviews were conducted in 2021 with 61 young adult LGBTQ+ people residing in France, Italy, Portugal, Sweden, and the UK. Each interview was summarized on a template covering the participants' experiences of pandemic restrictions, mental health, and minority stress during this period. A thematic analysis was conducted on the templates. Results: The pandemic restrictions had a large impact on the participants' lives, leaving them stuck at home. Not having access to the LGBTQ+ community was an additional stress, as this is a venue for support. Half of the participants had suffered from mental health issues during the pandemic. Those who were living in non-affirmative households had a particularly difficult time and experienced overwhelming stress. Increased feelings of gender dysphoria were seen among trans participants due to the lack of access to gender-affirming healthcare. Most participants experienced less distal minority stress than usual due to social isolation restrictions. Conclusion: The COVID-19 pandemic and the associated social restrictions had a large impact on the lives of LGBTQ+ young adults. Many experience worse mental health, although relief from distal minority stress was common. Policy Implications: Policy makers must consider the needs of LGBTQ+ young adults as they seek to explore and establish their gender and/or sexual identity. During a pandemic, it is particularly important to help young LGBTQ+ people to engage with the LGBTQ+ community. [ABSTRACT FROM AUTHOR]

Introduction: Self-criticism and subjective emptiness have been identified as possible transdiagnostic risk factors for various mental disorders. Guided by minority stress theory, this cross-sectional study revealed different latent profiles of these two theorized risk factors and their associations with childhood gender nonconformity and self-stigma. Methods: A sample including 366 gay and bisexual men was employed in the current study, using latent profile analysis to explore their self-criticism and subjective emptiness vulnerability profiles. Results: Results of latent profile analysis identified four possible profiles based on distinct combinations of self-criticism and subjective emptiness, including low-, mild-, moderate-, and high-level risk profiles. In addition, the profiles were differentially associated with self-stigma and childhood gender nonconformity. Policy Implications: We hope our findings will encourage Chinese gay and bisexual men to actively deal with underlying psychological processes and attempt to reconcile with themselves. We also suggest that the relevant personnel engaged in psychological counseling, psychotherapy, psychological services, and clinicians should pay attention to their clients' self-criticism and subjective emptiness experience when assisting these populations. Policies should support and encourage society to jointly create a relaxed and inclusive environment. [ABSTRACT FROM AUTHOR]

Introduction: Sexual and gender minority youth (SGMY) often report more experiences of rejection from their family environment which is typically linked with negative implications for their overall well-being. A factor frequently associated with increased rates of psychological distress and rejection from others is that of possessing a nonconforming gender expression. Family rejection is often categorized under the umbrella of minority stress theory; however, initial conceptualizations of minority stress theory did not account for other factors such as gender expression and cisnormativity and how these impact SGMY especially within the realm of family rejection. Methods: In April of 2020, 150 adolescents who identified as a sexual or gender minority were recruited via Qualtrics Survey platform. Participants completed a series of self-report measures on demographics, minority stress, psychological distress, and their family environment's views of gender identity and expression. Results: We observed significant correlations connecting family rejection of gender expression to anxiety and depression and minority stressors. Moreover, family rejection of gender expression accounted for additional variance in anxiety but not depression. Neither family rejection nor support of gender expression moderated the relationships between minority stress with anxiety or depression. Conclusions: These findings suggest that gender expression plays a role in experiences of family rejection and overall minority stress. Policy Implications: Results illustrate implications for extending our thinking of family support beyond the binary categories of acceptance and rejection of queer identity. This can assist in informing policy on best practices for creating supportive environments for SGMY to help alleviate distress caused by lack of family support. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about how neighborhood socioeconomic disadvantage influences sexual minority women's (e.g., lesbian, bisexual) mental health and whether minority stress moderates these associations. We examined the association between neighborhood deprivation and mental health and the potential moderating effects of minority stressors in a community-based sample of sexual minority women. Methods: Using data from Wave 4 of the Chicago Health and Life Experiences of Women study (N = 359, surveyed 2017–2019), we examined associations between census-tract deprivation—measured using the area deprivation index—and days of poor mental health, with moderation by minority stressors (LGBT community connectedness, internalized homophobia, concealment, stigma consciousness, gender presentation). We controlled for individual and neighborhood demographics and other stressors. Results: Higher area deprivation was unrelated to days of poor self-rated mental health in adjusted models, but effects were heterogeneous by gender presentation and LGBT community connectedness. As deprivation increased, more masculine and androgynous women evidenced no increased risks of poor mental health. However, among women presenting as neither masculine nor androgynous, risks were positively associated with deprivation (IRRs: 1.44 and 1.34, respectively). Unexpectedly, women with higher levels of LGBT community connectedness (IRR: 1.48) reported worse mental health as deprivation increased. No other minority stressor moderated associations. Conclusions: Gender presentation appears to be a key factor in the impact of neighborhood deprivation on poor mental health among sexual minority women; the relationship may be more complicated for community connectedness. Our findings suggest that to improve sexual minority women's mental health, interventions targeting deprivation ought to complement interventions targeting sexual minority stigma. Policy Implications: To improve mental health among sexual minority women, advocates must promote both broad economic policies and specific protective, anti-stigma policies. [ABSTRACT FROM AUTHOR]

Despite increased scholarly attention being paid to minority stress and sexual satisfaction among sexual minorities, to our knowledge, no researchers have attempted to systematically synthesize this literature. To address this omission, we conducted a meta-analytic review of the association between sexual minority stress (i.e. sexual identity stigma, internalized sexual identity stigma, and sexual identity concealment) and sexual satisfaction. Suitable studies were recruited through electronic databases, with article screening adhering to PRISMA guidelines. Twenty-eight articles containing 61 effect sizes were analyzed (N = 183,832). Findings indicated a small, inverse relationship between these constructs, indicating that minority stress may lead to diminished sexual satisfaction among gay/lesbian and bisexual individuals. Further, the overall effect size varied as a function of minority stress type, such that the effect for internalized stigma was significantly larger than the effects for sexual identity stigma or concealment. Age was also a significant moderator; specifically, older age was associated with a smaller effect, suggesting that older adults may be better than younger adults at coping with minority stress. Limitations and directions for future research are discussed. We also articulate the implications of these findings vis-à-vis the health and wellbeing of sexual minorities and suggest that clinicians should target internalized stigma in their treatment of sexual concerns among members of this population. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Weight bias internalization (WBI) is a robust, positive correlate of negative health outcomes; however, this evidence base primarily reflects cisgender individuals from Western cultural contexts. Gender‐diverse individuals from non‐Western cultural contexts (e.g., China) are at potentially high risk for WBI. Yet, no research has examined WBI and associated negative health consequences in this historically underrepresented population.A cross‐sectional, online survey sampled Chinese gender‐diverse individuals (N = 410, Mage = 22.33 years). Variables were self‐reported, including demographics, WBI, body shame, body dissatisfaction, disordered eating, physical and mental health status, and gender minority stress (e.g., internalized cisgenderism). Analyses included correlations and multiple hierarchical regressions.Pearson bivariate correlations demonstrated associations between higher WBI and more eating and body image disturbances and poor physical and mental health. After adjusting for age, BMI, gender identity, and gender minority stress, higher WBI was uniquely and positively associated with higher body shame, higher body dissatisfaction, higher disordered eating, and poor physical and mental health. Notably, WBI accounted for more unique variance in eating and body image disturbances (13%–25% explained by WBI) than physical and mental health (1%–4% explained by WBI).While replication with longitudinal and experimental designs is needed to speak to the temporal dynamics and causality, our findings identify WBI as a unique, meaningful correlate of eating and body image disturbances in Chinese gender‐diverse adults. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic had a particularly negative impact on mental wellbeing of vulnerable individuals, such as sexual minority men (SMM) living in Eastern Europe and Central Asia (EECA), where the social-political climate may be restrictive for SMM. Alcohol, tobacco, and other drugs (ATOD) use may be another factor contributing to exacerbated mental health among SMM in this region. Secondary analyses were conducted using data collected as part of the COVID-19 disparities survey from active users of Hornet, a popular geo-social networking app for SMM in late 2020. Using a subset of SMM living in EECA (n = 3209) and pre-validated scales (AUDIT-C and PHQ-4), we used multivariable logistic regression models to examine the relationship between changes in participants' use of ATOD and their mental wellbeing. Based on AUDIT-C, 35.1 % SMM screened for alcohol use disorder (AUD), 18.6 % reported an increase in alcohol use since the pandemic began. Over 30 % screened for depressive symptoms and anxiety based on PHQ-4 (30.4 % and 30.7 %, respectively). In multivariable models, AUD was significantly associated with screening positive for depressive symptoms and anxiety. Other factors associated with mental distress included lower socioeconomic status, unemployment, ethnic minority identity, IPV victimization, and financial and economic vulnerability. Cross-sectional data cannot be used to infer causality. Our results support the needs for integrated substance use reduction and mental health services tailored for SMM in EECA. Programs aimed at promoting mental wellbeing among SMM in EECA must consider both interpersonal and structural barriers. • Sexual minority men (SMM) reported increase in alcohol and tobacco (ATOD) use since the COVID-19 pandemic began. • SMM in Eastern Europe and Central Asia (EECA) reported high rate of mental distress, especially compared with other regions. • COVID-19 pandemic vulnerability contribute to worsening mental health of SMM when mental health service utilization was low. [ABSTRACT FROM AUTHOR]

AbstractBackground: College students who identify as a sexual minority (i.e., lesbian, gay, bisexual, or other sexual orientation) are at higher risk for e-cigarette use than their heterosexual or “straight” peers. However, little is known about factors, such as e-cigarette outcome expectancies, that might influence these differences in prevalence rates. Therefore, the current study examined differences between heterosexual and sexual minority college student e-cigarette users in terms of days of past-month e-cigarette use, e-cigarette dependence, and e-cigarette outcome expectancies. A secondary aim of the study was to examine whether outcome expectancies served as an explanatory mechanism in the association between sexual minority status and e-cigarette use frequency and dependence. Methods: Participants were heterosexual (n = 90; Mage = 19.65, SD = 2.70; 76.7% female; 77.8% White) and sexual minority (n = 44; Mage = 20.02, SD = 2.18; 68.2% female; 90.9% White) college student e-cigarette users who completed self-report measures. Results: Students who identified as a sexual minority reported greater e-cigarette dependence, more frequent past 30-day use, and greater negative consequences and positive reinforcement e-cigarette outcome expectancies. Follow-up mediation analyses indicated a significant indirect effect of sexual minority status on both days of past-month e-cigarette use and e-cigarette dependence through expectancies for negative consequences and positive reinforcement. Conclusions: These findings suggest that positive reinforcement and negative consequences outcome expectancies may be contributing to the disparities in e-cigarette use among college students who identify as a sexual minority and could be useful targets for cessation interventions for this population. [ABSTRACT FROM AUTHOR]

Studies have emphasized the importance of social support in mitigating the relationship between psychological distress and mental health effects, with family of origin and family of formation providing key sources of social support over the life course. However, LGBTQ+ people may experience family of origin relationships as a source of distress, while partners and friends may buffer the relationship between minority stress and psychological wellbeing. Through our online survey (March–June 2022), which was conducted when the social restrictions of the COVID-19 pandemic were lifted in the UK, we considered the association between psychological wellbeing and sources of social support by sampling n = 1330 LGBTQ+ and cisgender heterosexual adults. LGBTQ+ adults generally experienced poorer psychological wellbeing outcomes than did cisgender heterosexual people. For LGBTQ+ adults, social support from family of origin, a special person, or friends was not associated with depression, anxiety, or stress levels, but social support from family or a special person was positively associated with higher levels of life satisfaction. Our findings indicate the importance of considering negative as well as positive wellbeing. [ABSTRACT FROM AUTHOR]

Lesbian and gay (LG) people experience minority stressors, resulting in adverse mental health outcomes. To cope, many LG people engage in individualistic or collectivistic strategies, that is, self-distancing or connecting with their in-group, the LGBTQ+ community. Even though research suggests what may help LG people cope with minority stress, it is less clear how and under which conditions they do so. In this study, we examine how LG people employ individualistic and collectivistic strategies and what that entails for the negative relationship between minority stress and mental health. A total of 199 responses from British LG people were collected via the online crowdsourcing platform Clickworker. A custom mediation model indicated that, for collectivistic strategies, higher levels of minority stress were associated with increased LGBTQ+ community identification, and LGBTQ+ identification was positively related to high LGBTQ+ social support; in turn, LGBTQ+ social support was associated with positive mental health outcomes. For individualistic strategies, results show higher minority stress was related to an increased likelihood of individual mobility, but individual mobility was not associated with mental health outcomes. These findings highlight how collectivistic responses to minority stress might prove more reliable than individualistic ones in enhancing the mental health of LG people. [ABSTRACT FROM AUTHOR]

In the United States, an estimated 1.9 million youth 13 to 17 years of age (9.5%) identify as sexual and/or gender diverse (SGD), identifying as nonheterosexual and/or having a gender identity other than the assigned sex at birth.1 Up to 7% of SGD adolescents may have at least one parent currently or previously serving in the US military, an estimated 133,000 youth nationwide.1,2 SGD adolescents are highly exposed to acute and chronic stressors, including minority stress and discrimination, resulting in elevated rates of depression, anxiety, and suicidal ideation.3,4 SGD military-connected youth (ie, SGD youth with a parent or caregiver with military service experience) were found to be at even higher risk for these negative outcomes in one published report.2 While both military connection and SGD identity may foster strengths, these youth also face well-studied stressors,2,5 and the convergence of these identities and experiences is likely to produce greater challenges. Nearly half of military-connected youth are seen by civilian clinicians in local communities for primary care, and even more are seen for specialty care.6 As a result, all clinicians, both within and outside the military health system, and especially clinicians providing mental health care, must be familiar with these unique converging stressors facing SGD military-connected youth. [ABSTRACT FROM AUTHOR]

Both the sexual minority individual (SMI) and partner of the sexual minority individual (PSMI) in a mixed orientation relationship (MORE) experience stress, and stress related growth during the coming out process. However, the implications and experiences of this relationship through a dyadic perspective has yet to be explored. Using a phenomenological approach, this study examined the lived experience of the dyadic coming out process in MOREs through the theoretical lens of Meyer's (2003) minority stress model and Vaughan and Weahler's (2010) coming out growth (COG) model. Data analysis with nine MORE dyads provided a first-hand account of how minority stress and COG flow through the dyad before, during, and after SMIs and PSMIs engaged in the coming out process. The findings confirm the applicability of minority stress and COG theories to both members of the MORE. Themes that emerged in the data include awareness, disclosure, discovery, grief, support, and reconstruction. Mixed orientation relationships (MOREs) are intimate relationships of partners with differing sexual orientations. Individuals in these relationships experience stress and relational difficulties tied to the coming out process as a sexual minority. Research on MOREs have focused primarily on the stress related to a partner coming out as detrimental to the intimate relationship and little literature has examined this relationship under a stress related growth framework. The purpose of this study was to examine the lived experience of the coming out process of MOREs through the theoretical lens of Meyer's (2003) minority stress model and Vaughan and Weahler's (2010) coming out growth (COGs) model. The authors interviewed nine couples who identified as being in a MORE. Data analysis found minority stress and COG theories to be applicable to both members of the MORE. Themes that emerged in the data include awareness, disclosure, discovery, grief, support, and reconstruction. These findings are significant to mental health professionals by providing a systemic perspective through which to conceptualize common stressors and growth factors during the coming out process of a MORE. [ABSTRACT FROM AUTHOR]

This document provides a summary of various articles and studies related to LGBTQ+ issues and mental health. The topics covered include LGBTQ+ affirmative practices and challenges faced by LGBTQ+ individuals in Puerto Rico, South Africa, and the Philippines. The document also explores the experiences of transgender youth in school settings, changes in transprejudice among adolescents, and the experiences of same-sex couples in Taiwan. Additionally, it discusses LGBTQ+ rights and legislation in "neutral" countries, the impact of school climate on victimization among LGBQA+ students in China, and the representation of masculinities in South African film. The document concludes with summaries on sexual health needs of rural sexual minority adolescent males in the US, gender role discrepancy and male depression in Israel, and the impact of religiosity and sexual orientation on eating disorder symptomatology in Canada. These summaries provide valuable insights into the challenges and progress in LGBTQ+ rights and mental health support in diverse global contexts. [Extracted from the article]

Sexual minority individuals are at higher risk of mental health concerns than heterosexual individuals due to the impacts of minority stress. Previous counseling interventions for sexual minority individuals have focused on pathology and reducing negative symptoms. However, there is a need for more empirical counseling interventions that address these disparities from a positive psychology perspective. Utilizing a multiple probe single case research design, the current study examined the impact of a well-being therapy protocol for improving the psychological well-being for four sexual minority individuals. There was no functional relation observed for the Well-Being Therapy protocol on psychological well-being. Discussion of the findings and implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Suicidal ideation occurs at relatively high rates among adults identifying as sexual minorities compared to those identifying as heterosexual, and minority stress is one explanation for this disparity. Minority stress is known to associate with increased suicidal ideation, but research on how minority stress associates with suicidal ideation in sexual minority adults across the adult lifespan is lacking. Methods: Data were collected online from 284 sexual minority adults ranging in age from 18 to 85. Participants were recruited from Prolific and completed self‐report measures assessing past‐month suicidal ideation and multiple sexual minority stressors. Results: The minority stressors of acceptance concerns, concealment motivation, and difficulty processing one's identity were positively correlated with likelihood of past‐month suicidal deation. Age moderated the relationship between two minority stressors and suicidal ideation: identity uncertainty and internalized homonegativity. These relationships were only significant among older adults, compared to middle‐age and younger adults. Conclusion: Specific internalized minority stressors about one's sexual identity were significantly associated with past‐month suicidal ideation for older adults. More research is needed on how minority stress impacts recent suicidal ideation for sexual minority adults across the lifespan. [ABSTRACT FROM AUTHOR]

Objective: Sexual minority disparities in behavioral health (e.g., mental health and substance use) are well-established. However, sexual identity is dynamic, and changes are common across the life course (e.g., identifying with a monosexual [lesbian or gay] label and later with a plurisexual [queer, pansexual, etc.] label). This study assessed whether behavioral health risks coincide with sexual identity change among sexual minority people. Methods: Associations in a 3-year U.S. national probability sample of sexual minority adults were assessed between sexual minority identity change (consistently monosexual [N=400; 44.3% weighted], consistently plurisexual [N=239; 46.7% weighted], monosexual to plurisexual [N=19; 4.2% weighted], and plurisexual to monosexual [N=25; 4.8% weighted]) and five behavioral health indicators (psychological distress, social well-being, number of poor mental health days in the past month, problematic alcohol use, and problematic use of other drugs), controlling for demographic characteristics and baseline behavioral health. Results: Among female participants, monosexual-to-plurisexual identity change (vs. consistently monosexual identity) was associated with greater psychological distress (B=3.41, SE=1.13), lower social well-being (B=−0.61, SE=0.25), and more days of poor mental health in the past month (B=0.69 [Bexp=1.99], SE=0.23). Among male participants, plurisexual-to-monosexual identity change (vs. consistently plurisexual identity) was associated with lower social well-being (B=−0.56, SE=0.25), and identity change (regardless of type) was generally associated with increased problematic use of alcohol and other drugs. Conclusions: Sexual identity change is an important consideration for sexual minority behavioral health research, with changes (vs. consistency) in identity being an important risk factor for compromised behavioral health. Prevention and treatment interventions may need to tailor messaging to sexual minority men and women differently. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify and compare risk factors of substance use between heterosexual and LGB adults. Using data from the 2020 National Survey on Drug Use and Health (NSDUH), Chi-square, t-test, and standard multiple regressions were employed to analyze the data. The findings showed that LGB participants had significantly higher experiences with substances and initiated substance use earlier than heterosexual participants. Some risk factors were related to experiences with substance use for both groups (i.e. depression, emotional distress, age of first alcohol and marijuana use), but these factors accounted for more of the variance for LGB participants. Additionally, overall health was uniquely associated with experiences with substance use for LGB participants. These results have important implications for the design of culturally appropriate substance use prevention and intervention services for LGB individuals. [ABSTRACT FROM AUTHOR]

The present study examined the role of different forms of discrimination (individual-level, institutional-level, and both types of discrimination) in predicting identity concealment behaviors in a sample of sexual and gender minorities (SGM; n = 2296) living in Eastern Europe. Both the choice to engage in identity concealment at all and the frequency to which an individual concealed their identity were regressed onto each type of discrimination. Results of a logistic regression revealed that those who had experienced individual-level, institutional-level, or both types of discrimination were more likely to choose to conceal their identity than those who did not experience discrimination. Using a multivariate regression, each type of discrimination was found to have a positive association with frequency of identity concealment, with those who experienced both types of discrimination showing the strongest association. However, when controlling for country, the association between institutional-level discrimination and frequency of identity concealment was no longer significant. These findings suggest that not all forms of discrimination may have the same impact on SGM individuals and that experiencing multiple forms of discrimination may have compounding effects on one's choice to conceal their identity and the frequency to which they engage in this behavior. [ABSTRACT FROM AUTHOR]

Background and Objectives Population aging has led to an increased interest in cognitive health and, in particular, the role that stress plays in cognitive disparities. This paper extends previous work by characterizing coronavirus disease 2019 (COVID-19) stress type prevalence and its association with cognitive health in metro-Detroit among Black, Middle Eastern/Arab (MENA), and White older adults. Research Design and Methods Data come from a regionally representative sample of adults aged 65+ in metro-Detroit (N = 600; MENA n = 199; Black n = 205; White n = 196). We used generalized linear models to compare groups on sociodemographic, objective stress, and social stress indicators. Multiple group structural equation models evaluated whether COVID-19 stress predicted cognitive health and whether that association varied across racial/ethnic groups. Results MENA and Black older adults reported higher levels of objective stress than Whites. There were no racial/ethnic group differences in social stress. More objective stress was associated with better cognitive health, and more social stress was associated with worse cognitive health. The positive effect of objective stress was especially apparent for White older adults. Discussion and Implications Though it appears that minority stress was not exacerbated in the context of pandemic stress, links between greater objective stress and better cognitive health apparent among White older adults were not evident among MENA or Black older adults. Broadening health disparities research by including underrepresented populations allows us to elevate scientific knowledge by clarifying what is universal and what is unique about the stress process. [ABSTRACT FROM AUTHOR]

Purpose: Gender minority (GM) stress, resulting from distal (i.e., external) and proximal (i.e., internal) stigma-based stressors, is thought to drive mental health disparities among transgender and gender diverse (TGD) youth. We tested the gender minority stress and resilience (GMSR) model hypotheses that distal GM stress effects on mental health are partially mediated by proximal GM stress and moderated by GM-specific resilience (i.e., community connectedness, identity pride) among a U.S. national sample of TGD youth. Methods: As part of an HIV prevention study (NCT03185975), 159 TGD youth (ages 15–24) completed an online survey that included the GMSR measure, assessing distal and proximal GM stress and GM resilience, and the 18-item Brief Symptom Inventory, assessing past-7-day psychological distress. Three models linking GMSR constructs to psychological distress were tested using PROCESS v4.0: (1) simple partial mediation, (2) moderated partial mediation, and (3) serial partial mediation. Results: A direct effect of distal GM stress was observed in all models. An indirect effect through proximal GM stress alone was observed in model 1, but not models 2 or 3. In model 2, resilience did not moderate the effects of distal or proximal GM stress. In model 3, indirect effects were observed through proximal GM stress and GM resilience serially as well as GM resilience alone. Conclusion: Larger prospective studies are needed to confirm the role of GM resilience as a mediator, rather than moderator, of GM stress effects on mental health and a critical, rather than supplementary, target for mental health intervention among TGD youth. [ABSTRACT FROM AUTHOR]

Compelling evidence demonstrates that Lesbian, Gay, and Bisexual (LGB) populations have a higher prevalence of mental disorders compared to their heterosexual peers (Meyer in Psychol Bull 129(5):674–697, 2003). This has been attributed to minority stressors in the minority stress model. Since this model was established in 2003, there have been significant socio-political events that discriminate against SGM LGBTQ+ individuals. There have also been rival hypotheses, including rejection sensitivity (Feinstein in Arch Sex Behav 49(7):2247–2258, 2020) and 'misperceiving of neutral events' (Bailey in Arch Sex Behav 49(7):2265–2268, 2019). Examine SGM perspectives and investigate how well they align with Meyers model (2003). 16 qualitative studies capturing SGM minority stress experiences were extracted from scientific databases and, thematically analysed deductively using Meyer's minority stress model, in addition to generating original subthemes. This systematic review thematically analysed 16 eligible studies, which generated 6 superordinate themes (Discrimination, Lack of representation, Navigation, Harassment, Depersonalization and Mental Health Outcomes) and 18 sub-themes. These themes were then situated in categories from Meyer's Minority Stress Model (2003) (Circumstances, Minority Status, Distal stressors, Proximal stressors, and Mental health outcomes). SGM-specific stress experiences integrated into the Minority Stress Model (circumstances, navigation, distal, proximal, and mental health outcomes). The collected data elaborated the model with sub-themes such as discrimination, lack of representation, vigilance, depression, body image and positive coping in sum, this study offers support for and updates Meyer's minority stress model whilst rejecting competing theories (Bailey 2019; Feinstein 2019). [ABSTRACT FROM AUTHOR]

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation. A large international sample (n = 1156) of TNB adults (n = 654 partnered; n = 502 single) reported on minority stress experiences, relationship status and quality, and mental health outcomes (i.e., depressive symptoms and suicidal ideation). The effects of victimization and rejection on depressive symptoms and suicidal ideation were attenuated among partnered individuals. However, once relationship quality was considered, the buffering effects of relationship involvement applied only to those in more satisfying relationships; the stress-buffering effects were not observed among those in distressed relationships. Of particular importance, general interpersonal satisfaction did not act as a minority stress buffer, suggesting there may be unique stress-buffering effects of being in a satisfying romantic relationship on depressive symptoms and suicidal ideation. The cross-sectional nature of the current study precludes definitive conclusions regarding causation. These findings suggest that romantic involvement may serve a stress-buffering role for TNB adults, but only when these relationships are satisfying. Our results have important theoretical and clinical implications, and further research is needed to investigate the utility of relationship interventions to buffer the effects of TNB minority stress on depressive symptoms and suicidality. • Being partnered buffers TNB minority stress effects on depression and suicidality. • Buffering effects applied only to satisfying romantic relationships • Buffering effects most evident for interpersonal minority stressors • General interpersonal satisfaction did not buffer minority stress effects. [ABSTRACT FROM AUTHOR]

Abstract Purpose Sexual and gender minorities (SGMs) show a heightened risk of disordered eating compared to heterosexual and cisgender people, a disparity which may be caused by exposure to minority-specific stressors, such as discrimination and violence. This systematic review aims to summarize available evidence on the role of minority stress in disordered eating and SGM-specific aspects. Methods Following PRISMA guidelines, scientific search engines (EBSCO, PUBMED, Web of Science) were screened up to 31st of January 2024, including English-language original research papers containing analyses of the relationship between minority stress and disordered eating. 2416 records were gathered for screening. After application of inclusion and exclusion criteria, thematic analysis was conducted regarding 4 research questions: effects of minority stress on disordered eating, mediating factors, specificities of SGMs and differences between identity categories. Results 30 studies were included. Several aspects of minority stress are reliably associated with different forms of disordered eating. The relationship between minority stressors and disordered eating is mediated by aspects such as shame, body shame, or negative affect. SGMs show several specificities, such as the presence of a role of LGBTQIA + communities and additional gender-related pressures. Bisexual people and gender minorities appear to feature comparatively higher risks, and gender-related factors shape paths leading to disordered eating risk. Conclusion Minority stress is an important predictor of disordered eating, making SGM people’s health particularly at risk. Institutional and organizational anti-discrimination policies are needed, as well as further research. Clinical interventions may benefit from exploring and incorporating how minority stressors impact SGM people. Evidence level I—Systematic review.

The aim of this study was to examine the self-perceived reasons of suicide attempts among sexual and gender minorities (SGM). We surveyed SGM living in Canada (n = 2778) and respondents who had attempted suicide answered open-ended questions about their perceived reason(s) of their first/only attempt (FOA) and last attempt (LA) (for those who attempted multiple times). Responses were double-coded and categorized as discrete findings. A quarter (25%, n = 695) of the total sample reported a history of suicide attempt, of whom 72% reported multiple attempts. Respondents described a wide variety of reasons for their suicide attempts, with an important number of individuals reporting multiple reasons (corresponding to 47.5% of FOA and 43% of LA). Emotional issues (FOA:42.1%, LA:44.0%) were the most prevalent category of reasons for suicide attempts followed by experience of mental illness (FOA:30.1%, LA:36.1%). Other common reasons included violence (FOA:23.2%, LA:10.2%), interpersonal conflict (FOA:13.4%, LA:6.0%), stress related to life circumstances (FOA:9.5%, LA:16.7%), relationship issues (FOA:7.9%, LA:13.3%), and minority stress related to sexuality (FOA:11.1%, LA:6.2%) and gender identity (FOA:5.0%, LA:6.8%). SGM assessments of the reasons underlying their suicide attempts yielded a variety of factors, many of which were absent from the literature on SGM suicide but amenable to tailored interventions. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, trans, intersex, and queer (LGBTIQ+) individuals encounter persistent structural inequalities and discrimination that can lead to detrimental psychological and physiological health outcomes. Amid evolving legal landscapes, little attention has been directed toward understanding the physiological health effects of societal shifts on these communities. This study aims to explore the impact of a national marriage equality vote and associated debates on psychological and biological stress among LGBTIQ+ individuals and cisgender, heterosexual, endosex individuals (termed cis-heterosexual) in Switzerland. We gathered longitudinal survey and biological data collected in hair samples among LGBTIQ+ and cis-heterosexual individuals before, during, and after the 2021 national vote (survey data: NT1T2 = 954; NT2T3 = 880; biological data: NT1T2 = 393; NT2T3 = 354). Preregistered analyses reveal a notable increase in biological stress levels (i.e., cortisol and cortisone levels), but not perceived stress, among both LGBTIQ+ as well as cis-heterosexual individuals who were close to them during the campaign. Results further point out the negative impacts of the campaign against marriage equality (i.e., no-campaign) on LGBTIQ+ individuals' biological stress levels as well as on those of their allies. These effects were, however, moderated by exposure to the campaign for marriage equality (i.e., yes-campaign), indicating the powerful buffering effects of the yes-campaign on the impact of discrimination on individuals' health. However, these positive effects appear to come at a cost, potentially impacting the well-being of individuals engaged in advocating for the yes-campaign. This research underscores the lasting impact of political campaigns on individuals' health. [ABSTRACT FROM AUTHOR]