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his research project firstly considers what is known about Queer women's experiences of minority stress, and the ways they respond. Then a qualitative project explores and seeks to understand the impact of minority sexual orientation for UK clinical psychology trainees who identify as female and gay or lesbian. Section A: This literature review presents the current theoretical models and empirical data for Queer women and minority stress. It then uses a meta-ethnographic approach to extract primary and second order concepts from thirteen qualitative papers which describe Queer women's experiences of minority stress and their various responses. Third-order constructs of 'threat', 'response' and 'position' are extracted from this data and a model of how these interact for Queer women is described. Implications of how minority stress may present in Queer women, and the interaction between mental health and responses to minority stress are discussed. Section B: This empirical paper explores the experiences for lesbian/gay women on clinical psychology training, and the impact of minority sexual orientation on personal and professional development. Eight interviews are analysed using Interpretive Phenomenological Analysis. Three super-ordinateand nine subordinate themes emerged relating to psychological, relational and theoretical processes trainees engaged in largely in the absence of a shared reflective practice around sexuality and gender. Implications for training and practice are discussed.

This thesis consists of three separate papers: 1) a systematic literature review, 2) an empirical study, and 3) a critical and reflective review of the research process. The systematic review (Paper 1) has been prepared for submission to The Journal of Affective Disorders. The paper presents a narrative systematic review of the literature that reported quantitative analyses on associations between one or more minority stress factor and suicidal ideation and/or behaviours amongst Transgender and Gender Non- Conforming (TGNC) adults. Twenty-eight studies were included, with an overall number of participants totalling 101,378. Findings presented in a narrative synthesis highlighted positive associations between external and internal minority stressors and suicidal ideation and behaviour. Community resilience was negatively associated with suicidal outcomes but did not consistently buffer the effects of minority stress. Dysfunctional individual coping was associated with a greater likelihood of suicide attempts. In light of these findings, individual and systemic clinical implications and recommendations for future research are outlined. The empirical study (Paper 2) has been prepared for submission to The Journal of Gay and Lesbian Mental Health. The paper is a qualitative study that seeks to gain a greater understanding of self-harm urges and behaviour amongst non-binary young adults and what helped them to manage these urges. The impact of Covid-19 on participants experiences was also explored. Eleven participants were recruited to take part in the study. Data were collected and analysed in line with a constructivist grounded theory approach. This method allowed for the emergence of a theoretical framework, which consisted of seven categories: (1) Growing up feeling outside of the binary, (2) The pain of living in a cisnormative world, (3) Family discord, (4) Self-harm, (5) Suicidal ideation, (6) What helps, and (7) Life in Covid-19. Findings offer clinical implications and highlight a need for increased awareness, understanding and acceptance of non-binary identities. Paper 3 offers a critical and reflective appraisal of the entire research process. Strengths and limitations of the systematic review and empirical study are discussed, as well as theoretical and clinical implications of the work. Personal and professional reflections on the process of conducing the thesis are also discussed.

Section A: This section is a systematic literature review of empirical research exploring type and extent of social and legal transitions and their relationship with mental health and social wellbeing. The review included thirteen quantitative and one qualitative study. Most studies were published within the last five years, all within the last nine, demonstrating the relevance and importance of research in transgender and gender-diverse populations. The review highlighted numerous methodological challenges to researching such a diverse population with varying experiences. Clinical, policy and research implications are discussed. Section B: This section details a cross-sectional survey exploring gender identity-related minority stress and wellbeing in adolescents referred to a gender identity clinic in the UK. The internal consistency of an adapted measure of gender identity minority stress for adolescents is reviewed, with the measure demonstrating good internal consistency. On average, participants reported experience of 17 out of the 54 minority stressors assessed. The most commonly reported minority stressors related to negative expectations from others, internalised transphobia and transnegative communication from others. Statistical analyses found no significant differences in gender identity minority stress between minority and majority groups. Intersectionality is explored alongside clinical implications, limitations and future research.

It is widely accepted that the LGB (Lesbian, gay and bisexual) population have a higher risk of psychological distress compared to their heterosexual counterparts. Meyer (2003) proposed the minority stress model to explain this increased prevalence. This model proposed that the LGB population are subjected to additional stressors due to their minority status which results in the increased psychological distress observed. The purpose of this study was to investigate some of the risk factors proposed by this model, specifically experiences of sexual prejudice, negative internalised beliefs about homosexuality/bisexuality, coping strategies and how these factors interact to influence the development of psychological distress. This study included 542 LGB individuals who completed measures of sexual prejudice, internalised homophobia, coping strategies and current levels of psychological distress using an online survey. The study found a high prevalence of sexual prejudice within the sample, with 84% of the sample reporting at least one experience of sexual prejudice. 67% reported being verbally abused and 17% reported being physically assaulted. A high number of participants scored above the cut-off for a diagnosis of depression (27%) and anxiety (19%). Regression and path analysis revealed that maladaptive coping had the strongest effect on psychological distress. Sexual prejudice and internalised homophobia, also both had a significant direct impact upon psychological distress, and they were also partially mediated by maladaptive coping. Problem-focused coping was found to be a protective factor with a direct, albeit weak, effect on psychological distress. Problem-focused coping also partially mediated the relationship between sexual prejudice and psychological distress, slightly reducing the negative impact of sexual prejudice. The results suggest that maladaptive coping was the greatest risk factor, out of the ones measured, in the development of psychological distress in the LGB population. The outcomes suggest that clinical psychologists may wish to target their interventions at the development of more adaptive coping strategies, and the reduction of internalised homophobia. They should consider ways to reduce experiences of sexual prejudice by working at a community level to reduce the stigma of homosexuality/bisexuality.