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Introduction: Khwaja sira (third gender people) in Pakistan experience several forms of social marginalization, which were likely exacerbated during the COVID-19 pandemic. Methods: We completed 45 interviews with khwaja sira in Mingora, Khyber Pakhtunkhwa, Pakistan to understand the impact of the COVID-19 pandemic on their daily lives. Interviews were conducted in Pashto, digitally audio-recorded, and analyzed using Minority Stress Theory, which posits that sexual and gender minorities are at increased risk for mental health disorders due to the psychosocial stress resulting from experiences of stigmatization and discrimination. Results: We identified three overarching themes: (1) financial insecurity; (2) social vulnerability; and (3) resilience. Under the theme of financial insecurity, we identified three subthemes: (1) loss of income and financial stress; (2) dependence of khwaja sira's family members on their income; and (3) risk from engagement in sex work. Under the theme of social vulnerability, we identified three subthemes: (1) heightened social isolation; (2) psychological distress; and (3) the inability to access medical care. There were no additional subthemes under the code of resilience. Conclusion: Findings demonstrate that although khwaja sira experienced heightened vulnerabilities throughout the pandemic, they identified resilient coping strategies to handle these challenges. [ABSTRACT FROM AUTHOR]

Introduction: This review synthesizes the literature on the associations between concealment and mental health problems among Black, Indigenous, and People of Color (BIPOC) men who have sex with men (MSM). Methods: Following PRISMA guidelines, a systematic search was conducted using five databases to identify peer-reviewed articles and published dissertations. Results: Eleven studies were included. Mental health outcomes were (a) poor psychological well-being (k = 7), (b) depressive symptoms (k = 6), (c) anxiety symptoms (k = 4), and (d) substance use (k = 2). Conclusions: Results suggest potential differential associations by race/ethnicity. Methodological limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Introduction: This study examined self-reported levels of depression, anxiety, and stress and the correlation with social stigma in a sample of sexual minority people in Kosovo. Methods: One hundred and three Kosovo sexual minority people (aged 18 to 50) completed questionnaires about social stigma (HHRDS), depression, stress, and anxiety (DASS-21). Descriptive statistics were calculated, a multivariate ANOVA examined differences between sexual minority people, and the bivariate association between HHRDS and DASS-21 scores was examined. Results: Most participants reported moderate to high levels of depression, anxiety, and stress with positive associations with social stigma. Conclusion: Sexual minority people in Kosovo are experiencing a mental health crisis. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsConclusionData suggest there are within-group variations in cannabis consumption among sexually diverse individuals. However, less is known about specific sexual orientations, such as Two-Spirit, asexual, pansexual, and queer (2SAPQ+), when compared with lesbian, gay, and bisexual people, as they often are not given an option to indicate their identities on surveys, leading them to be grouped with bisexuals. This study aimed to compare the relationship between LG and 2SAPBQ+ (including bisexual) identification and routine cannabis use, and whether it was mediated by minority stress.Data were collected across two time points from 851 Two-Spirit, lesbian, gay, bisexual, queer, and questioning (2SLGBTQ+) youth participants. Structural equation modeling (SEM) was employed to analyze whether latent constructs within the minority stress framework mediated the relationship between sexual identity and cannabis use longitudinally.A preliminary logistic regression confirmed that 2SAPBQ + individuals were more likely to consume cannabis than LG individuals. The results suggest that the minority stress constructs accounted for a significant portion of the variance within the relationship between sexual orientation and cannabis use.The pathway between sexual orientation and routine cannabis use was complex. Findings signal that not all sexual minority individuals should be grouped into one category and call for attention to careful measurement practices. [ABSTRACT FROM AUTHOR]

Typically, LGBTQ + people sleep more poorly than their cisgender heterosexual (cishet) counterparts. However, there is a lack of literature investigating the impact of different lifestyle/psychosocial factors, outside of minority stress, on the negative relationship between being a sexual/gender identity minority and sleep quality. The current study aims to help fill critical gaps in the literature by looking at the effects generalized stress, COVID-19-related stress, social support, and sleep hygiene have on this relationship. Two hundred and seventy-three participants (74 LGBTQ+; 199 cishet), recruited online, completed a series of questionnaires assessing sleep quality, sleep hygiene, generalized stress, minority stress, COVID-19-related stress, and social support. Analyses showed that LGBTQ + participants reported worse sleep quality, higher levels of generalized stress and COVID-19 stress, and smaller social networks than their cishet peers. Generalized stress fully mediated the relationship between sexual/gender identity and sleep while sleep hygiene partially mediated the relationship between generalized stress and sleep quality. Social support and COVID-19-related stress did not moderate the relationship between generalized stress and sleep. Worse sleep quality in LGBTQ + than cishet adults is explained by differences in generalized stress and sleep hygiene. Stress management and sleep hygiene interventions may help prevent the negative associations between being LGBTQ + and poor sleep quality. [ABSTRACT FROM AUTHOR]

Sexual and gender minority young people (SGMY) experience mental health disparities and are overlooked in mental health practice and research. Self-compassion is a protective factor that promotes youth psychological well-being. This study examines SGMY perceptions of self-compassion and their experiences participating in self-compassion practices. SGMY (n = 30) ages 16–29 participated in empirically supported self-compassion practices. Using grounded theory, researchers uncovered three themes. SGMY indicated that (1) the practice of self-compassion may help SGMY cope with internal/external homo/bi/transphobia, (2) cultivating self-compassion can enhance well-being, and (3) self-compassion can support coping with difficult thoughts and emotions. Self-compassion may be a helpful approach for SGMY. Implications for SGMY mental health are explored. [ABSTRACT FROM AUTHOR]

LGBTQ + people are often studied as a uniform population. This study sought to examine health factors and outcomes across cisgender (CG) minorities, transgender (TG) minorities, and nonbinary/genderqueer (NBGQ) minorities. A self-reporting, cross-sectional survey was distributed to a sample of LGBTQ + people in a Midwest state. Binary logistic regressions were analyzed to identify significant minority subgroup differences in health factors and outcomes across gender identity. Compared to CG minorities (n = 520), TG minorities (n = 42) had higher odds (ORs = 2.0 to 3.9) of having a depression diagnosis, overall poor health, suicide ideation, and victimization. Likewise, compared to CG minorities, NBGQ minorities (n = 69) had higher odds (ORs = 1.9 to 4.2) of having depression symptoms, disability, a suicide attempt, and victimization. There were no significant differences in health factors and outcomes between TG minorities and NBGQ minorities. These gender-specific disparities may be secondary to unique obstacles (e.g., gender minority-related systemic discrimination) that gender diverse minorities face much more often than CG minorities. Further investigation into these distinctive minority subgroups is needed to establish future guidance for understanding and optimizing healthcare in LGBTQ + communities. [ABSTRACT FROM AUTHOR]

AbstractIntroductionResultsDiscussionThis paper reviews the literature on suicidal ideation, suicidal behavior, suicide methods and correlates of suicidality among Nigerian LGBT persons. Understanding the suicidality-related issues facing LGBT Nigerians can inform the designing of evidence-based interventions to reduce suicidality.Findings revealed that Nigerian LGBT persons experienced self-harm, suicidal ideation, suicide attempts and the repetition of suicidal behavior using suicide methods such as pesticide self-poisoning, jumping, hanging, and overdose of medicines. LGBT persons who attempted suicide more than once reported experiencing different forms of minority stress. Several LGBT suicide attempters and ideators reported experiencing prior internalized homophobia, anti-LGBT bullying in schools and the larger society, anti-LGBT discrimination from family and conversion therapy. Minority stress was found to be linked with self-harm, suicidal ideation and suicide attempts among Nigerian LGBT persons. Additionally, experiencing anti-LGBT discrimination, conversion therapy and depression were found to be correlates of suicidal ideation and suicide attempts among Nigerian LGBT persons.This study highlights the importance of addressing the minority stress experienced by Nigerian LGBT persons in order to reduce their vulnerability to suicidality. Finally, this study highlights research gaps and discusses the implications of the study findings for suicide prevention interventions, advocacy and policy making in Nigeria. [ABSTRACT FROM AUTHOR]

This study explores the relationship between sexual identity, coming out, and eating disorders to more fully understand the high rates of eating disorders and body dissatisfaction among sexual minority men. A sample of 15 sexual minority men (14 gay, one queer) with a diagnosed eating disorder completed qualitative interviews about their experiences related to their sexual identity, coming out process, and eating disorder. Qualitative data analysis based on grounded theory strategies revealed that the majority of participants identified their coming out process as playing a notable role in their body dissatisfaction and eating disorder. After coming out, participants identified unique stressors from within the community of sexual minority men. Participants' responses were categorized into four theoretical constructs: (1) The Mental Health Toll of the Closet, (2) The Mental Health Toll Out of the Closet, (3) The Mental Health Toll of Assimilating to the Gay Community, and (4) The Mental Health Toll of Gay Dating and Sex. The findings are contextualized based on three relevant theories: minority stress theory, intraminority gay community stress theory, and objectification theory. This study found the process of coming out, as well as navigating stressors within the mainstream gay community, are critical to more fully understanding the disparities in eating disorders among sexual minority men. [ABSTRACT FROM AUTHOR]

Sexual minority emerging adults in Appalachia face multiple sources of stigma and discrimination. We conducted four focus groups and five one-on-one interviews with sexual minority young adults and community stakeholders. Themes emerged from qualitative analysis: (1) Appalachian culture engenders discrimination and isolation; (2) a need to identify safe spaces; (3) lack of access to identity-affirming health services; and (4) participants draw strength from limited but persistent resistance, advocacy, and visibility. Sexual minority emerging adults experience intersectional stigma in a socially conservative Appalachian setting. Attention to their unique experiences points toward specific service and community support needs. [ABSTRACT FROM AUTHOR]

No study to date has reviewed the evidence base concerning prevalence and correlates of depression, anxiety, non-suicidal self-injury, and suicidality amongst LGBTQ people in Southeast Asia. We carried out a systematic review of quantitative articles (n = 25) identified through electronic databases. Heightened prevalence of mental health difficulties and minority stressors were found amongst Southeast Asian LGBTQ people which included significant effect size differences relative to cisgender and heterosexual people. This review underscores the need for a more nuanced understanding of minority stressors and protective factors to inform mental health prevention efforts. [ABSTRACT FROM AUTHOR]

Introduction: The coming out (CO) process frequently entails moments of questioning and challenge, as well as strength and resilience. The aim of the present study was to investigate the CO process and identity development of lesbian, gay, and bisexual (LGB) people through their own life narratives. Method: Adopting a social-constructionist perspective, we administered the Life Story Interview (LSI) from the qualitative protocol of the Generations Study. In total, 64 LGB people aged 23–75 participated in the study. Interviews were analyzed using the semiotic enunciative square technique, based on discourse analysis and mitigation markers. Result: The present study highlighted how participants' life stories were characterized by fluctuating moments lived between certainty/uncertainty, revelation/concealment, denial/non-denial (i.e., "blocked identity" vs. assertive-agent identities), and acceptance/non-acceptance (i.e., aware vs. fearful identities). Conclusion: The perspective of social constructionism was shown to be appropriate for investigating the CO process. Implications for clinical practice and future research are discussed. [ABSTRACT FROM AUTHOR]

We aim to identify the relationship between belongingness, internalized homonegativity, and depression among LGBQ members of the Church of Jesus Christ of Latter-day Saints (CJCLDS). Three hundred and eight sexual minority current and former CJCLDS members were recruited using convenience sampling to complete an online survey. CJCLDS belongingness alone was health-protective for current members of the CJCLDS. Internalized homonegativity did not moderate this relationship. Belongingness in the CJCLDS may be health-protective for sexual minority members of the CJCLDS, whereas LGBQ belongingness had no effect in this sample. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse individuals experience increased suicidality in comparison to same-aged peers. Protective factors—in particular, social support—may ameliorate painful life events and circumstances. Using a sample of 217 adults obtained through convenience chain-sampling methods with recruitment requests posted to list-servs, distributed to organizations related to LGBTQ issues, and social media, the current study tested whether social support moderated participants' experiences of gender minority stress and suicidality, and whether the type of social support changed the relationship between stress and suicidal ideation. Family and hetero-cisgender friend supports were significantly related to gender minority stress and suicidal ideation. However, neither LGBT-social support nor significant other support were found to moderate the relationship. Translation of these findings to clinical and research settings are provided. [ABSTRACT FROM AUTHOR]

Much of what shaped my career was set in the early years of the HIV epidemic, perhaps most importantly how I came to understand the impact of stigma on gay men's mental health as magnified by AIDS. His work includes study of adult development in gay men, the mental health effects of same-sex marriage denial, psychological and social well-being in sexual minority populations, and psychiatric issues in HIV-related mental health. RMK: It's gratifying for me to be one the first out residents at Columbia and to see at this institution and elsewhere historic change in acceptance and integration of LGBT trainees and colleagues, although I appreciate progress is not uniform, particularly for transgender colleagues. Robert Kertzner, MD, is an Associate Clinical Professor of Psychiatry at Columbia University and a clinician, researcher, and educator in the fields of LGBT and HIV mental health. [Extracted from the article]

Sexual minority men face mental health, substance use, and HIV disparities, all of which can be understood by minority stress and intersectionality theories. With the emergence of COVID-19 and considering its disproportionate impact on Latinx and sexual minority communities, Latino sexual minority men (LSMM) may be facing unique consequences of this new pandemic that intersect with pre-COVID disparities. The purpose of the current study is to explore the impact of the COVID-19 pandemic on LSMM's intersectional minority stress, general stress, and coping, filling a gap in the current literature. The current rapid qualitative study explores the impact of COVID-19 on LSMM in South Florida who reported being HIV-negative (N = 10) or living with HIV (N = 10). The rapid analysis revealed themes of exacerbated intersectional minority stress and general stress in the context of COVID-19, some of which was related to the impact of pre-COVID-19 disparities in the LSMM community. Participants reported a variety of coping responses, some of which participants found helpful and others (e.g., substance use) which further exacerbated disparities. The findings underscore the need to scale up and disseminate behavioral health resources to LSMM to address the impact of the COVID-19 pandemic on this community's health and well-being. [ABSTRACT FROM AUTHOR]

The present study examined whether sexual identity (bisexual/pansexual versus gay/lesbian) moderated associations between risk factors and lifetime suicide attempt (SA). Community/college adults who identified as sexual minorities (N = 231) completed a survey examining suicide-related risk factors. Greater discrimination and less social support from friends and significant others were associated with greater odds of lifetime SA for both groups, whereas greater emotion dysregulation and rumination were only associated with greater odds of lifetime SA for bisexual/pansexual individuals. There are common and unique risk factors for SA among subgroups of sexual minorities, which may have intervention implications. [ABSTRACT FROM AUTHOR]

Internalized sexual stigma, adult attachment, relationship satisfaction, and emotion regulation pay a major role in predicting depression in minority populations. We examined the variables in a sample of 165 gay (64.8%) and bisexual men (35.2%), ages 19-68 years (M = 36.2; SD = 11.6). Internalized stigma, attachment insecurity, relationship satisfaction, and emotion dysregulation predicted depression; emotion regulation mediated the relationship between internalized stigma and depression, between attachment and depression, as well as between relationship satisfaction and depression. Findings suggest the importance of improving educational community programs on sexual prejudices and on social homo and bi-negativity. [ABSTRACT FROM AUTHOR]

Background: Expressive writing exercises are associated with psychological benefits for LGBTQ + adults processing sexual minority stressors, but the processes through which this occurs remain unclear. Methods: A discovery-oriented task analysis was conducted on emotion-focused expressive writing responses about troubling heterosexist experiences. Eighteen cases were analyzed in total. Results: The analyses produced a four-stage model that describes the processes of resolving distress related to heterosexism. Conclusion: Results provide guidance for LGBTQ + affirmative mental health practitioners by naming the processes that clients may experience on the pathway to healing and identifying common obstacles to progress that clients may exhibit. [ABSTRACT FROM AUTHOR]

The study explored the unique associations of individual identity-based discrimination and relationship-based discrimination with mental health among sexual minority male couples. It also examined whether couples' relationship functioning moderated associations between relationship-based discrimination, the experience of one's romantic relationship being devalued, and mental health outcomes. Baseline dyadic data drawn from a clinical trial involving 70 couples (N = 140) were analyzed using Actor-Partner Interdependence Modeling. The sample consisted of sexual minority men, of which 54.3% identified as a person of color. Each partner completed the computerized survey independently. Data were collected using the Relationship Marginalization Scale, Dyadic Adjustment Scale, Generalized Anxiety Disorder-7, and Center for Epidemiologic Studies Depression Scale-Revised scales. Dyadic adjustment moderated (i.e., buffered against) the association between relationship-based discrimination and depressive symptoms. The effects appeared to follow an intra-individual pattern (BACTOR = −0.06, p =.048 and BPARTNER = −0.07, p =.030). The interaction terms predicting anxiety yielded non-significant results. The current research suggests that dyadic functioning buffers against the effects of stigma. These findings point to the potential utility of interventions to improve relationship functioning into interventions addressing stigma among partnered sexual minority men. [ABSTRACT FROM AUTHOR]

Introduction: Much of the sexual minority literature is developed from a deficit-based perspective with little consideration for flourishing. The purpose of the current study is to determine whether positive emotions offset the relationship between negative emotions and flourishing. Method: Data were collected from sexual minorities (N = 388) who completed an online survey. Result: Positive emotions moderated the association between negative emotions and flourishing; the relationship was substantially weakened at higher levels of positive emotions. Conclusion: Results offer preliminary evidence for positive emotions as a promotional factor to flourishing and provide insights to use positive psychological interventions with sexual minorities. [ABSTRACT FROM AUTHOR]

Mostly heterosexual adolescents experience heightened depressive symptoms compared to heterosexual adolescents, though prior comparisons with other sexual minority adolescents have been inconsistent and rarely used a comprehensive measure of sexual orientation. U.S. high school adolescents were considered mostly heterosexual if they either (a) self-identified as mostly heterosexual or (b) identified as heterosexual but reported same-gender attraction and/or sexual behavior. Depressive symptoms among both groups of mostly heterosexual adolescents were higher than exclusively heterosexual adolescents but similar to other sexual minority adolescents. Mostly heterosexual adolescents may be at risk for depression like their other sexual minority peers. [ABSTRACT FROM AUTHOR]

Sexual minorities are at risk for poorer mental health outcomes due to unique minority stressors. Anticipated stigma and concealment are documented as predictors of worse outcomes among this population; however, limited research has examined how interactions between minority stressors contribute to health outcomes. This study of sexual minorities (n = 147) recruited through social media examined the moderating role of concealment on the relationship between anticipated stigma and psychiatric symptoms (e.g., anxiety, depressive symptoms). Moderation analyses revealed concealment significantly moderated the relationship between anticipated stigma and anxiety symptoms, but not depressive symptoms. Clinically addressing minority stress may reduce psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Due to minority stress, sexual minority men experience mental health disparities. Sexual minority men who engaged in cognitive-behavioral therapy to address the minority stress underlying their distress completed an exercise eliciting their own resilience. This exercise involved writing an advice letter to a hypothetical peer about coping with minority stress. Qualitative analysis of these letters yielded 18 codes grouped into three categories reflecting resilience to minority stress. Categories included (1) cultivating internal affirmation strategies, (2) building supportive relationships and community, and (3) using cognitive and behavioral skills to cope with minority stress. Findings highlight this population's resilience and suggest building resilience through treatment. [ABSTRACT FROM AUTHOR]

This study explores the body image ideals among a racially/ethnically diverse sample of gay and bisexual men in the United States. Furthermore, it examines the role body image ideals play on mobile dating applications ("dating apps") for gay and bisexual men. Guided by Objectification Theory and Minority Stress Theory, 30 semi-structured interviews were conducted with young gay and bisexual men (ages 18-30 years) in Massachusetts. Using thematic analysis, three central themes emerged: 1) the ideal male body: muscular, thin, and light-skin toned; 2) discrimination; 3) navigating deviations from the ideal body: appearance comparison, retaliation, and body regulation and weight control behaviors. Our results suggest the dominant ideal male body is muscular and thin. Racial/ethnic minority participants added this ideal is further characterized as white/light-skin toned. Further, participants reported a wide variety of discriminatory experiences on dating apps, especially men deviating from the dominant body ideal. Over half of the men in our sample who reported use of dating apps recounted at least one experience of racial/ethnic discrimination or body weight and shape discrimination on dating apps. While some dating apps have modified their policies to promote inclusivity, further research into the impact of dating app-mediated discrimination are warranted. [ABSTRACT FROM AUTHOR]

This qualitative study examined the process of Internalized Sexual Stigma (ISS) in a sample of Egyptian gay men. Participants' experience of ISS was explained using the theoretical understanding that it represents an internal form of minority stress, which is the excess and harmful stress often experienced by individuals from stigmatized social categories due to their minority position. Thematic analysis of interviews with eight Egyptian gay males suggested that these men experienced internal minority stress as a result of the sexually-prejudiced messages they received from different sectors of their society, including its non-affirming religious institutions. Moreover, thematic analysis added cultural understanding to this theoretical explanation by producing an emerging theme that highlighted the possible role of societal pressure to meet gender expectations in perpetuating this problem. Recommendations for mental health professionals who conduct clinical interventions with gay men from diverse populations are provided. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) people experience significant disparities in mental health and substances use disorders. This study reached out to mental health professionals (MHPs) who treat SGM people to determine mental health priorities for research that would better inform their clinical practice. MHPs were surveyed and asked to rate items based on a likert-type scale. Open-ended questions were also queried and analyzed qualitatively. Five items had the highest mean scores: "stressors related to SGM status," "lifestyle factors that support emotional resilience and wellbeing," "depression," "intimate relationships," and "suicide." Intersecting identities and sexual relationships emerged as qualitative themes. [ABSTRACT FROM AUTHOR]

This paper explores factors which contribute to happiness among lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals as part of the largest study to date of mental health in the LGBTI community in the Republic of Ireland (LGBTIreland study). This mixed methods study informed by minority stress theory, contained an online survey (n = 2,264) which explored various aspects of mental health and distress, but also the extent and experience of happiness and concomitant factors. The survey included ratings of happiness and life-satisfaction and an open-ended question on LGBTI related happiness. Quantitative findings showed a mean happiness rating of 6.58 out of 10 (11-point scale), which is lower than the general population in Ireland. Those identifying as gay men or lesbian women rated their happiness significantly higher than bisexual, transgender, or intersex participants. There was also an effect for age: teenage LGBTI participants had significantly lower ratings than other age groups. Happiness ratings very highly correlated with life-satisfaction (.88). A multiple linear regression showed happiness was predicted most significantly by self-esteem and being in a relationship. Qualitative findings emphasized the importance of self-acceptance and peer support for happiness. Findings are discussed using the minority stress perspective and cognitive dissonance theory. [ABSTRACT FROM AUTHOR]

We explored how perceived discrimination and mental illness change as a function of mono vs non-monosexual minority identity. Archival data gathered through the Healthy Minds Network was used to examine these relationships between 249 mono and 554 non-monosexual minority individuals. Results indicated no differences in perceived discrimination between mono and non-monosexual minority individuals. Non-monosexual individuals evidenced significantly higher rates of mental health problems. Moderation analyses suggested perceived discrimination was a significant predictor of mental illness symptoms only for non-monosexual minority individuals. Clinical implication, limitations, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, and transgender (LGBT) older adults comprise a unique and growing subset of the aging population. The historical context in which they came of age was imbued with victimization and discrimination. These experiences are subjectively stressful and collectively known as minority stress. Older LGBT adults continue to face stressors related to their gender and sexual identities in their daily lives. Importantly, chronic minority stress (CMS), like other forms of chronic stress, is harmful to health and well-being. CMS contributes to LGBT health disparities, including cardiovascular disease and depression, conditions that in turn increase risk for premature cognitive decline. Furthermore, long-term exposure to stress hormones is associated with accelerated brain aging. Yet, the cognitive functioning of LGBT elders and the influence of CMS on their cognition are all but unexplored. In this review, we examine the influences of CMS in LGBT elders and connect those influences to existing research on stress and cognitive aging. We propose a testable model describing how CMS in LGBT elders heightens risk for premature cognitive aging and how ameliorating factors may help protect from CMS risk. Research is desperately needed to calibrate this model toward improving LGBT quality of life and mental health practices. [ABSTRACT FROM AUTHOR]

Although all SGMY and their caregiver(s) could potentially benefit from evidence-based programming to prevent ACEs, there are sub-populations of SGMY that are likely most in need of comprehensive prevention efforts. It is important to note that caregiver(s) of SGMY who are highly abusive and/or unaccepting of SGMY may be unlikely to participate in programs that seek to build family strengths and reduce SGMY minority stress. Adverse childhood experiences (ACEs; e.g., child abuse) represent a pernicious public health issue that disproportionately affect sexual and gender minority youth (SGMY; Craig et al., [4]; Schneeberger et al., [14]). [Extracted from the article]

Italy's government has enacted few supportive policies for lesbian, gay, bisexual, transgender and all other sexual orientations and gender identities with which persons may identify (LGBTQ+), and most of the fundamental rights for sexual minorities are still not recognized. Despite this social and political situation, the Department of Developmental and Social Psychology of the Faculty of Medicine and Psychology, Sapienza University of Rome established "Be as You Are," the first Italian clinical research center specifically created for LGBTQ + people on a university campus. The facility offers several public services, such as: (a) counseling or individual psychotherapy for LGBTQ + adolescents and young adults; (b) family therapy supporting LGBTQ + adolescents; (c) parent training programs; (d) interventions in different social contexts. This letter to the editor aims to present the clinical research center and to introduce the role played by LGBTQ + health care services to improve the well-being and mental health of sexual minority individuals, especially in stigmatized contexts where sexual prejudices are still rife, such as in Italy. [ABSTRACT FROM AUTHOR]

Existing literature suggests that both sexual and racial minorities are at a heightened risk of developing symptoms of depression and anxiety. However, there is minimal research addressing the mental health outcomes of lesbian, gay, and bisexual people of color (LGB-POC). Meyer's minority stress theory posits that the manifestation of depression and anxiety is related to both distal and proximal stress. The present study examines the predictive value of perceived distal stress (e.g., LGBT-POC microaggressions and daily heterosexist experiences) and internalized proximal stress processes (e.g., self-stigma, identity salience, and sexual orientation rumination) for self-reported depression/anxiety symptoms among LGB-POC. A sample of 88 cisgender LGB-POC was collected online. Regression analyses suggested that proximal stressors accounted for 15% more variance in reported mental health outcomes than distal stress factors alone. Additionally, distal and proximal minority stressors together accounted for 33% of the variance in participants' mental health outcomes. Results also indicated that bisexual/plurisexual participants reported significantly higher instances of depression and anxiety symptoms in the past month than lesbian/gay or monosexual participants. Implications regarding mental health outcomes for racial and sexual minorities and for conceptualizing the unique prejudices and stigma that LGB people of color face are discussed. [ABSTRACT FROM AUTHOR]

Using data from the National Longitudinal Study of Adolescent Health, this study examined the impact of sexuality factors and satisfaction with partner on stress, anxiety, and depressive symptoms. Multiple regression was used to evaluate the impact of predictors such as sexuality factors and relationship satisfaction on the dependent variables: stress, anxiety, and depression. Three main results were discovered. First, sexual minority females who have lower levels of education and are dissatisfied with their relationship experience significantly higher stress, while sexual minority males do not differ from heterosexual males in terms of relationship satisfaction or stress. Second, sexual minority females who have lower levels of education and who are dissatisfied with their relationship experience significantly higher anxiety, while sexual minority males do not differ from heterosexual males in terms of relationship satisfaction or anxiety. Finally, female sexual minorities who have lower levels of education reported fluid attraction, fluid identity, dissatisfaction with their relationship, and have significantly higher depression when compared to male sexual minorities or heterosexuals. Further research should examine gender and fluidity in greater detail. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations of enacted individual-level stigma and anticipated relationship stigma with negative affect among single sexual minority individuals. We hypothesized that enacted individual-level stigma and anticipated relationship stigma would be positively associated with negative affect. We also explored possible mediation models of how these variables might relate. Methods: A nationwide online survey was completed by 154 single sexual minority individuals 18+ years old, measuring enacted individual-level stigma, anticipated relationship stigma, and negative affect. Results: There were significant, positive bivariate associations of enacted individual-level stigma with anticipated relationship stigma and negative affect. In path model analyses, there was support for enacted individual-level stigma mediating an indirect pathway between anticipated relationship stigma and negative affect, as well as support for enacted individual-level stigma simultaneously predicting anticipated relationship stigma and negative affect. Conclusions: Findings expand the body of theoretical work examining multidimensional aspects and mechanisms of stigma. Results suggest that while anticipated relationship stigma is not directly associated with negative affect among single sexual minority individuals, it may still be relevant for well-being among these individuals through its association with enacted individual-level stigma. Clinicians and public health officials may consider addressing multiple forms of stigma, including both individual-level and relationship-based stigma. [ABSTRACT FROM AUTHOR]

Higher rates of mental health problems are reported among men who have sex with men (MSM) compared to heterosexual men, and this has been partly attributed to the discriminatory experiences they face. This study aimed to explore factors associated with poor mental health in MSM resident in Nigeria. Twenty MSM were recruited through a non-governmental organization working with the MSM community in Nigeria. In-depth interviews were conducted using a guide developed for the study. Interviews were recorded, transcribed, and analyzed using grounded theory. Sources of stress for Nigerian MSM include concerns about security and discrimination, needing to conceal their sexual orientation, and homophobia among health care providers. MSM in Nigeria face stress that has implications for their mental health. There is a need to provide mental health care accessible by community members, and to mitigate factors that also cause stress for MSM in Nigeria. Recommended interventions include educating health care providers about the harmful effects of homophobia and training peer counsellors to provide basic psychological support. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, and questioning (LGBQ) individuals have repeatedly demonstrated lower levels of psychological well-being than their heterosexual counterparts. The literature suggests that bisexually identified participants are more vulnerable to poor outcomes, yet some studies have called this statement into question. This study aimed to address this inconsistency, and investigate how factors related to cognitive dissonance, such as identity disclosure and certainty, influence well-being in the LGBQ subgroups. We used web-based sampling, and distributed an online questionnaire assessing identity disclosure, certainty, and three variables of psychological well-being (affect, happiness, and life satisfaction). This survey was predominantly advertised in and completed by people in New Zealand. Participants who were over 18 and had the technological skills and English proficiency to complete the survey were eligible for this study, resulting in a final sample of 402. Consistent with past research, participants with LGBQ identities had lower rates of psychological well-being than those identifying as heterosexual. Additionally, as expected, identity certainty and disclosure of identity were associated with higher psychological well-being. Cognitive dissonance theory may be a useful contributor to the Minority Stress Theory framework, as it expands our understanding of how internal stressors affect the complex relationship between sexual identity and well-being. Further investigation into sexual identity (particularly the development of certainty, and the “coming out” decision) and psychological well-being is recommended for future research. [ABSTRACT FROM AUTHOR]

The evidence is now overwhelming that discrimination negatively impacts both the physical and mental health of minority groups. Members of multiple-minority groups, such as lesbian, gay, bisexual, transgender, queer people of color (LGBTQ-POC), are more likely to be exposed to experiences of stigmatization, discrimination, and fear of rejection. However, whether the stress of having these unfavorable experiences translates into increased risk for negative health outcomes is unanswered by the literature. Research to date attempts to address the relationship of stress as a minority and health outcomes through examining the role of microaggressions, exploring the concepts of risk and resilience, and most notably the creation of the minority stress model. The model analyzes the complex relationship between external (discrimination/prejudice) and internal (self-doubt/rumination) stressors that shape the experience of multiple-minority groups, which helps us understand the lived experiences of LGBTQ-POC. LGBTQ-POC are adversely affected by cumulative discrimination and social exclusion, including racism from the LGBTQ community, and homophobia and heterosexism within their racial/ethnic community. In this way, they are a multiply marginalized group, which has implications not only for their risk of mental illness, but also for their access to mental health care, and the quality of care they receive. Using the minority stress model as a frame of reference, we will discuss current approaches to capturing the toll that stress as an LGBTQ-POC has on mental health consequences. [ABSTRACT FROM AUTHOR]

A nationwide online survey targeting college- and university-based LGBT student groups, community organizations, LGBT electronic mailing lists, and social media was utilized to collect data and measure the associations among victimization, childhood trauma, and attributional style (AS) in relation to depressive symptomology in LGBT young adults. Participants were 18- to 22-year-old LGBT individuals from across the United States, the majority of whom (88.9%) were European American. All participants reported same-sex attractions and/or behaviors in their lifetimes and/or identified as gender diverse. We hypothesized that childhood trauma and victimization (i.e., negative events) would be positively correlated with depressive symptoms and that a positive AS (i.e., attributing trauma and victimization to external, unstable, and specific causes) would buffer the relationship between trauma, victimization, and depression. Despite a nonsignificant moderated effect, positive AS may buffer overall against depressive symptoms among this at-risk minority demographic. Implications exist in regard to promoting resilience among LGBT youth and young adults through cognitive intervention and psychoeducational outreach. [ABSTRACT FROM PUBLISHER]

Sexuality-based stigma is associated with increased rates of depression for urban sexual minority persons. However, this relationship has not been explored specifically for rural sexual minority populations. This study examined the association between self-reported external and internal sexuality-based stigma and depression among an online sample of 771 rural sexual minority persons. Two regression outcomes were modeled, representing continuous depression scores and clinically significant depression. Anticipated, enacted, and internalized sexuality-based stigma were all significantly associated with increased depression scores and clinically significant depression. Interventions sensitive to the unique stigmas experienced by sexual minority populations in rural areas are needed. [ABSTRACT FROM PUBLISHER]

This study analyzed the content of 125 unique reports published since 1990 that have examined the health and well-being—as well as the interpersonal and contextual experiences—of sexual minority youth of color (SMYoC). One-half of reports sampled only young men, 73% were noncomparative samples of sexual minority youth, and 68% of samples included multiple racial-ethnic groups (i.e., 32% of samples were mono-racial/ethnic). Most reports focused on health-related outcomes (i.e., sexual and mental health, substance use), while substantially fewer attended to normative developmental processes (i.e., identity development) or contextual and interpersonal relationships (i.e., family, school, community, or violence). Few reports intentionally examined how intersecting oppressions and privileges related to sexual orientation and race-ethnicity contributed to outcomes of interest. Findings suggest that research with SMYoC has been framed by a lingering deficit perspective, rather than emphasizing normative developmental processes or cultural strengths. The findings highlight areas for future research focused on minority stress, coping, and resilience of SMYoC. [ABSTRACT FROM PUBLISHER]

An introduction is presented in which authors discuss articles within the issue on topics including U.S. President Donald Trump's ban on transgender people serving in the military; teachers' views on gender non-conforming children; and anxiety and depression in the LGBTQ community.

This study examined romantic relationship involvement as a moderator of the associations between discrimination/victimization and depression/anxiety in gay/lesbian versus bisexual individuals. Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were used. Analyses were conducted separately for gay/lesbian versus bisexual individuals (N = 577 lesbian, gay, or bisexual individuals). For gay/lesbian individuals, the only significant association was a positive association between discrimination and anxiety. For bisexual individuals, there were significant positive associations between discrimination and depression/anxiety for those who were single, but not those who were partnered. There was also a significant association between victimization and anxiety, but this association was not moderated by relationship involvement. Findings provide partial support for relationship involvement as protective for bisexual individuals. Promoting the benefits of relationships may contribute to reducing sexual orientation-related health disparities. [ABSTRACT FROM AUTHOR]

In this article, we report experiences that bisexual and other nonmonosexual people perceive as negative or threatening toward their sexual identity that may relate to mental health. A 28-day, daily diary study investigated whether participants encountered negative experiences related to their sexual identity. Using a constructivist grounded theory approach, participants' experiences were organized according to a social ecological model. Experiences were reported at the intrapersonal, interpersonal, and social-structural levels, though most negative sexual identity experiences occurred at the interpersonal level. Implications for negative health outcomes research and the inclusion of bisexual-specific stressors in minority stress research are discussed. [ABSTRACT FROM AUTHOR]

Predictors of mental health distress were examined in 316 older gay men in a cross-sectional analysis using resilience and minority stress theories. Stigma, discrimination, internalized homophobia, health locus of control, social supports, income, and age cohort were included in a stepwise regression that explained 46% of variance. Discrimination, resilience, income and being partnered emerged as significant main effects while interaction effects between internalized homophobia and age cohort and resiliency and being partnered/married were found. The importance of examining within group variability, resilience, and moderating factors, such as resilience and cohort effects, when examining mental distress among LGBT individuals are discussed. [ABSTRACT FROM AUTHOR]

In a context with limited attention to mental health and prevalent sexual prejudice, valid measurements are a key first step to understanding the psychological suffering of sexual minority populations. We adapted the Patient Health Questionnaire as a depressive symptom severity measure for Vietnamese sexual minority women, ensuring its cultural relevance and suitability for Internet-based research. Psychometric evaluation found that the scale is mostly unidimensional and has good convergent validity, good external construct validity, and excellent reliability. The sample's high endorsement of scale items emphasizes the need to study minority stress and mental health in this population. [ABSTRACT FROM AUTHOR]