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Lesbian, gay, bisexual, and transgender (LGBT) populations experience significant health disparities, theorized to result from LGBT specific minority stressors. The fully conceptualized Minority Stress Model was published more than 15 years ago. Minority stressors include external conditions and events, such as discrimination and victimization. Internal minority stressors include expectations of rejection and discrimination, concealment of minority identity, and internalizations of negative dominant cultural attitudes, beliefs, stereotypes, and values. Connection to sexual and gender minority communities is theorized to moderate the effects of minority stressors. In this integrative review, I examine two decades of research on minority stress. Based on this review, I highlight strengths and limitations of the model, and suggest next steps for moving minority stress research forward.

Among sexual minorities, bisexual individuals experience higher rates of victimization and symptoms of PTSD than their lesbian and gay peers as well as heterosexual individuals. Despite these disparities, little work has examined factors contributing to PTSD symptoms among bisexual adults. The current study examined the associations between bisexual-specific minority stress and PTSD symptoms in a sample of adults with bisexual orientation and tested social support as a potential mediator of this association. Participants were 488 adults (378 cisgender women, 49 cisgender men, 61 transgender individuals), ages 18 to 66 years, with bisexual orientation based on identity and/or attraction to multiple genders. Greater anti-bisexual prejudice was associated with greater PTSD symptoms (β = 0.16) and lower social support (β = −.16), while accounting for sociodemographics and sexual identity-based victimization. Social support was associated with lower PTSD symptoms (β = −.25), while accounting for sociodemographics, sexual identity-based victimization, and anti-bisexual prejudice. Mediation analyses indicated that anti-bisexual prejudice was indirectly associated with greater PTSD symptoms through lower social support. Addressing bisexual-specific minority stress and its role in diminishing social support for bisexual individuals represents a critical component of trauma-informed research and intervention development in the bisexual community.

This study uses Intersectionality-informed methods to quantitatively examine experiences of discrimination and depressive symptoms among historically marginalised populations. Using mediation model...

One pervasive societal norm in Western societies is that of monogamy as the ‘natural’ way of practising relationships. Polyamorous individuals, who practise consensual non-monogamy, risk experienci...

Sexual minorities are at greater risk for mental health difficulties than their heterosexual peers, and bisexual and asexual individuals may be at particularly heightened risk. However, the majorit...

Consensual non-monogamy (CNM) is an area of increasing empirical and clinical interest. Few studies have explored the mental health of CNM individuals. Using the minority stress framework, we sough...

Aside from prevalence estimates and comparisons to heterosexual and presumed cisgender (i.e., not transgender) samples, little is known about transgender and gender diverse (TGD) young adult tobacco use. This study explored reasons and contexts TGD young adults used a variety of tobacco products through 25 one-on-one semi-structured qualitative interviews in 2018. Thematic analysis yielded four themes: (1) smoking in response to anxiety, depression, or stress, (2) social smoking, (3) accepting smoking-related norms, and (4) appealing aspects of tobacco. The first three themes contained elements specifically tied to TGD identity; the final theme related to perceptions of tobacco unrelated to identity. Findings suggest reasons for smoking that are unique to TGD young adults, who frequently reported smoking cigarettes as a coping response to an amalgam of stressors. Accounting for unique stressors related to TGD identity will assist in developing culturally relevant interventions to reduce the disproportionate tobacco burden in TGD communities.

Concealment or hiding a transgender (trans) identity from a medical professional can negatively affect the care one receives. Reluctancy to disclose may be further exasperated when interacting with...

Taiwan's legalization of same-sex marriage affords legal status for romantic relationships between sexual minority individuals. Yet, little is known about the role of intimate relationships in the experiences of minority stress and mental health among gay men. This study tested a model where internalized homophobia mediated the association between distal minority stress and depressive symptoms and relationship satisfaction was posited as a moderator. Data came from a sample (

Bisexual people can internalize stigma from both heterosexual and gay/lesbian communities, which often occurs in the form of monosexism, the belief that people should only be attracted to one gender. Although community involvement is protective for lesbian, gay, bisexual, and queer+ (LGBQ+) people, bisexual people may benefit more from bisexual-specific communities than LGBQ+ communities because of monosexism. Further, how bisexual people define their identity may be related to internalized binegativity, especially given the historical invisibility of bisexuality in mainstream media and recent debates about the definition of bisexuality within LGBQ+ communities. We examined LGBQ+ and bisexual-specific community involvement, definitions of bisexuality, and internalized binegativity among an online sample of 816 bisexual adults. Multivariate regression analyses showed that those with spectrum definitions, which acknowledged the nuanced understanding of sex, gender, and sexuality, reported lower internalized binegativity than those with binary definitions, which described sexuality as consistent with mainstream norms. Involvement in LGBQ+ communities, but not bisexual communities, was associated with lower internalized binegativity. There was no interaction between the type of definition and type of community involvement. Our results suggest that broad community involvement may be protective for internalized binegativity, but findings should be considered in light of a lack of well-funded, local bisexual communities. The current study adds to a growing literature on sexual minority stressors among bisexual people, a population that continues to be understudied.

Minority gay, bisexual and queer (GBQ) men face not only stigma from the general population based on their sexual orientation, but stigma as well based on their race, body type and their gender ide...

Research on the interaction between gender and emotions has largely been constrained by the gender binary. This article seeks to advance theory of constructed emotions as relates to marginalized id...

Sexual minority college students are disproportionately impacted by sexual assault in college, however, there is a paucity of research exploring the role of the college environment in victimization. This study explores the relationship of campus climate with sexual assault victimization for these students. This sample included 1,110 current college students in the United States who identified as a sexual minority. Logistic regression results indicated that the more observations of harassment and discrimination of sexual minority students by participants, the more likely they were to experience sexual assault victimization in college. Also, the more out a participant was on campus, and the stronger sense of belonging they had to their college, the less likely they were to experience sexual assault victimization. Sexual assault prevention efforts on college campuses would benefit from programming and policies that support belonging and address discrimination and harassment.

Lesbian women and gay men are at greater risk of post-traumatic stress disorder (PTSD) than heterosexual people, however few studies have examined PTSD in older lesbian women and gay men. This study examined predictors of having ever been diagnosed with PTSD, as well as relationships to current quality of life, among 756 lesbian women and gay men aged 60 years and older in Australia. Participants were surveyed on their sociodemographic characteristics, experiences of sexual orientation discrimination over their lifetime, whether they had ever been diagnosed with PTSD, whether they were currently receiving treatment for PTSD, and their current quality of life. After adjusting for sociodemographic variables, participants who reported having a PTSD diagnosis (11.2%) had significantly more frequent experiences of discrimination over their lifetime and were significantly less likely to currently be in a relationship. Older lesbian women were significantly more likely than older gay men to report ever having had a PTSD diagnosis. Additionally, having ever been diagnosed with PTSD significantly predicted current poorer quality of life. These findings suggest that a history of PTSD among older lesbian women and gay men is linked to experiences of discrimination and other factors, with associated links to current quality of life.

The Minority Stress Model has proposed that connectedness to a specific minority community may be a protective factor for stigmatized groups. This study evaluated the mediational role of connectedness with the gay men's and lesbian women's community on the relationship between two minority stressors (internalized homophobia and perceived sexual stigma) with anxiety-depressive symptomatology and life satisfaction. The sample consisted of 467 Chilean self-identified as gay men (57%) and lesbian women (43%). Results revealed that the two minority stressors were associated with anxiety-depressive symptomatology, but only internalized homophobia was associated with life satisfaction. The mediation hypothesis was partially supported by the relationship between internalized homophobia and life satisfaction. Unexpectedly, we found a negative association between connectedness with the gay men's and lesbian women's community and life satisfaction. This finding introduces a view that contrasts with the literature, which proposes that connectedness with the specific community would be a protective factor against sexual stigma.

This article concerns childless bisexual and gay men’s expectations of potential future fatherhood. Social context, biological prerequisites and legal restrictions have in previous research proven ...

Minority stress is a cause of health challenges for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth experiencing homelessness. However, in over-focusing on family rejection, the resear...

Purpose: College students who identify as a sexual minority consume alcohol at rates that are equal to, or greater than, their heterosexual peers and sexual minority stress factors (e.g. discrimina...

Minority stress has a range of negative and protective outcomes for lesbian, gay, bisexual, queer, and other sexual minority (LGBQ+) people. The internalization of societal stigma associated with s...

Objectives: Empirical inquiry has targeted how same-sex couples grapple with unique stressors in their romantic relationships. Meta-analyses demonstrate that the adverse link between minority stres...

Objective: Prolonged experiences of discrimination can be a major source of physical and health-related stress, particularly in older Black Americans. However, there is limited information on the r...

Little research has been conducted to explore the impact of intersectionality among racial/ethnic minority groups and sexual/gender minority groups as it relates to violent, sexual, and stalking vi...

Utilizing minority stress theory and intersectionality framework, this qualitative content analysis explored sexual assault experiences among 532 diverse bisexual women and gender expansive people....

The minority stress model states that routine forms of discrimination are associated with adverse health consequences. Despite this well-supported association, there is a limited body of research a...

Minority Stress Theory posits that discrimination is associated with negative mental health outcomes; however, the location of the perceived discrimination may matter. This study examines whether r...

Sexual minority individuals (e.g., lesbian, gay, bisexual) are at increased risk to experience intimate partner violence (IPV) compared to heterosexual individuals. When working with these couples ...

Participation in activist groups has been demonstrated to have myriad benefits for LGBTQ+ individuals, including decreasing the negative mental health effects of discrimination. In this brief report, we present results from an exploratory study examining two factors that impact individuals' involvement in activist groups: internalized heterosexism and connection to LGBTQ+ community. Participants (

Background: Prior research suggests transgender individuals with multiple minority statuses experience higher psychological stress compared to their singly disadvantaged counterparts, and both Black, Indigenous, People of Color (BIPOC), and transgender minorities experience more frequent and severe forms of discrimination than White and cisgender individuals. Aims: This study aims to examine racial/ethnic differences in gender-related discrimination and psychological distress within a sample of transgender individuals. Methods: Using data from a convenience sample of 99 self-identified transgender adults recruited through North American LGBTQ organizations, data were analyzed to determine the relationship between race/ethnicity, gender minority stress, and psychological distress. Results: When White and BIPOC participants are compared, no significant group differences were found in levels of gender discrimination or victimization. However, some individual racial/ethnic groups reported significantly higher or lower scores and results indicate that changes in reported gender minority stress are in fact positively correlated with reported psychological distress. Conclusion: This research highlights that BIPOC are a heterogeneous group; by solely examining race/ethnicity as a binary variable, studies mask potential important differences among different groups.

Globally, transgender people have been described as a highly marginalised population due to cisgenderism that delegitimises their gender identities and expressions. Despite robust evidence from man...

COVID-19 has had far-reaching effects on people's lives, with evidence of a disproportionate impact on marginalized groups. Given existing health disparities and research on minority stress, COVID-19 may have uniquely impacted psychological well-being among sexual minorities. In an online survey of adults in the U.S. (N = 1,007) conducted in April 2020, we examined differences between sexual minority and heterosexual participants in psychological well-being, social distancing, computer-mediated communication, and COVID-19-related worry and experiences. Sexual minorities reported lower thriving and greater psychological distress, social distancing, computer-mediated communication, and COVID-19 worry and experiences than heterosexual participants. Social distancing and distress were positively correlated among sexual minorities and more frequent computer-mediated communication predicted greater thriving across groups. Path analyses showed sexual minorities' poorer psychological well-being was mediated by their greater COVID-19 worry and social distancing, in particular. These findings shed light on the distinct impact of COVID-19 on sexual minorities.

Approximately one million gay and lesbian Americans are veterans. Lesbian, gay, bisexual, and transgender (LGBT) veterans experience high rates of trauma, discrimination, and minority stress and sh...

College students in U.S. higher education institutions experience stress and anxiety. The psychological problems students encounter are roadblocks to college success. Due to historical and socio-ec...

Sexual minority women (SMW) engage in higher rates of substance use treatment than their heterosexual counterparts, yet little is known about how treatment can target the unique needs of SMW. This ...

This study focuses on the impact of the COVID-19 outbreak on mental health outcomes in Black and South Asian people in the United Kingdom. A sample of 226 participants completed a survey consisting of measures of ethnic identification, religiosity, British national identification, perceived discrimination, fear of COVID-19, generalized anxiety, depression and life satisfaction. Black participants reported more frequent ethnic discrimination than South Asians who, conversely, reported more religious discrimination. Structural equation modelling showed that discrimination had a direct impact on fear of COVID-19 and an indirect impact through decreased British national identification and life satisfaction. Religiosity and ethnic identification appeared to be protective against fear of COVID-19. Fear of COVID-19 was in turn associated with increased depression and generalized anxiety and decreased life satisfaction. The results suggest that some minority groups may be facing poorer mental health outcomes due to discrimination and minority stress.

This study examined characteristics of cisgender people who use non-traditional sexual orientation labels and investigated minority stress in these groups. Pansexual (n = 160), queer (n = 80), and asexual (n = 98) participants were compared with heterosexual (n = 1,021), bisexual (n = 1,518), and lesbian/gay (n = 2,730) individuals recruited from a cross-sectional survey. Participants were compared on sexual attraction, age, gender and childhood gender nonconformity. Hierarchical regression models with psychological distress as the dependent variable and outness, prejudice events, expectations of rejection, self-stigma, and rumination as independent variables were then tested in pansexual, queer, and asexual individuals. Sexual attraction, age, gender and recalled childhood gender nonconformity were significant predictors of group identity. Pansexual individuals were not significantly distinct from bisexual individuals in sexual attraction. Queer individuals fell between bisexual and lesbian/gay individuals in sexual attraction scores. Prejudice events and rumination were significantly associated with distress in all three non-traditional groups. Rumination scores attenuated the relationship between prejudice events and distress in all groups. These findings help characterize pansexual, asexual and queer individuals and suggest indirect effects of prejudice events on distress via rumination represent a worthy avenue for future minority stress research in these groups.

Heterosexism represents a pervasive minority stressor for sexual minority individuals; however, the research presents mixed findings on the association between heterosexism and relational dynamics....

Objective In 2017, the Australian Government announced that a voluntary postal survey would be used to quantify the views of the Australian public on marriage equality. This non-binding, voluntary postal survey-and the associated public debate-can be viewed as a discriminatory event for same-sex attracted Australians. The exacerbation of minority stress likely imposed by this unexpected event has resulted in an unprecedented demand for psychological services by members of this community. Despite this surge of use, relatively little is known about the specifics of the impact of this discriminatory event. Method In this article, we present the findings of a thematic analysis of semi-structured interviews that qualitatively examined the impact of the marriage equality debate among a sample of 14 Australians (eight sexual minority and six affected 'allies'). Results Two themes were identified from the interviews, each with four subthemes: (a)personal impacts(emotional wellbeing, empathic concern, devaluation, and connection to religion), and (b)social impacts(activism, avoidant behaviour, social connections, and societal perceptions). Conclusions Overall, the findings of the current study reveal a range of intra- and inter-personal negative impacts of public debate about the equal rights of same-sex attracted people to marry. Moreover, the results suggest that the impact is not only on this minority and at-risk group but also on their heterosexual allies. These results can help inform future policy with the aim of decreasing minority stress experienced by same-sex attracted people.

BACKGROUND Sexual minorities (e.g. lesbian, gay, bisexual) are at increased risk for alcohol use disorder (AUD) compared to heterosexuals. The minority stress model postulates that disparities in AUD stem, in part, from stress specific to sexual minorities (e.g. heterosexism). However, little research has examined psychophysiological markers of minority stress reactivity and how psychophysiological stress reactivity is associated with lifetime minority stress and alcohol use among sexual minorities. Emotion modulation of the startle response is a well-established paradigm for capturing psychophysiological stress reactivity under controlled laboratory conditions. Purpose: This preliminary study is the first to use the startle experimental paradigm to examine psychophysiological reactivity to stigma among sexual minorities. Procedures: Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, SD = 2.65), were recruited from the community. We compared startle reactivity in response to three types of stimuli (stigma, negative, and neutral) among heavy drinking sexual minority young adults. Although statistically underpowered, we also explored the associations between startle reactivity and self-reported drinking behaviors and lifetime minority stress. Results: Both stigma and general unpleasant stimuli produced more psychophysiological stress reactivity than neutral stimuli among sexual minorities. Psychophysiological stress reactivity was correlated with greater quantity of drinks reported on drinking days in the past month, but not greater frequency. Additionally, lifetime exposure to minority stress was associated with a blunted reactivity to stigma stimuli. Conclusions: These findings provide methodological advances and important implications for minority stress theory and alcohol use among sexual minorities.

Nigerian gay, bisexual, and other men who have sex with men (GBMSM) experience social marginalisation, discrimination and violence due to their sexual orientation and same-sex attraction, which may affect mental health, substance use, and HIV sexual risk behavior. The goal of the current study was to conduct formative qualitative research to gain better understanding of these issues among GBMSM in Lagos, Nigeria. Face-to-face, semi-structured, in-depth interviews were conducted with 30 GBMSM in Lagos, Nigeria. Data were analysed using a deductive content analysis approach. We found that Nigerian GBMSM experienced both general life stressors as well as proximal and distal sexual minority identity stressors, including rejection by family members, harassment, and physical violence perpetrated by the general public and police officers. Participants described dealing with mental health problems within the context of family rejection, experienced stigma due to sexual orientation, and feelings of social isolation. Substance use was described as occurring within the context of social settings. Lastly, some participants mentioned that they engaged in risky sexual behaviour while under the influence of alcohol and drugs. These findings call for comprehensive and innovative, GBMSM-affirming behavioural healthcare, substance cessation services, and innovative HIV prevention interventions specifically designed and tailored for Nigerian GBMSM.

INTRODUCTION: International evidence has found large mental health inequities among transgender people and demonstrates that mental health outcomes are associated with enacted stigma experiences and protective factors. This study aimed to examine the extent of associations of enacted stigma experiences specific to transgender people alongside protective factors with mental health of transgender people in Aotearoa/New Zealand. METHODS: The 2018 Counting Ourselves survey was a nationwide community-based study of transgender people (N = 1178, Mage = 29.5) living in Aotearoa/New Zealand. The survey assessed a wide range of gender minority stress experiences and protective factors that comprised primary (support from friends and family) and secondary social ties (neighborhood and transgender community belongingness). We calculated the predicted probabilities that transgender people exhibit very high psychological distress level, non-suicidal self-injury, and suicidal risks with different combinations and exposure profiles of enacted stigma and protective factors. RESULTS: Our findings demonstrated that enacted stigma was associated with negative mental health, and support of friends and family was linked to better outcomes across all mental health measures. Beyond primary social ties, sense of belongingness to neighborhood and transgender communities were linked to reduced odds of psychological distress and suicidal ideation. For those scoring high on enacted stigma and low on protective factors, our model revealed a 25% probability of attempting suicide in the last year compared to 3% for those scoring low on enacted stigma and high on protective factors. CONCLUSIONS: Echoing previous findings, this study demonstrates that transgender people across Aotearoa/New Zealand are less likely to manifest life-threatening mental health outcomes if they experience low levels of enacted stigma and high levels of access to protective factors. Our findings suggest a need to address the enacted stigma that transgender people face across interpersonal and structural settings, and also to enhance social supports that are gender affirmative for this population.

Current law in Zambia criminalises same-sex sexual contact while strong socio-cultural values drive a profoundly negative view of the moral status of gender and sexual minorities. Despite this, Zambia's national HIV programme has recently identified the predominantly young population of men who have sex with men as a priority group for HIV and other sexual health programming. Research in other African settings has shown how the sexual health of these young men is affected by mental health. This mixed-methods study, which drew on the minority stress model as an analytical framework, sought to explore mental health as an initial step towards understanding its influence on other health domains. Findings describe the tension, and its psychological effects, surrounding the trajectory of discovering and affirming same-sex sexuality in an environment replete with social, physical and emotional risks, but one in which young men must nevertheless seek to create and maintain a meaningful, if precarious, social existence. To achieve this, in the absence of supportive mental health services or other programmatic responses, they adopt numerous risk-mitigation or coping strategies to attempt to build resiliency and to preserve their psychological and emotional well-being.

Acceptance concerns and internalised homonegativity are associated with deleterious health outcomes for sexual minority persons, including psychological stress. However, previous studies examining ...

Drawing from the existing literature on minority stress and stigma, this article highlights challenges – psychological, social, and interpersonal – confronting transgender and gender nonconforming ...

Sexual minority men have consistently shown to be at-risk for adverse mental health outcomes due to minority stress, yet studies show some men successfully navigate these barriers. What is less kno...

This study used the minority stress model to explore experiences of gender transitioning among hijra (trans woman) individuals in Mumbai, India. It used a qualitative life history calendar approach to examine transitioning as a critical life experience in a chronological manner. Twenty hijra-identified persons were recruited using purposive snowball sampling and interviewed at a community-based organisation. Data were analysed using thematic analysis. Participants reported diverse experiences living as hijra and shared perspectives on transitioning. Most participants identified to undergo transitioning at their own will. Many cited biological families as a factor that restricted or delayed transitioning, while gharana (congregation of hijras) and gurus were listed as sources of support. Participants also differed in the reasons given for transitioning, expectations, types of practices, and issues of access and support. Transitioning was described as an integral part of their experiences as hijra and developing a congruent self. Implications of the study include the need to engage communities in determining their needs and social support, provide holistic transitioning services at public hospitals, and develop technical and cultural sensitivity training for health professionals.

Traditionally, different types of clinical cultural competency trainings have centered on racialized and gendered mental health statistics. Psychologists’ historical focus has been on typecasting c...

Our objective is to introduce therapeutic intervention, in an EFT framework, with gender diverse people. We review research outlining mental health comorbidity, and some of the unique needs of this...