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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.

Objective: This study aimed to create and validate a novel measure of gender-related minority stress in transgender and non-binary adolescents (TNBA). TNBA face higher risks of varied behavioral health concerns compared to their cisgender peers, a disparity often attributed to the presence of minority stress due to discrimination. To date, no comprehensive measures of gender-related minority stress exist for use with TNBA. Method: The present study recruited a U.S. national sample (N = 444, aged 12–17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% non-binary, 9.5% agender) of TNBA. An initial item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Analytic methods including principal components analysis, item response theory, measurement invariance testing, and reliability analyses were conducted to establish the final scale. Concurrent validity was established across behavioral outcomes (mental health, suicidal thoughts and behavior, substance use), and convergent and divergent validity compared the Transgender Adolescent Stress Survey–Minority Stress (TASS-MS) to existing measures of gender-related minority stress. Results: The TASS-MS and its subscales (disaffirmation, visibility and internalized transnegativity, family) were significantly associated with anxiety and depressive symptoms, PTSD symptoms, suicidal behaviors, non-suicidal self-injury, marijuana, and prescription drug use. The TASS-MS was moderately and weakly correlated with convergent and divergent measures, respectively, indicating specificity to minority stress. Conclusion: The TASS-MS is a reliable and valid measure for future research with TNBA. It is inclusive and usable by all gender minority adolescents, uses a standard simple scoring system, and assesses adolescent-specific stressors. [ABSTRACT FROM AUTHOR]

AbstractDespite existing research linking bisexuality to poorer health outcomes compared to gay and straight individuals, scholarship has largely neglected the unique vulnerabilities of Black bisexual men. The purpose of this research is to examine Black bisexual men’s reports of internalized stigma experiences with an intersectional framework. We utilize a purposive sampling method to target the engagement of Black bisexual men on a large anonymous social media platform. Our findings suggest that persisting stigmas of Black bisexual men, particularly related to hegemonic masculinity, heterosexism, and White supremacy, are underpinned by a matrix of domination seeking to retain the sub-status of Black sexualities. We end our article with a call for more intersectional models in Black LGBT mental health research. We extend the domains of stigma power as one possible strategy for future scholarship. [ABSTRACT FROM AUTHOR]

LGBTQ+ Asians face increased mental health risks due to intersectional discrimination and minority stress. This mixed-methods study examined associations between minority stress, intersectional discrimination, and mental health outcomes among LGBTQ+ Asians. Between 2022 and 2023, 136 LGBTQ+ Asian residents of New York City were surveyed. Adjusted logistic regression models compared the odds of clinically-significant depressive symptoms, anxiety symptoms, and suicide risk by self-reported measures of discriminatory experiences towards LGBTQ+ Asians. A subsample of 24 individuals completed semi-structured interviews in English, and thematic content analysis was utilised to understand contextual factors and discriminatory experiences influencing mental health. Individuals experiencing higher levels of everyday discrimination had increased odds of reporting clinically-significant depressive symptoms, anxiety symptoms, and high suicide risk. Individuals experiencing higher levels of racialised and LGBTQ-related microaggressions had increased odds of reporting clinically-significant depressive and anxiety symptoms. Interviews revealed themes including social isolation, anticipated stigma attributed to discriminatory experiences within LGBTQ+ and Asian communities, and pervasive impacts of racial and LGBTQ+ discrimination on mental health. These findings underscore mental health disparities among LGBTQ+ Asians associated with varying levels of discrimination and targeted microaggressions. More research is needed to understand the causal mechanisms by which intersectional discrimination impacts LGBTQ+ Asians’ mental health. [ABSTRACT FROM AUTHOR]

Those who engage in BDSM (bondage/discipline, domination/submission and sadism/masochism) activities may experience rare injury, physical/sexual assault, consent violation, etc. However, prior negative experiences with police coupled with the stigmatisation and in some country’s criminalisation of BDSM, may deter kink practitioners from seeking police assistance if needed. This may be increasingly true for Gender, Sexual and Relationship Diverse (GSRD) kink-involved individuals (e.g. LGBTQ+). Using mixed methods and an intersectionality and minority stress model framework, we surveyed 623 international self-identified BDSM participants, to explore their perceptions of police. Overall, GSRD participants (e.g. transgender) had greater negative perceptions of police inside and outside of BDSM-contexts compared to non-GSRD participants (e.g. cisgender, heterosexual). Within BDSM-contexts, participants felt that police were poorly educated about BDSM, viewed BDSM dynamics (e.g. dominant/submissive) negatively, did not take reports of consent violations seriously, and should play a minor role in kink communities. While some participants said they would contact police if there was evidence a severe crime was committed, they still expressed concerns and hesitancy. These included fears of judgement, discrimination, not being taken seriously and outing. Others explained a lack of trust in police and therefore would never seek police assistance, or only as a last resort. Nevertheless, participants recognised the existence of a poor relationship between police and kink communities, and a need to improve the relationship. Specific areas where BDSM/police relationships can be improved are discussed, including the use of collaborative officer education initiatives and on-going and future revisions to existing legal frameworks internationally. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the psychometric properties of a Swedish translation of the Sexual Orientation Microaggressions Scale (SOMS) in a convenience sample of 267 Swedish LGB+ people (Mean age = 36.41). Testing suggested some strengths in terms of factor structure and 2-week test-retest reliability (ICC >.79). Also, internal consistency (α =.80–.91) and convergent validity were supported for most subscales. However, the Assumption of Deviance subscale was associated with low response variability and internal consistency (α =.35), and the correlational pattern between the Environmental Microaggressions subscale and mental health variables diverged from the overall trend. Furthermore, measurement invariance between homo- and bisexual participants was not supported for most subscales, and although microaggressions would be theoretically irrelevant to a small comparison sample of heterosexual people (N = 76, Mean age = 40.43), metric invariance of the Environmental Microaggressions subscale was supported in comparison to LGB+ people. We argue that these limitations suggest a restricted applicability of the SOMS in a Swedish context, and this has consequences for the definition and operationalization of the construct of microaggressions as a whole. Therefore, more research on the latent properties of microaggressions in Swedish as well as in other contexts is required. [ABSTRACT FROM AUTHOR]

Background: There is limited availability and accessibility of health care facilities and services tailored to the specific health care needs of sexual and gender minorities (SGMs) in the Philippines. Objective: The purpose of this study was to describe SGMs' experiences with health care services in the Philippines. Methods: Using a phenomenological design, interviews were conducted with participants recruited online through SGM networks and organizations. Individual, online-recorded interviews were conducted with 14 participants who were at least 18 years old, were Filipino nationals residing in the Philippines, self-identified as SGM, could comprehend and write in Filipino, and received any health care service within the past year. Data were entered and analyzed using the NVivo software. Results: Three major themes emerged: patient-centered communication and relationship, holistic care, and caring environment. Participants identified the significance of genuine, affirming, and respectful communication in building positive relationships and continuing engagement with health care. Holistic care is embedded in clinical competence, gender sensitivity, continuity of care, and collaborative practice with other disciplines. A caring environment minimizes gender-related stigma and discrimination and promotes acceptance of diverse sexual identities. Conclusion: Filipino SGMs face several multifaceted health care concerns and challenges stemming at the individual, institutional, and societal levels. Sexual and gender biases, stigma, and discrimination are major barriers to health care among SGMs. Promotion of culturally and gender-sensitive care among Filipino SGMs should involve training of health care providers and creation of programs and policies to understand and respect SGMs while considering social, cultural, and political influences on their health and well-being. [ABSTRACT FROM AUTHOR]

The study examines the relationships between experienced heterosexism, perceived social support, and depression in people diverse in sexual and gender minority (SGM) identity. The cross-sectional online study was performed in Poland among 509 SGM people, with an average age of 22 years (M = 22.39, SD = 4.78). Minority stress was assessed using the Daily Heterosexist Experiences Questionnaire (DHEQ), perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS), and depression symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R). The study supported a buffering effect of social support from family and friends in the relationship between minority stress and depression symptoms. Network analysis (NA) showed that minority stress from family of origin, mediated by low family support, plays a key and bridging role in increasing suicidal ideation, especially in dual SGM individuals. Friends are the most important source of support for people with a single SGM identity. Therefore, to prevent suicidal thoughts in LGBTQ+ people at increased risk of depression, systemic therapy should be used in addition to interventions focusing on coping with minority stress and symptoms of depression. [ABSTRACT FROM AUTHOR]

Sexual and gender minorities (SGM) of colour in the United States experience heightened HIV vulnerability, but prevention interventions have not adequately met their needs. We analysed survey responses from sexually active men who have sex with men, transgender people and gender-nonconforming people of colour (N = 216), regarding barriers to participation in HIV prevention research and services. We applied Meyer's Minority Stress Theory (MST), which highlights that SGM are at increased risk for mental health disorders due to the psychosocial stress resulting from experiences of stigmatisation and discrimination. Themes regarding barriers to participation in HIV prevention research and accessing prevention services included: (1) concern regarding familial rejection; (2) decreased access to timely sexual health education; (3) financial challenges regarding study participation and continued access to antiretroviral medications; (4) concerns regarding intersectionality, race and stigma ; and (5) lived experiences of stigma, discrimination and internalised homophobia among Black respondents. Healthcare providers and researchers can utilise this information to better tailor HIV prevention interventions to the specific health needs of SGM of colour. [ABSTRACT FROM AUTHOR]

Although studies have remarked upon the increase in representation of kinksters and BDSM practices in mainstream media narratives, community voices indicate that these narratives do not provide an authentic portrayal of their community. This misrepresentation of kinksters results in stigmatization and forces the community to manage its minority stress. This article reflects upon the results from a series of interviews with Dutch poly-kink-identified participants about mainstream representations of their community. The participants agree on several main objections to this representation: mainstream media narratives ignore community norms, while they actively sensationalize and pathologize kink, and insist on stereotypical gender relations. Together, this representation undermines the transgressive potential of poly-kink relations and increases the stigmatization of this community. [ABSTRACT FROM AUTHOR]

The health and wellbeing of queer people, including gay and bisexual men, are worse than those of endosex, cisgender, and heterosexual individuals on average. The minority stress model states that stress resulting from experiencing discrimination (distal minority stress) as well as feared discrimination and internalized stigma (proximal minority stress) is responsible for poorer health and wellbeing in marginalized groups. There are international studies supporting Meyer's model, but only few studies focus on Germany. We analyzed the data for endosex-cisgender gay and bisexual men (N = 6404, N = 2278 sample without missing data) from the "How are you?"-study. To test the assumptions of the minority stress model, path analyses were performed. For differences between bisexual and gay men, t-tests and multigroup analyses were calculated. Our findings show that gay and bisexual men in Germany experience low stigmas (enacted stigma, felt stigma, and internalized stigma), that still relates to health (subjective health, physical health, and mental health), mostly with small effect sizes. Furthermore, differences in levels of enacted stigma, internalized stigma, and the relationship between wellbeing and health among gay and bisexual men were identified. Of the four resources that we examined (social embeddedness, community connectedness, educational level, and income), social embeddedness was shown to be the most important for health. The results are discussed in relation to differences between gay and bisexual men and in relation to anti-discrimination as a strategy for health promotion. [ABSTRACT FROM AUTHOR]

Self-rated health (SRH) is consistently related to mortality and morbidity. Yet, health ratings are subjective and reflect an individual's social context. Prior work has found differences in the structure of SRH—that is, in how self-assessments relate to underlying health conditions—across social groups, including by gender. However, prior work has not included transgender adults despite evidence that widespread interpersonal and structural stigma uniquely shapes their subjective experience of health. This study draws on information about 12 health conditions for a sample of transgender men, transgender women, nonbinary adults, cisgender men, and cisgender women. It examines whether the probabilities of reporting poor or fair SRH are similar among those with various underlying health problems. Findings reveal differences by gender identity and age group. For more than half of the examined conditions, self-rated health is poorer among nonbinary adults and younger transgender men than among other gender groups. These differences likely reflect distinct self-assessment processes that consider minority stress and structural stigma, as well as underlying differences in severity and comorbidity that stem from such stigma processes. SRH remains a useful, holistic measure of well-being, including for transgender groups. [ABSTRACT FROM AUTHOR]

Background: Sexual and gender minority (SGM) individuals experience elevated rates of depression due to exposure to unique social stressors associated with membership in a stigmatised minority group. Coping style has been shown to buffer or exacerbate responses to stress. To date, little is known about the risk or protective influence of coping styles on the relationships between stressors and depression in SGM populations. Aims: To examine the moderating effects of coping styles on the relationships between stressors and depression in Thai SGMs. Methods: This cross-sectional descriptive survey was conducted between March and August 2018 using in-person and online surveys. Convenience and snowball recruitment strategies were used. Standardised measures were selected according to the Minority Stress Model. Bivariate and multivariate analyses were conducted. Hayes's PROCESS macro was used to test for significant interactions. Results: Of the 411 participants, 40% of the participants reported symptoms of depression that were associated with multiple stressors. Problem-focused coping was reported by most participants (95.8%), followed by social support (83.1%) and avoidance (49.1%) coping. Problem-focused coping weakened the relationships between stressors and depression, whereas avoidance coping strengthened the relationships between depression and stress, loneliness and discrimination. Social support coping was negatively related to depression, with no statistically significant moderating effects. Conclusions: Problem-focused coping served to mitigate the influence of stressors on depression, whereas avoidance coping strategies exacerbated the impact. Nursing interventions aimed at improving problem-focused coping may reduce the negative consequences of stressors on the mental health of SGMs. [ABSTRACT FROM AUTHOR]

This study explores how Chinese migrants in Singapore navigate their overseas lives through social media use. Survey data collected from Chinese migrants reveals that social media use serves as a double-edged sword: while it is positively associated with migrants' life satisfaction, it also heightens their perception of online discrimination. Furthermore, results also suggest an essential role of self-esteem: elevated self-esteem correlates with improved life satisfaction and a decrease in online perceived discrimination. Besides, self-esteem can moderate the relationships between social media use and both life satisfaction and online perceived discrimination. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Objective: The present study conducted a meta‐analysis to synthesize the associations between sexual minority stress and relationship satisfaction, as well as to examine actor and partner effects. Background: Sexual minority individuals in same‐sex couples experience various distinct and chronic stressors related to their stigmatized identities and romantic relationships, and these stressors negatively impact relationship satisfaction. Although there have been two meta‐analyses that sought to examine these influences, some fundamental questions remain unanswered. In particular, the roles of dyadic processes and different types of sexual minority stressors remain unclear. Method: A comprehensive search identified 67 studies with 147 effect sizes representing 24,542 individuals. Results: The results revealed a significant small association (r = −.100 to −.188) between sexual minority stressors and relationship satisfaction. Internalized stressors were more strongly associated with relationship satisfaction than other types of sexual minority stressors (e.g., prejudice events and concealment). Dyadic analyses demonstrated a significant actor effect of concealment, experiencing prejudice events, and internalized stressors on relationship satisfaction, with the largest effect size for concealment effects. Conclusion: These findings suggest that sexual minority stressors could potentially contribute to same‐sex relational problems. They also underscore the importance of interdependence (both partners' responses as well as their interaction with sexual minority stressors). This understanding may be instrumental in shaping prevention strategies. Implications: The meta‐analysis emphasizes the nuanced impact of sexual minority stressors on same‐sex relationship satisfaction, highlighting the importance of targeted interventions. It underscores the role of dyadic processes, emphasizing the significance of both partners' responses and interactions with stressors in developing effective prevention strategies for healthier same‐sex relationships. [ABSTRACT FROM AUTHOR]

Stigma and minority stress affect the health of transgender and nonbinary (TGNB) people, leading to disparities across a range of outcomes. Barriers to accessing care, including reproductive care, further complicate these health disparities. Interpersonal stigma within the healthcare system, and high rates of physical and sexual violence survivorship, make TGNB people particularly vulnerable to healthcare trauma and poor care. This is particularly true among TGNB people with multiple intersecting marginalized identities. Trauma-informed care provides a framework for medical practitioners to provide safe, holistic, and sensitive care. Scant academic literature discusses trauma-informed reproductive care for TGNB individuals. We present a narrative review of the evidence for trauma-informed reproductive care for TGNB people and suggest potential application and implementation. [ABSTRACT FROM AUTHOR]

Background: Sexual orientation discrimination increases the risks of negative health outcomes for sexual minorities. Previous studies have found increased rates of eating disorder symptoms in sexual minority individuals, which is attributable to minority stress and discrimination that they experience. Emerging research suggests relationships between sexual orientation discrimination and eating disorder symptoms. However, there is a lack of studies focusing on early adolescents. The objective of this study was to determine prospective associations between discrimination based on sexual orientation and eating disorder symptoms in a national sample of 10–13-year-old early adolescents in the U.S. Methods: We examined prospective data from Year 2 (2018–2020) and Year 3 (2019–2021) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 8976). Multiple logistic regression analyses were used to estimate associations between self-reported experiences of sexual orientation discrimination in Year 2 and eating disorder symptoms in Year 3, adjusting for potential confounders, including eating disorder symptoms in Year 2. Sexual orientation discrimination was assessed based on the Perceived Discrimination Scale, which measures adolescents' perception of being treated unfairly based on various sociodemographic characteristics. Eating disorder symptoms were based on the parent-reported Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5). Results: In this demographically diverse sample of early adolescents (N = 8976, age range 10–13 years at Year 2), 5.5% of adolescents reported sexual orientation discrimination in Year 2. The prevalence of parent-reported eating disorder symptoms in Year 3 varied from 1.0 to 8.3%. In the adjusted models, sexual orientation discrimination was prospectively associated with worry about weight gain (adjusted odds ratio [aOR] 2.33, 95% confidence interval [CI] 1.15–4.69) and self-worth tied to weight (aOR 1.60, 95% CI 1.01–2.53) one year later. Conclusions: Early adolescents who have experienced sexual orientation discrimination have higher odds of experiencing eating disorder symptoms, particularly worrying about weight gain and tying self-worth to weight. Clinicians may consider screening for sexual orientation discrimination and providing affirmative, trauma-informed care when evaluating and treating even younger sexual minority adolescents for eating disorder symptoms. Plain language summary: Sexual orientation discrimination increases the likelihood of adverse health effects for sexual minorities. Prior research has identified increased rates of eating disorder symptoms among sexual minority individuals, linked to minority stress and discrimination they endure. Although recent studies suggest associations between sexual orientation discrimination and eating disorder symptoms, there is a gap in research concerning early adolescents. In this large, demographically diverse, national study of 8,976 adolescents aged 10–13 years, we found that early adolescents who have experienced sexual orientation discrimination are more likely to worry about weight gain and tie their self-worth to weight one year later. These findings support the Minority Stress Theory, which describes how discrimination, stigmatization, and internalized negative beliefs may contribute to worse mental health outcomes and maladaptive health behaviors, including eating disorder symptoms. Clinicians can screen for sexual orientation discrimination and provide affirmative, equity-focused care when evaluating even younger sexual minority patients for eating disorder symptoms. [ABSTRACT FROM AUTHOR]

Due to multiple minority statuses, transgender women of color are exposed to minority stress through distal (external) stressors from society causing proximal (internal) stress, leading to potentially negative physical and mental health outcomes. Often considered allies to the transgender community, cisgender members of the LGBTQIA+ “community” have historically presented different plights resulting in divergent rights, protections, and societal views. Guided by the minority stress framework, a secondary analysis of individual interviews and focus groups (n = 20) with transgender women of color was performed. Participants shared experiences of distal and proximal minority stressors when discussing the cisgender LGBTQIA+ “community” and mitigating resilience factors. Four main themes emerged: 1) preference for cisgender presentation; 2) discrimination and exclusion; 3) mistrust; and 4) resilience. This is the first study to demonstrate direct mental and physical health risks for transgender women of color associated with discrimination and exclusion by members of the cisgender LGBTQIA+ “community.” Negative experiences resulted in health care avoidance, verbal assault, social exclusion, mistrust of providers, and barriers to transgender-affirming care. Future research must consider minority stress to advance the understanding of LGBTQIA+ within-group marginalization and foster equitable opportunities for transgender women of color and other gender minorities. [ABSTRACT FROM AUTHOR]

Background: Veterans who identify as lesbian, gay, bisexual, transgender, queer, questioning, and related identities (LGBTQ+) have faced discrimination that puts them at increased risk for depression, anxiety, and suicide. Upstream interventions like the PRIDE in All Who Served program can improve internalized prejudice, suicidality, symptoms of depression, and symptoms of anxiety by addressing minority stress, facilitating social connection, and promoting engagement with the healthcare system. Yet, little is known about who benefits most from these types of services. Methods and materials: Sixty-six US military veterans (Mean age = 47.06, SD = 13.74) provided outcome surveys before and after a 10-week health promotion group for LGBTQ+ individuals at one of 10 Veterans Health Administration (VA) Medical Centers. Subscales of a coping self-efficacy measure (e.g., problem-solving, social support, thought-stopping), and demographic factors were examined as moderators of treatment outcomes. Results: Coping self-efficacy moderated effects across treatment outcomes with those lower in coping self-efficacy beliefs reporting the greatest benefit of the intervention. Reduction in anxiety symptoms was moderated only by problem-solving coping self-efficacy, while suicidality was moderated only by social support. Reduction of internalized prejudice and depression symptoms were moderated by both problem-solving and social support coping self-efficacy, while thought-stopping (a frequent target of traditional cognitive therapies) only moderated internalized prejudice, but not clinical symptom indicators. Most demographic factors (e.g., age, race, gender) did not impact treatment outcomes; however, sexual orientation was significant such that those who identified as bisexual, queer, or something else (e.g., pansexual) had greater reductions in internalized prejudice than their single gender-attracted peers. Discussion and conclusion: Individual differences like coping self-efficacy and sexual orientation are rarely considered in clinical care settings when shaping policy or implementing tailored programs. Understanding implications for who is most likely to improve could inform program refinement and implementation of affirming interventions for minoritized people. [ABSTRACT FROM AUTHOR]

Research into intimate partner violence (IPV) has focused on the experience of female victims resulting from dominant theoretical frameworks and societal biases casting females as victims and males as abusers. While emergent studies suggest that gay male victims experience a higher prevalence rate and more severe consequences from IPV than heterosexuals victims (male or female), few studies have explored the impact of IPV on gay male victims personal and working lives. We conducted a qualitative case study analysis using an Interpretive Phenomenological Analysis by interviewing four gay males with experience of IPV. Following a description of each case, a cross-case analysis identified the similarities and differences between the participants’ lived experiences according to four main themes: 1) formal support, 2) informal support, 3) workplace support, and 4) workplace performance. We found that the influence of minority stress may amplify the challenges that some gay male victims face when conceptualizing their abuse and seeking support in their personal and working lives. Organizations should develop targeted and inclusive policies that support victims, with LGBTQI±competent Employee Assistance Program (EAP) providers, and gender-neutral language when referring to IPV. [ABSTRACT FROM AUTHOR]

This study documented between-group differences in factors associated with lifetime sexual victimization in a sample of young sexual minority men. Diverse samples of gay (N = 205, ageM = 24.33 years) and bisexual (N = 201, ageM = 23.31 years) men were recruited using the CloudResearch platform to assess recent experiences of intimate partner violence (IPV). Participants were categorized into four groups, cross-classified by dichotomous self-reports of (a) childhood sexual abuse (CSA) and (b) sexual IPV. Principal components analysis was used to reduce the number of variables associated with sexual IPV in three domains: Past-year substance use involvement, minority stress, and relationship characteristics, separately for each sample. Gay men reporting both CSA and sexual IPV reported significantly higher mean factor scores for a principal component with high loadings for recent substance use, daily discrimination, relational aggression and relational victimization, compared to other groups of gay men. Bisexual men who experienced sexual IPV reported significantly higher mean factor scores for a principal component with high loadings for five measures of minority stress, compared to counterparts with no history of sexual victimization. Adult sexual IPV among gay men reporting CSA appears to occur in conditions that include harmful substance use, daily discrimination experiences, and relationship violence. Sexual IPV among bisexual men is associated with multiple minority stressors. Our findings highlighted different patterns of risk factors for sexual IPV among sexual minority men, providing information for tailored risk reduction initiatives, including the need for trauma-informed services and specialized training for service providers. [ABSTRACT FROM AUTHOR]

The recently posed intraminority gay community stress theory states that sexual minority (SM) men may experience stress within their community resulting in lower levels of mental well-being. However, only few quantitative studies have evaluated this theory, and none of these studies examined the impact of intraminority stress on the mental well-being of SM female populations. In Dutch-speaking SM individuals who were assigned male at birth (N = 293) and SM individuals who were assigned female at birth (N = 527), this exploratory study examined associations between the four facets of intraminority stress and five mental health symptoms. When controlling for demographics and minority stress, intraminority stress was positively associated with psychological distress, body dissatisfaction, and interpersonal awareness in both SM male and SM female individuals, while positive associations with timidity were only found in the latter. As for the intraminority stress facets, particularly the SM community's focus on competition and exclusion of social diversity seem to impact the mental well-being of SM individuals. The results support the notion that intraminority stress – along with minority stress – has important value in explaining mental health problems in SM male and SM female populations. Future research may examine how intraminority stress relates to the protective effects of community connectedness and having a sense of belonging, and to what extent and how intraminority stress should be addressed in interventions for stress-sensitive mental health symptoms in SM populations. [ABSTRACT FROM AUTHOR]

A proportion of gay and bisexual men (GBM) experience worse mental health when they encounter stress from problems within the gay community. This qualitative study examined the dominant standards held in the gay community in Taiwan, the intraminority-community stress experienced by GBM, and the strategies that GBM adopt to cope with such stress. Data from open and in-depth interviews with 26 GBM were subject to reflexive thematic analysis. The results found that appearance, sexual satisfaction, wealth and social status, being a member of gay groups, and youth were valued in the gay community in Taiwan. These standards resulted in a variety of stress responses, including concerns about not fitting in, diminished self-confidence, feelings of frustration due to unattainable standards and challenges in interpersonal relationships. The strategies adopted to cope with such stress involved acceptance and adherence, passive acceptance, rational thinking and critique, mental resilience, mutual support, and efforts to question and challenge norms. Our findings can provide mental health professionals with key insights into the intraminority gay community stress and coping responses in GBM. [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]

AbstractBlack/African American (hereafter, Black) adults who smoke are at risk for tobacco-related health disparities in the United States (US). Although racial-based stressors (e.g., discrimination) are associated with smoking among this group, past work has not characterized individual differences in negative emotional reactivity to racial/ethnic stress in terms of smoking. The present investigation sought to address this limitation and evaluate the incremental validity of negative emotional reactivity to racial/ethnic stress on smoking processes after accounting for clinically important covariates. Participants included 517 Black individuals from the US who endorsed daily cigarette smoking (≥5 cigarettes per day, Mage = 45.1 years of age, 51.5% female). Results indicated that negative emotional reactivity to racial/ethnic minority stress was associated with an increased risk of severity of problems when quitting (ΔR2 = .01), perceived barriers for smoking cessation (ΔR2 = .03), and addictive (ΔR2 = .03) as well as negative mood reduction smoking motives (ΔR2 = .04); with effects evident after adjusting for frequency of racial/ethnic discrimination and other factors (e.g., drug use problems). Overall, the present findings provide novel empirical evidence that negative emotional reactivity to racial/ethnic minority stress among Black adults in the US is associated with several smoking processes implicated in the maintenance and relapse of smoking. [ABSTRACT FROM AUTHOR]

Transgender and gender-diverse (TGD) menstruators are individuals assigned female at birth (AFAB)*, who retain the capacity to menstruate and have a gender identity that differs from their natal sex. Reports indicate up to 1.6 million individuals in the US identify as TGD. Until recently, the mainstream menstrual discourse has failed to capture the experience of transmenstruators. However, a better understanding of the menstrual experiences of TGD-AFAB will allow for more individualized patient-centered care. In this review, we provide the relevant data necessary to inform the psychiatric management of menstruation in TGD-AFAB individuals, including experiences of menstruation, preferences for menstrual management, and the impact on mental health. Our review indicates that menstrual care in TGD patients must be tailored to the individual; clinicians should remain open-minded to the unique experience of transmenstruators; gender-affirming menstrual care is necessary to reduce psychological burden. It should not be assumed that TGD-AFAB menstruators are utilizing appropriate contraceptive methods and should receive contraceptive and fertility preservation counseling. We highlight the importance of having these conversations early in the reproductive arch, even before puberty onset. Keeping in mind the gender minority stress model, in the upcoming sections, we discuss the limited body of literature on mood disorders in TGD-AFAB individuals who menstruate, undergo menstrual suppression, or continue to ovulate. The psychological impact of hormonal therapies is also reviewed. [ABSTRACT FROM AUTHOR]

AbstractSexual health among lesbian and bisexual (LB) women has largely been studied in the context of sexual health behaviors. Less is known about aspects of sexual health such as sexual satisfaction and minority stress processes as possible predictors of sexual satisfaction. This study explored sexual satisfaction and minority stress in LB women. Single and partnered cisgender LB women (N = 627) were compared on measures of sexual satisfaction and proximal minority stress (i.e., internalized homonegativity and outness/concealment). The proximal minority stress variables were tested as predictors of sexual satisfaction in a regression analysis. Multigroup analyses were also conducted to explore differences between lesbian and bisexual women in the regression analysis. Participants were recruited through LGBT+ websites and other social media platforms in Norway. Results showed that lesbian women were more open about their sexual orientation, reported greater identification with the LGBT+ community, and were more sexually satisfied than bisexual women. Those with a steady partner were also more sexually satisfied than those who were single. Being younger, partnered and experiencing less internalized homonegativity (IH) predicted greater satisfaction in LB women overall, and no differences in the predictors across sexual orientation were found in the multigroup analysis. [ABSTRACT FROM AUTHOR]

Queer individuals experience unique stressors related to their minority status, negatively impacting their mental health. One factor contributing to these disparities is exposure to minority stress, which involves social stressors related to minority status. Previous research has focused on the negative impacts of minority stress, with less attention to its impact on positive psychological functioning. This study explored the relationship between minority stress and psychological well-being among 270 queer individuals in German-speaking countries. Participants completed an online survey assessing minority stress and psychological well-being. Analyses of Covariance indicated that proximal factors of minority stress—such as self-stigma, concealment, and expectations of rejection—had a particularly negative impact on psychological well-being, but no effects could be found for gender and sexual orientation. Additionally, gender identity but not sexual orientation had a significant effect on minority stress, with non-binary and other gender identities reporting higher minority stress compared to females. Thematic analysis revealed concerns about survey inclusivity, gender identity challenges, and intersectionality of minority identities. Our findings emphasize the significant impact of minority stress on the psychological well-being of queer individuals, particularly non-binary people and those with diverse gender identities, while demonstrating the need for inclusive research methodologies, tailored interventions, and policies addressing the diverse experiences within the queer community. [ABSTRACT FROM AUTHOR]

BackgroundAimMethodsResultsConclusionBirth complications increase the risk of birth injuries and neonatal complications, as well as the risk of experiencing childbirth as a trauma. This, in turn, increases the risk of postpartum mental ill-health and may affect early bonding with the baby. Birth complications add additional stress on lesbian, bisexual, transgender and queer (LBTQ) parents, as they also must navigate hetero- and cisnormative assumptions, being subject to othering, and negative attitudes from healthcare staff.To explore LBTQ parents’ experiences of bonding with their child following a complicated birth.Semi-structured interviews with 22 birthing and non-birthing parents. Interviews were recorded, transcribed, and analysed using thematic analysis.The results describe obstructive and facilitating factors. Being traumatised was the main obstacle for mentally engaging with the baby. A focus on physical injuries and healing hindered caretaking and bonding for birthing parents. Stress related to their parental role was obstructive for some non-birthing parents, who struggled to find space to process their own experiences when the partner and/or child was not well. Other non-birthing parents experienced a head start in the bonding process when their partner was injured. Some birthing parents had positive bonding experiences despite the birth complications, as they felt an alliance with their child in the harsh situation.Complicated births and minority stressors can increase the risk of bonding difficulties and mental ill-health. Tailored, LBTQ-competent care is essential to support both birthing and non-birthing parents in overcoming these challenges. [ABSTRACT FROM AUTHOR]

Purpose of Review: Despite the growing attention toward minority stress, there remains a scarcity of studies on its associations with sexual wellbeing. This scoping review aimed to examine the empirical literature from the last five years concerning how minority stress may relate to sexual wellbeing among adults. Recent Findings: Results from the 13 peer-reviewed articles were inconsistent. Internalized negativity (e.g., homophobia) showed varying associations with sexual satisfaction and function. Concealing one's sexual identity was linked to lower sexual satisfaction and sexual function. Fear of being rejected was associated with worse sexual function. Prejudice-related events were negatively associated with sexual satisfaction and function, and positively with sexual distress. Personal discomfort with one's non-monogamous engagement did not correlate with sexual satisfaction. Summary: Findings suggest that greater minority stress tends to be related to lower sexual wellbeing, albeit inconsistently. Further research is needed to better understand the mechanisms involved in these associations. [ABSTRACT FROM AUTHOR]

Introduction: Gender and sexually diverse youth in schools experience exclusion, which detrimentally affects their ability to cope with the consequences of minority stress and may lead to absenteeism or dropout. The purpose of the study is to highlight a pressing need for inclusive policies and practices to aid in enabling LGBTQ+ learners in schools. Methods: This paper explores how multiple systems intersect to promote a sense of inclusion and engagement within the school environment and impact the resilience of LGBTQ+ youth in a rural school setting. This paper presents findings from a qualitative interpretive phenomenological study with twelve purposively selected self-identifying LGBTQ+ youth residing in a rural South African community. Data was gathered through semi-structured interviews. Results: This study shows the significance of teacher emotional support, addressing homophobic bullying, moving away from gender-based uniform prescriptions and designating some school bathrooms as gender-neutral to LGBTQ+ learners' resilience. Conclusion: The findings of this study demonstrate how certain schools in rural settings employ innovative methods to support LGBTQ+ learners despite limited resources and the absence of comprehensive, inclusive policies on gender and sexually diverse learners. The findings have implications for LGBTQ+ learners in rural community schools worldwide. Future longitudinal studies could focus on how school ecologies inclusive of teachers, parents and the wider community can foster the resilience of LGBTQ+ learners, particularly in rural community contexts. [ABSTRACT FROM AUTHOR]

Young gay and bisexual men and other men who have sex with men (GBMSM) in Kenya experience pervasive intersectional stigma and discrimination, contributing to elevated levels of negative mental health symptoms. Grounded in the Minority Stress Model, this paper explores associations of proximal and distal minority stressors with three types of negative mental health outcomes among young HIV‐negative GBMSM (n = 63) between the ages of 19–34 who participated in a pilot trial of a sexual health intervention. Using the PHQ‐9, GAD‐7, and PC‐PTSD‐5 screening measures, levels of clinically significant symptoms were reported as follows: 15.8% depressive symptoms, 12.7% anxiety symptoms, 31.7% posttraumatic stress symptoms. Results from stepwise linear regression analyses suggest that GBMSM‐related stigma (distal stressor) was the strongest correlate for all three mental health outcomes, and concealment motivation (proximal stressor) was an additional significant correlate only in the depressive symptoms model. These findings should be viewed with caution and seen as initial observations given the small sample which limits our interpretations of the findings. Structural‐level interventions are needed to decrease GBMSM's exposure to intersectional stigma and discrimination, such as decriminalization of same‐sex sexual activity, as well as individual and group‐level interventions that assist GBMSM with improving their adaptive coping strategies. [ABSTRACT FROM AUTHOR]

Background: LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for reducing transdiagnostic mental and behavioral health concerns among LGBTQ individuals. Preserving the effects of this intervention as it is translated into practice can maximize public health benefits. This study systematically identifies and evaluates implementation strategies for LGBTQ-affirmative CBT. Methods: First, we identified and operationalized implementation strategies used across five trials of LGBTQ-affirmative CBT using the Pragmatic Implementation Reporting Tool. Second, we evaluated the relative importance of these strategies via a quantitative assessment (N = 31 unique trial implementers). Survey responses were analyzed descriptively within each trial. Across all trials, we organized strategies as (1) high priority, (2) moderate priority, and (3) optional (if resources are available) for implementing LGBTQ-affirmative CBT. Results: Within each trial, we identified 20 or more implementation strategies that were used, many of which overlapped across trials. We identified nine high priority strategies (e.g., working with clients to engage them in LGBTQ-affirmative CBT), nine moderate priority strategies (e.g., conducting ongoing training in LGBTQ-affirmative CBT), and nine optional/resource dependent strategies (e.g., showing visual indicators of LGBTQ affirmation within the physical spaces where LGBTQ-affirmative CBT is delivered). Conclusions: LGBTQ-affirmative CBT is a complex intervention requiring a package of implementation strategies. Our findings provide guidance for implementers in settings with different levels of resources regarding the highest priority strategies that may be needed to preserve the effectiveness of LGBTQ-affirmative CBT as it is translated into real-world settings. [ABSTRACT FROM AUTHOR]

Introduction: For most people, gender identity is consistent with biological sex and such people are called cisgender. People in whom such a relationship does not occur or occurs to a lesser extent are referred to as gender non-conforming—and these include transgender, non-binary, agender and gender-fluid people. These individuals are usually affected by minority stress, which, combined with the circumstances of the pandemic and Russian aggression against Ukraine, may have led to mental disorders and sleep disorders in this population. The aim of the study was to analyze the symptoms of anxiety, depression and insomnia in a group of Polish youth during the Covid-19 pandemic and the outbreak of the war in Ukraine, taking into consideration gender differences, including non-binary gender. Methods: The study involved 1621 secondary school students aged 14 to 19, the average age was 16.73 ± 1.35, including 857 girls, 690 boys and 74 people who defined their gender as non-binary. A set of questionnaires for the Diagnosis of Depression in Children (CDI 2), the State-Trait Anxiety Inventory (STAI), the X-1 subscale, The Athens Insomnia Scale (AIS) and an original questionnaire of sociodemographic data were used in research. Results: Analyzing the results obtained in the study group, the respondents scored an average of 17.99 ± 9.55 points in the assessment of depressive symptoms. After division into groups taking into account gender, the corresponding score was 19.69 ± 9.40 points for girls, 15.03 ± 8.68 for boys and 25.86 ± 9.91 for non-binary people. The difference was statistically significant (p = 0.000) in all three study groups. In the anxiety symptoms assessment, the respondents scored an average of 46.92 ± 11.67 points. After division into gender groups, the corresponding score was 49.21 ± 11.12 points for girls, 43.39 ± 11.47 for boys and 53.39 ± 10.41 for non-binary people. The difference was statistically significant (p = 0.000) in all three study groups. Analyzing the results obtained in The Athens Insomnia Scale (AIS), the average score was 8.31 ± 4.58 points, which allows to evaluate sleep onset as a norm. After dividing into groups, the results were 8.95 ± 4.55 points, respectively for girls, 7.19 ± 4.21 points for boys and 11.35 ± 5.43 for non-binary people, the difference was significant in terms of comparisons between all statistically tested groups. The analysis of the relationships between the studied variables was presented for each gender separately. Statistically significant positive correlations were found between the results obtained on the scale assessing depressive symptoms (CDI-2) and anxiety symptoms (STAI-X1) and the results obtained on the AIS scale. Conclusions: Among the studied group of teenagers, the highest intensity of depressive symptoms is demonstrated by non-binary people, followed by females, and finally by males. Similar results were obtained in the assessment of anxiety symptoms. The non-binary group achieved results indicating sleep disorders, while the cisgender group's results of sleep onset were borderline normal. Whatsmore, the greater the severity of depressive and anxiety disorders, the greater the sleep disorders in all study groups, regardless of gender. [ABSTRACT FROM AUTHOR]

Although the potential of boredom has been part of the Christian tradition from its very beginning, the experience of boredom among adult believers has often been stigmatized or silenced. In this paper I explore the 'politics of boredom', suggesting that the experience of boredom within faith communities may be a form of minority stress, indicating that sub-groups do not find themselves represented in the shared narrative and practice. I argue that while many disciplines, including psychology and theology, have a tendency to problematise those who are bored, it may be more fruitful to change this scope and investigate the boring. As an example I explore a feeling I call 'Jesus fatigue'; the sense of being tired with the repetitive narrative investment in Jesus as a figure of inclusion, while actual inclusion is continuously postponed. I then discuss the subversive potential of 'the yawn', the open display of boredom, as a possible theological intervention that confronts tradition with its implicit exclusionary tendencies. [ABSTRACT FROM AUTHOR]

In the fields of medical and behavioral health care, there is a demonstrable scarcity of providers who possess the necessary levels of clinical and cultural competency required to serve transgender patients. As a result of this deficiency, many members of the transgender community engage in an avoidance of care. Among providers, there are observed deficiencies in awareness regarding specific acute and chronic health disparities experienced by members of the transgender population. We aim to demonstrate the unique and intersectional health disparities experienced by this community, to empower providers serving this community. Additionally, we endeavor to propose a range of potential clinical and political interventions and options for mobilization that providers can engage in. Public Policy Relevance Statement: In 2023, the National Center for Transgender Equality tracked 450+ bills introduced in state legislatures across the country, targeting the rights of transgender Americans. An estimated 147 of these bills attempted to restrict or ban access to age-appropriate, evidence-based transition-related care for transgender youth. In addition, these direct legislative attacks on access to transition-related health care, transgender patients experience persistent barriers in accessing safe and affirming services to address routine healthcare needs. This article elucidates common health disparities for transgender individuals in the United States. Lawmakers and health care officials must implement initiatives focused on directly addressing these disparities and their root causes, to ensure better health outcomes for transgender people in the United States. [ABSTRACT FROM AUTHOR]

Objective: 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. Method: 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. Results: 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). Discussion: 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]

Objective: The present study examines the relationship between minority stress and academic outcomes for ethnic minority college students in the U.S. We explore to what extent anxiety functions as a potential mediating mechanism for these relationships. Participants: Data were obtained from 347 undergraduate ethnic minority college students attending a public university in West Texas. Results: Results revealed that minority stress was significantly related to anxiety symptoms when controlling for ethnic minority group membership. Additionally, it was found that anxiety symptoms significantly mediated the relationship between minority stress and major satisfaction, controlling for ethnic minority group membership. Conclusions: This study contributes to the existing psychological literature on ethnic minority college students by highlighting the extent that minority stress is related to certain academic outcomes, taking a step further to investigate anxiety as a mechanism that may explain these relationships. [ABSTRACT FROM AUTHOR]

As the United States contends with racism and a social justice reckoning, the need to advance our understanding of how to build structural resilience continues to be pressing. This article proposes a culturally and structurally informed model of resilience for individuals with minoritized identities that integrates social–ecological and minority stress models. First, common stressors and traumas experienced by minoritized individuals at multiple levels of proximal/distal influence are reviewed: microsystem (e.g., family rejection), mesosystem (e.g., community-based discrimination), exosystem (e.g., barriers to health care), macrosystem (e.g., harmful legal policies), and chronosystem (e.g., historical legacy). Next, how these exposures have cascading effects on minority stress processes (e.g., discriminatory policies in the macrosystem affect how a child is socialized in the microsystem) are considered. Then, modifiable factors (e.g., community cohesion) that promote resiliency in the face of ongoing exposures are discussed. To conclude, guidelines are offered for advancing the psychological science of resilience in minoritized groups including mixed methods to reflect participants' experiences, ecological approaches to assess resilience, and multilevel modeling to understand the interplay between the social–ecological context and individual factors. Public Significance Statement: Minority stress has been historically excluded from seminal theories of resilience. This article proposes a social–ecological model of structural resilience to minority stress for guiding conceptual and methodological approaches to studying multiple systems of proximal and distal influence. [ABSTRACT FROM AUTHOR]

Transgender and nonbinary (TNB) people experience elevated rates of posttraumatic stress (PTS) due to transphobic violence, discrimination, microaggressions, and minority stress. Nonbinary people in particular experience unique chronic minority stressors (e.g., misgendering, interpersonal invalidation) because of the assumption that gender is inherently binary. Such examples of oppression against TNB people could contribute to complex PTS (c-PTS) symptoms, which arise due to exposure to chronic, cumulative, and interpersonal trauma. This study aimed to examine how misgendering and invalidation may be associated with PTS and c-PTS symptoms among nonbinary people and whether this association is moderated by pride and community connectedness. Cross-sectional data from 610 nonbinary people living in the United States and Canada were analyzed using hierarchical linear regressions. Misgendering and invalidation had significant positive associations with PTS and c-PTS symptoms. However, pride and community connectedness were not significant moderators of these associations. Findings from this study contribute to the conceptualizations of traumatic stress among nonbinary people and provide considerations for more affirming trauma-informed care. Public Significance Statement: The findings of this study suggest that misgendering and invalidation are associated with trauma symptoms among nonbinary people. Results can be applied to inform nonbinary-affirming clinical practice and advocacy. [ABSTRACT FROM AUTHOR]

We conducted a multilevel meta-analysis of 390 effect sizes from 167 studies with 157,923 participants examining the relationship between connectedness with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) communities and health-related outcomes, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted our initial search in January 2023 in APA PsycInfo, ERIC, Medline, and Open Dissertations, selecting studies that (a) measured LGBTQ+ community connectedness, (b) measured health, and (c) provided an estimate of the relationship between LGBTQ+ community connectedness and health. We found that connectedness with LGBTQ+ communities promotes mental health (r =.11), well-being (r =.17), and physical health (r =.09). Conversely, we found that connectedness with LGBTQ+ communities promotes substance use among younger participants, likely through behavioral engagement with LGBTQ+ others. We found that connectedness with LGBTQ+ communities was related to less mental health and more suicidality for younger people, likely because younger LGBTQ+ people seek out connectedness in response to this psychological distress. We also found that connectedness was not as health-promoting for LGBTQ+ individuals with multiple marginalized identities and that psychological feelings of belongingness with LGBTQ+ communities are generally more health-promoting than behavioral community engagement. Results from a narrative review and moderation meta-analyses suggested that, contrary to predictions made by minority stress theory, connectedness with LGBTQ+ communities does not buffer the relationship between minority stressors and health. Rather, meta-analytic mediation analyses suggested that proximal minority stressors negatively impact health-related outcomes by reducing connectedness with LGBTQ+ communities and that distal minority stressors are often less impactful on health-related outcomes because they promote connectedness with LGBTQ+ communities. Public Significance Statement: This meta-analysis illustrates the crucial role that connecting with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) communities plays for LGBTQ+ people, underscoring the importance of funding for and diversity training in LGBTQ+ community centers. It also shows that connecting with LGBTQ+ communities is generally health-promoting and often a reflexive response to stressful events, particularly for younger LGBTQ+ people, and that internalized stigma is harmful to LGBTQ+ people at least in part because it stops them from connecting with LGBTQ+ communities. At the same time, connecting with LGBTQ+ communities may encourage substance use among younger people and be less helpful for LGBTQ+ people with other marginalized identities. [ABSTRACT FROM AUTHOR]

• The full Interpersonal Theory of Suicide (ITPS) has yet to be empirically tested. • However, the ITPS provides explanation, clinical utility, and predictive validity. • The IPTS may be intensified by non-humanness, lack of agency, and discrimination. • Minoritized people may benefit by integrating the IPTS and Minority Stress Theory. In this state-of-the-science review, we summarize the key constructs and concepts within the interpersonal theory of suicide. The state of the scientific evidence regarding the theory is equivocal, and we explore the reasons for and some consequences of that equivocal state. Our particular philosophy of science includes criteria such as explanatory reach and pragmatic utility, among others, in addition to the important criterion of predictive validity. Across criteria, the interpersonal theory fares reasonably well, but it is also true that it struggles somewhat—as does every other theory of suicidality—with stringent versions of predictive validity. We explore in some depth the implications of the theory and its status regarding people who are minoritized. Some implications and future directions for research are also presented. [ABSTRACT FROM AUTHOR]

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Background Compared with their cisgender heterosexual peers, youth who are Two-Spirit, lesbian, gay, bisexual, transgender, and queer and those who use other terms related to gender or sexual diversity (2SLGBTQ+) are at elevated risk for mental health difficulties and suicidality. The social experiences of 2SLGBTQ+ youth, including the impact of minority stress, access to social support, and experiences of negative social interactions, may contribute to this disparity. Data and methods Participants were 2,047 youth aged 15 to 24 years who responded to the 2022 Mental Health and Access to Care Survey. The 2SLGBTQ+ population was derived from youth reports of their gender, sex at birth, and sexual orientation. Two dimensions of social experiences were assessed using the Social Provisions Scale and the Negative Social Interactions Scale. Symptoms of mental health and substance use disorders were assessed via computer-assisted diagnostic interview using a modified version of the World Health Organization Composite International Diagnostic Interview (CIDI). Use of formal and informal mental health supports was self-reported by youth. Results Results indicated significant group differences in the proportion of youth meeting criteria for any CIDI disorder, a major depressive episode, generalized anxiety disorder, and suicidal ideation in the past 12 months. For example, 56% (95% confidence interval [CI]: 49 to 63) of 2SLGBTQ+ youth met criteria for any CIDI disorder, compared with 29% (95% CI: 26 to 32) of cisgender heterosexual youth. Logistic regression models suggested that after adjusting for demographic covariates, 2SLGBTQ+ youth were at elevated risk of these mental health conditions compared with their cisgender heterosexual peers. These differences remained apparent after adjusting for social support and negative social interactions. Among those meeting criteria for any disorder, 2SLGBTQ+ youth were more likely to report receiving formal and informal mental health support. Interpretation 2SLGBTQ+ youth are at elevated risk of several indicators of poor mental health compared with their cisgender heterosexual peers – differences which are not fully explained by their access to social support and negative social interactions. Some of the remaining differences may potentially be explained by the impact of unmeasured aspects of minority stress on 2SLGBTQ+ youth. [ABSTRACT FROM AUTHOR]

Transgender health care is not just gender-affirmative transitional care but is committed to a superior objective, often beyond a medical perspective: to create and maintain physical conditions for social functioning under the signs of the individually appropriate sex and to contribute to significantly reducing gender dysphoria. For these purposes, it is a prerequisite to have a distinct contextual understanding of the complex reality of transpeople and knowledge about the numerous facets of transgender healthcare. Gynecology for transgender and gender-diverse people does not differ greatly from gynecology for cisgender female patients except in goals and context. Relief from complaints derived from genital organs is, of course important, but for transpeople there always is an overarching gender dimension that sometimes complicates treatment and might give rise to misunderstandings. Also, minority stress caused by societal factors frequently impacts the mental and physical state of health negatively and needs to be considered. This paper focuses on the context of trans gynecology and addresses various contentual aspects for both transmale patients having left genital organs in situ and transfemale patients with gynecological demands. Gynecological topics are addressed, highlighting their relevance for transgender and gender-diverse people (TGD), including the effects of supra-physiological androgen exposure on ovaries and uterus, vaginal bleeding, pelvic pain under testosterone treatment, screening policies, and benign gynecological disorders as clinical manifestations may appear differently and treatment may be more burdensome. [ABSTRACT FROM AUTHOR]

Transgender identity is often associated with gender dysphoria and minority stress. Gender-affirming hormone treatment (GAHT) includes masculinising or feminising treatment and is expected to be lifelong in most cases. Sex and sex hormones have a differential effect on metabolism and CVD in cisgender people, and sex hormone replacement in hypogonadism is associated with higher vascular risk, especially in ageing individuals. Using narrative review methods, we present evidence regarding metabolic and cardiovascular outcomes during GAHT and propose recommendations for follow-up and monitoring of metabolic and cardiovascular risk markers during GAHT. Available data show no increased risk for type 2 diabetes in transgender cohorts, but masculinising GAHT increases lean body mass and feminising GAHT is associated with higher fat mass and insulin resistance. The risk of CVD is increased in transgender cohorts, especially during feminising GAHT. Masculinising GAHT is associated with a more adverse lipid profile, higher haematocrit and increased BP, while feminising GAHT is associated with pro-coagulant changes and lower HDL-cholesterol. Assigned male sex at birth, higher age at initiation of GAHT and use of cyproterone acetate are separate risk factors for adverse CVD markers. Metabolic and CVD outcomes may improve during gender-affirming care due to a reduction in minority stress, improved lifestyle and closer surveillance leading to optimised preventive medication (e.g. statins). GAHT should be individualised according to individual risk factors (i.e. drug, dose and form of administration); furthermore, doctors need to discuss lifestyle and preventive medications in order to modify metabolic and CVD risk during GAHT. Follow-up programmes must address the usual cardiovascular risk markers but should consider that biological age and sex may influence individual risk profiling including mental health, lifestyle and novel cardiovascular risk markers during GAHT. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Purpose Method Results Conclusion Extant literature on transgender and gender‐diverse (TGD) people living in the United States is centered on bicoastal metropolitan cities. Little is known about the health status and health‐related barriers among TGD people living in the middle of the country. Minority Stress Theory (MST) provides a framework for understanding how TGD people experience stressors that shape their health‐related experiences.To describe health‐related experiences of TGD people living in Colorado using the MST framework.The scoping review was limited to peer‐reviewed, English‐language studies published between January 2018 and November 2023. Data abstraction and synthesis were performed using Thomas and Harden's approach to thematic synthesis.Twenty‐one articles were included in the review. Seventeen (80.9%) articles were quantitative studies, two (9.5%) were qualitative, and two (9.5%) were mixed methods. Most of the participants were transfeminine and 18 years old or younger. Three themes emerged (1) TGD Coloradans experience multiple health‐related stressors, (2) these stressors contribute to poor health outcomes, and (3) overcome with coping strategies and/or social support.TGD Coloradans experience multiple stressors related to their TGD identity that shape their health‐related experiences. Nurses play a critical role in intervening in these stressors and addressing care disparities. [ABSTRACT FROM AUTHOR]

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]