When Connecting With LGBTQ+ Communities Helps and Why It Does: A Meta-Analysis of the Relationship Between Connectedness and Health-Related Outcomes.

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]