“What If This Happiness Doesn’t Last Forever?”: Stressors Faced by Racialized SOGIE Refugees

For college students, holding a minoritized, stigmatized sexual orientation, gender identity, or both (SOGI) may have compounded the stress and upheaval of the COVID-19 pandemic, impacting not only their ability to freely express their SOGI but also their mental health and well-being. Using minority stress theory and mixed methodologies, we examined associations among lesbian, gay, bisexual, transgender, queer, questioning, or other sexual and/or gender diverse (LGBTQ+) college students’ (N = 368, M age = 20.5) perceived pandemic-related changes in SOGI expression, internalized LGBTQ+ stigma, and mental health. Consistent with minority stress theory, students who thought the pandemic restricted their SOGI expression and who had more internalized LGBTQ+ stigma had worse mental health than their peers. In addition, students who thought the pandemic restricted their SOGI expression perceived that their mental health worsened due to the pandemic. The importance of SOGI expression for mental health during the pandemic has implications for tailored university programming to support LGBTQ+ students’ mental health during times of stress and transition beyond the pandemic.

Sexual orientation and gender identity (SOGI) expression are key elements of LGBTQ+ young adults’ identities. The ability to safely and authentically express SOGI is crucial to LGBTQ+ individuals’ mental health and well-being. However, many LGBTQ+ young adults strategically decide how to express or conceal their identities in different social contexts to avoid SOGI-related stigma and discrimination. In the current paper, we used a developmental assets framework to examine open-ended survey responses of LGBTQ+ college students’ (N = 190, Mage =19.6; 36.8% bisexual; 47.9% cisgender women) perceptions of how their ability to express their SOGI differed during an academic break compared to during the semester. Participants most frequently described their SOGI expression over break as partially inhibited (35.8%), followed by fully inhibited (28.9%), no change (27.9%), and least likely, improved (10.0%). These findings have important implications for the critical role that SOGI expression plays in LGBTQ+ young adults’ mental health and well-being.

Background Minority Stress Theory (MST) explains health outcome disparities among trans and gender diverse (TGD) individuals as compared to the general population, emphasizing the impact of both distal and proximal stressors on well-being. TGD individuals may encounter additional stressors when seeking access to accessing services for their gender affirming pathway (GAP), particularly in Italy where the pathway maintains a strong gatekeeping approach. Methods This research explores the experiences of 45 TGD individuals aged between 18 and 38, with the majority identifying as nonbinary (77.8%) and within the context of the institutional Italian GAP. Participants are either currently on a waiting list in an institutional GAP, or they are still questioning if the GAP is suitable for them. Through a semi-structured interview, the study investigates how TGD individuals perceive the institutional GAP and whether it acts as a source of minority stress. The research employs Codebook Thematic Analysis, informed by MST. Results Findings reveal that the Italian GAP replicate both distal and proximal stressors. Distal stressors encompass manifest aggressions, invalidation, gatekeeping, and burdening, while proximal stressors involve vicarious stress, expectations of rejections, forced concealment, gender dysphoria, and self-gatekeeping. Results indicate a greater difficulty for nonbinary individuals due to the structural negation of their identity within the GAP. Conclusion The research underlines that the current institutional GAP exacerbates stress rather than promoting well-being. It underscores the necessity for reframing the GAP to provide a tailored and inclusive space to support the many manners of affirming TGD persons without a transnormative approach.

Despite growing attention to equity in healthcare simulation, persistent disparities in participation and learning outcomes among learners from minoritized backgrounds remain insufficiently explained. Existing simulation-based education frameworks describe how learning occurs but offer limited insight into how inequitable learning conditions shape learners’ experiences. We propose minority stress theory (MST) as a conceptual framework for understanding how stress related to minoritized identity operates within healthcare simulation environments. Originally developed to explain health disparities among sexual minorities, MST conceptualizes stress as arising from both structurally embedded conditions (distal stressors) and internalized vigilance and self-monitoring (proximal stressors). Through conceptual analysis, we map MST constructs onto core features of healthcare simulation, including its performance-based, socially intensive, evaluative, and immersive characteristics. We illustrate how minority stress processes may operate through education-relevant mechanisms, such as cognitive load, psychological safety, engagement, and help-seeking, to shape learning experiences and performance. By applying MST to simulation-based education, this paper offers an equity-informed framework for examining learning-environment mechanisms and informing inclusive simulation design, facilitation, and assessment practices.

The purpose of this study is to investigate the level of awareness and effect of the Sexual Orientation and Gender Identity Expression (SOGIE) Bill on the respondents’ experiences, specifically in terms of Discrimination, Emotional Distress, Social Isolation, and Low Self-esteem. The study aims to determine the level of awareness and effect of the SOGIE Bill on the respondents’ experiences, as well as to identify the factors that influence the level of awareness and effect. The statistical tool used in this research is the regression analysis to analyze the relationship between the level of respondents’ awareness and the effect level of SOGIE Bill, particularly in sexual orientation, gender identity, and gender expression, on the one hand, and the levels of discrimination observed, emotional distress, social isolation, and low self-esteem on the other hand. The finding reveals that the respondents have low awareness of sexual orientation, gender identity, and gender expression. The respondents have experienced high levels of discrimination in terms of education, health services, and employment and high levels of emotional distress, social isolation, and lower self-esteem due to the SOGIE Bill. On the test on respondents’ awareness and effect level of SOGIE Bill, the results show a significant effect between awareness of SOGIE Bill and effects level of SOGIE Bill, with sexual orientation and gender identity having a significant impact on emotional distress and social isolation and the gender expression has a significant impact on emotional distress and social isolation. Lastly, on the test on respondents’ discrimination observed to the effect level of SOGIE Bill, the results show a significant effect between discrimination observed and effects level of SOGIE Bill, with educational Institution and employment having a significant effect on emotional distress, social isolation, and lower self-esteem and the health services and community have a significant effect on emotional distress and social isolation. The study concludes that the SOGIE Bill has a significant effect on the respondents’ experiences, particularly in terms of emotional distress, social isolation, and low self-esteem. The study also found significant effect on the respondent discrimination observed effect and level of SOGIE Bill. Based on the findings of the study, it is recommended that education and awareness programs be implemented to increase awareness about the SOGIE Bill and its implications. The policies and programs should be implemented to address discrimination and promote inclusivity and acceptance for LGBTQ+ individuals. Additionally, it is recommended that further research be conducted to explore the long-term effects of the SOGIE Bill on individuals and to identify potential areas for improvement.

Minority stress theory (e.g., Meyer, 2003b), a model for understanding mental health disparities affecting sexual minorities, has primarily been tested in Western samples yet has not been carefully applied to the experiences of sexual minorities in a global context, including in East Asian countries. Combining minority stress theory with considerations of Chinese culture, the current study tested the associations among norm conformity, distal minority stressor (enacted stigma), proximal minority stressors (sexual identity concerns and concealment), lesbian, gay, and bisexual (LGB) family support, and psychological distress among Chinese sexual minority men (n = 748). Structural equation modeling showed that sexual identity concerns mediated the associations of norm conformity, enacted stigma, and lower family support with concealment. Psychological distress was associated with enacted stigma and lower family support, but not with proximal stressors (sexual identity concerns and concealment). Alternative model testing found sexual identity acceptance concerns predicted psychological distress and mediated the associations of norm conformity and LGB family support with distress. Findings provide partial support for the minority stress model in a Chinese context and suggest the importance of incorporating cultural considerations into minority stress conceptualizations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The right comparisons in testing the minority stress hypothesis: comment on Savin-Williams, Cohen, Joyner, and Rieger (2010).

Intimate partner violence (IPV) has become a global public health issue, including in men who have sex with men (MSM). This study, based on minority stress theory, examines the relationship between minority stress and IPV perpetration among Chinese MSM, emphasizing the role of hazardous alcohol use. We propose 3 hypotheses: (1) enacted stigma, internalized stigma, identity concealment, and hazardous alcohol use contribute to IPV perpetration; (2) hazardous alcohol use mediates the effect of minority stress on IPV perpetration; and (3) proximal stressors (internalized stigma and identity concealment) serve as mediators between enacted stigma and IPV perpetration. A total of 915 valid questionnaires were collected in China via snowball sampling for analysis, using structural equation modeling to examine the relationships between variables. Among 915 MSM, the IPV perpetration prevalence was 18.6% in the past year. The structural equation model showed that enacted stigma ( β = 0.414, P < 0.001), internalized stigma ( β = 0.179, P < 0.01), and hazardous alcohol use ( β = 0.245, P < 0.001) significantly contributed to IPV perpetration. Although identity concealment ( β = -0.134, P < 0.01) had a protective effect. Hazardous alcohol use mediated the relationship between minority stress and IPV perpetration, except for internalized stigma. Proximal stressors also partially mediated the link between enacted stigma and IPV perpetration. Findings suggest that enacted stigma, internalized stigma, identity concealment, and hazardous alcohol use are associated with IPV perpetration. Reducing stigma toward MSM and addressing hazardous alcohol use are crucial for IPV perpetration.

&lt;p&gt;本研究目的在了解正負向指標篩檢心理健康型態集群分佈情形，是否符合Keyes主張以主觀幸福感與憂鬱症狀雙指標區分的完整心理健康模式。研究設計以心理健康BMI幸福感問卷、病人健康狀況憂鬱問卷，做為正負向指標篩檢工具，架構完整心理健康模式；以問卷調查法立意取樣739份樣本，經群集分析法作統計分群。結果能區分出有意義的四群集，包括擁有高幸福低憂鬱之完整圓滿心理健康型態的「心盛型」群集（46.28%）、不完整心理健康型態三個群集:「冷靜型」（低幸福低憂鬱之不完整心理亞健康型態，31.94%）、「奮戰型」（高幸福高憂鬱之不完整心理健康型態，11.10%）、「混沌型」（低幸福高憂鬱之不完整心理健康型態，10.69%）。低憂鬱者佔全體 78.22%，其中59.17%擁有高幸福而處於完整圓滿心理健康型態；高憂鬱者佔全體21.78%，其中50.93%擁有高幸福感。驗證了幸福感、憂鬱傾向作為正負向心理健康指標，篩檢完整或不完整心理健康型態。建議:（1）高憂鬱者參照「奮戰型」這群人高幸福感來源，藉由參與社團獲得人際支持、找到工作及收入來增加自我價值感；（2）「冷靜型」不能單看低憂鬱的心理健康篩檢，需提升「友善人際支持 正念情緒平穩 認同自我價值意義」之正向心理健康BMI幸福感，以獲得完整心理健康；（3）未來研究可依據正負向心理健康指標去發展心理健康素養能力，作為心理健檢與自主管理完整心理健康之用。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This study aimed to understand the cluster distribution of positive and negative indicators for screening mental health patterns and whether they conform to Keyes’ claim that positive and negative indicators should be included in the complete mental health state model. The positive mental health indicators included social, emotional, and psychological well-being, which should be measured using the Mental Health Continuum Short Form (MHC-SF). Negative indicators measure the level of symptoms of mental illness concurrently, serving as a complete assessment of whether the individual is in a healthy state of positive and negative mental health indicators. Keyes employed these to distinguish four clusters of people with four mental health modes, of which the incomplete mental health cluster was in the state. Even if they have a negative mental illness, they could have positive mental health and well-being. Although some people do not have negative mental illness, they cannot have positive mental health and well-being. Therefore, Taiwanese scholar Li corresponded to these three well-being developments and selected three operational mental health skills: &amp;quot;&amp;quot;Befriend-Mindfulness-Identity&amp;quot;&amp;quot; as the Mental Health BMI Well-Being Index questionnaire (mBMI). After using them to evaluate 739 people, it was evident that the scores of the above two questionnaires were significantly correlated, and the mBMI questionnaire total score and Questions B, M, and I could effectively predict the total score, social, emotional, and psychological well-being of the MHC-SF, with a total explanatory power of 30.3%. This test should be used as a simple screening for well-being and as a positive mental health screening tool. Additionally, a Depression Scale Screening Tool for Negative Mental Health Depression was combined to explore the complete mental health state model of Taiwanese people. &lt;/p&gt; &lt;p&gt; Therefore, in this study, the mBMI questionnaire was selected as a simple tool to measure positive mental health well-being, and the patients&amp;rsquo; health questionnaire for depression was used as a screening tool for negative mental health indicators. These are used as positive and negative indicators to test whether a complete or incomplete mental health state model fits. The questionnaire survey method was used to deliberately sample the data from 739 valid samples, and the cluster analysis method was used for statistical grouping to verify its suitability. According to the results of the aforementioned positive and negative indicators, four meaningful clusters were distinguished, including one complete and three incomplete mental health models. One cluster was &amp;quot;&amp;quot;Flourishing type&amp;quot;&amp;quot;(46.28%) of high well-being and low depression, which belonged to the complete mental health state model. The other three clusters were incomplete mental health state models. &amp;quot;&amp;quot;Fighting type&amp;quot;&amp;quot; (31.94%) of high well-being and high depression, &amp;quot;&amp;quot;Calm type&amp;quot;&amp;quot; (11.10%) of low well-being and low depression, and &amp;quot;&amp;quot;Chaos type&amp;quot;&amp;quot; (10.69%) of low well-being and high depression could fight for high well-being. It was verified that well-being and depression could be used as positive and negative mental health indicators to screen for complete or incomplete mental health state models. When we identified people with high depression, we encouraged them to refer to the source of high well-being of the &amp;quot;&amp;quot;fighting type&amp;quot;&amp;quot; group and increase their sense of self-worth by participating in clubs to obtain interpersonal support, find jobs, and earn income. We reminded the &amp;quot;&amp;quot;calm type&amp;quot;&amp;quot; people with low depression to promote their high well-being to have a complete mental health state. Finally, we monitored positive and negative indicators of mental health using screening tools of the Mental Health BMI Well-Being Index and the Patient Health Questionnaire (PHQ-9) to screen for complete or incomplete mental health states as a reference for promoting positive and negative mental health. The befriend-mindfulness-identity skills should be improved to promote well-being and adjust depression to achieve complete mental health.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Positive mental health and wellbeing in adults with cystic fibrosis: A cross sectional study

The disclosure and expression of trans and non-binary gender identities introduce unique complexities and stressors to romantic relationships, affecting each partner and the relationship itself in distinct ways. The study aims to describe romantic relationship experiences regarding the disclosure and expression of trans and non-binary gender identities from the perspectives of trans and non-binary individuals from Chile. Interviews were conducted with 12 participants – six trans individuals and six non-binary individuals. The experiences of romantic relationships surrounding the disclosure and expression of trans and non-binary gender identities are diverse. Three types of experiences were identified: couples who co-transition, those who provide support, and those who reject. A single romantic relationship may likely move between these possibilities over time, depending on the composition and dynamics of the relationship, as well as familial and social factors. Couples reorganize in response to the processes of trans and non-binary gender identity disclosure and expression. These relationships can uniquely contribute to affirming and validating non-normative identity experiences.

Domains and levels of physical activity are linked to adult mental health and wellbeing in deprived neighbourhoods: A cross-sectional study

LGBTQ+ individuals experience disproportionately higher rates of mental health and substance use difficulties. Discrimination is a significant factor in explaining these disparities. Meyer's (2003) minority stress theory (MST) indicates that proximal group-specific processes mediate the relationship between discrimination and health outcomes, with the effects moderated by other social factors. However, online discrimination has been understudied among LGBTQ+ people. Focusing on LGBTQ+ young adults experiencing online heterosexist discrimination (OHD), the current study aimed to investigate the effect of OHD on mental health outcomes and explore whether the effect was mediated by proximal factors of internalized heterosexism, online concealment, and acceptance concerns and moderated by social support. Path analysis was used to examine the effects. A total of 383 LGBTQ+ young adults (18-35) from an introductory psychology subject pool, two online crowdsourcing platforms, and the community completed a questionnaire assessing these constructs. OHD was associated with increased psychological distress and cannabis use. Two proximal stressors (acceptance concerns and sexual orientation concealment) mediated the relationship between OHD and psychological distress. Sexual orientation concealment also mediated the relationship between OHD and cannabis use. There was no evidence that online social support from LGBTQ+ peers moderated any of the relationships. MST is a viable guiding framework for exploring OHD. Acceptance concerns and online concealment are important constructs to consider and may be potential treatment targets for individuals experiencing psychological distress or engaging in cannabis use due to OHD.

How do sexual minority medical students navigate their first year of medical school? How do their sexual identities affect this learning environment and wellness? Two theories about underrepresented individuals offer general perspectives to social experiences. Queer theory establishes that sexual identity is a vital part of the human experiences, while minority stress theory indicates that minorities experience higher levels of stress in situations than their majority counterparts. How can these theories be used to be proactive and supportive of sexual minority students? This qualitative research examines first‐year sexual minority medical students at Indiana University School of Medicine–Bloomington as they experience encounters with peers, instructors and LGBTQA+ specific curriculum. This research was approved by the Indiana University Institutional Review Board (IRB # 1810842950). Each sexual minority medical student volunteer completed 2 interviews about their experiences and were observed during a classroom activity. Thematic analysis of field notes and interview transcripts was performed. Five major themes of identity manifestation were identified and will be discussed in this poster: Advocacy, Representation, Ignorance/Disrespect, Heteronormativity, and Humor. A model for manifestation of LGBTQA+ identity in medical school is also proposed using the tenets of queer and minority stress theories. Understanding the unique experience of sexual minority medical students may provide instructors with more tools to better assist students during a major life transition.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

IntroductionMuch research on the health and well-being of third level students is focused on poor mental health leading to a dearth of information on positive mental health and well-being. Recently, the Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed as a measurement of positive mental health and well-being. The aim of this research is to investigate the distribution and determinants of positive mental health and well-being in a large, broadly representative sample of third level students using WEMWBS.MethodsUndergraduate students from one large third level institution were sampled using probability proportional to size sampling. Questionnaires were distributed to students attending lectures in the randomly selected degrees. A total of 2,332 self-completed questionnaires were obtained, yielding a response rate of 51% based on students registered to relevant modules and 84% based on attendance. One-way ANOVAs and multivariate logistic regression were utilised to investigate factors associated with positive mental health and well-being.ResultsThe sample was predominantly female (62.66%), in first year (46.9%) and living in their parents’ house (42.4%) or in a rented house or flat (40.8%). In multivariate analysis adjusted for age and stratified by gender, no significant differences in WEMWBS score were observed by area of study, alcohol, smoking or drug use. WEMWBS scores were higher among male students with low levels of physical activity (p=0.04). Men and women reporting one or more sexual partners (p<0.001) were also more likely to report above average mental health and well-being.ConclusionThis is the first study to examine positive mental health and well-being scores in a third level student sample using WEMWBS. The findings suggest that students with a relatively adverse health and lifestyle profile have higher than average mental health and well-being. To confirm these results, this work needs to be replicated across other third level institutions.